Healthcare. The Affordable Care Act, Wyoming, and You. What s Inside: A basic ACA overview 2. Wyoming healthcare statistics 4

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1 Healthcare Reform The Affordable Care Act, Wyoming, and You What s Inside: A basic ACA overview 2 Wyoming healthcare statistics 4 How is the ACA going to affect you? 6 Warnings about penalties 12 Key dates you need to know 14

2 2 Healthcare Reform The Affordable Care Act, Wyoming, and You 3 Greetings, As the healthcare industry enters a new era of change, I d like to take this opportunity to reach out to you with information about your choice in health care and possible changes for next year and into the future. The Affordable Care Act created in 2010 is now becoming a reality. For us, it s been a journey to develop our plans so that they not only meet the federal requirements, but also give our members the best value we can. For you, it s a new opportunity to explore your options for healthcare plans, benefits, and costs. Stephen K. Goldstone At WINhealth, we ve long recognized the need for healthcare to do more than just provide protection against those what if moments in life your healthcare plan should help you live your best life. Through personal customer service, wellness programs, and education, we empower our members to take control of their own health. I m pleased to let you know that we have added new benefits to our health plans. Beginning in January, WINhealth plans will cover a set of preventive services, such as preventive visits and immunizations, plus screening tests including mammograms, colonoscopies and cholesterol tests, at no cost to our members, regardless of whether deductibles have been met. Also, coverage limits will disappear with new plans purchased for Our new plans will meet and in many instances exceed the Essential Health Benefits criteria for the ACA and we are excited to announce that we are able to offer them on the new insurance exchange, known as the Health Insurance Marketplace (Federally Facilitated Marketplace). If you re curious about our new plans, you can see them now that the Marketplace is open by visiting: winhealthplans.com and clicking the link at the top left of the homepage. On the Marketplace, you can also see if you qualify for an Advanced Premium Tax Credit or subsidy, and select a WINhealth ACAcompliant plan through the exchange. We hope you will call us if you have any questions about your health plan options. We are available at (307) , or you can visit our website any time at winhealthplans.com. Sincerely, Stephen K. Goldstone President & CEO, WINhealth See our calendar of important dates on page 14 to be sure you won t miss the window of eligibility for the Marketplace. The 5 Ws of the ACA the What The Patient Protection and Affordable Care Act (ACA) is the comprehensive federal health care reform law enacted in March Key Provisions of the Act: No more exclusions for pre-existing conditions New ways to purchase coverage plans Expanded coverage for young adults Tax penalties for the uninsured Advanced Premium Tax Credits (APTC), i.e. subsidies Tax credits for qualified small employers the when For 2014, the Open Enrollment Period is October 1, 2013 March 31, 2014 For 2015 and later years, the Open Enrollment Period is October 1 to December 7 For more information about Special Enrollment Periods and Qualifying Life Events, visit winhealthplans.com. the Why Intended to address rising health costs, the ACA is designed to provide more oversight of insurance premiums and practices, emphasize preventive care, reduce health care fraud and abuse, and foster comparison-shopping to increase competition and price transparency. the who No one plans to get sick or hurt, but most people need medical care at some point. Health insurance covers these costs and protects you from very high expenses. In 2011, almost 48 million Americans were uninsured. The ACA seeks to make it easier and more affordable for the uninsured to get coverage. the where The Health Insurance Marketplace is a new way to find quality health coverage. It can help if you don t have coverage now, or if you have it but want to look at other options. With one Marketplace application, you can learn if you can get lower premiums based on your income, compare your coverage options side-by-side, and enroll.

3 4 Healthcare Reform The Affordable Care Act, Wyoming, and You 5 Wyoming Healthcare Facts & Figures The Affordable Care Act (ACA) can be confusing it s long, complicated, and affects millions of people. It can be difficult to decipher just how it will have an impact on you or the residents of Wyoming. Below are some ACA facts and figures to help clarify what s new, what s changing, and what it means to you in Wyoming: OCT 1 83 The percentage of Wyoming residents currently insured through health care plans. For them, the ACA will provide more health plan choices and stronger coverage. The number of Wyomingites who are not currently insured. For these individuals, along with families and businesses who purchase their own health care coverage, the Health Insurance Marketplace will make new options available The earliest coverage start date if you sign up for health insurance during open enrollment (no later than December 15, 2013). 26 The maximum age at which children can remain on their parents health insurance plans. 82,494 that s 17% The open enrollment start date for the Health Insurance Marketplace, also known as the Health Exchange Jan The number of cents per premium dollar that health insurance companies are required to spend on health care or improvements to care, or else they must provide a refund $ 15,888,085 The amount of funding provided to Wyoming community health centers to support ongoing health center operations and to establish new health center sites, expand services, and/or support major capital improvement projects , The number of people in Wyoming who are already free from worrying about lifetime dollar limits on health coverage. The ACA also currently restricts the use of annual limits and bans them completely in ,000 The number of Wyomingites with private health insurance who gained preventive service coverage with no cost-sharing in 2011 and $ 2.2 $ 10 Mil The grant money received from the federal Prevention and Public Health Fund to support effective policies in Wyoming and its communities. 48,752 The number of National Health Service Corps (NHSC) clinicians providing primary care services in Wyoming. The NHSC repays educational loans and provides scholarships to certain primary care providers who practice in areas of the country that have too few health care professionals to serve the population. Mil The amount of money that Wyomingites saved on prescription drugs due to the ACA. The number of Wyoming individuals with traditional Medicare who used one or more free preventive services in Data provided by the U.S. Department of Health & Human Services, as of July 29, Visit for more information.

