| (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. |
|||||||
|
Covered California – Urgent Last Minute Alert
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 [email protected] .
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
[email protected]
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
Update on Enrollment Deadlines: Extensions for OFF Exchange Plans
(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.)
ON Exchange (Covered CA) plans:
As reported earlier, the 12/15/14 deadline has been extended to midnight Sunday 12/21/14. Online applications only. This applies to all Covered CA Exchange plans from Anthem Blue Cross, Blue Shield and Kaiser.
OFF Exchange plans (outside of Covered CA and direct with insurers):
Anthem: The deadline has been extended to midnight Sunday 12/21/14. Applications must be on paper.
Blue Shield: There are no extensions. The deadline passed on 12/15. (If you still want Blue Shield but do not need a subsidy, you may still apply through the Covered CA portal. But you will still have to provide income and immigration status to the Govt.)
Cigna: The deadline has been extended to Friday 12/19/14 at 5 pm PST.
Health Net: The deadline has been extended to midnight Sunday 12/21. Online applications only. Applicants are encouraged to pay their initial premium by 1/1/2015, without waiting for their NOA (Notice of Acceptance). You may use HN’s 24-hour payment line at 1-800-539-4193. You will hear the amount due as soon as HN has your enrollment in their system.
In all cases, the application extension plus the time required to process the files will impact timely receipt of the NOA (Notice of Acceptance) letters, initial premium bills, delivery of ID cards and policy descriptions.
If you need help, please call us at 925-284-2000 or email [email protected].
Phil Lee
800-286-7445
Health Plan Enrollment Deadlines
This is a friendly reminder of several deadlines that are approaching.
Deadlines for INDIVIDUAL & FAMILY HEALTH PLANS (Either On-Exchange Covered CA plans or Off-Exchange plans)
(1) Deadline to enroll or change plans for a Jan. 1st effective date is Monday, Dec. 15th
(2) Open enrollment runs from 11/15/14 to 2/15/15. The deadlines corresponding to each effective date are:
Deadlines for each Effective Date
12/15/14 for 1/1/15
1/15/15 for 2/1/15
2/15/15 for 3/1/15
(3) If you are currently receiving a subsidy, then you must Renew by logging into Covered CA with your User ID and Password in order to re-certify to continue receiving the subsidy. (4) If you are uninsured, you may enroll by Dec. 15th to avoid a penalty in 2015.
Deadlines for EMPLOYERS WITH SMALL GROUP PLANS
(1) Groups on Grandfathered or Grandmothered plans will already have renewed on Dec. 1st.
(2) All groups, whether Grandfathered or Grandmothered will have a chance to change to new ACA plans with another insurance carrier on Jan. 1st.
(3) If you are dissolving an Employer Group plan and allowing employees to buy individual plans, they need to enroll by Dec. 15th for a Jan. 1st start. (Note that Individual health plans have significantly smaller Provider Networks than Group plans, and smaller Drug Formulary lists. Each of your employee will need to research their providers and formularies carefully before making a switch. Not all employees will qualify for subsidies. Employers are not allowed to use pre-tax dollars to pay for employees’ Individual plan premiums.)
Deadlines for SENIORS ON MEDICARE PLANS
(1) The deadline to change from a Medicare Advantage MA-PD plan (HMO or PPO) to another is Dec. 7th.
(2) The deadline to change from a Medicare Prescription Drug PDP Plan to another is Dec. 7th.
(3) For Medicare Supplement (or Medicare Gap) Plans there is no deadline and no renewal is necessary. These plans will continue as long as you continue paying the premium.
(4) For those of you who received termination notices from Scan Health and Health Net Medicare Advantage plans, you must enroll before Dec. 31st for a Jan. 1st effective date. Since some carriers will be closed during the holidays, you should submit these applications 2 weeks before Dec. 31.
(5) If you are on a Medicare Advantage MAPD plan and wish to switch to a Supplement plan and a PDP plan, you may do so, guarantee issue, only under 13 specific conditions. Otherwise, underwriting approval may be required and the timing of the switch can be tricky. The ideal time to make a change is between Oct. 15 and Dec. 7th, and as early as possible during this window. This should not be done without the assistance of a knowledgeable agent.
Please contact us, Lee Health Insurance Services, at 925-284-2000 if we can be of assistance.
Phil Lee
Open Enrollment and Renewal for 2015 Individual Health Plans
(Please Note: This information pertains only to those of you who are on Individual or Family Health plans. This does not affect either Employer Group plans or Medicare.)
This past year just flew by. But Open Enrollment is upon us again. The Open Enrollment period runs from Nov. 15th through Feb. 15th. (Any plan changes to start on the first of a month must be made by the 15th of the previous month.) All of you should have received letters or emails from either your insurance carrier or from Covered CA, or from both. Many of you may not need to do anything at all for your plans to continue. However all of you who received subsidies through Covered CA will all need to take action. Details on how to do this are at the bottom of this email.
NOTE: If you require assistance, but we are not your agent, you may designate us as your agent in order to receive our assistance.
If you have an ON Exchange Individual Health Plan
(i.e. you obtained your Anthem Blue Cross or Blue Shield or Kaiser or Health Net plan through Covered CA, either with or without our assistance as your agent.)
You must “Renew” your plan if you want to continue receiving your subsidy for the 2015 year. You do this by logging into CoveredCA.com using your User ID and Password. Government regulations require that you so this in order to continue the subsidy. If you don’t do this, the premium for your plan will jump up to the full non-subsidized rate and you will be billed for that. Some may also lose the cost reduction feature on the Silver 70+ AV plans. Details on how to do this are at the end of this email.
If you have an OFF Exchange Individual Health Plan
(i.e. you obtained your Anthem Blue Cross or Blue Shield or Kaiser or Health Net or Cigna health plan, outside of Covered CA. You did not apply for a subsidized plan. You may or may not have used us as your agent.)
Please read the letters from your insurance carrier carefully. Most of your plans will continue and you may not need to do anything to continue. However for some of you, especially those who are on Health Net plans, they have cancelled some plans and changed many from PPO to EPO. You may want to research new carriers or plans.
How to “Renew” Your Covered CA Subsidized Health Plan
Log into your account on Covered CA by going to: www.coveredca.com and once you are on your account page choose Renew (yellow box). Next will appear Household Plan Selection and click Renew Health Plan (yellow box).
On the next page, two boxes will appear: Choose either Keep the Plan you now have or Shop for a different plan.
If you want to keep your current plan click Keep (yellow box) and checkout (yellow box) check all boxes, put in your pin number, sign and click Enroll (yellow box). On the next page you can print out your confirmation page and make sure you click Done (yellow box). Submit your payment to the carrier no later than December 26, 2014 by either calling your carrier or logging into their website to pay online.
If you want to change your plan when you are on the page that says: Keep the plan you now have or Shop for a different plan you will “remove your plan” (yellow box) first and then click on “Shop for a different plan”. Next page you will review all plans and choose a new plan, check out, check all boxes, put in your pin number, sign and click “Enroll” (yellow box). You can print out your confirmation page and click Done (yellow box). Submit your payment to the carrier no later than December 26, 2014 by either calling your carrier or logging into their website to pay online.
Please contact us, Lee Health Insurance Services, at 925-284-2000 if we can be of assistance.
Phil Lee