You may or may not be surprised to hear that there are three different versions of the application, of course these are “paper” or PDF versions of the application and would be required to be mailed in once completed.
I assume (hope) that this process will be streamlined when the online application process goes live with the rest of the marketplace. However, this should give you a good sneak peek at what you are in store for come October.
Individual Short Form
You will want to complete this application if you are applying for coverage by yourself and wish to seek financial assistance. That means if you want to see if your income qualifies you to receive federal tax credits to lower your health insurance costs.
Here you will be required to provide your basic information, name, address, city, etc. All of which is fairly standard until you get to question 23, which asks. “Are you pregnant, if yes how many babies are you expecting during this pregnancy.”
Outside of the fact I have never seen a health insurance company ask how many babies you were having at one time, the main question itself is irrelevant. It doesn’t matter if you are having octuplets, you will have to be approved.
The irrelevant questioning doesn’t stop there. The very next question, number 24 asks if you have a physical, mental, or emotional health condition that causes limitations in activities (like bathing, dressing, daily chores, etc.) or live in a medical facility or nursing home?
Again, your answer should have no bearing on the outcome of your health insurance.
This step is all about your current employment status. They are going to get fairly specific here, since this is what will determine the amount of assistance you receive towards your premium.
You will have to provide information like wages earned, average hours worked, even how much you have left to pay on your student loan.
All of this information is fairly relevant to determining the cost of your health insurance, so you will want to be as detailed as possible.
Here you will need to provide what other health coverage you currently have. You will need to check if you are on any other government funded programs or have other coverage. You will need to provide the name and policy number for that existing private health insurance policy.
You should be able to see the light at the end of the tunnel now. This is the “terms and conditions” section of the application, basically letting you know what’s what.
This information is all pretty standard, except for the “Renewal of Coverage in Future Years” portion.
You have the option to allow the federal government to pull your tax information and essentially automatically renew your marketplace eligibility for 1-5 years. You also can also obviously opt out of the automatic renewal process.
Depending on your feelings of letting the government stick it’s hand in your cookie jar, I know there are plenty of secret squirrels out there who will probably not be comfortable with this.
This final step simply provides you with instructions on how and where to mail your completed application.
They saved the best for last. This is the most important part of the application. If you are working with someone, like myself, that is helping you through the process, you are going to want to make sure their information appears in this section. If not, then it’s very likely they will not be able help you with the policy and application moving forward.
The family application is largely the same as the single, with the exception, yep you guessed it, provides room to include your spouse and dependents.
This is where things get a little intense. This portion of the application is designated for uncovering any premium tax credits you might be eligible for if your employer isn’t offering “affordable coverage.”
Essentially this is the government's way to cross-reference and weed out companies not playing by the rules. That means you could inadvertently blow the whistle on your employer if there plan does not meet the affordability standards or have not paid their fine for not offering health insurance (only applicable to companies with 50 or more employees).
Employer Coverage Tool
This is essentially a duplicate of Appendix A. I haven’t been able to figure out the reasoning behind this page or the purpose it servers. If/when that happens, I will be sure to let you know.
This page is designated for any American Indian or Alaska Native Family Members. There’s just a few questions here and they are very straight forward and help to determine your eligibility based on that family history.
This is the same as on the single family, but it’s never a bad idea to remind you, this is the section that needs completed to grant your independent insurance agent or broker (that’s me) permission to continuing assisting you with your marketplace health insurance.
Individual without Financial Assistance
If you find yourself getting ready to complete this application, you might want to stop.
The main reason you are going to want to buy coverage through Ohio’s health care marketplace is to receive those tax credits. As of right now, that is the only difference between buying a plan inside or out of the marketplace.
This application is going to have all the same sections as the previous two with the exception of all the work and income information. That means you will need to included basic information for you and or your entire family and read over the disclosures and submit the application.
The Bottom Line
Now that medical underwriting will become a thing of the past, an insurance application could fit on a note card.
Don’t let the government tell you their three and seven page applications have been “simplified and significantly shortened.” or that they are “shorter than industry standards for health insurance applications today.”
90 percent of today’s insurance applications are dedicated to medical questions. When those questions are no longer necessary, any health insurance application government or private will be substantially shortened.
If you still have questions about the marketplace application, make sure you watch the video walk through, as it will give you a lot more detail on how to properly complete it.
What about you, what are you planning to do when Ohio’s marketplace finally goes live?