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Marketplace Information 

Hereís a quick rundown on the most important things to know about the Health Insurance Marketplace, sometimes known as the health insurance ďexchange.Ē Follow the links for more information on each topic.

The new Health Insurance Marketplace helps uninsured people find health coverage. When you fill out the Marketplace application it will tell you if you qualify for:

No matter where you live, you can use the Marketplace. In Michigan, the Marketplace is run by the Federal government. Enroll Michigan assists Michigan residents with enrolling in the Marketplace and in locating in-person assisters who can guide you through the process.

Most people must have had health coverage in 2014 or they pay a fee.

If you didnít have coverage in 2016, youíll pay the higher of these two amounts at the filing of your 2016 federal tax return:

  • 2.5% of your yearly household income. (Only the amount of income above the tax filing threshold, about $10,000 for an individual, is used to calculate the penalty.) The maximum penalty is the national average premium for a bronze plan.

If you donít have coverage in 2016, youíll pay the higher of these two amounts:

  • 2% of your yearly household income. Using the percentage method, only the part of your household income thatís above the yearly tax filing threshold ($10,150 for individuals, $20,300 for couples filing jointly in 2014, the most recent year available) is counted. The maximum penalty is the national average premium for a bronze plan.
     
  • $695 per adult for the year ($347.50 per child under 18). The maximum penalty per family using this method is $2,085.

Youíre considered covered if you have Medicare, Medicaid, CHIP (i.e., MI Child), any job-based plan, any plan you bought yourself, COBRA, retiree coverage, TRICARE, VA health coverage, or some other kinds of health coverage. 

If youíre eligible for job-based insurance, you can consider switching to a Marketplace plan. But you wonít qualify for lower costs based on your income unless the job-based insurance is unaffordable or doesnít meet minimum requirements. You also may lose any contribution your employer makes to your premiums.

If you have Medicare, youíre considered covered and donít have to make any changes. You canít use the Marketplace to buy a supplemental or dental plan.

Marketplace open enrollment ends February 15, 2015.

Questions? Call 24 hours a day, 7 days a week: 1-800-318-2596 (TTY: 1-855-889-4325) or call the tri-county health department and talk to a certified navigator at:

Branch County:  517-279-9561, ext. 0104# or 0337#

Hillsdale County:  517-437-7395, ext. 0104# or 0337#

St. Joseph County:  269-273-2161, ext. 0104# or 0337#

 

How to Apply for Marketplace Coverage?

You can apply for health coverage in the Marketplace 4 ways: with a paper application, online, by phone, or in person with an assister.

Get status updates about HealthCare.gov site performance and the actions weíre taking to improve your experience.

Apply with a paper application

You can fill out a paper application and mail it in. Youíll find out whether youíre eligible for lower costs on private insurance, Medicaid, or the Childrenís Health Insurance Program (CHIP).

Once you get your eligibility notice, you can either go online to compare, choose, and enroll in a plan or contact our call center. A customer service representative will help you.

If you or someone on your application is eligible for Medicaid or CHIP, a representative will contact you to enroll.

To get a paper application, download the application form and instructions.

Apply online in 4 steps:

When you apply online, youíll follow a 4-step process:

  1. Set up an account. Start by going to the Marketplace page. First you'll provide some basic information. Then choose a user name, password, and security questions for added protection.
     

  2. Fill out the online application. You'll provide information about you and your family, like income, household members, current health coverage information, and more. This will help the Marketplace find options that meet your needs. Important: If your household files more than one tax return, call the Marketplace Call Center at 1-800-318-2596 (TTY: 1-855-889-4325) before you start an application. This is a very important step. Please donít skip it. Representatives can provide directions to make sure your application is processed correctly. 

Before you begin, it may help to have this information ready:

  • Social Security number (SSN)

  • Document number (if youíre an eligible immigrant who wants health coverage)

  • Birth date

  • Paystubs, W-2 forms, or other information about your income

  • Policy/member numbers for any current health coverage

  • Information about any health coverage from a job thatís available to you or your family  

  1. Compare your options. You'll be able to see all the options you qualify for, including private insurance plans and free and low-cost coverage through Medicaid and the Childrenís Health Insurance Program (CHIP) (i.e., MI Child). The Marketplace will tell you if you qualify for lower costs on your monthly premiums and out-of-pocket costs on private insurance. Youíll see details on costs and benefits to help you choose a plan thatís right for you.
     

  2. Enroll. After you choose a plan, you can enroll online and decide how you pay your premiums to your insurance company. You must pay your premium by the date the insurer provides before your coverage can begin. Payments must be received by December 15, 2016 to assure that you are covered for 2017. If you or a member of your family qualifies for Medicaid or CHIP, a representative will contact you to enroll.

Learn what you can do to get ready to enroll. If you run a small business, hereís what you can do to get ready to offer coverage for your employees in the SHOP Marketplace.

If you have any questions, thereís plenty of live and online help along the way.

Apply by phone or with an in-person assister

  • To apply by phone, call 1-800-318-2596, 24 hours a day, 7 days a week (TTY: 1-855-889-4325). A customer service representative will work with you to complete the application and enrollment process.
     

  • You can also apply with the help of an assister who can sit with you and help you fill out a paper or online application. The Branch-Hillsdale-St. Joseph Community Health Agency offers trained and certified navigators and application counselors in each of its three county offices.  We are currently taking appointments.  Call and ask to talk to a Navigator to schedule an appointment:

Branch County: 517-279-9561, ext. 0104# and 0337#

Hillsdale County: 517-437-7395, ext. 0104# and 0337#

St. Joseph County: 269-273-2961, ext. 0104# and 0337#

Find in-person help

In all states, there are people trained and certified to help you understand your health coverage options and enroll in a Marketplace plan. Theyíre known by different names, depending on who provides the service and where theyíre located. All can provide the help you need with your application and choices.

