Health Insurance Navigator
Lobstermen are independent business owners. They don’t have a Human Resources department to help them enroll in a health insurance plan. Many lobstermen have never had health insurance, or have been under-insured. The MLA has partnered with Fishermen’s Partnership Support Services (FPSS) and is serving as a “Navigator” to help Maine lobstermen and their families understand Affordable Care Act requirements including health insurance options, subsidies and penalties. The MLA is committed to ensuring that Maine lobstermen have the information they need to make an informed decision when it comes to health insurance enrollment.
- Open enrollment begins November 1, 2015 for coverage in 2016.
- You must be enrolled by December 15, 2015 for coverage to begin January 1, 2016.
- Premiums may not exceed 9.5% of an individual’s income
- Plans must cover 10 essential health benefits
- Out of pocket max is $6,600/individual or $13,200/family, no lifetime limits
- No denial for pre-existing conditions during open enrollment
- Catastrophic plans available to people under age 30
- You must have health insurance or pay a penalty when you file taxes
- REMEMBER: You qualify for Medicare at 65
Special Enrollment Periods (SEPs)
Even though enrollment is closed until November, you may be able to enroll in a health insurance plan if any of the following apply to you.
- Get married or lose coverage in a divorce
- Have or adopt a child
- Lose other insurance (MaineCare, employer plan, parents’ plan)
- Move to a new part of the state
- Become a US Citizen
- Become a member of a recognized Indian tribe
- Leave jail
If your income changes significantly and you qualify for subsides while you currently have insurance, you may qualify for a new plan.
Get a Quote
- Maine Community Health Options (MCHO) (http://www.maineoptions.org/Individuals-Families/Compare-Quote-Plans)
- Harvard Pilgrim (https://www.harvardpilgrim.org/portal/page?_pageid=213,5053992&_dad=portal&_schema=PORTAL)
Ready to Enroll
Health Insurance Marketplace (www.healthcare.gov)
Health Insurance Marketplace Call Center, open 24/7, call 1-800-318-2596
Health Insurance Marketplace paper application: http://marketplace.cms.gov/applications-and-forms/individual-short-form.pdf
Instructions for paper application: http://marketplace.cms.gov/applications-and-forms/individual-short-form-instructions.pdf
Health Insurance Marketplace Resources for Mainers (www.enroll207.com)
Subsidy Calculator: Kaiser Family Foundation (www.kff.org/health-reform/)
Consumers for Affordable Health Care (CAHC) (www.mainecahc.org)
We are required by law to protect the privacy of information used to apply for health insurance through a Health Insurance Exchange, that may reveal your identity. Information here means your Personally Identifiable Information. We are also required by law to provide you with a copy of this Privacy Notice which describes our legal duties and information privacy practices, as well as the rights you have with respect to your Information.
If you need help with your application, please sign the MLA Authorization Form and send it to April. The form allows April to assist you with your application and to talk with you concerning your Personally Identifiable Information. Download the MLA Authorization Form here.
Questions on the Health Insurance Marketplace?
Contact April Gilmore McNutt at 207-967-4555
© 2012 Maine Lobstermen's Association