(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 [email protected] 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:
Sincerely,
Phil Lee Lee Health Insurance Services
925-284-2000 Ext. 101
Employee Benefits & Health Insurance
]]>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
[email protected]
Employee Benefits & Health Insurance
I received the following email from Anthem to agents and brokers last week with details about this decision. Please click on the link below:
Please review the following to be sure that you will actually be affected by this:
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
]]>SB 562 is very bad for you, your family and the future of the State of California for many reasons:
CALL TO ACTION:
If you object to losing your right to Medicare, losing your employer plan, being taxed an additional $9,200 per family member, losing your right to choose your doctor, your hospital and your insurance benefits, then please contact your State Senator to let him/her know. Click on the link below to find your State Senator and his/her contact information. Then click on the name to reach their website to communicate your message: http://findyourrep.legislature.ca.gov/
Just say No On SB 562 to preserve your choice in health care and to keep California from declining into certain economic ruin. Thank you for taking the time to read this email.
]]>As a courtesy, we are passing this information onto you.
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As reported by the San Francisco Business Journal, Blue Shield of California will be closed from September 3 to September 12 while its employees take the week of Labor Day off. Although Blue Shield announced there will be some customer service staff working that week we assume the phone lines will be jammed for the entire week.
It appears that Individual, Small Group and Medicare departments are affected by the shutdown.
We do not yet know whether the Blue Shield member portal, broker portal or employer portal will be accessible and will reflect current information during the shutdown.
ALL APPLICATIONS FOR BLUE SHIELD PLANS SHOULD BE SUBMITTED AS SOON AS POSSIBLE SO THEY CAN BE PROCESSED WITH AN ID NUMBER ISSUED BY FRIDAY, SEPTEMBER 2. APPLICATIONS ARE CURRENTLY TAKING 10-14 DAYS TO BE PROCESSED.
This is an unprecedented announcement by an insurance company. We will do our best to provide service to our clients during this shutdown, but if Blue Shield is closed our ability to provide customer service will also be severely impacted.
(NOTE: This information relates only to Blue Shield of California, a taxpaying non-profit insurance carrier that operates only in California. Please do not confuse this company with Anthem Blue Cross, or any other Blue Cross or Blue Shield organization in states outside of CA.)
Phil Lee
Lee Health Insurance Services (BLIS Corporation)
925-284-2000
]]>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:
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)
925-284-2000
www.linkedin.com/in/philwlee www.yelp.com/biz/lee-insurance-services-lafayette-7Affordable
]]>
For years, we have been suggesting to many of our clients that HSAs (Health Savings Accounts) frequently offer more benefits and flexibility than pension plans such as IRA’s. This article from the WSJ appears to agree with that.
We are obviously not suggesting that you replace pension plans with HSAs, but in many instances, you may want to contribute to an HSA before a pension plan, or use the HSA to increase your tax-sheltered contribution limits.
I welcome your comments.
Sincerely,
Phil Lee
Philip W Lee, Lee Health Insurance Services www.health-insurance.com 800-286-7445
Wall Street Journal, Jan. 29, 2016:
HSAs Offer Tax Benefits Beyond 401(k)s
Health-savings accounts can be used to cover medical costs, a major expense, in retirement
Most people overlook health-savings accounts, or HSAs, as a retirement-savings vehicle. A SeniorsPLUS networks representative talks with a Bangor Savings Bank official in Maine. PHOTO: GORDON CHIBROSKI/PORTLAND PRESS HERALD/GETTY IMAGES
By
ANNE TERGESEN
January 29, 2016
When saving for retirement, there is a place to put money that may be even better than your 401(k).
Most people overlook health-savings accounts, or HSAs, as a retirement-savings vehicle. But these accounts, which were authorized in 2003, come with more tax advantages than 401(k)s and individual retirement accounts when used to cover medical costs, which are a major expense in retirement.
“It’s the most tax-preferred account available,” says Michael Kitces, director of financial planning at Pinnacle Advisory Group Inc. in Columbia, Md. “Using one to save for retirement medical expenses is a better strategy than using retirement accounts” to cover those expenses, he says.
As with a traditional 401(k) or IRA, an HSA allows you to set aside pretax money without paying federal or state income tax on it. Most people who contribute through payroll deductions also save 7.65% in FICA tax, which finances Social Security and Medicare.
Money in HSAs grows tax-free and, if used for medical expenses, can also be withdrawn tax-free. In contrast, with a traditional 401(k) or IRA, you pay income tax on your withdrawals.
‘A lot of people don’t think about how to save for health care in retirement, yet it’s one of the major expenses people will have.’
