The Oregon Homecare Workers Supplemental Trust does not provide medical insurance, and does not have employer-sponsored coverage. Rather, the Trust provides assistance with the cost of monthly premiums and some out-of-pocket expenses for Trust-Approved Qualified Health Plans purchased through your state or federal health insurance marketplace. Please refer to your Plan Booklet, pages 11-20, for more information.
If you are eligible to enroll in Medicaid, please visit your applicable State’s Medicaid website. You can apply for Medicaid at any time throughout the year. If you are unsure if you qualify for Medicaid, you can check on healthcare.gov. If you are enrolled in Medicare, please visit the Medicare Page for more information.
The information provided on this page assumes you are eligible to receive Supplemental Trust assistance and are not eligible for Medicare or not enrolled in Medicare. If you are unsure if that is true for you, please refer to your Plan Booklet. If you are looking for information regarding coverage for 2019, please visit the 2019 Enrollment Materials Page until October 31, 2019. Beginning November 16, 2019, you will not be able to make changes to your 2019 Marketplace enrollment.
Information on this page will be updated as more information and guides become available. Last updated: September 6, 2019.
Open Enrollment for 2020 plans is November 1-December 15, 2019.
If you have experienced life changes, such as loss of previous job based-coverage or experienced a change in income that makes you no longer eligible for Medicaid, you may qualify for a Special Enrollment Period. To see if you qualify for a Special Enrollment Period, visit the screener at Healthcare.gov.
You can enroll into any medical insurance plan you would like to on the Marketplace. However, if you are eligible for benefits through the Supplemental Trust, you must select a Trust-Approved Plan in order to get assistance paying for your premium and out-of-pocket medical costs.
As Trust-Approved Plans are decided for 2020 they will be listed here. Last Updated: September 6, 2019.
- For participants who reside within the Kaiser Service Area: KP OR Silver 2500/35, Plan ID 71287OR0420011.
- For participants who reside within the Kaiser Service Area: KP WA Silver 2500/35, Plan ID 23371WA1760002.
Open Enrollment is November 1-December 15, 2019.
Complete these steps to enroll into medical coverage through the Marketplaces:
1. Review the Trust-Approved plans and find the Trust-Approved plan for your area - Oregon or Washington plans. Note the plan name and plan ID number. If you are currently enrolled, even though your renewal plan is still the same, we highly recommend you review the plan for any new information or provider network changes.
2. Fill out the required annual paperwork securely using DocuSign. If you need assistance using DocuSign, please use this guide. Note: this paperwork is not the enrollment application. This paperwork allows the Trust and Valley Insurance Professionals to better assist you with the enrollment process and link you to the Supplemental Trust benefits after you enroll, if you are eligible.
If you still need to submit paperwork, please visit the Additional Materials Pre-Enrollment section and select the link that applies to you.
3. If you are renewing your coverage, you should update your Marketplace application with your most recent income and household information so you get the right amount of financial assistance for 2020. You can use this step-by-step guide to walk you through the process.
Internet option: Go to www.healthcare.gov and click on “LOG IN TO RENEW/CHANGE PLANS.” Your current plan will show first as your “Selected Plan.” If you were enrolled in a Trust-Approved Plan in 2019, the plan you auto-enroll into should also be a 2020 Trust-Approved Plan. To confirm that a plan is the Trust-Approved Plan for your area, you can refer to the list of Trust-Approved Plans at the end of this page. To enroll in this plan, simply click “Enroll.” As you complete your application, remember the benefits you receive through the Supplemental Trust are not employer-based coverage.
Agent Assistance option: If you are a new Trust Eligible Homecare Worker and this is your first time enrolling or if you would like assistance from an agent, you can set up an appointment with Valley Insurance Professionals.
4. Make sure the Trust Administrative Office gets your new premium information through the Enrollment Information Form to start processing or to update your benefits. If you need assistance filling out the information, please refer to the Guide to Fill Out the Enrollment Information Form.
5. Pay your first month's premium to your insurance carrier to activate your insurance. If you are Supplemental Trust eligible, for...
New enrollment: after the Trust Administrative Office receives and processes your Enrollment Information form, you should receive a reimbursement check for this month’s premium. In order to active your insurance, please do not wait for the check to pay your premium.
Renewal: keep using your Benefit Convenience Card to pay your premium payment.