4 6 Healthcare Reform The Affordable Care Act, Wyoming, and You 7 How is the ACA going to affect you? Healthcare reform is going to impact all of us differently, based on our lifestyles, incomes, employment, and family status. We d like to introduce you to five people here in Wyoming who wanted to explore how health care reform will affect them. Here are their stories. 7 CARRIE PRE-EXISTING MEDICAL CONDITION Meet Carrie Pre-existing medical condition ERIC HUSBAND & FATHER MARCUS SMALL BUSINESS OWNER ALICE LOYAL PATIENT Carrie, 24, loves her job, but struggles to pay the monthly health insurance premium on her employer-provided plan and her rent, as well as other expenses. She doesn t want to drop coverage because she takes several medications and needs regular health screenings to manage her bi-polar disorder. How will the ACA help her? 11 TOM & SUSAN NEW PARENTS By checking the Marketplace, Carrie may find that a WINhealth plan is an affordable health insurance option. Since her bi-polar disorder is a pre-existing condition, she can t be denied coverage or charged a higher premium because of it. Plus, mental health services and treatments will now be covered by the Ten Essential Health Benefits provision. Carrie may qualify for an Advanced Premium Tax Credit (APTC), sometimes referred to as a premium subsidy, or she may decide she still cannot afford insurance and may be able to access dependent coverage on her parents plan until she is 26 years old.

5 8 Healthcare Reform The Affordable Care Act, Wyoming, and You 9 Meet Eric husband and father Meet Marcus small business owner Eric and his family have always received health insurance through an employer-provided plan, but recently he received a letter saying that his employer will cover only employees next year. Can his family get coverage through the Marketplace? What about Eric? Both individual and family plans are offered by WINhealth on the Marketplace. Some families will learn that they qualify for subsidies to help offset their monthly premiums or a tax break for signing up for insurance through the Marketplace. If Eric has questions about the plans available to his family, he should call a WINhealth advisor, a licensed broker, or a Navigator who will help him understand his options. Eric can also change plans along with his family during the Open Enrollment Period of Oct. 1, 2013 through March 31, 2014, but if Eric s group (employer) plan meets the Affordability & Adequacy criteria, he would not be eligible for the APTC subsidy and he may decide to stick with his employer s plan. Marcus is a small business owner with less than 25 employees. He values his employees and believes that providing benefits such as health care is one important factor in helping to attract and retain talented workers. Even though he wants to continue to offer health benefits, the costs have continued to rise higher and higher over the past few years, and now he s not sure he can afford the rates or that his employees are happy with the limited coverage. What are his options? Small businesses with fewer than 50 full-time employees face different obligations for the ACA and may have more advantages than larger businesses. The Small Business Healthcare Options Program (SHOP) Marketplace will offer small employers a choice of qualified health plans that make it easy to compare prices and benefits side-by-side. Marcus can get help from an insurance broker, a Navigator, or work with WINhealth to evaluate how much of his budget he can contribute toward his employees health care and he can explore his eligibility for the Small Business Healthcare Tax Credit.

