Online registration with Maryland's insurance marketplace, the Maryland Health Connection, got off to a smooth start this year, with thousands of residents successfully enrolling in a qualified health plan in the first day online registration was offered, according to officials.

Online self-enrollment kicked off Tuesday and, including those who registered through the inaugural enrollment fair in Glen Burnie on Nov.15, more than 4,000 Marylanders had registered for coverage through the exchange by 3 p.m. on Wednesday, according to Andrew Ratner, director of marketing and outreach for the Maryland Health Connection.

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This is in marked contrast to the inaugural launch of the Maryland Health Exchange in 2013, when website woes greatly hampered the initial registration process, according to Eric Masten, director of communications for the Door to HealthCare Western Maryland, a connector organization that provides enrollment assistance for residents in six western counties, including Carroll.

"We have come a long way since day one of last year … [Last year] we ended up relying on paper enrollment for folks in the first few days of open enrollment," Masten said.

While the Maryland Health Connection website has been working smoothly this time around, it is only one of several ways to enroll in a plan.

According to Masten, those who would like assistance with the process can speak with a health care navigator by calling Maryland Health Connection's consumer support center at 855-642-8572, or meeting with one in person at one of six Carroll County sites: the Department of Social Services, Carroll Hospital Center and its new Tevis Center for Wellness, the Business and Employment Resource Center, Access Carroll and the Carroll County Health Department.

Access Carroll and Social Services are the only walk-in sites, according to Masten — appointments at the other sites can be made by calling the Healthy Howard call center at 855-288-3667 — and officials there also reported a much smoother opening day than in 2013.

"The first day last year was just a disaster; I am going to be honest with you," said Tammy Black, executive director of Access Carroll. "This year we were bracing ourselves for whatever happened but [our navigator] Lisa Wack told me everything is smooth … everything is golden."

Wack said that Access Carroll saw 15 people come in to inquire about enrolling on Wednesday, most of whom enrolled at that time.

An enrollment count for all of Carroll County was not available by 5 p.m. Friday.

In 2013, however, 1,292 Carroll residents enrolled in private insurance plans through the Maryland Health Connection, according to Masten, while an additional 4,400 qualified for and enrolled in Medicaid coverage, the 5,692 total enrollments representing 37.7 percent of the estimated uninsured in Carroll.

There is a legal incentive for any remaining uninsured Carroll residents to explore getting coverage during the open enrollment period.

Health insurance for adults and their dependents is now required under the Affordable Care Act, also called Obamacare. This requirement, sometimes referred to as the individual mandate, will be enforced through a tax penalty charged to those who choose to forgo coverage last year, according to Masten. Those who choose not to obtain coverage this year will face an even larger fee.

"Individuals that were not covered last year, their potential tax penalty was 1 percent of their income or $95 per adult," Masten said. "This year that will actually increase to 2 percent, or $325 per adult, whichever is greater."

There are multiple ways to satisfy the insurance mandate, according to Masten, including coverage offered through an employer, Medicare or Medicaid, or coverage through a parent's plan up to age 26. Those without such coverage must purchase an insurance plan either directly through a private insurer, or through the Maryland Health Connection, where income-based subsidies are available, and where — in theory at least — competition between insurers should decrease the cost of plans even for those who earn too much to receive a subsidy.

Those who plan to purchase insurance through the Maryland Health Connection have until the end of the open enrollment period, Feb. 15, to do so, but Masten said that those who purchased a plan last year and received a subsidy must update their information by Dec. 18 if they wish to keep their plan and continue receiving that assistance.

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Those who have access to insurance through their employer or a spouse's employer are not eligible for subsidies if they choose to shop for a plan through the Maryland Health Connection, Ratner said. There are some exceptions, however: Plans that are not considered affordable or do not provide a minimum value of coverage could qualify employees for access to income-based subsidies.

"Employer coverage is considered affordable if the employee's share of the annual premium for self-only coverage is no greater than 9.5 percent of annual household income," Ratner said. "Employer coverage provides 'minimum value' if it covers 60 percent of health care costs on average."

A worksheet for determining whether an employer's insurance plan meets these standards is available online at healthcare.gov.

In addition to the Maryland Health Connection website, call center and in-person enrollment centers in Carroll County, there will also be enrollment events at various Carroll locations throughout the open enrollment period for those who have questions, according to Brian Mattingly, director of the Door to Healthcare Western Maryland.

"We'll also be holding enrollment activities … at the Carroll County libraries as well as at the community college," Mattingly said. "The best way for folks to get information on dates and times is to call our call center or check our website.."

Reach staff writer Jon Kelvey at 410-857-3317 or jon.kelvey@carrollcountytimes.com.

Health care enrollment basics

•To browse insurance plans or self-enroll: Go to marylandhealthconnection.gov

•To speak with a health care navigator or enroll by phone: Call 855-642-8572

•To get more information or make an appointment to meet face to face with a navigator in Carroll County: Call 855-288-3667

•For a calendar of upcoming enrollment events in Carroll County: Go to doortohealthcare.org/find-health-coverage/find-enrollment-events/

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