The OOIDA Members Healthcare Exchange launched

By Greg Grisolano, staff writer

The Owner-Operator Independent Drivers Association has launched an online marketplace offering health insurance policies.

The OOIDA Members Healthcare Exchange has an online link that is now available. Plans offered through the exchange meet the criteria of the Affordable Care Act.

OOIDA Medical Benefits Group Manager Brenda Smith said the Association has set up a web portal to get online quotes and compare plan options on the OOIDA website for members who live in Illinois, Indiana, Kansas, Missouri, Ohio and Texas.

It can be accessed under the Benefits and Services section. Residents of the above mentioned states can access the site for plan options and to run quotes on the plans, but you have to be an OOIDA member to purchase the plans. While the online quote tool is set up for six states, Smith said members from most other states can still call and get quotes for other health care exchange options.

Smith said New York and New Jersey are two states where residents have no choice but to go through the state or federal exchange. Private exchanges are not authorized under those states’ laws.

The portal works much like other online insurance shopping experiences. The customer enters his or her contact information and ZIP code, as well as age and gender. Then the software provides a range of plans available in that area. Plans can be filtered by coverage level (bronze, silver, gold or platinum) as well as by deductible or premium costs, office copays and other factors.

Customers who purchase health insurance through a private exchange, such as OOIDA’s, are not eligible for federal tax subsidies. In order to qualify for the subsidies, insurance must be purchased through state or federal exchanges. Furthermore, those applying for subsidies must fall between 133 percent and 400 percent of the federal poverty level in order to qualify.

The deadline to enroll for health insurance under the Affordable Care Act is March 31, 2014. If you are not already enrolled in a public or private health care plan or do not have health insurance through an employer-provided plan, you must be enrolled in a qualified health care plan by the deadline, or possibly pay a penalty.

Rick Welsh, president of Welsh and Associates, a Kansas City-based health care and insurance consulting business that works with OOIDA’s Medical Benefits Department, said those who do not already have a policy compliant with the Affordable Care Act and who choose not to purchase one will be faced with the possibility of paying the penalty next year at tax time.

If you’re still without insurance once the open enrollment period ends on March 31, you can purchase insurance only by having a qualifying event, such as loss of job, marriage, divorce or birth. You can also qualify by moving from one state to another.

The penalty for not having insurance in 2014 is $95 per person ($47.50 per child under 18), or 1 percent of your gross annual household income, whichever is greater. Unless your gross annual household income is less than $9,500, you can expect to pay much more than $95 in tax penalties.

The penalty for being without insurance is calculated on a monthly basis. So if you have a qualifying event and get insurance later in the year and are without insurance for only six months, for example, you will owe half of the penalty.

On top of the possibility of having to pay a penalty, Welsh said those who are uninsured after the deadline will have no choice but to pay all of their medical expenses out of pocket for the remainder of 2014.

Welsh said the risk in waiting until the deadline to enroll is, “once March 31 passes, you’re done.”

“You’re going to have to wait until the next enrollment period, unless you have a qualifying event,” he said.

The next open enrollment period will be much shorter than this year’s period, lasting from Nov. 15 to Jan. 15, 2015. But Welsh cautions folks that insurance policies bought during that time period will be effective beginning Jan. 1, 2015.

“Just because you sign up in November, your coverage still won’t start until January (2015),” he said.

Limited pay and indemnity plans may not be enough
Both Welsh and Smith said truckers who have a hospital indemnity or other limited pay/scheduled benefits policy may not be properly insured to avoid the tax penalty.

Under the Affordable Care Act, qualifying medical insurance plans must now cover “Essential Health Benefits” such as preventive care, prescription drugs, pediatric and maternity care, and mental health.

Smith said the medical benefits group has already sent out letters to members who participate in the Association’s Advantage Plans (scheduled benefit) to inform them that the plans do not meet the requirements of the Affordable Care Act. All drivers, with coverage outside the Association, need to check with their providers, to make sure the plan they are paying for complies with the Affordable Care Act.

Subsidy calculator
The Kaiser Family Foundation offers an interactive subsidy calculator on its website, kff.org, to help determine whether an individual or family may qualify for the health insurance subsidy. LL