Or you can visit LocalHelp.HealthCare.gov to find help in your area. You can search by city and state or zip code to see a list of local organizations with contact information, office hours, and types of help offered, such as non-English language support, Medicaid or MI Child enrollment, and Small Business Health Options Program (SHOP).

Types of In-Person Assisters?

Certified application counselors, navigators, in-person assistance counselors, and other assisters: These are professional individuals or organizations that are trained to help consumers looking for health coverage options through the Marketplace, including help with completing this application. Services are free to consumers. You can ask to see certification showing theyíre authorized to perform this work. They can help you complete this section. The ID number is the navigatorís identification number. This is a unique alphanumeric ID (13 letters and numbers) given to each navigator.

Agents and brokers: Agents and brokers can help you apply for help paying for coverage and enroll in a Qualified Health Plan (QHP) through the Marketplace. They can make specific recommendations about which plan you should enroll in. Theyíre also licensed and regulated by states and typically get payments or commissions from health insurance companies when they enroll consumers. They can help you complete this section.

List both ID numbers for agents and brokers:

FFM User ID: A unique ID that the agent or broker creates when registering with the Marketplace.

National Producer Number (NPN): A unique number (up to 10 digits) thatís assigned to each licensed agent or broker. An NPN can be easily located by going to the National Insurance Producer Registryís website at www.nipr.com.

Permission for information submitted:  By submitting this application, you represent that you have permission from all of the people whose information is on the application to both submit their information to the Marketplace, and receive any communications about their eligibility and enrollment.

Privacy Protection

Privacy Act Statement (effective 09/01/2013)

We are authorized to collect the information on this form and any supporting documentation, including social security numbers, under the Patient Protection and Affordable Care Act (Public Law No. 111-148), as amended by the Health Care and Education Reconciliation Act of 2010 (Public Law No. 111-152), and the Social Security Act.

We need the information provided about you and the other individuals listed on this form to determine eligibility for: (1) enrollment in a qualified health plan through the Federal Health Insurance Marketplace, (2) insurance affordability programs (such as Medicaid, CHIP, advanced payment of the premium tax credits, and cost sharing reductions), and (3) certifications of exemption from the individual responsibility requirement. As part of that process, we will verify the information provided on the form, communicate with you or your authorized representative, and eventually provide the information to the health plan you select so that they can enroll any eligible individuals in a qualified health plan or insurance affordability program. We will also use the information provided as part of the ongoing operation of the Marketplace, including activities such as verifying continued eligibility for all programs, processing appeals, reporting on and managing the insurance affordability programs for eligible individuals, performing oversight and quality control activities, combating fraud, and responding to any concerns about the security or confidentiality of the information.

While providing the requested information (including social security numbers) is voluntary, failing to provide it may delay or prevent your ability to obtain health coverage through the Marketplace, advanced payment of the premium tax credits, cost sharing reductions, or an exemption from the shared responsibility payment. If you donít have an exemption from the shared responsibility payment and you donít maintain qualifying health coverage for three months or longer during the year, you may be subject to a penalty. If you donít provide correct information on this form or knowingly and willfully provide false or fraudulent information, you may be subject to a penalty and other law enforcement action.

In order to verify and process applications, determine eligibility, and operate the Marketplace, we will need to share selected information that we receive outside of CMS, including to:

  1. Other federal agencies, (such as the Internal Revenue Service, Social Security Administration and Department of Homeland Security), State agencies (such as Medicaid or CHIP) or local government agencies. We may use the information you provide in computer matching programs with any of these groups to make eligibility determinations, to verify continued eligibility for enrollment in a qualified health plan or Federal benefit programs, or to process appeals of eligibility determinations;
     

  2. Other verification sources including consumer reporting agencies;
     

  3. Employers identified on applications for eligibility determinations;
     

  4. Applicants/enrollees, and authorized representatives of applicants/enrollees;
     

  5. Agents, Brokers, and issuers of Qualified Health Plans, as applicable, who are certified by CMS who assist applicants/enrollees;
     

  6. CMS contractors engaged to perform a function for the Marketplace; and
     

  7. Anyone else as required by law or allowed under the Privacy Act System of Records Notice associated with this collection (CMS Health Insurance Exchanges System (HIX), CMS System No. 09-70-0560, as amended, 78 Federal Register, 8538, March 6, 2013, and 78 Federal Register, 32256, May 29, 2013).

This statement provides the notice required by the Privacy Act of 1974 (5 U.S.C. ß 552a(e)(4)). You can learn more about how we handle your information at healthcare.gov/privacy/.

Before you apply, preview plans and estimated savings

Before you fill out a Marketplace application, you can do 2 things to learn your options:

By using both the Kaiser calculator and the plans and prices tool together, you'll be able to see the plans and full prices available to you, and find out whether you'll qualify for lower costs.

If your income is too high to qualify for lower costs, there are 4 ways you can buy a health plan.

Small business coverage: If you own a small business and want to apply for SHOP coverage for your employees, youíll follow a different process. Begin that process now. Select your state from the drop down menu. Then click the green button to take the next step.

Still Need More Information?

For more information, contact your local county health department office or visit Healthcare.gov.

 

570 N. Marshall Rd
Coldwater, MI  49036

517-279-9561
20 Care Drive
Hillsdale, MI 49242

517-437-7395
1110 Hill St.
Three Rivers, MI  49093

269-273-2161
 
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