2026 Annual Paperwork

By completing the 2026 Annual Paperwork, you’re taking the first step to find a Carewell-approved Marketplace health (medical) insurance plan, and the financial support to put it in place!

This paperwork is not an application for health (medical) insurance. You need to enroll on the Marketplace for this coverage. When you enroll in a Carewell-approved Marketplace plan, you can request Healthcare Cost Assistance benefits. If eligible, this benefit covers 100% of your net monthly medical premiums, as well as $8,000 in 2026 for covered out-of-pocket medical expenses.

This form does not cover Dental Insurance. If you're eligible for Healthcare Cost Assistance, you are enrolled in a Kaiser Dental Insurance plan from Carewell, unless you opted out. Any additional dental coverage is not covered by Healthcare Cost Assistance, and you are financially responsible for premium payments. If you have questions about family coverage, please reach out to Carewell before selecting a plan on the Marketplace.

Submitting the 2026 Annual Paperwork confirms that you understand and agree to the rules of the Healthcare Cost Assistance program. These forms also give the Carewell SEIU 503 Benefits team and our partners permission to assist you with enrolling in and maintaining your healthcare coverage and HCA benefits.

Trust rules require you to provide proof of your Marketplace plan by submitting your premium bill and Marketplace Eligibility Notice to receive Healthcare Cost Assistance benefits. Care providers who enroll in or renew an approved plan or update their income with assistance from Valley Insurance Professionals (VIP) have this information submitted by VIP on their behalf.

Once you have completed the 2026 Annual Paperwork, you can download a PDF of your signed documents.

If you have any questions about this paperwork, give us a call at 1-844-503-7348, Monday-Friday, 8am-6pm PST.

We're here to help!

The following agreement concerns my eligibility for, and participation in, the Healthcare Cost Assistance Benefits provided under the Oregon Homecare Workers Supplemental Trust (referred to in this document as “Carewell SEIU 503”).

I acknowledge:

• In order to receive Healthcare Cost Assistance from Carewell SEIU 503, I must select a health insurance plan that has been approved by Carewell SEIU 503, which is based on my location. I must also continue to meet Carewell SEIU 503’s eligibility requirements. 

• Carewell SEIU 503 does not provide employer-sponsored or “group” medical coverage. Medical insurance obtained through the Marketplace (HealthCare.gov) is considered individual or family coverage. If I move, stop doing homecare or personal support work, my hours change, I become eligible for other coverage, or I enroll in a plan not approved by Carewell, my insurance is not automatically canceled. However, these events may impact my eligibility to receive Healthcare Cost Assistance from Carewell SEIU 503.

• Carewell SEIU 503 provides a Benefit Convenience Card (“BCC”) for me to use, to pay my monthly premium payments (if applicable), and to pay for covered out-of-pocket medical expenses, up to the annual BCC allowance amount. The out-of-pocket expenses include the deductible on my approved Marketplace plan, and medical copayments and medical coinsurance expenses, including those for covered prescriptions.

• Any charges other than those listed above are considered unauthorized charges. I understand that if I use my BCC for unauthorized charges, I am held liable for that overpayment and am obligated to repay those unauthorized charges back to Carewell SEIU 503. (See the Overpayments section in the Carewell SEIU 503 Guide to Training and Benefits.)  

• I am also eligible to receive dental, vision and hearing coverage at no premium cost to me, through the Oregon Homecare Workers Benefit Trust. I understand that if I choose to enroll in an additional dental plan through the Marketplace (HealthCare.gov), it is my responsibility to pay those premium payments each month out of my own funds.

• I cannot use my BCC for any expenses related to my dental, vision, or hearing benefits. Using the BCC for such expenses is unauthorized and is considered an overpayment that I must pay back to Carewell SEIU 503.

• In order to receive Healthcare Cost Assistance, Carewell SEIU 503’s rules require that I provide proof of my enrollment each year. There are 2 ways to provide this proof.

