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Oklahoma small businesses, self-employed plan to shop new health insurance marketplace

Enrollment opens Oct. 1 for Oklahoma's federally run online health insurance marketplace. Though employer mandates have been delayed one year, new health reform laws require most individuals to have insurance starting Jan. 1.
by Paula Burkes Published: September 22, 2013
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Oklahoma City small-business owner Jeff McKenzie said he's “fingers-crossed” that he'll stay healthy for three more months.

He let his health insurance policy — which he'd held for 20 years — lapse nearly two years ago.

“We were in the thick of the recession, and it came down to paying my monthly premium or our electric bill,” said McKenzie, 64, who's owned and operated a T-shirt shop downtown for 37 years.

“Business had gotten so slow, and my premium so high” — $1,200 a month for an annual policy with a $500 deductible — “that I panicked,” he said.

Come Oct. 1, McKenzie plans to buy a new policy in Oklahoma's federally run online health insurance marketplace so that he'll be covered starting Jan. 1, when new laws require him, and most Americans, to have insurance or pay penalties on their tax returns.

The new marketplace — and a companion marketplace for employers who want to shop for group plans — are mandated under the Affordable Care Act. Signed into law in March 2010, the act is meant to provide affordable quality insurance to people who don't have it through work, Medicare or Medicaid, the state-federal welfare program.

McKenzie said he's hoping to find a reasonably priced, high-deductible policy that will cover him until July 12, when he turns 65 and will become eligible for Medicare.

Preparing for the worst

Cheryl McEvoy, 55, a self-employed nail technician who leases a storefront in northwest Oklahoma City, also plans to shop the new health insurance marketplace.

She currently has medical insurance through Insure Oklahoma, but new, stricter income requirements, which were recently imposed by the Obama administration on individual participants in the state-federal premium assistance program, will force her to leave the program Dec. 31.

“I'm fairly healthy, but that could change at any time,” McEvoy said. “I want something in case I have an emergency and need to go to the hospital.”

She currently pays $50 a month for insurance, and about all she can afford is $300 a month, she said.

Participating companies

According to a report by Oklahoma Watch, published in The OklahomanSept. 14, most monthly premiums on the marketplace will range from $200 a month to $700 a month, based on consumers' ages, tobacco use and where they live in the state. In addition to monthly premiums, the most any individual consumer in the exchange would pay per year is $6,350, including doctor’s office and hospital co-pays and prescription co-pays, the news agency reported.

Any Oklahoma resident is welcome to shop in the marketplaces, and individuals who have incomes between 100 percent and 400 percent of the federal poverty level ($11,490 to $23,550, or $31,322 to $94,200 for families of four) will be eligible for variable subsidies, depending on income and family size. For example, a resident who qualifies for discounts, starting in January, might pay monthly insurance premiums of $200 versus $400, and the federal government would pay the insurance carrier the remainder.

The Kaiser Family Foundation has posted a calculator at kff.org/interactive/subsidy-calculator/ for people to estimate costs and learn if they qualify for subsidies.

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by Paula Burkes
Reporter
A 1981 journalism graduate of Oklahoma State University, Paula Burkes has more than 30 years experience writing and editing award-winning material for newspapers and healthcare, educational and telecommunications institutions in Tulsa, Oklahoma...
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Information

Oklahoma's new federally run health insurance marketplaces:

Online: www. HealthCare.gov

Individuals: (800) 318-2596 (round-the-clock operators) or (855) 889-4325 (teletypewriter for the hearing-

impaired)

Businesses: (800) 706-7893 (8 a.m. to 4 p.m., weekdays) or (800) 706-7915 (teletypewriter for the hearing-

impaired)

Part-time hourly employees will be restricted to working no more than 20 hours per week & Human Resources will only approve Appointment Requests listing up to 20 hours per week. Adjunct professors may work up to 12 credit hours per semester or a total of 24 credit hours per calendar year.”

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Rose State College President,

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