COLUMBUS – More Ohioans are eligible for health insurance premium financial assistance starting April 1 due to recently passed federal legislation. The American Rescue Plan Act of 2021 instituted a subsidy for people in need of COBRA continuation coverage through their former employer and expanded subsidy access and amounts for people with a Marketplace plan.
“As the COVID-19 pandemic continues to impact Ohioans, we want to make sure that people are aware of these new opportunities for financial assistance,” Department of Insurance Director Judith L. French said.
Financial assistance covering 100% of COBRA premiums is available to eligible individuals between April 1 and Sept. 30, 2021. COBRA provides certain former employees, retirees, and dependents the right to temporarily continue their employer-provided health coverage.
The act also expanded subsidies for Marketplace plans to people above 400% of the poverty level and increased subsidies for those making between 100% and 400% of the poverty level. These subsidies are available through www.healthcare.gov starting April 1.
The Ohio Department of Insurance provided these additional insights:
Who is eligible?
Employees (and dependents) who become eligible for COBRA because of involuntary termination of employment for reasons other than gross misconduct or because of a reduction in hours that caused them to lose eligibility for their employer’s health plan.
How is premium financial assistance paid?
Through a tax credit to the employer sponsoring the health plan or the insurer providing the coverage.
Is there a notification process for eligible individuals?
Employers and group health plans are required to provide new notices to those eligible for COBRA addressing the new subsidies, potential options to enroll in different coverage, and the extended period to enroll.
How do current enrollees in a plan qualify for a potential subsidy?
Current enrollees must reselect their current plan or a new plan on or after April 1, 2021 for reduced premiums to take effect for the remainder of the year. Additionally, individuals have through August 15, 2021 to take advantage of the current Special Enrollment Period to change to a new plan if they find a plan with lower costs. Deductible amounts already met under current plans should be considered to determine if a plan change makes sense, as they may not be carried over to a new plan.
When is the subsidy received if an enrolled individual does not switch plans?
The individual will receive the additional premium tax credit amount when they file their taxes in 2022.
When should an enrollee new to a plan apply?
New enrollees should apply by the end of March for coverage effective April 1, but have until August 15, 2021 to enroll under the Special Enrollment Period. New enrollees who enroll prior to April 1 will have to reselect a plan on or after April 1 for the increased tax credits to apply.
For More Information
Individuals in these situations with specific questions are encouraged to contact their employer, insurance company or agent. Consumer assistance representatives from the Ohio Department of Insurance are also available at 1-800-686-1526, firstname.lastname@example.org, and www.insurance.ohio.gov.