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Navigating Georgia’s Healthcare Exchange

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With open enrollment underway, now is the time to apply for coverage.

By Cory Sekine-Pettite

By the time you read this, 2020 enrollment in the federal health insurance marketplace will have opened. If you are in need of health insurance, you will have until December 15 to complete the application process for coverage that will begin on Jan. 1, 2020. If you’ve never been through this procedure, it may seem daunting at first, so we asked one of the insurance providers in Georgia who participates in the healthcare exchange to walk us through the process.

CareSource, a leading nonprofit health plan provider whose metro office is located at Atlanta Galleria, is new to Georgia’s healthcare exchange, but not new to offering insurance on the exchange. The company has been providing these services and more to four other states (Ohio, Kentucky, West Virginia, and Indiana) for more than 30 years. Until now, CareSource provided only Medicaid and CHIP (Peach Care for Kids) coverage in Georgia. You may recall that in the July/August 2019 issue of Cobb In Focus, we interviewed local CareSource executives about the company’s Life Services program, which offers coaching, supportive resources, job readiness, and placement opportunities for Georgia’s unemployed or under-employed residents. As a local firm, we sought the company’s input on navigating the health insurance marketplace. We spoke with Bobby Jones, CareSource’s president of the Georgia market, Jason Anavitarte, director of state development and advocacy, and Darren Morgan, VP community relations & network development.

“I think the biggest concern or question that consumers have is what information does the consumer need when they apply or reapply for health care for open enrollment,” said Morgan. “One of the things that the healthcare.gov website does a good job with is, they actually have a checklist that a consumer can print off that will help them organize their information when they apply, whether they do it directly or whether they do it through an insurance agent or broker.”

Georgia residents can apply for coverage through the federal website, or by calling 800.318.2596. There is no application fee, but applicants must pay the first premium on their chosen healthcare plan before the insurance kicks in. More good news: According to healthinsurance.org, an independent, consumer resource for health insurance, after several years of insurer exits and fairly substantial rate increases, Georgia’s individual insurance market appears to be stabilizing. The average rate increase for 2019 was less than 4 percent, and insurers have proposed an average rate increase of just 2.4 percent for 2020. And with two new companies in the market, including CareSource, Georgians have even more choice when it comes to choosing the best, most affordable healthcare plans for themselves and their families.

What sets CareSource apart, according to Morgan and Jones, is its longevity in providing healthcare plans, and its experience in the federal healthcare exchange. “We’re a nonprofit, which is a distinction between us and the other [health plans],” Jones added. “We feel it’s a selling point for us.” For the consumer, this means more of CareSource’s income is spent on services for its customers, the company says, rather than on payouts to shareholders.

In addition to providing the essential health benefits through the exchange, CareSource offers supplemental services such as vision and dental plans. “When they purchase the dental and vision on top of the medical, we also include at no charge for the member a program called Active Fit. It is a program where members can access gyms, places like LA Fitness or Planet Fitness, at no extra charge to them,” Morgan said. “Or if they don’t want to go to a gym, they can order a home fitness program. Of course, the reason we do that is to promote wellness and a healthy lifestyle.”

In addition to the premium costs, CareSource said consumers should factor in their deductibles, their out-of-pocket max, and the tax credit (if any) they can expect from their chosen plan before deciding upon a provider. “The costs vary by plan, but you also have to look at these other factors to see which [plan] is the most effective … the plan that’s going to meet your family’s need,” Morgan said.

“While cost is important, be smart and look beyond the price point when choosing a plan,” Anavitarte said. “Be wary of short-term plans that lack basic benefits, such as, preventative and maternity care. All CareSource Marketplace plans offer ACA-compliant coverage with the option of dental and vision plans.”

Again, the open enrollment deadline is December 15. Visit healthcare.gov to learn more and to begin the application process for your own coverage.

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Cobb Chamber Names 2019 Public Safety Award Winners
During the annual Public Safety Appreciation Breakfast on October 7, the Cobb Chamber named the 2019 Public Safety Award winners. Nominations for the Public Safety Awards were solicited from public safety agencies throughout Cobb County, including police, fire, sheriff’s office, campus police, and EMS. Congratulations to the following winners: Detective Meredith Holt, Smyrna Police Department (Public Safety Employee of the Year); Deputy Stephen Arsenault, Cobb County Sheriff’s Department (Award of Merit); Cobb Police SWAT Team members, Officers David Cavender, Zach Day, Brett Gossett, Caleb Reid, and JC Tranquille (Awards of Merit); Director Marty Billings, MetroAtlanta Ambulance (Distinguished Achievement Award); Officer Paul Hill, Marietta Police Department’s Citizens Academy (Outstanding Community Contribution); Officers Timothy Burns and Armando Sanchez, Kennesaw Police Department (Medals of Valor); Lars Marvin, Paul Molinaro, and James Walker, the crew of Engine 55-C, a unit of Marietta Fire Department (Medals of Valor). The annual Public Safety Appreciation Breakfast was presented by Cobb EMC and WellStar, at the Cobb Galleria Centre.