6. Review your eligibility notice from the Marketplace and respond to any Marketplace requests for information.
7. Get your new medical ID card.
8. Do not lose coverage - set up recurring payments for your monthly premiums and make sure to monitor them.
Additional Materials you may find useful to assist your Marketplace enrollment.
- If you still need to submit previous paperwork, please select the DocuSign link(s) that applies to you. These links are for previous years' paperwork, filling them out will not count for your 2020 annual paperwork. Please use the above links for 2020 annual paperwork.
- Employer Coverage Tool (PDF) – only if you or anyone in your tax filing household is eligible for or has other medical insurance through an employer
English, Spanish, Vietnamese, or Russian
- Guide to Create a Free Email Account (PDF)
English, Spanish, Russian, Vietnamese, Simplified Chinese
- My HealthCare.gov Account, Updated October 2018
- My Washington HealthPlanFinder Account (PDF)
- Creating a Washington HealthPlanFinder.org Account (PDF)
Additional Materials to assist you after your Marketplace enrollment.
- Benefit Convenience Card Frequently Asked Questions - Revised March 2019
English, Spanish, Russian, Vietnamese, Chinese
- Benefit Convenience Card Affidavit:
Below are answers to several common questions about the enrollment process and receiving benefits from the Trust.
Below are answers to several common questions about the enrollment process and receiving benefits from the Trust.
Q: How do I set up automatic payments?
A: Your premium is due by the first of the month for that month’s insurance, so it is highly recommended you set up automatic payments to make sure your premium is paid on time. If you don’t make your premium payment on time, your insurance carrier can cancel your insurance for the rest of the year.
For Kaiser, once your first premium payment has been processed, Kaiser will create a new online member account for you that will allow you to set up automatic payments for the rest of the year. Visit kp.org for more information.
For PacificSource, you can set up automatic payments through the PacificSource website. More information about payment options, including setting up automatic payments online, is available from PacificSource’s website.
For Moda, once your first premium payment has been processed, you can call Moda customer service at 503-243-3962 or toll-free at 877-605-3229, identify yourself as a homecare worker and let them know you need to pay your monthly premium. Moda does not currently accept automatic payments, and you will need to remember to call in to make your payment every month no later than the due date. Many participants set up calendar reminders to make sure they do not miss making a premium payment.
For Providence, once your first premium payment has been made you can set up automatic payments by calling Providence billing at 503-574-5791. You can also pay your premium online – for first time premium payments, use this link and select New individual & family applicants. Once your account is set up you can pay through your Providence account.
Q: Where do I find my monthly premium bill?
A: To make sure your premium payments are made on time, make sure to check your mail for monthly bills and information from your carrier. If you are not receiving a paper copy of your bill from your carrier every month, you may be receiving your bill in an online account. For assistance in finding and monitoring your monthly bill, you can contact your carrier; see the additional contacts page on the Trust website for the best contact information for your carrier.
Q: There are no phone appointments available on the website scheduler. What should I do?
Please call the Healthcare Enrollment Team at 503-303-5668 (Portland Metro Area) or toll free 1-855-437-2694 right away.
Q: Am I required to enroll in one of the Trust-Approved Plans?
A: No, you can select any plan on the Marketplace. However, if you are eligible for Supplemental Trust benefits and would like to get assistance paying for your premiums and out-of-pocket medical costs, you must enroll in one of the Trust-Approved Plans on the Health Insurance Marketplace. Refer to your Plan Booklet--available in English, Spanish, Vietnamese, or Russian--for more information.
Q: I am currently receiving the Average Premium Reimbursement for 2019, what should I do if I want to receive Supplemental Trust benefits?
A: To continue to receive Trust benefits, you need to enroll into a Trust-Approved Plan at your first opportunity and no later than Open Enrollment. Open Enrollment is from November 1 to December 15 and you need to take steps to enroll into a Trust-Approved Plan if you would like to continue to receive benefits in 2020 and are otherwise eligible. Otherwise, your reimbursement benefit under the Trust will end in December of 2019.
Q: I appealed last year and was allowed to select another Trust-Approved Plan, what should I do if I want to continue to receive Supplemental Trust benefits?
A: If the plan you enrolled in is still the same Trust-Approved Plan for 2020, the decision on your appeal still stands. You will need to review the information on this page to make sure that you take the appropriate steps to continue to have medical insurance and receive Trust benefits. You are also encouraged to review the 2020 plan summary and provider networks to make sure this option still works for you.
