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New health insurance market opens this week

OLYMPIA, Wash. (AP) - Washington residents will begin the process of ordering health care through the state health exchanges this week, as open enrollment for the new health care law begins.

An estimated 1 million Washington residents are uninsured, or about 1 in 7 people who live in the state. Officials don't know the total number who might buy health insurance through the exchange, but the Insurance Commissioner's office expects an estimated 328,000 people in Washington to benefit from the expansion in Medicaid coverage.

Some questions and answers on what people can expect:

_When can I start buying insurance through the exchange?

You can begin the process of purchasing health insurance starting at 7:30 a.m. Tuesday, either on the website (, by phone (855-923-4633) or in person at one of several locations set up to provide additional help to people (

_When will my new plan be active?

New insurance policies will start taking effect Jan. 1, 2014.

_ If I already have insurance through my employer or have purchased health insurance on my own, do I need to check out Washington Healthplanfinder?

The new health care law requires everyone to have some kind of insurance by the end of 2014 or they will have to pay a fine when you file your income taxes. If you already have insurance, you're all set. However, you may want to check out the exchange anyway because you may be eligible for a government subsidy or find that the plans being offered are less expensive or more comprehensive than the insurance you currently have. Depending on your income, you may also qualify for Medicaid, under the new state rules that set eligibility at 138 percent of the federal poverty level.

_Who qualifies for a subsidy?

The income threshold for a government subsidy offered on the state exchanges varies based on a number of factors, but generally tops out at incomes of $46,000 a year for an individual or $94,200 for a family of four. The way the subsidies are figured depends on the cost of a policy as a percentage of income. Since older people pay more for insurance, they can earn more money and still get a subsidy, whereas a 21-year-old couldn't make more than about $33,000 to buy individual insurance and have the government pay part of the cost.

_How long will I have to purchase insurance through the exchange?

Open enrollment runs from Oct. 1 until March 31, 2014. The next open enrollment will be much shorter, running from Oct. 15, 2014, through Dec. 7, 2014.

_What do I need to have on hand when I start the process?

Officials with the Washington Health Benefit Exchange suggest having the following list of items on hand: Names, birthdays, addresses and contact information for all household members; social security numbers for all of the people who will be covered under the plan; for legal immigrants, passport or other immigration numbers; estimated tax status for 2012, 2013 and 2014 for all household members; income information for 2012, 20134 and 2014 for all adults and minors age 14 or older who are required to file a tax return; information about health insurance currently available to your family such as employer-sponsored plans or Medicare.

_How many plans will I have to choose from?

So far, the state has certified 38 health plans from eight insurance carriers, as well as five dental plans. Under the plans approved by the Washington Health Benefit Exchange board, rates will vary based on factors like age, home county, smoking habits and choice of plan. Not every plan will be available in every county. Consumers can pick from four levels of coverage: bronze, silver, gold and platinum. All the plans cover the same benefits and cap annual out-of-pocket expenses at $6,350 for an individual, $12,700 for families. The main difference is cost sharing through annual deductibles and copayments. Bronze covers 60 percent of expected costs; silver, 70 percent; gold, 80; and platinum covers 90 percent. Bronze plans have the lowest premiums and the highest cost sharing.

_What happens if I decide to forego health insurance?

People will be asked to prove they have insurance or pay a fine when they fill out their 2014 federal income taxes in early 2015. If you're not insured by that time, you will pay a yearly penalty, which will start out low and then climb yearly. The first year, people with face the greater of $95 or 1 percent of 2014 household income, but that would increase over the next few years, to $325 per uninsured person or 2 percent of household income over the filing threshold for 2015 and $695 per person, or 2.5 percent of household income, in 2016. After that, the penalty will be assessed by a cost-of-living formula. Exemptions from the penalty include people whose income is below the federal income tax filing threshold, members of federally recognized American Indian tribes, and religious groups exempt from Social Security, like the Amish.


AP writer Donna Gordon Blankinship contributed from Seattle. Follow Rachel La Corte at

(Copyright 2013 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.)


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