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2019 Open Enrollment. Important Details You Need to Know.

 

During this time, individual policy holders can enroll in a health plan or make changes to their existing plan. *If you obtain health insurance from your employer, you are likely to have a different Open Enrollment period.*

 

What to Expect in 2019

 

  • The penalty has been removed! This means you will no longer receive a penalty for not having coverage or for obtaining a plan that does not provide the 8 coverages required by the  Affordable Care Act.
  • Short term medical plans will now offer coverage for the full year. These plans do not provide coverage for pre-existing conditions, maternity, or wellness visits. However, these plans are a fraction of the cost of plans offered through the Marketplace and they all have a PPO network.
  • BCBS will continue to offer virtual visits for PPO plans only.  Policy holders can call or chat online with a nurse practitioner to obtain a diagnosis and prescription for medication.
  • Group plans are still an option for small employers. Blue Cross Blue Shield does offer relaxed guidelines during this time to allow for a 1-person group. The employer must have at least 2 full time employees that are not husband and wife.

How to Avoid Rate Increases

 

  • Be prepared to discuss your household, estimated adjusted gross income for 2019.  This will be used to determine if you qualify for assistance.
  • Those without pre-existing conditions should consider a short term medical plan.  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. I specialize in personal lines insurance, which includes auto, home, and Medicare. 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.

NOTE:  This is an extremely busy time for me.  I suggest scheduling early as my schedule will fill up.  Call 708 444-0050 or email, kelly@kellyburkeinsurance.comfor an appointment.  Please include your availability (i.e. mornings, afternoons, or evenings) and the type of appointment you are requesting (face to face or conference call).

Trump’s Executive Order Defined

 

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!

Blue Cross Blue Shield Announces MAJOR Network Changes

Posted: September 29, 2015

Open Enrollment this year will be November 1st-January 31st.  During this time, Blue Cross Blue Shield has already announced major network changes.  The biggest being the elimination of their broad PPO network.  Those with a plan in this network will receive a letter and or phone call from BCBS stating that their policy will expire 12/31.  You will need to pick a new plan by 12/15 to ensure there is no gap in coverage. 

 

Those with the Blue Choice, the HMO network, or on an employer plan will NOT be affected by this change. 

 

BCBS has also announced that there will not be a cap on out of network charges, making it extremely important to stay in your plans network.  What this means is that a service that costs $10,000 at an out of network facility will cost you $10,000.  Nothing will be applied towards your deductible.

Questions
Questions

Feel free to email or call me with any questions or comments about my services or if you have any insurance related inquires.

Contact
Contact

Phone: 708.444.0050
Email: kelly@kellyburkeinsurance.com

Availability
Availability

Monday - Friday: 10am - 5pm
Evening and weekends
available upon request