The American Rescue Plan (ARP) was recently passed to reduce health care costs, expand access to coverage, and ensure nearly everyone who buys their own individual or family health insurance through a Marketplace can receive a tax credit to reduce their premiums. The following is a breakdown of what it means to you.
A New Open Enrollment Period Now Through May 15th
*New enrollees can enroll in a plan without providing proof of a special election period
*Current enrollees can make changes to their existing plan
*Coverage will start the first of the month after plan selection
The new law will lower premiums for most people who currently have a Marketplace health plan and expand access to financial assistance for more consumers. This means that if you made too much, you may now actually qualify for assistance.
In order to take advantage of the savings immediately, you must revisit your application via healthcare.gov. If processed this month, premiums will be lowered effective 5.1.
Consumers who enrolled in Marketplace plans prior to April 1 have the choice of waiting until they file their taxes next year in 2022 to receive the additional premium tax credit amount when they file and reconcile their 2021 taxes.
The increased subsidies are retroactive to 1.1.21.
Explanation on How the Premium Tax Credits Work
For consumers who are eligible for premium tax credits, an individual or a family’s tax credit amount is calculated based on the following factors:
Household’s total expected income for the year
Total number of people in the household that file taxes together
The tax credit calculation uses a percentage of the household’s income that they need to contribute (spend) on monthly health insurance premiums.
Prior to the American Rescue Plan, households had to contribute up to 9.83% of their income to pay for health insurance premiums to be eligible for tax credits. Consumers can choose to enroll in plans that cost more or cost less than the benchmark plan. Households with incomes greater than 400% FPL weren’t eligible for tax credits to help reduce the cost of purchasing a Marketplace plan.
Since passing the American Rescue Plan, individuals and families may be eligible for a temporary increase in premium tax credits for this year and next, with no one paying more than 8.5% of their household income towards the cost of the benchmark plan or a less expensive plan. Meaning, many consumers will be eligible for higher tax credit amounts to help cover their health plan premiums.
Additional Changes
People who were involuntarily terminated April 1st-September 30th and offered COBRA will have their premiums covered for FREE until September 30, 2021.
People can not take the COBRA subsidy if they are now eligible for other coverage (including new group plan or Medicare)
Taxpayers who received unemployment compensation during any week beginning in 2021 may be eligible to receive additional premium tax credits to help pay for 2021 Marketplace coverage. -This part of the plan is not available at this time, but is estimated to be available by summer.
People who underestimated their income in 2020 won’t have to pay back the APTC when they file their taxes. No word yet what happens to those that have already filed and paid. I suggest contacting your accountant for more information.
Bright Health is a new provider that will offer plans via the Marketplace. Their network consists of Palos Medical Group and the Adventist network.
NO penalty continues! This means you will not 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.
Blue Cross Blue Shield and Cigna will continue to offer virtual visits. While Blue Cross Blue Shield only offers this service to their PPO plans, Cigna will offer the same service on all of their plans. Policy holders can call or chat online with a nurse practitioner to obtain a diagnosis and prescription for medication.
Carriers continue to waive cost sharing and co-pays related to COVID 19 testing and treatment. You MUST select an in-network provider/facility.
Northwestern Memorial will now accept plans from Cigna (Connect HMO). They will continue to accept Blue Cross Blue Shield (Blue Precision HMO and Blue Care Direct HMO).
Out of pocket maximum will increase to $8,500 per person. You can offset this by purchasing an accident or critical illness rider. The rider starts at $25 per month and provides coverage to you in the event of an accident or diagnosis of a critical illness (heart attack, cancer, or stroke).
Group plans are still an option for small employers. Blue Cross Blue Shield and now Humana 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. The employees can be 1099’d.
How to Avoid Rate Increases
Be prepared to discuss your household, estimated adjusted gross income for 2021. This will be used to determine if you qualify for assistance.
Those without pre-existing conditions should consider a short term medical plan. These plans do not provide coverage for pre-existing conditions, maternity, and limited wellness visits. However, these plans are a fraction of the cost of plans offered through the Marketplace and they all have a PPO network.
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.
I am a broker. This means I represent MULTIPLE carriers which allows me the opportunity to review rates with each carrier. This helps me determine which carrier is offering the best package to fit your family’s needs. There is NO additional cost associated with working with a broker.
Each year Patti and I review your renewal. If there is a $100 increase to your home or auto insurance renewal, Patti will contact you to inform you of the increase and ask if it is okay to review options. I have saved some of my own clients $800+ per year just by reviewing their renewal!
