Educating a small group of concerned SRJC students on the Affordable Care Act, speakers Matthew Heredia and Marie Wilson, certified enrollment counselors from the Petaluma Health Center, conducted their first seminar Nov. 20 at the Petaluma Campus. In previous webinars Heredia and Wilson tackled the key changes to, benefits of and enrollment processes for California health care for 2014.

“Twenty-five percent of SRJC students don’t have health insurance,” said Cheryl Higgins, a nurse practitioner at SRJC Student Health Services. Wilson gave a friendly reminder to the group that when students pay for registration it includes a health services fee. Students can visit the health center without any additional costs.

The Affordable Health Care Act, or Obamacare, will start Jan. 1, 2014. As a result of many upcoming health care changes, such as men and women paying the same price for insurance, “There is an increased access to health insurance,” Heredia said. Californians will have guaranteed coverage availability, insurance companies can’t drop individuals because of pre-existing conditions, age, or if they become ill, starting in the new year. The act phases out annual or lifetime limits that a health plan can place on most benefits an individual receives. Insurance companies can only raise their prices once a year.

“As long as your parents maintain their insurance, you can remain covered by them until age 26,” Wilson said, bringing good news to many SRJC students.

“Previously, those who had an annual income of $11,000 or less received free health insurance and now this law has changed to include those who earn an annual income of $15,914 or less,” Wilson said, explaining the new benefits under Obamacare.

People who already use health care provided by their employers will see caps placed on deductions for doctor visits and receive free preventative care. Although this law will not be in effect until 2015, full time employees of large companies whose employer currently doesn’t cover them will receive coverage. Small businesses with under 50 full time employees are not required to provide health insurance. Some, however, will be offered temporary tax breaks if they do.

Those who find their workplace coverage too expensive, along with individuals seeking to purchase their own coverage, can do so with the help of government-created marketplaces such as Covered California. The system will help individuals compare health insurance plans.

Families and individuals with lower incomes who don’t have access to insurance through their employer or a government program can calculate whether they qualify for premium assistance or Medi-Cal.

Providing a virtual shopping experience on its website, Covered California offers four levels of health coverage including Bronze, Silver, Gold and Platinum. The ‘metal tiers’ provide options based on the amount of health care an individual expects to use. Using the shop and compare tool, Wilson and Heredia demonstrated possible plans.

The Silver Plan has individuals or families paying a monthly premium along with 30 percent of their health care costs while the insurance company pays 70 percent of health care costs. Moving up through the tiers, monthly premiums become higher while doctor visits and services become lower.

All plans offered by Covered California provide the same services, including maternity care, mental health care, prescription drugs, vaccines, immunizations, colonoscopies, mammograms and hospital and doctor visits, to name a few.

Wilson and Heredia explained that older citizens who frequently use health care services would want a Gold or Platinum Plan. They encouraged SRJC students to consider a Bronze or Silver plan which has lower monthly premiums with higher service costs. “Go for the Silver,” both counselors repeated over the course of the seminar, explaining that it is the best option for young, generally healthy SRJC students.

“It’s up to the individual to do their homework and see what options are available,” Wilson said.

Options for enrollment include submitting an application by mail, over the phone, or by meeting with a certified enrollment counselor such as Wilson and Heredia for one-on-one assistance in finding the best health care option.

“Our culture in the U.S: you go along with your life and when you get sick you go see a doctor. You want to be healthy all the time,” Wilson said, urging her audience to get the care and coverage they need early on before something sets in or happens. Using a hypothetical scenario of being involved in a car crash, then receiving a medical bill of $80,000 Wilson explains the dangers of living without insurance.

The tax penalties for not having insurance are as follows: in 2014 an adult will be charged $95, and every child $47.50. In 2015 an adult will owe $325 and child $162.50. In 2016 an adult will owe $695 and child $347.50. An SRJC student said,

“It’s still nowhere near what you would be paying if you had insurance.” Total penalties for the taxable year will not exceed the national average of annual premiums of a Bronze level health plan.

Responding to a student questioning the ‘affordable’ in the Affordable Care Act, Wilson said, “Depending on your plan and the number of people in your household, the average cost is about $200 for middle income. Thinking that somewhere along the line you may want insurance, it’s so important to be insured.” Contact Covered California: www.CoveredCA.com, call (888) 975-1142 Open Monday-Friday 8 a.m. to  8 p.m. and  Saturday 8 a.m. to 6 p.m. Register at one of the eight locations in Santa Rosa or at various health service centers in the area.

•The enrollment period for coverage starting on Jan. 1, 2014 began Oct. 1, 2013 and ends Dec. 15, 2013.
•Consumers will have until March 31, 2014 to enroll for coverage starting on April 1, 2014.
•The deadline to receive premium assistance in 2014 is April 1, 2014.
•People who are unemployed in 2014 can enroll in Covered California.
•Oct. 15, 2014 – Dec. 7, 2014: open enrollment will begin for coverage in 2015.