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!
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.
Assurant Health just announced they will exit the Individual Medical and Short Term Medical markets effective JUNE 15th. If you have a policy with Assurant Health, contact me to discuss your options.
The tax filing special enrollment period is now open available for plans on and off the Marketplace. In order to qualify for the special election period
*You had to pay a penalty for 2014
*Are not currently enrolled in a plan
Application submitted March 15th-April 15th will take effect May 1st and April 16th-30th will take effect June 1st
A Special Election Period (SEP) for individuals and families that did not have coverage in 2014 and qualify for assistance, can apply for coverage March 15th-April 30th. In order to qualify…
*You must not be enrolled in a plan currently
*Attest that when you filed your 2014 tax return you paid the penalty for not having health coverage (1% of your income or $95/adult in the household and $47.50/child)
If you apply during this time, coverage will take effect May 1st.