Open Enrollment Starts Nov. 1 for Delaware's Health Insurance Marketplace

Press Release

As the COVID-19 pandemic continues, Delawareans seeking health insurance, especially those who have lost coverage, can shop for 2022 coverage through the Health Insurance Marketplace. Enhanced federal subsidies, which began earlier this year under the Biden administration, will continue for 2022. The subsidies have helped to reduce consumer costs by as much as 40%.

The marketplace's ninth open enrollment period started today, Nov. 1, and ends Saturday, Jan 15, 2022, atwww.HealthCare.gov, where consumers can renew existing coverage or sign up for a new plan. Coverage for enrollees who sign up by Dec. 15 and pay their first month's premium will take effect Jan. 1, 2022.

Individuals who don't act by Jan. 15, 2022, cannot get coverage for 2022 unless they qualify for a Special Enrollment Period based on circumstances such as a loss of qualifying health coverage, change of income, becoming a parent, or other qualifying factors.

Monthly premiums for 2022 plans in Delaware will be 3% higher on average than the 2021 plans, Insurance Commissioner Trinidad Navarro announced in August. Highmark Blue Cross Blue Shield Delaware is the sole health insurer offering plans on Delaware's Health Insurance Marketplace. Enrollees will choose one of 13 Highmark plans or they will be re-enrolled automatically in a plan similar to their current one.

This year's single-digit increase in premiums follows decreases the last two enrollment years, totaling more than 19%. Those base premium reductions and the overall stability of Delaware's Health Insurance Marketplace reflect continued federal approval of Delaware's reinsurance program. The program has lowered health insurance premiums for plans sold in the individual insurance market by partially reimbursing insurers for high-cost health care claims through a fund that uses a mix of federal funding and assessments collected by the Delaware Department of Insurance from health insurance carriers. Because the insurers' claims costs are lower, the insurers can reduce the cost of premiums or limit increases.

In addition, the Biden administration has made increased access to health insurance and affordability a priority by using American Rescue Plan Act funds to increase tax credits and expand subsidies further into the middle class. For instance, a family of four (both parents in their 40s) making $50,000 are eligible for a credit of roughly $16,500, compared with $14,300 previously. A majority of Delaware marketplace enrollees will be eligible for financial assistance, which can help reduce the cost of monthly premiums and/or deductibles, and lower out-of-pocket health care costs.

Through last year's Open Enrollment and a Special Enrollment Period held earlier this year for people who lost coverage because of the pandemic, about 30,000 Delawareans now have coverage through Delaware's Health Insurance Marketplace.

Federal tax credits are available for those whose household income is between 138% and 400% of the Federal Poverty Level. For 2022 coverage, that's between $17,775 and $51,520 for an individual, or between $36,570 and $106,000 for a family of four. For coverage in 2021, about 81% of enrollees in Delaware were eligible for tax credits, which help reduce the cost of the monthly premium.

"All Delaware families need access to affordable, quality health care," said Governor John Carney. "Delaware's reinsurance program has stabilized premiums on the marketplace and the Biden administration has enhanced federal subsidies to make coverage even more affordable, even reaching into the middle class. As we continue to battle COVID-19, having access to affordable coverage is especially critical. I particularly encourage small-business owners, independent contractors and individuals who don't have access to health insurance through an employer to check out the plans available on Delaware's marketplace."

Plans on the marketplace are spread among metal-level categories -- bronze, silver, gold, platinum and catastrophic -- and are based on how enrollees choose to split the costs of care with their insurance company. Bronze plans have low monthly premiums but high costs when you need care; gold plans have high premiums but lower costs when you need care. In a silver plan, the insurer pays about 70% of medical costs and the consumer pays about 30%. Consumers who pick silver health care plans might also qualify for additional savings through discounts on deductibles, copayments, and coinsurance. In Delaware, about 25% of current enrollees qualify for cost-sharing reductions. For any marketplace plan in 2022, individual consumers can't pay more than $8,700 in out-of-pocket medical costs and families can't pay more than $17,400.

For 2022, Highmark will offer 13 plans for individuals -- four gold plans, three silver, three bronze, two platinum and one catastrophic. Two dental insurers -- Delta Dental of Delaware, Inc. and Dominion Dental Services, Inc. -- will offer a collective 12 stand-alone dental plans on the marketplace, seven with a low actuarial level (71.6%) and five with a high actuarial level (84.2%).

All plans offer essential health benefits such as coverage of pre-existing conditions, outpatient care, emergency services, hospitalization, prescription drugs, mental health and substance use disorder services, lab services, pediatric services, birth control and breastfeeding coverage, and COVID-19 vaccines, including any necessary boosters. In addition, coverage cannot be terminated due to a change in health status, including diagnosis or treatment of COVID-19.

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