On October 12th, President Trump signed an Executive Order, forcing changes to be made toward some of the rules of small business health insurance plans, short-term health insurance policies, and cost-sharing reduction payments (aka subsidies).
What does the Executive Order mean
- Broader rules for AHP’s (Association Health Plans), allowing small businesses to purchase plans across state lines. By joining an AHP, small employers within the same line of business could purchase plans collectively.
- Increase the policy period on short-term plans from 3 months to 12 months with the option to renew. These plans are not required to follow the rules of the ACA mandate (i.e. they do NOT provide coverage for pre-existing conditions)
- Cost-sharing reduction payments (aka subsidies) will no longer be funded by the government. Insurers are required by law to offer assistance to low-income individuals. Customers who are currently receiving assistance through the Marketplace will likely see little change.
- Rates have not been released and likely will not be released until November 1st. This means renewals will not be available until November 1st.
How to Avoid Rate Increases:
- Be prepared to discuss your household, estimated adjusted gross income for 2018. This will be used to determine if you qualify for assistance.
- Those without pre-existing conditions should consider temporary insurance. The premium is much lower and all plans offer a PPO network. Wellness visits are not included with these plans.
- If you are going to opt to self-insure, protect yourself with an accident or critical illness plan. The plan works separate from health insurance and pays you based on a diagnosis of a critical illness (cancer, heart attack, or stroke) and in the event of an accident (slip, fall, and break an ankle) the plan will pay you a certain dollar amount. The purpose is to use the funds to pay towards the unexpected hospital or urgent care visit.
- Review ALL of your insurance policies. As a broker I have access to multiple carriers which allows me the opportunity to find the best plan based on your needs. I’ve saved people thousands by reviewing rates with multiple carriers. Personal lines insurance (auto, home, life, and health) is my area of expertise!
On March 31st, 2014 the historic 1st year of the Health Care Reform Act enrollment will come to a close. As a last reminder, if you are eligible for enrollment this is what you can expect…
IF YOU ENROLL IN A PLAN
- If you currently have a health insurance plan, you will NOT be able to make ANY changes until the next open enrollment. Generally the open enrollment period will be each year between October-December. Any changes made during this time will take effect January 1, 2015.
- If you are still planning to enroll, policies applied for by March 15th will take effect April 1st. Policies applied for between March 16-March 31st will take effect May 1st. As long as you make a decision by March 31st you will avoid the penalty.
- If you qualified for a subsidy (via the marketplace) be sure to check your results. MANY require that you send additional documentation by the end of open enrollment in order to keep your subsidy. The additional requirements can be sent via mail or uploaded to your marketplace account. If you plan on mailing the documents I suggest sending it certified so you have proof that it was received.
IF YOU DO NOTHING
- You will be locked out of being able to join a plan…unless you fall into a special election period (marriage, child birth, loss of coverage, etc). If you’ve chosen this option I recommend purchasing a critical illness/accident plan. It is NOT the same as health insurance but in the event you injure yourself or are diagnosed with a critical illness, the plan will pay you an allotted amount ($5,000-$50,000). The plans start as low as $2 per month for critical illness and $15 per month for accident coverage.
- You can expect to receive a $95 per person ($47.5 per child under the age of 18) penalty on your 2014 federal tax return (this will increase in 2015)
Have you heard about Critical Illness Insurance and Accident Coverage?
- Critical illness insurance is an insurance product, where the insurer is contracted to typically make a lump sum cash payment if the policyholder is diagnosed with one of the critical illnesses listed in the insurance policy (usually cancer, heart attack, or stroke).
- Accident Coverage is an insurance product, where the insurer is contracted to typically make a lump sum cash payment if the policyholder is involved in an accident at work or play (examples include: broken bones, stitches, sports related injuries and general clumsiness).
Since preventative services come standard with ALL plans you are more likely to use your deductible due to a critical illness or injury. The purpose of these plans are to use the funds towards your deductible.
Rates depend upon age and amount of coverage but can start as low as $2.75 per month with $10,000 in coverage.