6 10 Healthcare Reform The Affordable Care Act, Wyoming, and You 11 Meet Alice loyal patient Meet Tom & Susan new parents Alice likes her doctor, but she wonders if there is a more affordable health insurance option available to her. Can she keep her doctor? Depending on the plan Alice chooses in the Marketplace, she may be able to keep her current doctor. When comparing plans in the Marketplace, like the WINhealth plans, she will see a link to a list of providers in each plan s network. If staying with her current doctors is important to her, she can check to see if they are included before choosing a plan. Tom makes a great hourly wage, but his company doesn t provide benefits. His wife Susan works full-time but really wants to stay home with their new baby. Susan has high blood pressure and diabetes and has been told that if she leaves her job, she would have limited health insurance for the first two years because of her pre-existing conditions. Tom s salary is enough to allow them to meet their expenses, especially if they don t have to pay for childcare anymore, but Susan continues to work so the family can keep their access to affordable insurance. They both wonder if the Affordable Care Act (ACA) will allow them to change their lifestyle? Do you have specific questions or concerns about how the ACA will affect you? Share your story with us at winhealthplans.com and we ll be glad to discuss your options with you. The ACA prevents insurance companies from limiting or denying coverage to people with pre-existing conditions, so Susan may find that a WINhealth plan available through the Marketplace would allow her to make the career change she has been seeking. Getting WINhealth insurance through the Marketplace eliminates the need to depend on an employer for benefits, allowing members to switch jobs or stop working and still access affordable, quality health care.

7 12 Healthcare Reform The Affordable Care Act, Wyoming, and You 13 A warning about penalties The 10 Essential health benefits Why do we all need to What if I don t have health have insurance? coverage in 2014? When someone without health coverage There are a few exemptions, needs urgent (often expensive) medical but people who can afford to treatment but cannot pay the bill, these take responsibility for their uncompensated costs spread across healthcare and choose not to everyone else and we all end up paying have coverage will have to pay a higher price. a penalty. What s the big concern? Anyone without health coverage will also have to pay the entire cost of all his or her medical care and there s no more protection from very high medical bills that can sometimes lead to bankruptcy. All private health insurance plans offered in the Marketplace will include the same set of essential health benefits. These are services all plans must cover. The essential health benefits include at least the following items and services: Ambulatory patient services (outpatient care you get without being admitted to a hospital) Emergency services Hospitalization (such as surgery) Maternity and newborn care (care before and after your baby is born) WINhealth plans meet the requirements for all 10 Essential Health Benefits and even provide additional coverage for our members. See exactly what each plan offers and compare your options side-by-side in the Marketplace. The fee in 2014 is 1% of your yearly income or $95 per person for the year, whichever is higher. The fee increases every year. In 2016 it is 2.5% of income or $695 per person, whichever is higher. In 2014 the fee for uninsured children is $47.50 per child. The most a family would have to pay in 2014 is $285. The penalties $695pp Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy) Prescription drugs Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills) Laboratory services Preventive and wellness services and chronic disease management Remember, if a person fails to enroll during Open Enrollment, he or she won t be eligible to enroll or receive a subsidy (APTC) until the next open enrollment period unless there is a qualifying event. $95pp Pediatric services If you d like more explanation about what these benefits mean or if you have questions about any of these services, please visit our website or contact us. For more information about Exemptions or insurance that qualifies as minimum essential coverage, visit winhealthplans.com.

8 14 Healthcare Reform The Affordable Care Act, Wyoming, and You 15 dates to remember Enrollment reopens on October 1, If you re not sure what to do in between that timeframe, call us and we ll help you understand your options. october 2013 NOVEMBER 2013 october FEBRUARY : Open enrollment begins for individuals 15: Last date to enroll in order for coverage to begin Mar 1, DECEMBER JANUARY Employers must notify employees of the ACA health insurance exchange NOVEMBER 15: Last day to apply for or renew a Freedom plan 16: WINhealth begins offering only ACA-compliant plans MARCH 15: Last date to enroll in order for coverage to begin Apr 1, : Open enrollment closes; last date to enroll in order for coverage to begin May 1, DECEMBER : Last date to enroll in order to start coverage on Jan 1, JANUARY FEBRUARY MARCH : Coverage begins for individuals and premium tax credits will be available to certain low-income individuals Individual Mandate starts, requiring individuals to obtain minimum essential coverage or pay a personal income tax penalty 15: Last date to enroll in order for coverage to begin Feb 1, 2014 We hope you will call us if you have any questions about your health plan. We are available at (307) , or you can visit our website anytime at winhealthplans.com.

9 PRSRT STD US POSTAGE PAID CHEYENNE, WY PERMIT NO East 20th Street Cheyenne, WY checklist to get ready Go to WINhealthplans.com, click the link to the Marketplace, then follow these steps. Create an account Apply for coverage* Pick a plan Enroll You will also need: Social Security Numbers (or document numbers for legal immigrants) Employer and income information for every member of your household who needs coverage (for example, from pay stubs or W-2 forms Wage and Tax Statements) Policy numbers for any current health insurance plans covering members of your household winhealthplans.com Visit our website to learn more, or stay up to date with us on Facebook at facebook.com/winhealthpartners A completed Employer Coverage Tool (you can find this on our website) for every job-based plan you or someone in your household is eligible for. (You ll need to fill out this form even for coverage you re eligible for but don t enroll in.)

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