A Guide for Individual Massachusetts Artists Working in all Disciplines and for the Self-employed to Navigate Massachusetts Health Care Reform (aka the Don't Panic Guide)

(This guide was updated 4/24/08- * indicates where the updates are in the guide)

Navigating the health care system can be daunting. It is important to take a step back and see what options are available to you and what new requirements are expected of you with the health care reform law. It is important not rush and enroll into something you cannot afford. It is also very important not to forgo medical care if you need it. The State Legislature, the Connector, health care providers, and advocacy groups are working hard to make sure that people who are uninsured and those who are struggling to stay insured are not negatively impacted by this new law. They are there to help you and need to be informed if something is not working properly with the new law, especially amongst the artists population. It critical that when you interact with an enrollment specialist and/or a staff person at a designated State agency or a designated advocacy organization that you identify yourself as an artist. Many are training their staffs to become familiar with artists' needs. Some agencies and organizations have even designated a staff person to work specifically with artists. We encourage you to print out sections from this web site to reference.

We are using a broad and inclusive definition of artists working in all disciplines. It encompasses- visual artists, musicians, composers, writers, poets, film makers, playwrights, new media artists, crafts people, actors, singers, performance artists, graphic designers, lighting designers, dancers, choreographers, and the like.

We are monitoring and advocating for the artists population on the health care reform law and we need to know what is working and what is not working with the law implementation and the new health care options. Several artists across the state have been alerting us to problems they have encountered and as a result we have been able to fix these issues not only for the those artists, but we have also been able to work to fix the issues "through out the system". Please email us if you have or are experiencing difficulties or have had a good experience for that matter. All the information is kept confidential. Email us: feedback@healthcareforartists.org Also see our contact info as well.

Also we need your help: ALL MASSACHUSETTS ARTISTS WORKING IN ALL DISCIPLINES NEED TO STAND UP AND BE COUNTED! The Artists Foundation has collaborated to create on-line tool, Stand Up and Be Counted, to better determine how many artists of all disciplines are living and working in Massachusetts. Your answers will also help us and others to better advocate for our population. Go to the OnLine Questionnaire. Help us make the invisible- VISIBLE! Help us spread the word on this on-line tool!

As mentioned in the basic information* section of this web site, beginning of July 1, 2007, residents of Massachusetts 18 years of age and older are required to have health insurance that is deemed affordable to them at their income level (Note, however, one must have proof of health insurance by December 31st 2007 or they may be subject to a financial penalty issued and is enforced by the State's Department of Revenue for their 2007 State Income Taxes). This is referred to as the "Individual Mandate" * and we recommend that you print out that section. Also in that section are links to the online tools that can help you determine if you are exempt from the Individual Mandate. The proposed 2008 state tax fines were released by DOR on Dec 31st, 2007 (see our News section * for more info).

By January 1, 2009, you will need to verify that your health insurance meets the State's "minimum creditable coverage" standards for Health Insurance. These standards have been finalized and we have a section on those requirements and what health plans are exempt from those requirements. Also there are changes that have occurred to what was called "the Free Care Pool" that often covered the medical expenses of low income people. It is now called the Health Safety Net and there are new eligibility requirements and new restrictions in place.

A message from the Connector (aka The State Agency-Commonwealth Health Insurance Connector Authority):

"The Connector is not interested in penalizing people, we¹re interested in insuring them. With that in mind, we understand the issues at hand regarding enrollment efforts and penalties for those still trying to get into a plan. We encourage all individuals to continue to apply, enroll in a plan, and pay their initial premiums as soon as possible. As things stand now, there is a robust appeals process that has been put in place that will take those situations into consideration, and other options are being discussed."

As an individual you will need to know the following:
• How to define your income and how to prepare for interacting with an enrollment specialist.*
• The health care options available to you from health care reform and the existing health care options *
• What a Section 125 Cafeteria plan is and the pros and cons of it
• Key information about Minimal Creditable Coverage (MCC) requirements
• What you need to know about the Health Safety Net (HSN) formerly known as the "Free Care Pool"

• Plus there is important key information for those with multiple part-time jobs (even if they are seasonal or temporary and you get a W-2 for them) and/or those who are independent contractors

• How to prepare for interacting with an enrollment specialist.

Please read through the above information sections before picking from the below scenarios:
• You currently have insurance *
• You currently do not have insurance *
• You are currently unemployed or are going to be in the very near future
• You are in danger of becoming uninsured in the near future
• You are planning on staying uninsured *
• You are going to be graduating or have recently graduated from High School or College or you are taking a semester off or you will be uninsured in between academic years * (i.e. you don't have health insurance lined up after you graduate, or the job you have lined up does not offer you insurance, or the job you just got and will offer you insurance doesn't start for a couple of months, etc..)
• You uninsured and are not a Massachusetts resident You do not file MA state income taxes but you are currently residing in MA - i.e. you are an out of state student, a visiting artist, an immigrant (legal, illegal, documented, undocumented). Or you are commuting to your job in Massachusetts but live out of State and you may be staying multiple days in MA as part of your commute (i.e. you teach Mon-Wed in MA).
• You currently have medical debt, credit card medical debt, or I am having trouble paying my medical bills, and/or I need legal assistance

• Special information for college/university students*

Again we must stress that the information on this web site should not be used in replacement for talking to an enrollment specialist and/or a staff person at a designated State agency or a designated advocacy organization. It is only meant to act as preparatory information and is intended only for educational purposes and is not meant to be legal and/or tax advice.

NEXT STEPS- after reading the above information*