Tag: benefits


CMS Issues Final Marketplace Stabilization Rule


Last week, The Centers for Medicare and Medicaid Services issued the final Marketplace Stabilization rule to “help lower premiums and stabilize individual and small group markets and increase choices for Americans.” While the rule is designed to help lower premiums and increase the choices consumers will have, some of the policy changes in the rule may potentially impact consumers in a negative way. Below are the key components of the final rule:

2018 Open Enrollment Period: The final rule shortens the annual open enrollment period to November 1, 2017, until December 15, 2017. This is half the duration of open enrollment periods in the past. This shortened window to enroll will result in many consumers potentially missing the opportunity to enroll in coverage and will overwhelm the already limited capacity of organizations providing in-person enrollment assistance. During the 2016 Open Enrollment period for the New York State of Health Marketplace (November 1, 2015 – January 31, 2016), about 74% of consumers enrolled or renewed their coverage with the help of an assistor. Consumers that do not enroll during the open enrollment period will only be able to enroll if they are eligible for a Special Enrollment Period (those eligible for Medicaid, Child Health Plus or the Essential Plan can enroll at any time during the year.)

Special Enrollment Period: Individuals applying outside of open enrollment will be required to provide proof of eligibility for a special enrollment period by submitting supporting documents. This rule aims to reduce fraud and abuse by ensuring that only those who are eligible are able to enroll. Consumers are not currently required to submit proof and this additional documentation burden could result in consumers experiencing delays in their coverage.

Continuous Coverage: The final rule allows insurers to require individuals to pay back past due premiums before enrolling in a plan with the same insurer the following year. Consumers who fell behind in premium payments will have to pay the balance due or they will not be able to enroll in the same coverage, forcing consumers to choose between overcoming a financial burden or being locked out of coverage for the entire year.

Ensuring Additional Choices for Consumers: the final rule allows insurers additional flexibility with the actuarial value of plans so they can offer more plan choices with lower premium options. While at first glance it does seem beneficial to offer greater consumer choice, actuarial value flexibility will allow insurers to offer cheaper plans by removing benefits or increasing out of pocket costs. Consumers may not realize what benefits are not being offered with their plan or what out-of-pocket costs they will be responsible for.

While overall these policy changes may be aimed at increasing choices and lowering costs, a robust education and outreach component should also be included to ensure that consumers understand how these changes may impact their coverage.

State-run marketplaces, like the New York State of Health, do often have more flexibility in establishing some of these policies so it is not entirely clear at this time how this final rule will impact consumers currently enrolled or enrolling in coverage through the New York State of Health Marketplace. HWCLI will continue to follow these changes and provide further updates when additional information is provided by the state.


New York Finalizes $153.1 Billion Budget


Below is a brief overview of some key provisions in New York State’s 2017-2018 Budget that may have an impact on the health and well-being of Long Islanders, especially those living in poverty.

 

Free College Tuition

New York students from families making less than $100,000 a year (which will increase to $125,000 per year by 2019) will be eligible for free tuition at SUNY or CUNY schools under the “Excelsior Scholarship.” The initiative won’t cover room and board and students will have to meet residency, grade point, and class load rules to participate. The program will be phased in over three years and also sets aside $19 million for tuition aid for students attending private colleges. Upon graduating, recipients will have to live and work in New York for several years or the grants will be converted into loans. The state estimates nearly 113,000 families with college age students (55%) on Long Island would be eligible for this program.

 

Community Health Advocates

The CHA program received $3.5 million in funding, which was less than the requested $4.75 million, but more than was allocated in last year’s budget. The Community Health Advocates network provides critical consumers assistance and counseling related to obtaining, utilizing, and resolving issues with all types of health insurance coverage. HWCLI, as well as other Long Island non-profits, has provided services through the CHA network for over 5 years and appreciates NYSDOH’s on-going support in assisting low-income and vulnerable families with navigating health insurance.

 

Legal Aid for Immigrants

The budget includes $10 million for immigrant legal aid efforts, with $4 million set aside specifically to assist New York immigrants at risk for deportation. The funding includes money for the Vera Institute of Justice as well as the New York Immigration Coalition, Empire Justice Center, Northern Manhattan Immigration Coalition for Immigrant Rights, the Hispanic Federation and Catholic Charities Community Services. HWCLI applauds the State for providing additional funding for much needed legal services for this extremely vulnerable group. Since 2014, more than 7,800 children have arrived on Long Island from Central and South America to reunite with family after crossing into the United States. To coordinate and convene the work of agencies assisting recently arrived children, HWCLI facilitates efforts between legal, education and social service agencies to provide integrated services, collaborate on advocacy, share best practices, and leverage limited resources- including legal supports and services.

