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PAGE 2 COVER OREGON OVERVIEW FOR PROVIDERS Betse Thielman, Provider Campaign Coordinator OCTOBER 2013
PAGE 3 What is Cover Oregon and who will it serve? How does the Cover Oregon application work? How will providers be affected by Cover Oregon? How can providers help their communities know about Cover Oregon and access coverage? WHAT WE’LL COVER TODAY
PAGE 4 Cover Oregon is a new online marketplace where Oregonians can compare and enroll in health insurance that fits their needs and budget, and access financial help. WHAT IS COVER OREGON?
PAGE 5 BACKGROUND Created in 2011 by Oregon Legislature Formed as public corporation Key piece of Affordable Care Act Custom-built for Oregonians
PAGE 6 Can’t be denied for pre- existing condition Essential health benefits Financial help Medicaid expansion Requirement to have insurance Health insurance marketplaces (exchanges) Carriers must spend 80% of premiums on care CHANGES
PAGE 7 INDIVIDUAL PROGRAM: ONE DOOR Qualified Health Plans (With or without financial assistance) Oregon Health Plan and Healthy Kids
PAGE 8 INDIVIDUALS AND FAMILIES Financial help Clear information and price transparency Side-by-side comparisons One-stop shopping Quality coverage and grades Help enrolling
PAGE 9 ELIGIBILITY FOR FINANCIAL HELP
SMALL BUSINESSES Choice Clear information Set contribution Quality coverage Streamlined administration Access to tax credits Help enrolling
PAGE 11 EMPLOYER CHOICES
PAGE 12 HOME PAGE
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PAGE 15 PREMIUM COSTS VS. COST SHARE
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PAGE 18 INDIVIDUAL PRIVATE PLAN CARRIERS formerly ODS
PAGE 19 PUBLIC PROGRAMS
PAGE 20 DENTAL CARRIERS formerly ODS
PAGE 21 SMALL BUSINESS CARRIERS formerly ODS
PAGE 22 Now: Public awareness campaign and continuing development October 2013: Enrollment begins January 1, 2014: Coverage begins for OHP expansion and private insurance plans October – December 2014: Second open enrollment period TIMELINE
PAGE 23 Agents and Community Partners trained to help Oregonians COVER-OR (service center) 50 full-time and 100 temporary staff at Salem service center Help in multiple languages available HELP WITH APPLYING
PAGE 24 Multiple languages and formats available Ordering and submission process remains the same The same rules will determine eligibility whether submitted online or on paper PAPER APPLICATION (AVAILABLE WHEN NEEDED)
PAGE 25 DMAP Contracted Providers Grantees Volunteer Organizations All: Account creation process Criminal histories w/fingerprints General liability and automobile insurance Community Partner enrollment assistance training Regional collaboratives and list serv COMMUNITY PARTERS
PAGE 26 MANAGING EXPECTATIONS Honda Civic picture
PAGE 27 QUESTIONS?
For general questions about Cover Oregon: To get involved with outreach and enrollment assistance: Betse Thielman