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CPBJ Extra Blog

The marketplace questions start

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This week, I'd like to welcome you to my email inbox.

Don't panic; it's not the whole thing. I'm not actually trying to inspire readers to flee in terror.

It's not even unabridged. In fact, it's just a summary. Here's a blow-by-blow.

• As required, my company promulgated the "Obamacare marketplace will be available" notice. And the cover letter plugged my coverage of the issue. (My company is affirming like that!)

• Co-worker emailed: currently gets coverage for stay-at-home spouse and young kids through the company, wonders if it would be possible to cut back to individual and go to the marketplaces for the rest of the family.

• I canvass my brain, determine that I have vague inklings, not a watertight answer.

• I check out our health care reform expert advisory panel's roster of answered questions. This isn't among them, but I think it should be, so I submit it. (I recommend this course of action, by the way.)

• I respond to the questioner with a report of what I've done, and this: "I will say that if you can shop on the marketplaces for their coverage, you'll want to pay close attention to the deductibles and networks. Based on speculation I've seen, you may see significantly higher deductibles and smaller networks in the marketplace plans than your current plan has."

• The same day, I get an answer from one of the experts, and affirmation of said answer from another. I make sure I understand by restating said answer in my own words, and get quick confirmation that I am correct.

And now, because I am sure that by this point I have you sufficiently interested, here's the answer in my words.

If your employer offers you adequate coverage that does not, for your single plan, cost more than 9.5 percent of W-2 earnings, you don't qualify for subsidies that are the big draw for the new Obamacare marketplaces. And if said single plan passes the affordability test — no matter how much it costs to have your spouse and children on your plan — if that coverage is available to them, they don't qualify for the Obamacare subsidies either.

And yes, it has been called a glitch, and worse. But it's where things currently stand.

• • •

I have received at least two news releases citing websites as places for people to access information about Obamacare, specifically in reference to the new marketplaces. One is run by the Pennsylvania Insurance Department, and the other is run by Penn State Extension specialists.

I haven't spent much time perusing them, for this reason: Healthcare.gov exists. It's supposed to be the one-stop shop. And whether it actually is — to date it has, in my estimation, had a lot of verbiage that essentially says, "All the details you really need are coming later" — it's as close to the source as you can get. So you might as well start there.

• • •

For those who want personal help navigating the new individual Obamacare marketplace, I suggest visiting localhelp.healthcare.gov.

• • •

Cumberland County-based Rite Aid Corp. has been named the first national retail partner of text4baby, the nation's largest mobile health information service, which is free and designed for pregnant women and mothers of infants under age 1. Rite Aid will provide 10,000 free flu shots to text4baby mothers this flu season.

Women who text "RABABY" or "RABEBE" to 511411 will receive three free text messages per week throughout their pregnancy and baby's first year, in English or Spanish, respectively. The interactive messages are personalized to the mother's due date or baby's birth date. Topics include safety, nutrition, birth defects prevention, safe sleep, developmental milestones and more.

Beginning Oct. 15, text4baby will notify those enrolled in the program about the availability of free flu shots from Rite Aid. Mothers who wish to receive a flu shot will text a reply and receive a unique code to use at any Rite Aid to redeem their free flu shot.

Text4baby has reached more than 600,000 moms since launch in 2010. It is a service of the nonprofit National Healthy Mothers, Healthy Babies Coalition, provided in partnership with Voxiva with support from founding sponsor Johnson & Johnson. It provides free materials and resources for more than 1,000 partners nationwide. The service is free for participants thanks to The Wireless Foundation and participating mobile carriers.

• • •

Speaking of free things, Lancaster Cleft Palate Clinic was one of eight finalists in Ephrata-based GSM Roofing and the Gooding Group Foundation's second annual roofing giveaway, which was open to Lancaster County nonprofits. The clinic will receive roof repairs valued at approximately $5,000.

I mention this because according to a news release, "Each of the eight 501(c)(3) organizations entered in the contest were named as finalists to receive an award from GSM Roofing and the Gooding Group Foundation. All told, the GSM awards totaled nearly $30,000."

So if you're a Lancaster County nonprofit and if you have you have a roof issue and if there's a third annual edition of this giveaway, it would might behoove you to enter it.

• • •

And speaking of nonprofits, United Concordia has launched a "Champions for Wellness" charity program that will split a donation of $25,000 between three charities: American Diabetes Association, March of Dimes and Arthritis Foundation. Votes on United Concordia's Facebook page will be used to determine which of the three receives first prize of $20,000, second prize of $3,000 and third prize of $2,000.

The program will end Nov. 30.

Do you think that charity program model would work for your company or nonprofit?

• • •

Ndlovu Women's Health has joined PinnacleHealth System's medical group and been renamed PinnacleHealth Obstetrics and Gynecology. It will continue operating at the same location in the PinnacleHealth Harrisburg Campus, Suite 4A of the Alex Grass Medical Sciences Building.

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