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Health insurance marketplace open enrollment begins Tuesday

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Northern New York residents who are uninsured or who do not have affordable health coverage will be able to choose an appropriate, affordable plan that fits their needs, beginning Tuesday.

On that date, a six-month open enrollment period begins through the NY State of Health, an online tool people may use to compare and shop for health insurance coverage. This is a part of the federal Affordable Care Act.

Kyle R. Kotary, director of external affairs, outreach and marketing, said people can enroll online, via telephone or in person through marketplace navigators. Navigator roles are held locally by ACR Health, the North Country Prenatal/Perinatal Council, the Health Initiative of St. Lawrence County and the Greater Watertown-North Country Chamber of Commerce.

“New Yorkers will be able to select from any of the 16 qualified health insurers and 10 dental insurers across four levels of plans — bronze, silver, gold or platinum,” Mr. Kotary said.

Residents who do not have insurance, those who pay for unaffordable insurance — when premiums total more than 9.5 percent of annual income, and those who experience specific life-changing events, such as having a baby or getting married, can shop for insurance through the marketplace. People who are insured, but pay less than 9.5 percent cap, will remain in their plans.

To help local residents decide which options are the best for them, NYS State of Health has contracted with the four local organizations to provide step-by-step guidance.

“We can’t help them choose a plan, but can show them their options,” said Steve Wood, community health coordinator of Community Health Advocates, a program offered through ACR Health. “A big part of our job is showing the plans and processing through that.”

ACR Health, he said, already receives about 20 calls daily about the setup, and now navigators are just waiting for Tuesday to get here.

Mr. Wood said a navigator’s role will be to have a brief conversation on why it’s important to have health insurance, take down the client’s personal information, plug that into the system and go through plans that come up.

Donna Hynes, insurance program coordinator at North Country Prenatal/Perinatal Council, said people can mull over information after their appointment, and either go back online and select a plan or come back to a navigator and have that person help them finish up with the process.

Mr. Wood said aside from the five-year navigator contracts, agencies expect to be even more busy continuing to enroll people in Medicaid and Child Health Plus throughout the year.

Since the entire system is new, Mrs. Hynes said, she does not know how long appointments will take, nor the extent of how busy or booked navigators will be. She said the council has more than 300 letters going out to people within Jefferson and Lewis counties who have been waiting for Tuesday to arrive.

“So many people need coverage,” she said.

That includes small businesses and their employees. Lynn M. Pietroski, chief executive officer and president of the Greater Watertown-North Country Chamber of Commerce, said the organization’s Small Business Assistance program has helped educate small businesses regarding their options since March.

“This is one of the largest initiatives in New York state, and what better way to be than to be a conduit to businesses and community members,” Mrs. Pietroski said. “If people come here and see us as a resource, then we’ve fulfilled our mission. The unknown is awful, but there’s a lot of things in place that will help with those unknowns.”

For more information, contact the NYS State of Health at 855-355-5777 or www.nystateofhealth.ny.gov; ACR Health at 475-2430 or www.aidscommunityresources.com; North Country Prenatal/Perinatal Council at 788-8533 or www.ncppc.org; the Health Initiative at 261-4760 or www.gethealthslc.org, or the chamber at 788-4400 or www.watertownny.com. An interactive map with statistics on insurance coverages is available at http://covernys.nyshealthfoundation.org/#19.

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