 

Child Care Tax Credit

The final budget amends New York State’s child and dependent care tax credit to increase the tax credit for families earning between $60,000 and $150,000 per year. The benefit for the average household will increase from $169 to $376 and assist more than 200,000 families in offsetting the costs of child and dependent care.

 

Essential Plan

Premiums and co-payments will not increase for those enrolled in the Essential Plan with incomes between 138-150% of FPL as initially proposed by the Governor in the Executive budget. This proposal would have placed additional financial burden on low-income individuals and households making between $16,643 and $18,090 for a household of 1 and between $33,948 and $36,900 for a family of 4.

 

Child Care Subsidies

The final budget cuts funding for child care subsidies for low-income families with incomes less than 200% of the federal poverty level by $7 million. Currently, 83% of eligible families do not have access to these subsidies because of inadequate funds. It is estimated that the cut will result in an additional 900 families losing their child care subsidy.

 

Enhanced Safety Net Hospitals

The budget allocates $20 million over 2 years to enhanced safety net hospitals, a new category of hospitals that serve low-income New Yorkers. To meet the new criteria, hospitals must show that in any of the last three years at least 50 percent of their patients were uninsured or on Medicaid, at least 40 percent of inpatient discharges were billed to Medicaid and no more than 25 percent of patients had commercial insurance.

 

Farm to Foodbank

The budget includes a new tax credit for farmers who donate fruits, vegetables, and other farm products to local Food Banks- the credit is limited to $5,000 per year but will help farmers offset the harvesting and transportation costs of moving surplus crops that might otherwise go to waste.

 

Click here to read the entire budget.

 

 


Tweet Chat: Q&A with CBPP


We partnered up with the Center on Budget and Policy Priorities on January 27th, 2017, to celebrate EITC Awareness Day through a Q&A Tweet Chat.

CBPP and their Director of Federal Tax Policy, Chuck Marr, answered all of our questions regarding the Earned Income Tax Credit and how it affects low-to-moderate income working individuals.

 


Free Tax Preparation!


Free Tax Preparation with HWCLI’s Virtual VITA Program!

If you made less than $54,000 in 2016, you may be eligible for free tax preparation assistance through the Health and Welfare Council of Long Island’s Virtual VITA program. The Virtual VITA program utilizes technology to connect the tax payer and tax preparer. Instead of waiting at the intake site for an available tax preparer, the tax preparer is at an off-site location. The intake process takes less than 20 minutes and tax returns are completed in a few days, ensuring clients get access to all tax credits and refunds they may be eligible for.

It’s fast, easy and free!

For more information or for times and locations call 516-505-4424, or comment below.

 


10/29- Legal and Financial Planning for Caregivers of People with Dementia


Save the date for a very informative event given by Long Island Chapter of the Alzheimer’s Association. This workshop given by George R. Tilschner, Esq. is designed to help caregivers for people with dementia take a hold of their legal and financial planning needs. A few topics that will be covered include: government programs that could help you pay for care, tax deductions and credits and how to find legal and financial assistance. A complimentary lunch will be served to all in attendance!

The event will take place on October 29, 2016 from 11:30 am- 3 pm at the First Baptist Church of Riverhead. Registration is required and space is limited so don’t wait to register for this event!

To register, call: 1-800-272-3900

Or e-mail: jcorrales@alz.org

For more information, click here.


Home Energy Assistance Program Opens November 14


The Home Energy Assistance Program (HEAP) is a federally funded energy program intended to provide assistance to low income households in meeting their immediate home energy needs. Eligible households can receive a one time benefit toward their home heating costs and may also be eligible for an additional emergency benefit. The program will begin accepting applications on November 14, 2016 and end on March 15, 2017, or when funding is exhausted. The HEAP application will be available through http://otda.ny.gov/programs/heap/ beginning November 14, 2016. Applications can also be completed through My Benefits. Eligibility for benefits is based on income, household size, type of heating and composition of household members. Additional benefits may be available to households with children under 6, adults over 60 or a permanently disabled household member.

The HEAP Emergency component will be available beginning January 3, 2017.

Income guidelines, 2016-2017 benefit amounts and Emergency HEAP eligibility guidelines can be found here