—Roy Ramthun
Due to this combination of tax advantages, HSAs—which are paired with the HSA-qualified health plans available on health-care exchanges and offered by 43% of employers—can even be a better deal than a 401(k) with an employer matching contribution. That is most likely to be the case if you are in a high tax bracket and the 401(k) match is less than dollar for dollar, says Greg Geisler, an associate professor of accounting at the University of Missouri-St. Louis.
For people with a high deductible health plan, “an HSA should be either the first or second place they look to save” for later life, Prof. Geisler says.
To open an HSA, you must be covered by an HSA-qualified health plan. For 2016, these plans have deductibles of at least $1,300 for individuals and $2,600 for a family. In return for exposing policyholders to potentially higher out-of-pocket costs, the plans generally charge lower premiums and offer individuals and families the chance to save up to $3,350 or $6,750 a year, respectively, in an HSA. (Those over 55 can save $1,000 more).
ENLARGE
Because employers save on premiums too with a high-deductible plan, many contribute to employees’ HSAs as an incentive to get them to enroll, says Eric Remjeske, president of Devenir Group LLC, which advises banks offering HSA investment platforms.
The biggest payoff with an HSA comes when the money set aside isn’t all used for current medical bills and instead compounds over time, before being used for qualified expenses. Those expenses can include not just medical bills but also dental and vision-care expenses, Medicare premiums and a portion of long-term-care insurance premiums.
According to Fidelity Investments, a 65-year-old couple who retire today and live another two decades will spend $245,000 on expenses including Medicare premiums and the 20% of medical costs Medicare doesn’t cover—a number that doesn’t include dental and long-term-care expenses.
“A lot of people don’t think about how to save for health care in retirement, yet it’s one of the major expenses people will have,” says Roy Ramthun, president of HSA Consulting Services in Silver Spring, Md.
Once you are enrolled in Medicare you can no longer contribute to an HSA. But you can continue to tap your HSA balance for medical expenses for yourself, your spouse and any dependents you may have.
You can also use your HSA for nonmedical expenses, but you will owe income tax on your distributions—and a 20% penalty if you are younger than 65.
Experts recommend that those who can afford to contribute to both an HSA and a 401(k) kick in the maximum to both. And what if that isn’t feasible? If you don’t incur much in the way of medical bills and can sock away a significant portion of your HSA contributions for retirement, the HSA has an edge, says Mr. Kitces. Some employees may want to allocate enough dollars to a 401(k) to get the company match and then direct the next dollars of savings to the HSA.
Some people go so far as to suggest maximizing the balance in an HSA by opting to pay current medical bills in cash, rather than tapping the HSA. Here, the advice is less clear, says Mr. Kitces.
While the HSA will “get better tax treatment in the future,” you will pay a price for preserving it since you will likely have to pay your current medical expenses in after-tax, rather than pretax, dollars, he says. “You have to decide whether it’s worthwhile to spend more today” on your medical bills “to get more dollars into a tax-free medical account that’s turbocharged for the future,” he adds.
Some people stockpile medical receipts for many years and file for reimbursement in retirement to create tax-free withdrawals to supplement their income in years in which tapping other accounts would push them into a higher tax bracket.
If your goal is to use an HSA to save for medical expenses in retirement, be sure to invest the account in a diversified portfolio of stocks and bonds. (If you don’t like your HSA’s investment options, you can transfer your money tax-free to an HSA elsewhere.) By leaving your contributions in a low-risk option like a money-market fund, you won’t get much return, which limits the tax-free growth that is one of the HSA’s biggest advantages, says Mr. Kitces.
Write to Anne Tergesen at [email protected]
]]>We frequently hear stories about seniors who made this change hastily because they attended a meeting, or an agent came to their home. Frequently these agents would represent a limited number, usually just one, Medicare Advantage HMO plan. They typically do not give prospects an adequate overview or understanding of the entire universe of plans in the marketplace because they have limited knowledge and products to offer. They don’t fully explain the consequences of your making such a switch.
If you are contemplating such a change, you should not do so lightly. You should only do this after much thought and research. It’s not a matter of simply changing plans or changing carriers. It’s nothing short of changing from one world of plans, Original Medicare with Medicare Supplement, to another entirely different world of plans, Medicare Advantage.
These are the issues you must consider:
Phil Lee
Lee Health Insurance Services
800-286-7445
Re: Premium Reimbursement by Employers (outside of an ACA-Approved Group Health Plan) is a Costly Violation
Starting on July 1st, the IRS will begin assessing a penalty of $100 a day (per employee for each affected employee) to employers who continue to pay for employees’ individual health plans. Please click below link to this article.
We would be happy to help your company find affordable solutions to comply with local and federal requirements regarding health insurance.
Phil Lee
Lee Health Insurance Services
800-286-7445