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4 health insurance paths taken

Health insurance reform expands range of employment choices

Carolyn and John Sheridan are exploring their options for
health insurance. Carolyn worked away from their Greenville, Iowa, farm for 36
years. “Health insurance has been my responsibility for most of these years,”
she says. John and their two children were on her policy. Then a few years ago,
John was injured in a farm-related incident, and they learned that his medical costs
were excluded from their insurance coverage. “We realized we needed to buy John
a separate policy,” she says. In a few weeks, Carolyn is leaving her job to
work full time as clinical director for the AgriSafe Network, but she no longer
will have insurance through her employer. She visited the Health Insurance
Marketplace, compared policies, and submitted an application. John plans to
keep his policy for at least another year. Their daughter, who is
self-employed, and her husband are comparison-shopping for a policy on the
Marketplace. The newlyweds, ages 24 and 26, may qualify for tax credits or
subsidies, Carolyn says.

Staying with the status quo seems the best option in the short term


Mandi and Traci Goretska are curious if they could do better
for their insurance needs on the Health Insurance Marketplace. The Corydon,
Iowa, couple has two children, ages 13 and 4.

Their insurance is through the Iowa Farm Bureau; it’s a
Wellmark Blue Cross of Iowa policy. “We pay $1,000 per month out of pocket for
our policy,” Mandi says. “We’re happy with the coverage, but that’s a lot of

When Mandi visited the website last fall, she was unable to
get through the process. “Wellmark isn’t participating in the Exchange this
year but plans to in 2015,” she says. “It would be too much of a headache to
change policies this year and possibly switch again in 2015. We’ll stay with
our insurance.”

Younger employees are prime candidates for new insurance


Chantale and Aaron Nadeau insure their family of five through
her job as a public health nutritionist at the Vermont Department of Health.
She compared policies on the Vermont Health Connect Marketplace and found that
none would improve upon her current insurance coverage.

The ACA doesn’t require the Derby, Vermont, dairy farmers to
provide insurance to their three employees. “We’re encouraging two of them to
look into policies on the Vermont Marketplace,” Chantale says. “They’re young –
exactly the group that’s needed to enroll.”

Their employees, Sheena and Nick, already are winners,
remaining on their parents’ insurance policies until they turn 26 in 2014.
Catastrophic insurance is available in the Marketplace for those under 30 years
old (without tax credits or subsidies). Vermont has expanded its health
insurance and broadened eligibility for Medicaid. “Many farmers have
benefitted, and it helped lay the groundwork for ACA here,” Chantale says.

After exhausting all other options, she crosses the
healthCare.Gov finish line


Carol Bork, 58, provided insurance for her husband and family
through her job as an R.N. until she had to retire in 2011 after suffering
incapacitating back pain. Her COBRA policy ran out 18 months afterwards, and
the Ogden, Iowa, farm woman was turned down when she applied for insurance in
the individual market. She obtained coverage from the Iowa High-Risk Pool for
$780 per month, with a high deductible and co-pay. “I used up my small
pension,” she says. 

On October 1, she logged onto “It was glitchy at first, but I kept going back,” she says. She
sought help from a navigator at 800/318-2596 who could view her computer screen
remotely. “I was determined and kept going,” she says. “That’s what farmers
do.” She attended an Iowa State University Extension health care workshop. “It
made me more secure about the process,” she says. The next day she clicked on
Live Chat on the website and received help. Then she clicked Confirm. That was
November 27. Carol’s Platinum-level coverage pays 90% of all bills, with a
$1,000 out-of-pocket maximum and a $500 deductible. “I’ll pay $35 less per
month and have free preventive health services,” she says. The Borks don’t
qualify for premium tax credits or reduced co-pays.

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