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Cover Oregon: Apply for insurance in April and avoid federal penalty

Cover Oregon: Apply for insurance in April and avoid federal penalty

PORTLAND, Ore. (AP) — Though Monday marks the national deadline to apply for health insurance for this year under the Affordable Care Act, uninsured Oregonians have an extra month to sign up because of the state exchange's technology problems.

Oregon got the broadest reprieve in the nation from the federal government when it comes to extending the enrollment period, because the state's online portal is the only one in the country that still doesn't allow the general public to enroll from start to finish in one sitting.

The 30-day extension, announced last week, means residents can apply for coverage until April 30.

The enrollment deadline affects people applying for private health insurance. Cover Oregon's public relations specialist, Ariane Holm, said it will not affect those who are eligible for the Oregon Health Plan, Oregon's version of Medicaid, since they can enroll year-round.

Once Oregonians have applied, Holm said it takes about 10 days to hear back from the agency.

If people apply through Cover Oregon before April 30 and then enroll in a Cover Oregon plan, they will be exempt from a potential penalty, Holm said.

People who apply and enroll in plans outside of Cover Oregon between April 1 and April 30 may have to pay a partial federal penalty. That penalty would likely be a pro-rated amount for the month of April, which KATU learned would be 1/12 of the yearly $95 penalty. In other words, if you enroll directly with insurance companies in the month of April, expect to be fined approximately $7.90.

A spokeswoman at the Oregon Insurance Division said it will provide more information about how penalties may apply to individuals who do not apply for coverage through Cover Oregon as soon as possible.

Once people have applied by April 30 and then qualify for private coverage through Cover Oregon, Holm said they will have a reasonable period of time to enroll.

The only exception is if you experience certain qualifying events, such as becoming a parent or a change in your marital status. In such cases you may be able to enroll later in 2014.

See the full explanation in Cover Oregon's New Deadline Q and A.

"Oregon has made the deadline complicated," David Taxer-Nelson, an insurance agent with Portland Benefits Groups, said.

Taxer-Nelson said he's helped dozens of people get insurance through the state's health exchange. He believes Cover Oregon can't guarantee Oregonians will avoid the fine.

"Because you have to have insurance nine months of the year to avoid the penalty," he said, pointing out that there isn't enough time if people don't have insurance by May.

Taxer-Nelson is advising his clients they may pay a fee in April even if they apply through Cover Oregon.

"Leeway has been given based on processing time, but the assumption is you have to have an application that's dated March 31," he said.

In Oregon, the public and Cover Oregon staff must use a hybrid paper-online process to enroll, despite $134 million in federal funding spent on building the exchange.

To boost enrollments in April, especially among young people, Oregon is rolling out a last minute $1 million ad campaign. It consists of eight new television and cable spots, online banners, and paid posts on Facebook and other social media.

The goal of the campaign, said Cover Oregon's chief communications officer Amy Fauver, is to target deadline driven people, those who might have been waiting for a fully functional website, and younger Oregonians.

"We want to make sure to get the word out that people can still enroll in Oregon," Fauver said.

The new federal health care law requires nearly all Americans to have health coverage. Those who don't will be subject to financial penalties.

Enrollment figures fall short

So far, 178,000 Oregonians have enrolled in coverage through Cover Oregon. About 55,000 of those enrolled in private health plans, while nearly 123,000 enrolled in the Oregon Health Plan, the state's version of Medicaid.

The enrollment figures still fall short of the Obama administration's original projections, which assumed 237,000 would sign up for coverage by the end of March - although lower-than-expected enrollment isn't limited to Oregon.

Cover Oregon officials are still trying to decide what technology to use for the 2015 enrollment period, which begins Nov. 15. They have narrowed the options to three. They can continue with the current technology but hire a new vendor to finish building it. The state and its current technology contractor, Oracle Corp., have begun parting ways.

The state can also switch to the federal exchange or transfer technology from another state where it's working well.

Oregonians who want to enroll for coverage can apply online at www.CoverOregon.com and electronically submit a PDF form. They can print a paper application, then mail or fax it in. Workers will process the applications, determining whether the applicant is eligible for financial assistance, then mail an enrollment packet with information about the available insurance plans. The applicant can then select his or her choice online and wait to receive a bill from the insurance company.

Residents can also get help from insurance agents and community organizations certified by Cover Oregon, who have access to an online portal that lets them complete the entire application from start to finish - though it doesn't work with complicated family situations.

Several other states that built their own exchanges and the federal exchange extended the deadline for enrollment into April for consumers who say they began their application prior to March 31 but ran into difficulties such as technical website errors.

The U.S. Centers for Medicare and Medicaid Services agreed to give Massachusetts a two-week extension for those who had trouble with completing enrollment due to that IT systems issues. But Massachusetts, whose health reform law became the model for national health reform, already had more than 90 percent of its residents insured before heading into the signup process.

The Associated Press contributed to this report.

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