Turning 21? Here's How To Avoid A Big Hike In Health Premiums

For young people, turning 21 is generally a reason to celebrate.

If they're insured through the federal health insurance marketplace that operates in about three-dozen states, however, their birthday could mean a whopping 58 percent jump in their health insurance premium in 2015, according to an analysis by researchers at the Center on Budget and Policy Priorities.

Many 21-year-olds who qualify for premium subsidies will be able to sidestep the rate increase if they re-evaluate their coverage options on the federal marketplace before Feb. 15, when the annual open enrollment period ends.
If they don't, they'll generally be automatically renewed into the same plan and with the same premium tax credit they had in 2014.

Families with federal marketplace plans whose now 21-year-old children are covered as dependents will face a premium jump as well.

Under the health law, insurers can no longer base premiums on people's health or pre-existing medical conditions. Instead, insurers are permitted to apply just four premium rating factors in their calculations: age, where someone lives, how many people are going to be covered and whether someone uses tobacco.
The law also prohibits premiums for older adults from being more than three times higher than those for younger adults.

Because of age rating, premiums for most adults will rise slightly every year as they get older. But with children, it's different. Insurers apply the same age-rating factor to all children when computing their premiums. When people turn 21, however, the insurer begins to compute their premiums based on an adult age-rating factor, which results in that 58 percent premium increase.

Young people who go back to the marketplace to shop for a 2015 plan can generally avoid any age-related premium increases. They likely qualify for premium tax credits that are available to people with incomes between 100 and 400 percent of the federal poverty level ($11,670 to $46,680 for an individual). If they return to the marketplace, their premium tax credit will be adjusted to cover the higher age-related premium for their 2015 coverage.


"We've been encouraging everyone to update their profiles on HealthCare.gov so they can ensure that they have a tax credit that reflects what they should be getting," says Jen Mishory, executive director at Young Invincibles, an advocacy group for young people.

npr.org and Kaiser Health News

Open Enrollment 2015 has begun!

View in browser | This newsletter created and distributed by Centers for Medicare & Medicaid Services

Official Notice: Open Enrollment 2015 has begun Enroll in a 2015 health plan! Find a quality health insurance plan that meets your needs and fits your budget. Take a moment to review your options for 2015 and see if you qualify for help with costs. You may be eligible for $0 or low-cost health coverage. Remember: Enroll by December 15th so your coverage will start on January 1, 2015. We want to make sure you #GetCovered, so enroll today to get the quality coverage you deserve. The HealthCare.gov Team

Spread the word! Open Enrollment runs from Nov 15th to Feb 15th

Webinar - Focusing on Education Outcomes to Improve Health Equity

You are invited to a webinar hosted by the Federal Interagency Health Equity Team. A decade ago, Spokane public schools’ graduation rate was less than 60%. The same year, Eastern Washington University’s Policy Department started an initiative to compile data in the sectors of health, education, economic vitality, public safety, and environment in Spokane County. Community leaders recognized the data’s utility for identifying challenges, measuring change, and prioritizing actions to maximize impact in the community. With this vision in mind, Priority Spokane was launched as a collaborative organization to fostering measurable improvements across sectors. Their work demonstrates the importance of recognizing education as a social determinant of health, and how addressing the education needs of a community is a critical step in promoting health equity. In this webinar, speakers will discuss the structure of Priority Spokane as well as the strategies, resources and tools implemented through the Promote Spokane to promote equity in education and health. TOPIC: Priority Spokane: Focusing on Education Outcomes to Improve Health Equity SPEAKERS:    Lyndia Wilson, MS, Division Director, Disease Prevention and Response, Spokane Regional Health District   Gloria Ochoa, JD, Director of Local Government and Multi-Cultural Affairs, City of Spokane  DATE: December 3, 2014 TIME: 3:00 p.m. – 4:30 p.m. EST

Register Here*: http://tinyurl.com/FIHETWEBINARSERIES  Click Here for Full Abstract and Speaker Biographies: http://tinyurl.com/PrioritySpokane  The Federal Interagency Health Equity Team (FIHET) is a group of 12 federal agencies convened under the National Partnership for Action to End Health Disparities (NPA). The NPA is a national movement with the mission to improve the effectiveness of programs that target the elimination of health disparities through coordination of leaders, partners, and stakeholders that are committed to action. The FIHET provides a forum for federal agencies to increase dialog between traditionally siloed programs in ways that enhance cross-agency coordination, maximally leverage existing resources, and increase the impact of federal resources on conditions within communities. *If the registration link does not work, please copy the entire link and paste it into your web browser. For webinar-specific or technical questions, contact the moderator at enoyes@explorepsa.com.

