ONLINE COMMUNITY MEETING

DAMIAN BRAYKO, DIRECTOR OF OPERATIONS

AUGUST 6, 2013

• Cover Oregon overview

• Cover Oregon for individuals and families

• Cover Oregon for small businesses

• Questions & Answers

WHAT WE’LL COVER THIS EVENING

OVERVIEW OF COVER OREGON

Cover Oregon is a new online marketplace where Oregonians can compare and enroll in health insurance that fits their needs and budget, and also access financial help.

WHAT IS COVER OREGON?

Improving the health of all Oregonians by providing health coverage options, increasing access to information, and fostering quality and value in the health care system

MISSION

BACKGROUND

• Created in 2011 by Oregon Legislature

• Formed as public corporation

• Key piece of Affordable Care Act

• Custom-built for Oregonians, by Oregonians

• October 2013: Open enrollment

• January 2014: Coverage begins

• January 2016: Groups to 100 Employees

TIMELINE

A NEW DAY FOR HEALTH COVERAGE

CHANGES

• Can’t be denied for pre-existing condition

• Essential health benefits

• Financial help

• Medicaid expansion

• Requirement to have insurance

• Health insurance marketplaces (exchanges)

• Carriers must spend 80% of premiums on care

INFORMED DECISIONS ABOUT PREMIUMS VS. COPAYS

INDIVIDUAL PRIVATE PLAN CARRIERS

formerly ODS

PUBLIC PROGRAMS

SMALL GROUP CARRIERS

formerly ODS

DENTAL CARRIERS

formerly ODS

PLAN CHOICE

Number of plans in individual market: 110

Number of plans in small group market: 73

Number of HSA-qualified plans (tentative): 29

HEALTH INSURANCE RATES

• Oregon Insurance Division (OID) conducted a rigorous public rate review process

• Rates have been approved by OID

• Cover Oregon is currently certifying carriers and plans

• Rates are based on age, county of residence and tobacco usage

• Sample rates for your area are at www.oregonhealthrates.org

Mental/behavioral health

ESSENTIAL HEALTH BENEFITS

Hospitalizations Ambulatory services

Maternity/newborn care

Emergency services

Prescription drugs

Laboratory services

Rehabilitative/habilitative services & devices

Pediatric vision care

Prevention/wellness

INDIVIDUALS AND FAMILIES

INDIVIDUALS AND FAMILIES• Financial help

• Clear information and price transparency

• Side-by-side comparisons

• One-stop shopping

• Quality coverage and grades

• Help enrolling

• HSA-eligible plans

INCOME ELIGIBILITY GUIDELINES

Program Eligibility Medicaid Cost-Sharing Assistance

Healthy Kids Premium Tax Credits

Household Size 138% 250% 300% 400%

1 $15,856 $28,725 $34,470 $45,960

2 21,404 38,775 46,530 62,040

3 26,951 48,825 58,590 78,120

4 32,499 58,875 70,650 94,200

5 38,047 68,925 82,710 110,280

6 43,594 78,975 94,770 126,360

For families/households with more than 8 people, add $4,020 for each additional person

SMALL BUSINESSES

SMALL BUSINESSES

• Choice

• Clear information

• Set contribution

• Quality coverage

• Streamlined administration

• Access to tax credits

• Help

ELIGIBILITY FOR TAX CREDITS

EMPLOYER CHOICES

TIMELINE FOR EMPLOYERS

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ONLINE MARKETPLACE

CONSUMERS CAN SEARCH PLANS BY:

• Geography

• Price

• Provider

• Quality rating (11 metrics first year)

• Carrier

• Plan type (e.g., HMO, PPO)

• Deductible

• Out-of-pocket maximum

• Metal tier (bronze, silver, gold, platinum)

HOME PAGE

HELP WITH APPLYING

• 1-855-COVER-OR (service center)

• 50 full-time staff at Salem call center

• Up to 100 temporary staff

• Agents certified with Cover Oregon

• Community partners

MARKETING AND OUTREACH

INTEGRATED CAMPAIGN

Research

Paid

Media

Earned Media

Online Outreach

Statewide+ Grassroots

Partners

Marketing Materials

Community Meetings

ORDER MATERIALS ONLINE

CoverOregonStore.com

COMMUNITY MEETINGS

• August 6: Online Meeting

• August 14: Pendleton

• August 15: Hood River

• Sept 4: Coos Bay

• Sept 24: Medford

• Past meetings: Eugene, Portland, Bend, Astoria and Seaside

INTRODUCING…

SWITCH TO PLAY TWO ADS

Digital/Out-of-Home Artwork

Digital/Out-of-Home Artwork

Digital/Out-of-Home Artwork

CONNECT WITH US

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