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More competition, less angst over keeping policies likely when NC's Obamacare market reopens

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RALEIGH, North Carolina — The last-minute confusion over a new program has died down. The website should work. And people in North Carolina who liked health insurance coverage they had prior to new requirements of the Affordable Care Act can still keep it, at least for two more years.

The second open enrollment period under President Barack Obama's signature health insurance overhaul is ramping up. The three-month period for people buying subsidized policies on an insurance market expanding to three companies kicks off Nov. 15.

North Carolina was among the top states for people buying health insurance on the state's federally run marketplace over the first enrollment period, a six-month term that ended in March. Almost 360,000 people signed up for private insurance plans, nearly doubling initial expectations.

The health law, which many critics refer to as "Obamacare," requires most Americans to have health insurance or risk fines. The law also provides subsidized coverage to people who don't get it at work. The amount of a consumer's insurance tax credit can vary by income, family size, hometown and other factors, all of which makes sorting through the choices confusing.

That's why the federal government is giving community groups $2.3 million to return to churches, libraries, and local festivals with people trained to navigate the complicated law.

Thousands of people who don't pay attention to news on broadcast, online or printed media still don't know that the new health care law includes subsidies that helped 90 percent of those who purchased coverage last year to pay for it, said Jennifer Simmons, a Legal Aid of North Carolina attorney heading the organization's statewide insurance enrollment efforts.

"So we have this new pocket of people that weren't aware. We have people that were aware and chose not to do anything, and this year they may be coming in with the reality of the fine or tax penalty that's going to be assessed," Simmons said. "Getting that word out to people and then helping them actually enroll is our big task and we're more dedicated to it this year even than we were last."

Efforts will range from large-scale events to personal appointments, she said. Navigators are trained to explain the new insurance marketplace but don't provide financial advice or point consumers toward one policy over another, Simmons said.

"I'm not a salesperson. I don't get a commission," she said. "I want to make sure they understand their options and are taking the action that's right for them and their family."

One thing you won't see during this enrollment period: a wave of complaints about old policies being canceled because they don't meet the law's requirement to cover pre-existing conditions, hospitalization or other costs.

It was more than a month into the last enrollment period when Obama last November decided to allow a one-year extension for people to keep their individual policies. In March, the Obama administration announced another two-year extension and North Carolina's regulator followed suit.

More than 120,000 Blue Cross Blue Shield of North Carolina policyholders facing cancellations last year chose to keep their old plan. Many were younger, healthier people with policies that covered less than the ACA required and cost less.

Blue Cross and most of the other 14 insurers that allowed customers to keep their old policies are allowing further extensions until 2016, state Insurance Department spokeswoman Marni Schribman said.

Only Blue Cross offered insurance plans statewide on the exchange. Coventry Health Care, a division of industry giant Aetna Inc., sold policies to consumers in more than a third of the state's 100 counties. Both will be back again this time. And they could get new competition if UnitedHealthcare, the state's second-largest health insurer after Blue Cross, follows through with plans to sell marketplace policies.

Meanwhile, nine small health insurers have decided to cancel their policies and withdraw from the state since December, according to the state Insurance Department. They had as few as one policy in North Carolina and no more than 742 customers. Eight similarly small companies exited the state market in the first 11 months of 2013, the state agency said.

Blue Cross is waiting for approval from state regulators before disclosing the premiums it will charge for transition policies, plans offered on the exchange marketplace and individual policies sold elsewhere, spokeswoman Ryan Vulcan said.


Emery Dalesio can be reached at http://twitter.com/emerydalesio.

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