Reminder: Anthem Blue Cross Cancellation of IFP Plans in Certain CA Counties

Reminder: Anthem Blue Cross Cancellation of IFP Plans in Certain CA Counties

(Note: This information concerns those who are on Individual & Family health plans.  It does not concern you if you are on Medicare or an Employer or Employee on a Group-sponsored or Government-sponsored health plan.  This information pertains only to California and does not apply to other states.)

This is a reminder that if you are currently on an Anthem Blue Cross Individual or Family (IFP) health plan (not Medicare or Group plan), and you received a notice from Anthem that your health plan will not be renewed on Jan. 1, then you need to take action by Dec. 15.

On Jan. 1, Anthem will be withdrawing IFP plans from all regions in California EXCEPT for 3. Those 3 regions and the affected counties are listed below.  These include 22 sparsely populated counties in N. Calif., Santa Clara county and 5 counties in the Central Valley.

The IFP plans that are affected include plans within the Covered CA Exchange (On-Exchange), as well as plans outside the Covered CA Exchange (Off-Exchange). They include Subsidized plans as well as Non-Subsidized health plans.  Those who are on Grandfathered IFP plans are not affected.

If you need help securing a plan from an alternate insurance carrier such as Blue Shield, Health Net or Kaiser, please contact me at plee@health-insurance.com or call 925-284-2000 Ext. 101.

Anthem Blue Cross IFP Plans will be discontinued on Jan. 1 from all CA Counties EXCEPT the following:

  • Northern California: Alpine, Amador, Butte, Calavaras, Colusa, Del Norte, Glenn, Humbolt, Lake, Lassen, Mendocino, Modoc, Nevada, Plumas, Shasta, Sierra, Siskiyou, Sutter, Tehama, Toulumne, Trinity, Yuba.
  • Santa Clara
  • Central Valley: Mariposa, Merced, San Joaquin, Stanislaus, Tulare.

Sincerely,

Phil Lee Lee Health Insurance Services

925-284-2000 Ext. 101

plee@health-insurance.com

http://www.Health-Insurance.com

www.linkedIn.com/in/philwlee

Employee Benefits & Health Insurance

Reminder: Annual Open Enrollment Period

(This information concerns those who are on Individual & Family health plans, and Medicare health plans. It does not concern you if you are an Employer or Employee on a Group-sponsored or Government-sponsored health plan. This information pertains only to California and may or may not apply to other states.)

This is a reminder that we are in Open Enrollment season for several lines of health insurance plans.

(A) For Those Under Age 65 on Individual & Family Plans
Annual Open Enrollment period (AEP) this year runs from Nov. 1 through Jan. 31.
• You may enroll into or change Covered CA On-Exchange (with subsidy) as well as Off-Exchange (no subsidy) plans.
• Competitive Rate Comparison Proposals for On Exchange as well as Off Exchange plans are now available for Jan. 1, 2018. Please let us know if you would like one prepared for you.
• On Jan. 1, Anthem Blue Cross will be terminating their Individual plans in most counties in California except for some in rural Northern California.
• If you received a cancellation notice from Anthem Blue Cross, please contact us for a proposal to show you alternative plans from Blue Shield, Health Net, Kaiser, etc.
• If you received a large rate increase, ask us for a proposal showing alternatives.

(B) For Those Seniors Over Age 65 on Medicare
• For those on Supplement plans, there is NO Open Enrollment Period. Your supplement plans do not require renewal and continue uninterrupted until you cancel it.
• For those on Supplement Plan F, CMS (Center for Medicare Medicaid Services) will prohibit new sales after Jan. 2020. But those who are already on Plan F at that time will be grandfathered indefinitely.
• For those wishing to switch from a Medicare Advantage HMO plan to a Supplement Plan, there is no Open Enrollment and no Guarantee-Issue (GI) unless you have a Qualifying Event (QE), such as a move from out of state. You will wish to review the 13 Guarantee-Issue (GI) situations in CA that you may possibly qualify for. Even if you don’t qualify, there is no penalty for applying and going through the non-GI underwriting (approval) process. Chances are good that you may still qualify based on your health. The process for this type of transition is tricky and the timing very tight. If you think you may want to do this, start this process early to give yourself enough time to receive approval. We recommend that you seek professional assistance from an experienced agent knowledgeable in this area.

