It's time to go shopping – for healthcare insurance.

Tuesday, Nov. 1 was the opening day for individuals and families who don't get healthcare insurance through their employers to check out insurance plans through the Washington Health Benefit Exchange, an online system that offers insurance options through the Affordable Care Act, better known simply as Obamacare.

Those who buy insurance through the exchange have until Dec. 23 to pick a plan and pay for the insurance for it to take effect Jan. 1, 2017. Open enrollment – the timeframe to selecting a plan – technically ends Jan. 31.

People with low incomes can sign up for Medicaid, the state health insurance program, throughout the year.

Premiums for all other plans are expected to rise next year: How much depends on the plan.

In Jefferson County, Kristin Manwaring of Kristin Manwaring Insurance, said that an 8 percent increase the state is saying is the average plan hike is not a full story of what she's seeing.

“Rate increases depend on the carrier. We are seeing 8 to 20 percent depending on the carrier,” Manwaring said.

FRONT LINES, CHANGES

And there are changes to those plans that Manwaring, who is on the front lines of helping people select plans, wants people to know about.

For starters, Premera Blue Cross and LifeWise are no longer offering plans outside the Washington Health Benefit Exchange, which means anyone wanting those plans needs to go to

wahealthplanfinder.org, and set up an account to buy that insurance.

“There are a lot of people that have their policies direct with the carrier versus going through the Healthplanfinder. And if those people do nothing, they will not have insurance Jan. 1,” said Manwaring.

Being required to go through the Exchange is one big change, but it's not the only one.

Regence BlueShield is also now the only insurance company that is offering people in Jefferson County nationwide access to providers.

“It would be important for people who travel or who have children in college in another state to pay attention to that,” Manwaring said.

Manwaring notes that the Exchange is the only way for people to access subsidies for insurance or get tax credits. A subsidy is available on a month by month basis and relates to the plan chosen and income that month. A tax credit is taken on taxes at the end of the year.

GETTING HELP

For those who don't have an account set up yet on the Exchange, getting help this year is different than when the Exchange first came online several years ago when there were free clinics offered almost weekly.

Jefferson Healthcare's business office continues to help people sign up for Medicaid, the state health insurance program for people with low incomes, but it is not assisting people to sign up for plans offered through the Exchange.

“We are only going to continue with Medicaid enrollments and we won't be supporting the QHP (qualified health plans),” said Erin Brown, compliance officer and manager of patient access services at Jefferson Healthcare in Port Townsend.

Brown is referring people to either Kitsap Public Health District, which has navigators, or Manwaring's office.

Brown also noted that Jefferson Healthcare's financial counselors had been navigators – people trained to help people review the different plans available on the Exchange, so they still can respond to questions.

“But they won't be able to do enrollments for the qualified health plans,” Brown said.

Kitsap Public Health District was awarded the contract as the lead organization for people accessing help in Kitsap, Jefferson, north Mason and Clallam counties.

“We help them navigate and help them obtain insurance,” said Shelley Rose of Kitsap Public Health, who is one of the navigators who can assist people. She noted that the agency has been helping people for four years.

People can call the agency at 337-5235 for assistance; she's based in Bremerton.

There are three other organizations under the Kitsap umbrella that also can help people from Jefferson County.

Rose notes that Washington is one of 13 states nationwide that set up its own marketplace for insurance and she's glad that happened.

Exchange officials have noted that insurance prices in Washington have not gone up as much as policies in states that have no marketplace. The second lowest “silver plan” has gone up 8 percent in Washington and 25 percent elsewhere in the nation, Rose said.

CREATE AN ACCOUNT

Manwaring said open enrollment – the period from Nov. 1 through Jan. 31 – is always a challenging season. What she hopes people do is create an account on that

Healthplanfinder.com website and then call her. It's important for people to know their user name and their password before coming in for help.

And she wants people to be thinking about when the insurance takes effect. For those who need insurance effective Jan. 1, 2017, the deadline is Dec. 23, not Jan. 31, she noted.

For those who aren't computer literate, Manwaring offers a step-by-step instructions for creating an account with the Exchange. The Port Townsend Public Library and Jefferson County Public Library in Port Hadlock have computers that users can access.

For those who don't have computer skills, Manwaring said they should call the Exchange.

“Has the government thought about the fact that some people don't have a computer?” Manwaring asked.

During open enrollment, Manwaring's company does not charge a fee for consultation.

“Our area of expertise is helping consumers review/consider their tax credit eligibility, carrier options, benefits and plan selection, access to providers for each plan/provider networks, review of RX formularies and premiums,” Manwaring said.

Both Manwaring and Brown note that for people who qualify for Medicaid – the state health insurance plan – there are no deadlines.

And Brown notes for those people who have high deductibles, Jefferson Healthcare does offer financial assistance through Patient Access Link.

“Families enrolled in health insurance may still apply for financial assistance, and we encourage them to do so given the financial burden of some of the plan’s deductibles,” Brown said. “Our goal is to remove financial stress as an obstacle for families needing medical care and attention.”