Health insurance enrollment fair held in Plainfield

The Plainfield Senior Center was the site of an AccessHealthCT enrollment fair on Jan. 15. Navigator Eva Csejtey and in-person assister David Sugrue were available to give one-on-one help to anyone interested in applying for health insurance coverage through the state's online marketplace.

The only enrollment centers for the state are in New Britain and New Haven. The enrollment fairs are part of an outreach effort on the part of the state to get the word out to communities about health care coverage. The fairs also provide opportunities for residents to get in-person assistance.

Csejtey and Sugrue went through 34 hours of online and group training, passed a certification exam with a minimum score of 80 percent and underwent background checks before qualifying to be assisters. Both of them came equipped with laptops, cell phones, health insurance know-how and telephone numbers that were assister-specific.

Sugrue helped a woman whose Cobra coverage had been terminated without her knowledge. The telephone lines were so busy she hadn't been able to get through to the AccessHealthCT call center. Sugrue helped her complete and file her application. Csejtey gave her the telephone number to the Office of the Healthcare Advocate to follow up on her Cobra termination.

The woman, who didn't want to give her name, left with confirmation of her new health care coverage. 'It hasn't been fun,' she said.

Csejtey also helped Kathy Wood, who came for help after months of trying to make sense of her insurance options. Wood learned in November that she would no longer be covered by the state's Husky program once the Affordable Care Act became effective. Confused about finding a plan that was affordable and unsuccessful with her online application or getting information over the phone, she came for help. 'I was a nervous wreck,' she admitted.

Sugrue said it usually takes anywhere from 20 to 45 minutes to complete an application on the website. Specific information is required for all family members who will be covered, such as employer and income information, citizenship or immigration status, and tax return information. That information must be entered in specific ways.

'The main difference between AccessHealthCT and the federal website is that the feds are serving 30 states,' Sugrue said. 'Connecticut took this on its own. This portal is so much better for people. The problems we have are small-scale compared to problems with the federal website.'

Data entry accounted for many troubles. If someone entered an initial instead of a middle name, the application wasn't accepted. Only technicians at the call center can fix that type of error. 'It's a technical problem, but it is fixable,' Sugrue said. 'There haven't been any system crashes or documented security issues.'

Once all the application information is entered correctly, a list of eligible health plans pops up. At that point, Sugrue's assistance turns to one of education. 'I'm not here to influence you, I'm here to make sure you know what the terms mean,' he said. Assisters and navigators can help with deciphering the benefits, costs and exclusions of available plans. Trained in health insurance lingo, they can explain what 'co-payment,' 'out-of-pocket maximum,' 'deductible,' 'co-insurance' and 'medical necessity' mean.

'If you don't have the right information, you don't have the right outcome,' Csejtey said. 'It helps to know a little about insurance plans and how the tax system works.'

Some common mistakes were made. For instance, many people don't click on the button that will show them what kinds of federal assistance they might be eligible for. 'Clicking 'yes' doesn't mean you have to choose those plans,' Csejtey said, 'but it will bring up a wider range of options.'

Wood called Csejtey's help instrumental. 'She didn't make me feel like I was a jerk or looking for freebies,' Wood said.

Individuals, families and small businesses have until March 31 to apply for health insurance under the Affordable Care Act. After that, penalties may be assessed for those without insurance. 'That's where the mandate comes in,' Sugrue said. Penalties will be assessed on those who haven't had insurance for three consecutive months, he said. That penalty will be 1 percent of your income or $95 a year. 'Every year that penalty will increase to influence more people to join,' he said.

For more information about enrollment fairs in the area, call the AccessHealthCT call center at 855-805-4325. Individuals with a hearing disability may contact the call center via the TTY: 855-789-2428.