(The above is meant to be informational. This information has not been approved by CMS or any regulatory agency. This is not sales material and should not be relied upon to make purchase decisions. We recommend that you consult a knowledgeable insurance agent before making any decisions.)

Phil Lee
Lee Health Insurance Services 925-284-2000
www.linkedIn.com/in/philwlee
www.Health-Insurance.com
plee@health-insurance.com
Employee Benefits & Health Insurance

Anthem Blue Cross to Discontinue Individual Health Plans in Most Counties in California

Anthem Blue Cross announced that they will discontinue selling Individual medical plans in CA in 2018 except for three counties, Santa Clara, Stockton/Modesto, and Redding.

I received the following email from Anthem to agents and brokers last week with details about this decision. Please click on the link below:

Anthem Announcement

Please review the following to be sure that you will actually be affected by this:

  • This change only affects those on Individual Health Plans, NOT Employer Group plans or Medicare plans.
  • It affects both On Exchange (Covered California), as well as Off Exchange health plans.  It affects both subsidized as well as non-subsidized plans.
  • It does not affect “Grandfathered” plans.
  • It will take effect on Jan. 1st, 2018.
  • This change does not affect these 3 counties: Santa Clara, Stockton/Modesto and Redding.

We might be able to help you find alternatives as soon as the insurance carriers such as Blue Shield, Health Net and Kaiser release their new rates for Jan. 1, in either September or October.

Phil Lee

Lee Health Insurance Services (BLIS Corporation)

925-284-2000

http://www.health-insurance.com

www.linkedin.com/in/philwlee  

Covered California – Urgent Last Minute Alert

(This information concerns those who enrolled into Individual and Family Health Plans through the Government Exchange – Covered California – and received a Subsidy or APTC.  It does NOT concern you if you are either on an Employer-Sponsored Group Health Plan or a Medicare Health Plan. This information pertains only to California and may not apply to other states.)

As a courtesy, we are passing this information onto you.

December 19, 2016

 

Consumer Outreach for Consent for Verification

Yesterday, Covered California sent an email to consumers that are at risk of losing their Advanced Premium Tax Credit (APTC) and/or cost-sharing reductions for their 2017 health insurance coverage.  Consumers need to ensure that they have provided their Consent for Verification as this allows Covered California to electronically verify their eligibility for tax credits.

The following two fields are provided to help identify those consumers who need to provide consent.

  • Years of Consent – provides the number of years the consumer provided consent to using their information for verification purposes.
  • Date of Consent- provides the date the consent was provided by the consumer to use their information for verification purposes.

Without taking action now, consumers who have not updated their consent will lose their premium assistance including federal tax credit and/or cost-sharing reductions (lower copayments, coinsurance and deductibles). Read our Consent for Verification Quick Guide for additional information.

LAST DAY to Enroll for January 1 Coverage

Consumers only have until midnight tonight, December 19, 2016 to enroll in a health plan for coverage beginning January 1, 2017. Plans selected after this time may have a February 1 or March 1, 2017 coverage start date.

 

Covered California Service Centers

Consumers that need last minute application support can contact the Covered California Consumer Service Center for the Individual Marketplace at 800-300-1506, which will be open tonight until midnight.

 

Upcoming Outage

Sunday, January 22 from 8:00 p.m. to Monday, January 23, 2016 at 6:00 a.m.

Phil Lee
Lee Health Insurance Services, BLIS Corporation
800-286-7445
www.linkedIn.com/in/philwlee
www.Health-Insurance.com
plee@health-insurance.com
Employee Benefits & Health Insurance

Understanding Special Enrollment Period (SEP) and Qualifying Events (QE)

(This information concerns Individual & Family Health Plans. It does not concern you if you are either on a Medicare Health Plan or on an Employer-Sponsored Group Health Plan)

The year-end Open Enrollment Period for Individual Health Plans ended on January 31, 2016.  However, certain individuals may still be able to apply for a health plan in 2016. This special circumstance is called the Special Enrollment Period (SEP).  You need to have a Qualifying Event (QE) to qualify.  Here’s what you need to know.