Child Welfare Information Gateway will launch the Family Engagement Inventory December 2014

Family Engagement Inventory Coming December 2014

Child Welfare Information Gateway will launch the Family Engagement Inventory (FEI) in December 2014. The FEI is an interactive web-based tool designed to familiarize professionals in child welfare, juvenile justice, behavioral health, early childhood education, and education with family engagement as defined and implemented across these fields of practice. It also aggregates knowledge in a way that assists professionals in multidisciplinary exploration of family engagement. The FEI will help practitioners, managers, and system leaders understand the commonalities and differences in family engagement across the disciplines in order to support collaboration among multiple systems often working with the same families.

The Family Engagement Inventory, a microsite of Child Welfare Information Gateway, will be accessible through the Child Welfare Information Gateway website, https://www.childwelfare.gov/, when it is launched in December 2014. In the interim, please visit Information Gateway and explore our current family engagement resources, including:

- Our web section on family-centered practice and engaging families: https://www.childwelfare.gov/famcentered/engaging/
- The Family Engagement and Retention in Prevention Services web section: https://www.childwelfare.gov/preventing/developing/fam_engage.cfm
- The Family Group Decision-Making web section: https://www.childwelfare.gov/famcentered/decisions/
- Our bulletin for professionals, Engaging Families in Case Planning: https://www.childwelfare.gov/pubs/engaging_families.cfm

New Health Care Law Webinars: The ACA and Immigrant Families

Health Insurance Options for Immigrant Families

November 13 at 4 pm ET

(3 pm CT, 2 pm MT, 1 pm PT)

To Join By Phone Only: Dial: +1 (480) 297-0022, Access Code: 160-972-179 For those joining by phone only, the Pin Number is the # key

Please join the HHS Partnership Center and the Centers for Medicare & Medicaid Services (CMS) for a webinar (in English) on the benefits available to immigrant families through the Health Insurance Marketplace and how to get covered during open enrollment. Open enrollment starts on November 15 and ends on February 15, 2015. Please send your questions to ACA101@hhs.gov before noon on November 13.

Reaching Special Populations

Marketplace.cms.gov has a number of resources for special populations. You can visithttps://marketplace.cms.gov/outreach-and-education/special-populations.html for the full list. Below are the links to resources which were discussed during the call.

Disability Populations

National Disability Navigator Resource Collaborative (NDNRC)  http://www.nationaldisabilitynavigator.org/

Cancer Support Community http://www.cancerinsurancechecklist.org

Asian American, Native Hawaiian, and Pacific Islander populations

Report from Action for Health Justice (AHJ) entitled, Improving the Road to Coveragehttp://www.apiahf.org/sites/default/files/2014.10.14_Improving%20the%20Road%20to%20ACA%20Coverage_National%20Report.pdf

Hispanic and Latino Populations https://marketplace.cms.gov/outreach-and-education/special-populations.html

African American populations

Location of HRSA Community Health Centers near your community http://findahealthcenter.hrsa.gov/Search_HCC.aspx

Local help applying for health coverage https://localhelp.healthcare.gov/

Coverage to Care initiative https://marketplace.cms.gov/technical-assistance-resources/c2c.html

Reminder: The Health Insurance Marketplace DIY Design Toolkit

There are some communications materials that CMS must create and others you can create yourself following a few simple guidelines. The more we become “brand champions,” the better 4

we’re able to define and differentiate the program from other programs run by CMS and from similar programs run by organizations outside of the federal government.

Access the DIY toolkit today: http://marketplace.cms.gov/outreach-and-education/diy-toolkit-summary.pdf

Affordable Care Act 101 Webinars for Small Employers

Health care continues to be an important issue for small business owners. The Small Business Administration, Department of Health and Human Services, and Small Business Majority are committed to helping businesses navigate the changes and opportunities in health care through the Affordable Care Act 101 webinar series.