I represent A+ carriers. Some of the carriers I represent are Travelers Insurance, AAA, The Hartford, Nationwide, Progressive, etc. When classified as an A+ carrier, this means they pay claims, have a good customer service department, and billing department.
It is easier to call one person for all of your insurance needs.
I have consistently saved people money on their home and auto insurance.
Patti will be reaching out to you soon to discuss your home and auto insurance policies renew and options to combine your policies.
What You Need to Know About Auto and Home Renewals
The summer months are the time that most homeowner’s insurance policies renew. The biggest reason is that many people purchase/move during the summer months.
Here are some tips to keep in mind when reviewing your renewals.
When looking at rates, always review the total package (i.e. home and auto). Often, some carriers will have a better rate on home as opposed to auto however, the total calculation needs to be reviewed when determining the best scenario.
Consider a higher deductible. Most people now have a $500 deductible on auto and $1,000 deductible on home.
When reviewing rates, make sure to consider the wind/hail deductible. Some carriers will now require a 1% deductible for wind/hail claims. If your deductible is $1,000 and your replacement cost is $250,000, your wind/hail deductible would be $2,500. This means any claims related to wind/hail are subject to a separate, larger deductible. If your current policy has $1,000 deductible, you’ll need to get an accurate comparison.
Do NOT skimp on coverages. Dropping your liability limits saves very little in your annual premium.
If you own a rental, also assess the total package when shopping rates. Some carriers will require the primary residence in order to consider the rental property. Their rates can be ½ of what the other carriers offer by packaging your primary residence with the same carrier.
Ask to have your home’s replacement cost recalculated. Each year the carrier will increase the dwelling coverage to protect against inflation.
Make sure you are matching coverages. Some carriers are notorious for removing full coverage to reduce the rate. Sadly, some people do not realize that until they have an accident. Full coverage means the carrier will fix your vehicle in the event of an at-fault accident. On the flip side, liability only means your vehicle is NOT getting fixed in the event of an at-fault accident.
Choose your words wisely when calling other companies. If you tell an agent you want the “cheapest rate possible” or “basic coverages”, this often means the lowest possible liability limits ($25,000/$50,000) and liability-only coverage. Again, you do not save much by reducing the liability limits.
If you would like to get a free quote and find out how you can save money by about combining your insurance policies, please call Kelly or Patti at 708-444-0050. Get Ready to Save!
What you NEED to know about your Insurance and COVID 19
There have been many questions that have come up concerning the effects of your insurance during this COVID-19 crisis. I understand these are stressful and unsettling times for everyone and I am here to help and answer the questions you have about the changes and updates for health and auto insurance.
Health, Medicare, Short-Term Medical, including Marketplace plans
Ambetter: Ambetter will cover COVID-19-related testing and treatments at no cost to you. You do not need prior authorization.
BCBS: (Includes Individual health plans, Group/Employer health plans, and Medicare)
Testing: You won’t pay copays, deductibles or coinsurance for medically necessary lab tests to diagnose COVID-19. You do not need prior authorization to test for COVID-19.
Testing-Related Visits: You won’t pay copays, deductibles or coinsurance with in-network providers for visits related to COVID-19, whether at a provider’s office, urgent care clinic, emergency room or by telehealth. (Testing must be medically necessary, consistent with CDC guidance and at the direction of a doctor.)
Treatment: You will not pay copays, deductibles or coinsurance related to treatment for COVID-19. This applies to costs associated with COVID-19 treatment at in-network facilities and treatment for out-of-network emergencies.
Currently, this covers treatment from April 1 to May 31, 2020.
Virtual Visits
You may also access your Virtual Visits benefit2 provided by BCBSIL and powered by MDLIVE3. You can consult a board-certified doctor for non-emergency situations by phone, mobile app or online video 24 hours a day, 7 days a week. Virtual Visits doctors can even send e-prescriptions to your local pharmacy. (MDLIVE is not available for Medicare.)
Cigna: Cigna is waiving out of pocket costs for COVID-19 testing-related visits with in-network providers, whether at a provider’s office, urgent care center, emergency room or via virtual care, through May 31, 2020.
National General: National General will waive 100% of customers’ out-of-pocket costs for COVID-19 diagnostic tests and will ease access for customers seeking diagnostic testing. This waiver will extend to all National General Short-Term Medical customers.