  1) I can use Carewell SEIU 503’s partner, Valley Insurance Professionals (VIP), to help me enroll, and then VIP sends my enrollment information to Carewell SEIU 503 on my behalf; or

  2) I can provide proof of my enrollment by submitting my Marketplace Eligibility Notice and either my premium bill or the “My plans & programs” page from my 2026 Marketplace (HealthCare.gov) application.

  If I do not provide these supporting documents, I understand that my Benefit Convenience Card will be turned off until the required documents are submitted and approved.

• Carewell SEIU 503 requires that if I qualify for an Advance Premium Tax Credit (APTC) or a state sponsored Tax Credit, I must elect to receive and apply the full amount of all monthly Tax Credits available to me. I must then apply the Tax Credits toward the premium for Carewell SEIU 503 approved health insurance plan I enroll in. If I do not apply the full amount of Tax Credits toward the premium, I may be required to reimburse Carewell SEIU 503 at tax time. (See the Overpayments section in the Carewell SEIU 503 Guide to Training and Benefits.)

• If I use VIP’s enrollment services, VIP may provide my Protected Health Information (PHI) to Carewell SEIU 503, RISE Partnership, and Carewell SEIU 503’s other providers, for the purpose of administering the Healthcare Cost Assistance benefits available under Carewell SEIU 503 to eligible care providers.

• IT IS MY RESPONSIBILITY TO MAKE PAYMENTS TO MY INSURANCE CARRIER FOR MY HEALTH (MEDICAL) PREMIUMS. If my premiums change, I understand that I must submit my new premium information to Carewell SEIU 503, along with the required documentation.

• According to Marketplace (HealthCare.gov) rules, past due premiums owed to my insurance carrier must be paid before my coverage for the next plan year begins.

• Carewell SEIU 503 does NOT provide Healthcare Cost Assistance for my spouse or dependents, even though Tax Credits may be available for them.

• In order to receive Healthcare Cost Assistance under Carewell SEIU 503, I cannot be enrolled in more than one type of health coverage. This includes health coverage offered through Medicare (Parts A and/or B), Medicaid, CHIP, an employer, COBRA, TRICARE, VA health care program, Peace Corps, or any other type of health coverage that meets the federal minimum essential coverage (MEC) standards for insurance coverage.

• If I am currently enrolled in, or become newly eligible for, any of these coverage types throughout the year, I will notify Carewell SEIU 503 immediately by calling Carewell SEIU 503 at 1-844-503-7348.

• I must review and respond to all notices I receive throughout the year from Carewell SEIU 503 and RISE Partnership to ensure there is no delay or interruption in my Trust benefits.

• I am responsible for submitting timely and accurate information to the Marketplace (HealthCare.gov), Carewell SEIU 503, and VIP (if applicable). Failure to do so could result in a delay in benefits being administered to me. I also understand that submitting this form does not guarantee my benefits and does not enroll me in Trust benefits or Marketplace health insurance.

Take a moment to review the Carewell-approved Marketplace health (medical) insurance plans for your county. You need to enroll on HealthCare.gov for your medical plan. The plan needs to be Carewell-approved to request Healthcare Cost Assistance benefits.

1. Select your county on the dropdown list below.
2. Review the 2026 Carewell-approved Marketplace plan(s) available to you.
3. Choose an approved plan and write down the name and plan identification number. You need this when you enroll on the Marketplace (HealthCare.gov).

Now you need to share information with the Marketplace to either enroll in a new plan for 2026 or, if you are renewing a plan, to update the Marketplace with your most current information. To complete your Marketplace application, you need the following information for you and your tax-filing household:

• Name
• Date of Birth
• Social Security number
• Immigration documentation, if applicable
• Estimated pre-tax (gross) income and deductions for 2026, including things like any 2026 Carewell PTO you plan to cash out, 2026 wage increases, overtime earned, Social Security and Disability benefits, rental income or wages, and alimony payments
• If anyone in your tax-filing household has access to employer coverage, you will need the employer name, employer phone number, and the monthly cost for the insurance
• The approved plan name and ID for the plan you are enrolling in (you can find Carewell-approved plans for 2026 here)