You can buy health coverage outside of the open enrollment period when you have a qualifying life event—through a special enrollment period (SEP).  Most SEPs last 60 days from the date of the qualifying life event.
Qualifying life events for a SEP include:

  • Getting married or entering a domestic partnership
  • Child aging off a plan
  • Gaining a dependent or becoming a dependent through marriage, birth, adoption, or placement for adoption or foster care
  • Permanently moving to a new area that has different health plan options
  • Employer coverage not being considered minimum essential coverage
  • Losing other healthcare coverage that is considered minimum essential coverage, such as due to job loss, termination of employer health plan by the employer or expiration of COBRA coverage
  • Returning from active military service
  • Change in eligibility for advance premium tax credit or cost-sharing subsidies

Please note that voluntarily terminating other health coverage or being terminated for not paying premiums is not considered a qualifying event.

All insurance companies will require written proof that you have an acceptable qualifying event.  When enrolling during an SEP, please make sure to include qualifying events verification documents in the application.

This is a link to Blue Shield of California’s interpretation of the ACA laws regarding SEP and QE’s.  Different carriers may have slightly different interpretations and requirements.

https://bliscorp.egnyte.com/dl/QJhtXag1KT

Phil Lee

Lee Health Insurance Services (BLIS Corporation)

www.health-insurance.com

925-284-2000

www.linkedin.com/in/philwlee   www.yelp.com/biz/lee-insurance-services-lafayette-7Affordable

 

Last Chance to Enroll into a Health Plan in 2015

(This information relates only to Individual and Family Health Plans, not Medicare or Group plans)

If you are uninsured and do not have a special Qualifying Event, Thursday April 30th is the last day that you may enroll into an Individual Health Plan using the Govt.’s special extension by claiming that you are unaware of the uninsured penalty.

If you apply by April 30th, you will receive a June 1st effective date. Otherwise, you will have to wait until the end of the year.
In order to apply for coverage during this extended enrollment period to a plan either On or Off the Covered California health exchange, most carriers require you to do so through a certified agent. Anthem Blue Cross further requires the application to be on paper through an agent.

At Lee Health Insurance Services we would be happy to serve as your agent. As always, there are no costs, no fees for our services. The premium rates you pay are the same approved and regulated rates whomever you get them from. If you qualify, you will receive the tax subsidies that you are eligible for based on your household income.
Phil Lee
Lee Health Insurance Services
800-286-7445
www.health-insurance.com

Extended Enrollment Deadlines for Individuals

(This information relates only to Individual and Family Health Plans, not Medicare or Group plans)

For those of you who are still uninsured or who just found out from doing your 2014 tax return that you have to pay a penalty, there is still time to enroll. If you are currently uninsured and can testify that you were not aware of the penalty, you may still enroll. However, there’s not much time left. The deadlines are:

April 15th, for a May 1st Effective Date.
April 30th for a June 1st Effective Date.

In order to apply for coverage during this extended enrollment period to a plan either On or Off the Covered California health exchange, you must do so through a certified agent or broker. We at Lee Health Insurance Services (800-286-7445) would be happy to serve as your agent. As always, there are no costs, no fees for our services. The premium rates you pay are the same approved and regulated rates whoever you get them from. If you qualify, you will receive the tax subsidies that you are eligible for based on your household income.

Covered California Application Problems

We are finding that many of you trying to enroll onto Covered California online got stuck or sent off to MediCal (Medicaid). E.g. if you happen to put an Employment End Date, you would likely be sent to MediCal.
We, at Lee Health Insurance Services, have figured out the “fixes” to these issues, and would be delighted to help you resolve them in order to secure coverage from Covered California.

Very sincerely,
Phil Lee
Philip W Lee MBA
Lee Health Insurance Services
Employee Benefits and Health Insurance
800-286-7445
www.Health-Insurance.com

Obamacare: Enroll by Sunday 2/15 or Pay a Penalty

(Please disregard this if you have an Employer Group plan or have Medicare.)

For those of you who have not already enrolled into an Individual health plan, the enrollment deadline is this Sunday Feb. 15th.
After the Feb. 15th deadline, you will have to wait until the end of the year to enroll for Jan. 1, 2016. If you are uninsured, you may also face a penalty when you file your tax return in April 2016.

Possible Extension:
For those of you applying through Covered California for an On-Exchange health plan, if you start an online application before 2/15 but are not able to complete it on that day, we, as agents, have been given an extension to help you complete it, by 2/24. This extension is not available to the public and does not apply if you do not start an application by 2/15.
If you need help, please call us at 925-284-2000 or email agent@health-insurance.com .

