MOSES LAKE - The changes in the health insurance market, prompted by implementation of the Affordable Care Act, could leave consumers with questions, maybe lots of questions. Answers are out there, but consumers should be careful when looking for them.

The law requires all US residents to buy health insurance, and mandated 10 benefits to be added to every insurance plan, David Chandler, of Chandler Insurance, Moses Lake, said.

Consumers can consult an insurance agent to sign up, or go through a state-run website, Washington Health Plan Finder, or affiliated call centers. There are also "navigators" in many communities, who can help people navigate the sign-up process but can't recommend a specific plan.

A commission is built into the process for an insurance agent, so agents don't have to charge a fee for helping people sign up, Chandler said. That's one reason he recommends going to an insurance agent, he said, since the new laws are complicated. "It's free help. Free professional help," he said.

"It's recommended you come to a broker," he said.

Brokers can charge a fee, but they are required to disclose that up front, he said. Any person offering to help with sign-up who says the law mandates a fee is wrong, Chandler said.

People who help with sign-up could have access to an applicant's information, including Social Security number and income, so people should pay attention to the potential for identity theft, he said.

Because of the rocky opening on the exchanges, Chandler said the professional organization of insurance agents is recommending people wait to sign up. "Wait a few weeks and definitely go to an agent," he said.

The law's mandates mean that people will be paying for insurance coverage they can't use, the most frequently cited example being men paying for maternity services. States could add mandates and Washington did, he said. "The state added a few. Quite a few."

The effect on insurance rates will be mitigated for some people through subsidies and cost-sharing plans, Chandler said. People who are earning at or below 138 percent of the federal poverty level will qualify for coverage under Medicare, he said.

In those cases, the sign-up process encourages people to consult the navigators, he said.

People making between 138 percent and 250 percent of the federal poverty level are eligible for some subsidies and cost sharing, he said. The cost sharing would help people pay deductible and co-pay costs, Chandler said.

A subsidy, based on a sliding scale, is available for individuals and families earning up to 400 percent of the federal poverty level, he said. But eligibility for the subsidy depends in part on any insurance plan offered at work.

The law establishes guidelines for an "affordable" health care plan. If a plan offered by an employer fits the affordability requirements, and is offered to the employee's family, no one in the family is eligible for the subsidy, he said.

That's true even if the employee is required to pay all or most of the premium for family members, Chandler said. He cited the case of a woman whose husband worked for a company that offered affordable health insurance, according to the guidelines, but required the employee to pay the premium for family members.

The woman wanted to sign up for the subsidized coverage, but wasn't eligible even though she met the income guidelines, he said.

The exchange application asks for income information, although applicants aren't required to verify it, for the first year at least, Chandler said.

But if the system is working right the feds will have a way to check that information. "All of this is being married to your taxes," Chandler said. The health exchange will be able to check submitted information against Internal Revenue Service records, he said.

People who are reporting income information should give their maximum income, he said. Because the subsidy is based on a sliding scale, people who earn more than their reported income may be required to pay back the subsidy, he said.

People who don't buy insurance will pay a penalty, which is $95 for an individual and $285 for a family, or 1 percent of income, whichever is higher, Chandler said. That amount goes up after the first year, he said. The penalty would be assessed each month, he said.