United Healthcare: (Includes Medicare Advantage, Individual and Group health plans) United Healthcare is also waiving cost-sharing for COVID-19 testing and the testing-related visits. Cost-sharing is also waived for COVID-19 treatment until May 31, 2020. * Starting March 31, 2020 until June 18, 2020, UnitedHealthcare will also waive cost-sharing for in-network, non-COVID-19 telehealth visits for its Medicare Advantage, Individual and Group/Employer plans.
Marketplace: As a reminder, if you’ve had a loss of income, you may qualify for the additional annual premium tax credit.
Auto Insurance Updates
Because COVID-19 stay-at-home orders, there have been fewer drivers on the road, which means few accidents. Auto Insurance companies are recognizing this and rewarding customers with discounts and refunds.Here is a full list of the discounts by provider.
Travelers: Launched the Stay-at-Home Auto Premium Credit Program, which will automatically give U.S. personal auto insurance customers a 15% credit on their April and May premiums
Kemper: Providing a 15% deduction for April and May as long as the policy was in effect April 30.
Hartford: Giving 15% for April and May
Mercury: Giving up to 15% discount by May
Safeco: Providing a 15% refund on two months of auto premium, based on your premium amount as of April 7.
They are planning to issue the refund in the manner you made your most recent payment or by check.
They will begin issuing refunds in the coming weeks after they have approval from state insurance regulators.
Your refund will happen automatically, and you do not need to call to get your refund.
AAA – The Auto Club Group: Providing $60 million in premium refunds to its auto insurance customers. Every policyholder with auto insurance in effect as of April 30 will receive a 20% policy refund applied to two months of premium, for April and May.
We all have been affected by this COVID-19 crisis and I want you to know that I am here to assist you in any way I can. You can contact me at 708-444-0050 or kelly@kellyburkeinsurance.com if you have questions. I am also offering remote meetings by Phone, ZOOM or GoTo Meeting to help answer any concerns you may have.
We all know that living in Illinois we can experience temperatures and wind chills that are below -20. Our heating systems are not designed for. -20º to -30º temperatures with wind chills down to -50º, and can create a lot of damage to your house.
Homes can struggle to keep up, and the temperature may drop while the heating system is working at full capacity. To help your home make it through the winter without any mishaps, here are tips to properly winterize your home, inside and outside.
Inside The House
Keep your house heated to a minimum of 65 degrees. The temperature inside the walls where the pipes are located is substantially colder than the walls themselves. A temperature lower than 65 degrees might not keep the inside walls from freezing.
Identify the location for the main water shutoff in your home. Find out how it works in case you have to use it.
Open hot and cold faucets enough to let them drip slowly. Keeping water moving within the pipes will prevent freezing.
If you use fireplaces, wood stoves and electric heaters, watch them closely and make sure they are working properly.
Remember to close the flue in your fireplace when you’re not using it.
When traveling, ask a neighbor to check the house regularly. If there is a problem with frozen pipes or water leakage, attending to it quickly could mean far less damage.
If you plan to be away for an extended period of time, have the water system, including pool plumbing, drained by a professional to keep pipes from freezing or bursting.
Outside The House
Keep sidewalks and entrances to your home free from snow and ice.
Watch for ice dams near gutter downspouts. Ice dams can cause water to build up and seep into your house.
Clear gutters of leaves and debris to allow runoff from melting snow and ice to flow freely.
If you own a swimming pool and temperatures are expected to dip below freezing, run the pool pump at night to keep the water flowing through the pipes.
Make sure all hoses are disconnected from outside spigots.
If your garage is attached to your house, keep the garage doors closed. The door leading to the house is probably not as well-insulated as an exterior door.
If ice forms on tree limbs, watch for dead, damaged or dangerous branches that could break loose when stressed by ice, snow or wind and damage your house or car, or injure someone on or near your property.
If your home suffers water damage, it is important to make sure that it is properly dried and repaired to prevent any potential problem with mold. Remember, mold cannot survive without moisture.
Frozen or Burst Pipes
If you discover that pipes are frozen, don’t wait for them to burst. Take measures to thaw them immediately, or call a plumber for assistance.
If your pipes burst, first turn off the water and then mop up spills to avoid further damage.
Your Insurance Coverage
Standard homeowners policies will cover most kinds of damage that result from a freeze. For instance, if house pipes freeze and burst or if ice forms in gutters and causes water to back up under roof shingles and seep into the house. You would also be covered if the weight of snow or ice damages your house.
Most policies do not cover backups in sewers and drains or flood damage, which can also happen in winter. To be covered for flooding, you need a separate flood policy from the National Flood Insurance Program.