Each week, small business owners can learn the basics of the Affordable Care Act and how they can enroll in small business health insurance marketplaces. Other topics discussed include insurance reforms, the small business health care tax credit, and employer shared responsibility provisions. SBA and HHS representatives help small business owners understand the facts of the Affordable Care Act so they can make informed decisions about providing health insurance for their employees. 5

The webinar is offered on Thursdays at 2:00 pm ET every week; the webinar will also be offered in Spanish on alternate Tuesdays at 4:00 pm ET. To register for the webinar and to learn more about how the ACA affects small businesses, you can visit http://www.sba.gov/healthcare.

Schedule of English-language Weekly ACA 101 Webinars for Small Employers:

November 13, 2014 at 4 pm ET: Click to Register  

November 20, 2014 at 4 pm ET: Click to Register

December 4, 2014 at 4 pm ET: Click to Register

December 11, 2014 at 4 pm ET: Click to Register

December 18, 2014 at 4 pm ET: Click to Register

Schedule of Spanish-language Bi-Weekly ACA 101 Webinars for Small Employers:

November 18, 2014 at 4 pm ET: Click to Register

December 2, 2014 at 4 pm ET: Click to Register

December 16, 2014 at 4 pm ET: Click to Register

For more information on how the new health care law affects small businesses, check out www.sba.gov/healthcare.

Utah's Pacific Islander population is the focus of week-long health promotions

SALT LAKE CITY — At 469 pounds, Lemz Asi believed his future health depended on landing a spot on "The Biggest Loser."

"I couldn't really see myself doing it by myself," said Asi, of Midvale. "(The TV show) was going to be my only chance to get the mental and physical help I needed to lose weight. I didn't have the mentality to stay focused on my own."

But instead of impending stardom, the 6-foot-6-inch Samoan man put his dusty gym membership to use — and while the treadmill and elliptical machines were just "too slow" for him, an attempt at Zumba really hit home.

"I'd been dancing all my life. I figured I could do that," he said.  And dance he did — to the tune of losing more than 170 pounds, something he never thought was possible.

More than 52 percent of the native Hawaiian and Pacific Islander population in Utah is obese, compared with 24.8 percent of whites and 25.6 percent of black Utahns, according to the Utah Department of Health.

Pacific Islanders in Utah are also among the highest prevalence of arthritis (27.9 percent), diabetes (16.1 percent) and other health conditions. Infant mortality is also a struggle for the minority population, as maternal weight influences the health of babies.

In response to the high rates, the Utah Department of Health's Office of Health Disparities is kicking off a week of health promotion events aiming to encourage the Utah Pacific Islander population to make healthy choices.

A lot of the people in the Polynesian community rationalize it because of the culture. Growing up, it was so normal. I was raised my whole life being big, and I was comfortable with it. –Lemz Asi

Many of the events, held at locations from Salt Lake City to St. George, intend to "expose folks to different forms of exercise than they might be used to," said Jake Fitisemanu, an outreach coordinator for the office. He said people know they need to be healthier but might not know how to get there.

More details on Utah Pacific Islander Week can be found online at utahpacifichealth.org.

"The food folks are accustomed to eating and the much more sedentary lifestyle now is different from the active lifestyle of our ancestors in the islands," Fitisemanu said, adding that the epidemic of chronic disease among Pacific Islanders is a historically new phenomenon.

"Before the arrival of colonizers, we didn't have beef, there was no fried foods, 80 percent of the diet was plant-based, and they ate mostly fresh seafood," he said. "In order to survive in those outlying islands, life involved lots of paddling, climbing trees and dependence on growing your own food, working the gardens and being active."

 Today's sedentary workplaces and an increasing reliance on heavily processed foods, Fitisemanu said, has produced "a level of sedentarism that we've never experienced before."

"I know how these really big people feel," Asi said. "I know how they feel, and I know how I feel now after losing weight. And I want to help them."  The road to fitness hasn't been easy, he said, adding that the past almost two years have been full of speed bumps and disappointments, but also accomplishments.

"I've fallen so many times. I just make sure I tell myself that I cannot go back to that life," Asi said.

Choosing a more healthful life, he said, has also helped him quit drinking alcohol and become more social and helpful to people around him.

