CIBOLA COUNTY – Last Tuesday’s shut down of the federal government did not affect state residents’ ability to enroll in the new healthcare insurance program.
“There are approximately 430,000 people uninsured in New Mexico. And many of them began registering on Oct. 1 for the new insurance,” Steve Morgan, New Mexico Health Insurance Exchange (NMHIX) representative, explained to an audience of approximately 30 community members. He acknowledged that user demand temporarily overwhelmed the State website during its first day of operation.
The Cibola Family Health Center, located on Roosevelt Avenue in Grants, hosted the first of a series of presentations scheduled for around the state with a two-hour program last Thursday.
Staff members of the New Mexico Association of Counties and NMHIX have scheduled a series of tours around the state to explain the new program, which is part of the federal AHA (Affordable Healthcare Act).
A majority of those who attended the Oct. 3 informational session represented area agencies including hospitals and clinics.
The free seminar was designed to inform employers and individuals about the newly created Health Insurance Exchange. Participants received detailed information about the program including enrollment requirements for employees and/or themselves along with information about the tax credits.
Robin Hunn, NMHIX presenter, emphasized how the State had developed its insurance exchange program in less than six months. She pointed out that Governor Susana Martinez had appointed a board last April to oversee the process, which included certification of 370 health guides who assist with the registration process. “This is a free service,” emphasized Hunn. “Health guides are located at 200 sites across the state and are paid by the program not by the insurance copy or the enrollee.”
The NMHIX offers individuals the choice of five providers: Blue Cross/Blue Shield, Lovelace, Molina, New Mexico Health Connections, and Presbyterian.
Policy categories include four levels: bronze, silver, gold, and platinum. All plans offer the same essential health benefits but the “metal” level determines premiums, co-payments, co-insurance, deductibles, and out-of-pocket costs.
Employers can choose from the NMHIX Small Business Health Option Program (SHOP) that includes: Blue Cross/Blue Shield, Lovelace, New Mexico Health Connections, and Presbyterian as provider options.
Businesses with 50 or fewer employees can enroll in SHOP, which offers the same “metal” options based on employer/employee contributions. The Bronze level has a 60/40 actuarial level and the Platinum is 90/10, according to NMHIX officials.
“Many employers may find it easier to work with an agent or broker to make health plan choices and enroll through SHOP,” noted Morgan.
Individual coverage and the employer SHOP initiative become active on Jan. 1, 2014. There is no minimum participation fee for business owners who enroll during November and December.
There will be a minimum 50 percent employee participation fee after Dec. 31, 2013.
Non-profit organizations are eligible to participate in SHOP if they meet the requirements, according to Hunn.
“So who pays for this?” asked one audience member.
“This is funded by the federal government as part of the AHA,” responded Hunn. “It is not funded by the State but the State is required to make sure that NMHIX is self-funded by 2016.”
She emphasized that educational efforts were produced in bi-lingual formats, English and Spanish, to help inform state residents. Outreach activities include radio and TV public service announcements, billboards, and media advertising.
“It’s super easy to use the website (www.BeWellNM.com) and the call center is available seven days a week, 24 hours a day for those who do not have Internet access or are unfamiliar with computers,” said Hunn.