*EVERYONE can expect to see a 3-5% increase on their health insurance premiums. This is the cost associated with the new tax to fund the Healthcare Reform.
*Those that have purchased coverage on their own can expect to see a 40-60% rate increase on current rates.
* BCBS is renewing ALL plans effective January 1st. Those with BCBS can expect to see the increase and the essential benefits added at that time.
*Humana, United Health, and Assurant plans will not see the rate increase or the essential benefits added until your plan renewal date.
PLEASE NOTE, if your plan effective date was prior to March 23, 2010 your plan is considered “grandfathered” and you will not be required to accept the new essential benefits. In turn you will have lower rates; however if you make ANY changes to your plan you will lose your “grandfathered” status.
*EVERYONE will have the option to view plans on or off the exchange. Selecting a plan on the exchange will qualify you for the subsidy or cost sharing. Pricing for both options has been released this week. I am certified to review plans to determine which route is better for you and your family.
*The subsidy is based on household size and annual income. If you qualify for the subsidy, you can elect to have the funds applied towards your monthly health insurance premium or you can have the funds applied towards your tax return.
*9.23.13 Health Insurance Carriers released a letter to those that have purchased coverage on their own, explaining options. The letter requires that you return it by 12/15/2013 if you are choosing a different plan. I would be happy to discuss your options, please contact me before returning this letter.
These are just a few of the details of this new law. I will be available to answer your questions or get you signed up every Saturday in October from 10am-2pm. I will be located at my office in the Prime Realty Building at 17208 Oak Park Avenue Tinley Park, IL 60477. Please stop by so we can get you headed in the right direction.
1. Open Enrollment begins October 1st and lasts through March 31st. If you do not enroll in a plan or your plan does NOT meet the government’s standard for qualified coverage, you will NOT be allowed to purchase a plan unless you trigger a special election period (marriage, child birth, loss of employer-sponsored coverage, etc).
2. A qualified health plan (QHP) must offer at least 60% co-insurance and the essential benefit categories. Plans that qualify can be purchased through the exchange, include Medicaid or Medicare, CHIP, TRICARE, or an employer-sponsored plan.
3. Those with pre-existing conditions will NOT be denied coverage and will NOT be subject to a higher premium.
4. During Open Enrollment, plan effective dates are as follows
*October 1st-December 15th = January 1st
*December 16th-January 15th = February 1st
*January 16th-February 15th = March 1st
*February 16th-March 15th = April 1st
*March 16th-31st = May 1st
5. Essential Benefits will be added to all plans in 2014. The benefits include
*Emergency Services
*Pediatrics
*Mental Health/Substance Abuse
*Prescription Drugs
*Maternity/Newborn Care
*Ambulatory Patient Services
*Preventative Care/Wellness
*Rehabilitative Services and Devices
*Hospitalization
6. The subsidy (also known as cost sharing) is based on household size and annual income. If you qualify for the subsidy, you can elect to have the funds applied towards your monthly health insurance premium or you can have the funds applied towards your tax return.
I am finally seeing a time frame for receiving answers and in doing so, the next few months will be crucial. July begins the certification process. As a licensed agent I will be getting certified to be able to advise you of your options in and out of the Marketplace/Exchange. Below is a breakdown of the information I received today. You will notice some differences between my original Healthcare Reform post.
-Open Enrollment begins October 1st-December 15th policies written during this time will have an effective date January 1st.
-Policies written between December 16th-March 31st will have an effective date of the 1st of the following month (for example: a policy written January 15th will have an effective date of February 1st).
-Enrollment ENDS March 31st. If you do not have a policy at this time you will NOT be able to enroll until open enrollment. You will be able to enroll at any time if there is a qualifying life event (for example: marriage, divorce, birth of child, loss of employment, etc).
Last week I attended a Health Care Reform Seminar. Below is some of the information I obtained from the seminar. Please note that some of the kinks are still be worked out and we are still waiting for some answers. As I obtain more information I will pass it along. Feel free to call or email with any questions and I will do my best to get an answer if I don’t know it myself.
INDIVIDUALS
*Will be required to obtain a qualified healthcare plan starting in 1/2014.
*Health insurers must cover EVERYONE that applies for a plan (i.e. all plans are guaranteed issue, will not contain a waiting period, and will cover all pre-existing conditions).
*Individuals may qualify for a subsidy; which is based on income.
*All plans will offer the same benefits (maternity and newborn care, emergency, fertility, obesity, mental health and substance abuse, perscription drugs, rehabilitative services and devices, dental, and vision).
*Plans in the marketplace are Platnum, Gold, Silver, and Bronze. You will be required to carry at least the Bronze plan to avoid the penalty.
*Platinum plan is 90% co-insurance, Gold is 80%, Silver is 70%, and Bronze is 60%.
*If you choose not to carry health insurance you will be required to pay a penalty of $95 for 2014, $325 in 2015, $695 in 2016. This penalty will be charged per person in the household. Chicldren under age 18 will be charged 1/2 of that amount (i.e. $47.50 for 2014).
*You may decide to carry no insurance for 1/2 the year. In that case the amount will be pro-rated to reflect the number of months without coverage.
*When you file your taxes for 2014 you will have to attach documentation from you health insurance carrier to show proof that you had purchased a qualified health plan.
*Coverage will be required to be maintained by all individuals, with exceptions; religious objections, financial hardship, undocumented immigrants, citizens not residing in the US, and those with short gaps in coverage.
*If you currently carry health insurance your plan MUST meet at least the Bronze plan benefits.
EMPLOYERS
*Under 50 full-time employees=no penalty
*Full time employees are considered 30 hours per week OR have a combination of full-time and part-time employees that is equivalent to at least 50 full-time employees
*The employer will need to make a decision on how they choose to handle covering their employees, especially employers with more than 50 employees.
*Employers will be required to offer at least the Bronze plan to their employees (assuming they are offering health insurance).
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