"I'm more confident with myself in doing what is right and being a positive role model for people," Asi said.

The health department has begun collecting success stories such as Asi's from local Pacific Islanders, hoping to change the dialogue from a previous focus on negative impacts and obituaries caused by poor health choices.

 "Let's not dwell on the negatives, but let's acknowledge them and find ways to improve our health, individually and in our families, and move forward," Fitisemanu said. "Small changes can make a big difference."

Utah Pacific Islander Health Week kicks off Monday at the Sorenson Multicultural Center, 855 W. 1300 South, from 6 to 8:30 p.m. 

KSL.com

See if you can save on health insurance

Want to find out if you qualify to save on health insurance? We can help.

When you apply for 2015 Marketplace coverage, you may be eligible for premium tax credits or low-cost coverage through Medicaid and the Children’s Health Insurance Program (CHIP).

Take a look at the chart we've put together here:

 

See an accessible version of this chart and learn how it applies in your state.

Come back to HealthCare.gov on or after November 15th to apply and find new health insurance coverage.

We want to make sure you get covered!

The HealthCare.gov Team  

Free Training for the ACA Pediatric Dental Benefit: Consumer Assisters and Oral Health Stakeholders in Regions VII & VIII (UT)

Wednesday, November 12

9:00-10:00am MST/10:00-11:00 am CST

The ACA Pediatric Dental Benefit: Issues for Consumer Assisters and Oral Health Stakeholders to Consider

Issues: The separate treatment of dental and medical benefits in federal law and regulations pose a number of challenges to ensure that all children have access to affordable, high quality dental coverage:

1.   Stand-alone dental plans are optional to purchase (unless a state requires a dental plan be purchased)

2.   Separate insurance policy & premium

3.   Separate deductible

4.   Separate out-of-pocket maximum

5.   Adult coverage may be part of some plans

6.   No cost-sharing reductions

7.   Some consumer protections may not apply

Training Goals:

1.   Equip Navigators, certified application counselors, and other consumer assisters, Primary Care Association (PCA) staff, and State Oral Health Program and oral health advocates with knowledge and tools about the pediatric dental benefit so they can assist consumers with plan selections that are clinically sound and affordable;

2.   Raise the awareness of Navigator organizations, PCAs, and State Oral Health Programs and Oral Health Coalitions about the roles they can fulfill:

a.      serving as content experts advising consumer assistance personnel and other oral health advocates

b.      providing surveillance and feedback to advance an ongoing dialogue in their respective states about issues associated with implementation of the pediatric dental benefit.

Training Topics:

ü  Overview of the Pediatric Dental Benefit

ü  Marketplace Coverage: Benchmarks, Participating Dental Plans, and Optimal Benefit Design

ü  Providing Consumer Assistance in terms of Covered Benefits, Service Limits, and Out‐of‐Pocket Expenses

ü  Consumer Protections, Network Adequacy, and Tracking Consumers’ Experiences

Join the Webcast using the following URL:

http://services.choruscall.com/links/hrsa141112.html

Utah Vets Battle Back Against Arthritis

Utah Vets Battle Back Against Arthritis

Self-Management program gets them moving again

(Salt Lake City) – One in three Utah veterans is fighting a home-front battle with arthritis: of the 53,000 Veterans in Utah, more than 17,000 are currently diagnosed with the disease. A published CDC report shows a higher rate among Veterans than civilians that is likely related to joint injuries incurred during their military service.  The most common type of arthritis is osteoarthritis, most often brought on by joint injury and trauma.  

Dave Buchholz of Salt Lake City served in the Army Special Forces as part of an Air Force pararescue team in Southeast Asia from 1971 to 1975. He survived land and scuba jumps with 150 pounds of equipment, and even simulated helicopter crashes.  Dave suffers from PTSD and became addicted to pain killers to help manage his chronic pain. The trauma and impact of the jumps took their toll on his lower back, where joint pain and arthritis led to major back surgery in July, 2013.  Dave also has arthritis in his hands, which especially limits mobility in his thumbs. 

“I had an issue acknowledging my pain level.  I even self-medicated a bit with alcohol. It’s been a challenge. I’m pushing 63 years old, and I’ve got to ask myself, ‘How do I want to live the rest of my life?’”

