With Enrollment Deadline Approaching, An Uptick in Marketplace Clients | KBIA

With Enrollment Deadline Approaching, An Uptick in Marketplace Clients

Dec 9, 2015

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  Jeremy Milarksy sits behind his office computer and opens up the calendar of appointments for the week. There’s hardly any white space. Appointments are scheduled back-to-back.

Milarsky expected that this week.

“We've been very, very busy around here because it's close to a deadline day,” he says.

Next Tuesday, December 15, is the last day to enroll in health insurance through the federal marketplace created by the Affordable Care Act to guarantee health coverage starting January 1, 2016.

At Primaris, one of many free health consulting firms in Columbia, Milarsky helps clients evaluate what their best options are for health insurance—if they should enroll in the ACA marketplace or not.

Talking about insurance isn’t always easy. “You’re talking about a product that causes anxiety,” Milarsky says. “We have to think about our own mortality, we have to think about our family budget. We have to sit down and go over numbers.”

Milarksy thinks Primaris could see 20 to 30 clients by the end of this week. Most, he says, will have the same two big questions: how much will a plan cost, and how much will it cost to treat a chronic condition? Milarksy says healthcare.gov offers tools for that, which he and other enrollment counselors at Primaris will use.  

They’ll also clear up some potential misconceptions about the ACA, such as what the penalty fee entails if you don’t have health insurance.

"Somebody who is in a particularly vulnerable population and working hard, and doesn't qualify for subsidies," Milarsky says, "they think they're going to have some kind of huge fine."

"That's not true."

Homelessness, facing eviction or filing for bankruptcy are just a few of the exemptions to paying the fee, which is higher than last year.

For those who don’t have health insurance and don’t qualify for one of the exemptions, they’ll pay 2.5 percent of their taxable income or $695, whichever is higher.

“And here’s another thing,” Milarsky says, “(the penalty fee) is only charged for the months you’re not covered.”

So if a person went without health insurance for 3 months of the year, they would only pay a quarter of the penalty fee.

Figuring out the numbers can be tricky, but Milarsky says when clients do decide to enroll in the marketplace, it can be life changing..

“I have a client who had a baby who would not have considered having a baby if she did not do this,” he recalls.

“She’s an entrepreneur and her husband is a graduate student. The couple had never had health insurance before fall 2013.

“They have a little baby now and she shows me pictures every time she comes in.”

The first deadline to enroll in health insurance under the Affordable Care Act is next Tuesday, December 15. A filled application and payment of the first premium are required to receive coverage starting January 1.