Phil Lee
Lee Health Insurance Services
925-284-2000
www.health-insurance.com

Avoid Penalty – Deadline Feb. 15th to Enroll into Individual Health Plan

Avoid Penalty – Deadline Feb. 15th to Enroll into Individual Health Plan

To avoid a penalty, the deadline to enroll into an individual health plan is Feb. 15th, 10 days from today. If you submit an online application by that date, you will be able to secure an Effective Date of March 1st. If you miss this deadline, you may not enroll again until the end of 2015.
This deadline does not apply to you if you experience a qualifying event during the year, such as a loss of Employer group coverage, a change in family status such as a marriage, divorce or newborn, a move out of the area, etc.
If you are uninsured, or insured only with a temporary or non-creditable health plan, you may face an IRS-assessed penalty for 2015 of up to 2% of your household income. (This is up from 1% in the 2014 tax year.)
If your estimated 2015 household (MAGI or Modified Adjusted Gross Income) is between 138% and 400% of the Federal Poverty Line (FPL, equivalent to roughly between $16,106 and $46,680 annual income for a single person household), you may apply to Covered California for an APTC (Advance Premium Tax Credit or Tax Subsidy) to help pay the monthly premium on a creditable health plan. If not, you may apply for an Off-Exchange health plan at the same price without a subsidy. We can help you with both. If you income is below 138% FPL (or your children below 200% FPL), then you may qualify for Medi-Cal (California’s Medicaid).
Please call us at 800-286-7445 if you need help.

Philip W Lee
Lee Health Insurance Services
Employee Benefits and Health Insurance
plee@health-insurance.com
www.Health-Insurance.com

Alert to Individuals who Received Tax Subsidies or APTC to Pay for Covered California Health Plans – Form 1095A

(Note: This alert relates only to Individual and Family health plans. It does not relate to Employers with group health plans, nor to Seniors with Medicare plans.)

Re: IRS Form 1095A and Form 8962

Covered California, the California health insurance exchange, will shortly be sending out a form called the IRS Form 1095A to all individuals and families who received tax subsidies in 2014 to help pay for their Individual/Family health plans. This is required by the federal ACA law (Obamacare) and will be sent out by Jan. 31st.
These forms will show, in detail, by month, the amount of APTC (Advance Premium Tax Credit or Tax Subsidy) that the recipient received in helping pay the premium for their subsidized health plans in 2014.
These individuals will be required to use this Form 1095-A to obtain information needed to complete Form 8962 (Premium Tax Credit (PTC)). They must then complete IRS Form 8962 and file it with their 2014 Tax Return by April 15.
Those who enrolled into Off-Exchange health plans need not be concerned, since they did not receive any tax credit, you will not receive a 1095A. Only those who applied for a health plan through Covered CA AND who received an APTC to reduce the premium paid, will be receiving these 1095A forms.
Those enrolled into Medi-Cal (California Medicaid), those on Medicare, and those enrolled on employer group plans are not affected by the above.

Disclaimer: We are not qualified to give tax advice. If you have any questions concerning either Form 1095A or Form 8962, please contact Covered CA, your tax adviser, the IRS or go to the IRS website links below:
www.irs.gov/uac/About-Form-1095-A
www.irs.gov/uac/About-Form-8962

Philip W Lee, MBA
Lee Health Insurance Services
www.health-insurance.com
800-286-7445

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Lee Health Insurance Services | Healthcare Insurance Agency, Individual Health Insurance, Family Health Plans, Group Medical Insurance, Small Business Health Insurance, Whole & Term Life Insurance, Dental Insurance, Health Care Reform Assistance, Covered California Insurance Exchange Plans, Medicare Supplement Insurance, Medicare Advantage, Medigap Plans, Anthem Blue Cross, Kaiser Permanente, Blue Shield of CA, Health Net, Cigna, Aetna, Contra Costa County CA, Pleasant Hill, Danville, Concord, Berkeley, Martinez, Albany, Oakland, San Ramon, Alameda, Santa Clara, Campbell, Milpitas, Cupertino, Sunnyvale, Saratoga, Fremont, Palo Alto, Newark | 935 Moraga Road, Suite 240, Lafayette CA 94549 (925) 284-2000 or Toll-Free, (800) 286-7445