Q: I live in the Lane County Kaiser Service Area and I am enrolled in the 2018 Trust-Approved Providence plan, do I need to change plans?
A: No, you do not have to change plans. You can change to the 2020 Trust-Approved KP Silver 2500/35 plan if you would like, or you can stay in the Trust-Approved Providence plan. Once you transition to the Trust-Approved Kaiser plan, that will be your Trust-Approved Plan for the rest of the year and you will no longer have the option to receive Trust benefits for the Providence plan after you switch.
Q: I live in the Lane County Kaiser Service Area and I am enrolling for the first time for Trust benefits; can I get benefits for the Trust-Approved Providence plan?
A: No, if you live in the Lane County Kaiser Service Area and you are newly enrolling into Trust benefits for 2020, your Trust-Approved Plan is the Kaiser KP Silver 2500/35 plan.
Q: I have a Benefit Convenience Card from last year and I am still eligible; can I use it to pay my premiums next year?
A: Yes! You can use your Card to pay for your insurance premiums as long as you are eligible.
Q: I am enrolling for the first time, how do I pay my first premium?
A: You can pay your first month’s premium and submit your new plan information to the Trust Administrative Office using the Enrollment Information Form if you or your assister has not already done so, as long as you are eligible. Once the Trust receives your enrollment information, it will verify your eligibility and issue you a check. It will also start the process to send you a Benefit Convenience Card from Ameriflex. It is your responsibility to pay the first month's premium by the due date, so make sure that you or your assister are submitting your information to the Trust Administrative Office as soon as possible. If you need assistance with paying your first month's premium and you have not yet received your reimbursement check, you can call the Trust Administrative Office at 1-844-507-7554, Option 3, Option 2.
Q: My Benefit Convenience Card didn't work to pay my premium, what should I do?
A: First, you will want to make sure the Trust has your most up to date premium information. If you have already submitted your most up to date premium information, you can check your MyAmeriflex Mobile App or Ameriflex online account to check your balance. If you see enough money to pay the premium, ask your carrier to try again. If you do not have enough money on your Card, please call the Trust Administrative Office at 1-844-507-7554, Option 3, Option 2 right away. If you get voicemail, please leave only one message with your name, best phone number, best days and times to reach you, question, preferred language if other than English, and whether or not it is ok to leave you a detailed message.
Q: My Benefit Convenience Card didn't work to pay for my out-of-pocket costs, what should I do?
A: If you attempted to use your Benefit Convenience Card to pay your eligible out-of-pocket costs and your Card was denied, reach out to Ameriflex, the Card Administrator, at 1-888-868-3539 for assistance. You will want to identify yourself as a Homecare Worker with the Trust and have your Card, the date and type of service you were attempting to pay for and what happened with you at the time of the call.
Q. I have medical bills from last year. Can I pay them with my Benefit Convenience Card?
A: You may only use the annual reimbursement benefit on your Benefit Convenience Card to pay covered expenses for services received in the same year to which the reimbursement benefit applies. If you receive claims from a previous calendar year you will need to utilize the reimbursement process. For more information, please see the Benefit Convenience Card Frequently Asked Questions - English, Spanish, Russian, Vietnamese, Chinese.
Q: I enrolled in a Non-Trust-Approved Plan, what should I do if I want to receive Supplemental Trust benefits?
A: If you became Trust-eligible outside of Open Enrollment and already have coverage under a plan, you may qualify for the Supplemental Trust’s average premium reimbursement benefit. Refer to pages 11-12 of your Plan Booklet, and if you qualify, you can submit your information to the Trust Administrative Office for review via the reimbursement process. If you became Trust-eligible for the first time in 2019, you may be eligible for reimbursements through the above process. You need to enroll in a Trust-Approved Plan during your first available opportunity, or no later than Open Enrollment that begins November 1 for medical coverage beginning January 1 if you are still Trust-eligible and would like to continue to receive benefits from the Supplemental Trust.
Q: I need to file my taxes. How do I get a copy of my 1095?
A: If you have any questions or concerns about your 1095, you can look to see if it has been posted in your account on Healthcare.gov, or you can call the Marketplace at 1-800-318-2596 for additional information. More resources can be found on healthcare.gov/tax-form-1095. You can also find more information about your advance premium tax credit here.