NY State of Health, together with the New York State Department of Financial Services (DFS), recently announced that New York will now extend the 2021 Open Enrollment Period through the end of the year. Eligible New York individuals will be able to enroll in insurance coverage through NY State of Health and directly through brokers like the North Country Chamber of Commerce. This step is being taken in light of the Coronavirus pandemic to further protect the public health of New Yorkers.
NY State of Health, DFS, and New York State health insurers are taking this action
so that individuals do not avoid seeking testing or medical care for fear of cost.
Individuals who are eligible for other NY State of Health programs (ex. Medicaid, Essential Plan and Child Health Plus) can enroll year-round.
What is the Premium Tax Credit?
The Premium Tax Credit helps pay for health insurance coverage bought from the Health Insurance Marketplace. When a taxpayer or a family member of the taxpayer applies for coverage, the Marketplace estimates the amount of the PTC the taxpayer may be able to claim for the year of coverage. This estimate is based on information the taxpayer provides about family size and projected household income.
Eligible taxpayers then choose to have all, some, or none of the estimated credit paid in advance directly to their insurance company on their behalf. These payments – which are called advance payments of the Premium Tax Credit, advance credit payments, or APTC – lower what taxpayers pay out-of-pocket for their monthly premiums.
Alternatively, taxpayers can choose not to get APTC, pay the full amount of their monthly premium, and claim all of the benefit of the PTC that they are allowed when they file their tax return. This will increase their refund or lower the amount of tax they owe.
Taxpayers use Form 8962, Premium Tax Credit, to figure the amount of their PTC and reconcile it with their APTC.
What does your company need to know about group health insurance and the COVID-19 Pandemic?
- At this time you should refer to and implement your company's internal policies regarding keeping employees on your health insurance during a lay off or a medically imposed quarantine. Your internal company policy should dictate whether an employee can keep their health insurance during a lay off or if it needs to be cancelled. It is the company's obligation to collect the employee’s portion of the premium.
- Premium payments are still required to keep policies active, there may be a grace period, but you must contact your Health Insurance's Accounts Receivable department for details or to set up payment options beyond that grace period. This is considered on a case by case basis. Premiums are not being waived at this time.
- COBRA insurance will be offered to any employee you remove from your policy. COBRA is the same plan you currently offer your employees at the same rate, but they are responsible for the premium payment.
- Employees need to be aware that when they have a loss of insurance coverage they get one special enrollment period. If they use that to enroll in COBRA they cannot then decide later to move to the NYS Individual Marketplace unless they qualify for other reasons – such as reduced income making them eligible for a state funded plan such as Medicaid or the Essential Plan which offer year round enrollment.
ATTENTION BUSINESS OWNERS: Guidelines for Health Insurance Cancellation
- If you have reduced your workforce and need to cancel insurance benefits for those employees, be sure to reach out to your broker or contact from the insurance company if you do not have a broker.
- You will need to provide a written request – an email or termination form to cancel coverage including your group number, the names of individuals laid off and the date you want the coverage to be cancelled. Individual cancellation paperwork is not necessary.
- If you have access to your group account online cancellations can also be made online electronically.
- Your company policy will dictate when you cancel coverage – such as the date of lay off or the end of the month etc.
Contact Lisa Bedard-Dupee for additional questions or to enroll today!
TELEMEDICINE: Need medical attention, but don't want to go out?
Other things you should know:
- Insurance Companies Waiving Co-Pays for Tele-Health visits
- If you have questions or concerns about health insurance costs related to COVID-19 tests or care, please call the OAG’s Health Care hotline: 1-800-428-9071.
- NYS Department of Financial Services Health Insurance FAQ
- If you need help navigating the NYS Marketplace and can't reach Lisa. We suggest you contact Adirondack Health Institute at1.866.872.3740, or visit the EASE web page to request a free telephone appointment.
Fidelis can answer your questions and help you enroll in health insurance or renew your coverage by phone call 1-866-435-9521.
**Please remember, all New York insurers will have waived cost-sharing for a COVID-19 testing!**
For more information on other Coronavirus related topics, visit our home page HERE.
Have questions? Let us know! Email us and we will do our best to find the answer.