Dave is living a better life today after taking the Living Well with Chronic Conditions self-management course, a scientifically-proven program that can reduce the adverse effects of arthritis (e.g., pain, poor function, depression) and its comorbidities (e.g., heart disease, diabetes). It’s a resource available to all Veterans.

Living Well with Chronic Conditions is offered throughout Utah, teaching people with arthritis and other chronic conditions how to control symptoms and understand how their health problems affect their lives. The course brings together groups of 10-15 participants who meet for two hours a week for six weeks. The courses are run by lay leaders with relevant health problems of their own. The VA Medical Center in Salt Lake City held its first Living Well with Chronic Conditions workshop in March 2013. Dave attended in April of this year. 

“I got the most out of the workshop’s group discussions, learning about dealing with chronic pain and how to set goals.”  Dave’s goals were to stay active throughout the day, hitting the gym five times a week to release natural endorphins and help lessen the pain. “The Living Well workshop gave me the motivation to keep going to the gym. Endorphins free up some of the pain, that’s the good side,” he added. “The down side is that you have to overcome the pain to get to the workout.”  

Since his back surgery, Dave has beaten his addiction to pain killers and feels well enough to pursue his interest in music by taking drum lessons. “With my history of addiction, alcoholism, PTSD, and chronic pain, I knew I had to do something to get my mind going in the right direction.” 

Dave will be a grandfather for the first time in January. “That’s very motivational for me” he explains.  “I’m not one who likes to complain. I’m really pleased with the health care I’ve received through the VA. They are great.”

If you are interested in improving the quality of life for a Veteran you know, you can help by letting them know of the free Living Well with Chronic Conditions self-management education classes.

For more information about how to manage your arthritis, visit http://health.utah.gov/arthritis/, or contact Christine Weiss, UDOH, at(801) 538-9458 or cweiss@utah.gov. To sign up for a class at the Salt Lake City VA Medical Center, contact Joan Heusser at 801-582-1565, ext 4246, or Joan.Heusser@va.gov.

A Call with President Obama In Advance of the ACA Open Enrollment

You are invited to join a conference call on Friday, November 7^th at 4:00 PM ET with President Barack Obama and Department of Health and Human Services (HHS) Secretary Sylvia M. Burwell to discuss the upcoming open enrollment period for the health insurance marketplaces under the Affordable Care Act. We encourage you to circulate this invitation to all of your members, volunteers, and partners who will engage on enrollment efforts during the open enrollment period from November 15^th-February 15^th.

Call Details

·         Date: Friday, November 7^th  

·         Time: 4:00 PM ET, please join 5-7 minutes early to avoid connection delays

·         RSVP: To receive the dial-in information, please register for the call by clicking: http://ems6.intellor.com?p=600397&do=register&t=1

This call is off the record and not for press purposes. We look forward to speaking with you on Friday.

Sincerely,

The White House Office of Public Engagement

CMS Tribal Affairs Webinar - American Indians and Alaska Natives in the Marketplace

Date: Wednesday November 5, 2014

Time: 1:00 - 2:00 pm, Eastern Time (ET)

CMS Tribal Affairs Webinar

American Indians & Alaska Natives in the Marketplace

Call-In Number: 855-897-8197

Webinar link: http://www.cmsitutrainings.net/

The Centers for Medicare & Medicaid Services (CMS) Tribal Affairs will host a webinar entitled American Indians & Alaska Natives in the Marketplace on Wednesday, November 5, 2014 from 1:00 – 2:00 pm, ET.

This webinar will provide an overview of the Health Insurance Marketplace and highlight updates and changes for the upcoming open enrollment period – beginning November 15th.

The webinar will specifically focus on American Indian and Alaska Native provisions in the Marketplace, Medicaid and CHIP that will help increase enrollment in these programs. CMS subject matter experts will be available to answer your questions.

To obtain further information on special protections for AI/ANs in the Marketplace visit: http://www.healthcare.gov/tribal

Instructions to join the webinar:

• Go to the website www.cmsitutrainings.net
• Enter your email address, First and Last names in the dialog box
• Next click on “Continue” near the bottom of the box. You will be redirected to a CMS ITU page that will generate an email to you.
• Follow the instructions in the email to join webinar from the CMS ITU Trainings Center.
• Click on today’s webinar from the list of webinars.