Covered California announced that they are extending the March 31st deadline to buy health insurance through its Exchange website CoveredCa.com to April 15th. There are conditions. You may fulfill these conditions by working with a Certified Insurance Agent, like me. We are prepared to help you. Please call us at 925-284-2000 or email [email protected].
Re-cap of announcement from Covered CA:
1. If you were unable to create an online account or start your online application because of technical difficulties you can contact me, a Covered California Certified Insurance Agent, to explain that you attempted to get through on March 31 and experienced difficulties. You will have until 11:59 p.m. April 15 to complete your application and choose a plan. Your coverage will be effective May 1.
2. If you created an online account and completed the first page of the application by 11:59 p.m. March 31, 2014, you will be able to complete your application for the open-enrollment period, either by yourself online or with my help. I am a Certified Insurance Agent. You must complete your application and select a plan by 11:59 p.m. April 15. Your coverage will be effective May 1.
In addition, for those applying to OFF-Exchange (i.e. non-Covered CA, non-subsidy) plans, we understand that Blue Shield and Health Net’s online application links are both still working.
Please call us at 925-284-2000 if you still need help getting coverage.
Phil Lee
Lee Health Insurance Services
www.Health-Insurance.com
Blog: www.HealthPLanTalk.com
News this past week (Quite a lot has happened):
• 12 month Delay in Cancellations
Obama’s press conference last week called for a delay of 12 months to the millions of plan cancellations letters that consumers have received. The President vetoed similar bills submitted to him by Congress to remedy this, but preemptively, offered up his own version, an “administrative fix” which did not give him the legal authority to force a delay, but basically passes the problem down to the States and the insurance carriers.
Although many States have instituted this delay, many have not, including California.
• California Cancellations
In California, Dave Jones the Insurance Commissioner was in favor of a delay, but the final decision rested with the head of Covered CA, Peter Lee, who thought otherwise. The Covered CA Board decided yesterday not to follow Obama’s recommendation for a 12 month delay in cancellations. Cancellations scheduled for Dec. 31 and March 31 will go into effect as planned.
• Dec. 15th Application Deadline Extended to Dec. 23rd
It was announced today that the Dec. 15th deadline for enrolling into a health plan with an effective date of Jan. 1st, has now been extended to Dec. 23rd. This new deadline will apply to all individual plans on or off the Covered CA Exchange. You will have one extra week to enroll for a Jan. 1st plan.
• Off Exchange Rates and Benefits Released
Insurance carriers in CA have now released rates and benefits for all their Off-Exchange health plans, i.e. those plans that are outside of Covered CA and not eligible for subsidies. We now have all the information necessary to help you make a decision.
• Annual Open Enrollment Period (AEP) for all individual plans
The AEP for 2014, which was previously scheduled to begin on 10/15/14, has now been delayed to 11/15/14, after the midterm elections.
Important Information to Know:
1. Those Cancellations that were delayed to March
Only some of you, but not all of you, have received letters from your carriers (Anthem Blue Cross, Blue Shield or Health Net) notifying you that your current health plan’s cancellation date has been extended to March 2014. And that if you wish to accept this delay, you must notify them in writing.
This is a tempting delay to accept, but you should understand that you may have to satisfy two deductibles in one year, instead of one. The reason is that you will be satisfying one deductible from Jan. to March, then start a whole new deductible after March. The deductible satisfied in the first 3 months do not carry over to your new plan in April.
For the same reasons, even if the open enrollment period does go to March 31st, you may want to enroll on Jan.1st to avoid the two deductible problem.
2. Although you may apply to Covered CA for a health plan, even if you do not qualify for a subsidy, this is not advisable for these reasons:
a) There are 3 buckets of health plans in the Individual marketplace: On-Exchange plans, Off-Exchange plans and Off-Off-Exchange plans. All the plans offered inside the Covered CA Exchange, the metallic plans, are also available outside of the Exchange at exactly the same premium and same benefits. We call these “mirror plans” of “Off-Exchange” plans. They are similar, but may not use the metallic names of Bronze, Silver, Gold and Platinum. The only difference is that these plans do not have subsidies.
b) Inside the Exchange, you are required to report personal and financial information like your income.
c) Inside the Exchange, your personal and financial information will be shared with government agencies like the IRS, Dept. of Homeland Security, INS, HHS, CMS and their contractor Equifax.
d) Inside the Exchange, you may be subject to retroactive audits and recalculations years down the road, by the IRS, for any errors in reporting.
e) Outside the Exchange, there will be many more plan designs and rate levels available, besides the “metallic plans”.
4. If you do not qualify for a subsidy, then you should consider a health plan outside the Exchange. All plans are guarantee-issue regardless of pre-existing conditions, you will not be asked for any health or financial questions. And your information will not be shared with any government agency.
Next Steps
A. Use the Covered CA Calculator to see if you qualify for a subsidy (See instructions in my piece “Choosing an On or Off Exchange Health Plan”)
B. Ask for a comparison proposal that compares all plans inside and outside of the Covered CA Exchange. Email me at [email protected] or call 925-284-2000.
C. Ensure that your doctors and other providers are on the network of the plan you are applying to. (See instructions in my piece “Choosing an On or Off Exchange Health Plan”)
D. Ensure that your prescription medications, especially Brand Name drugs are on the formulary list of the plan that you have chosen. (See instructions in my piece “Choosing an On or Off Exchange Health Plan”)
Decision
a) If you decide to keep a Grandfathered plan, then you do not need to do anything. Your plan will continue at the rate that the carrier has notified you of.
b) If you are eligible for a subsidy, then you must apply to a Covered CA Exchange plan.
c) If you are not eligible for a subsidy, or you choose to voluntarily forgo any subsidy, and your current plan is being cancelled, then you may apply for an Off Exchange health plan.
d) If you find that your providers are not on any of the 2014 plans, but your current plans is going to be cancelled. There is one possibility. You may apply to a Cigna 2013 Off-Off-Exchange health plan by Dec. 14th for a Dec. 15th effective date. This application requires underwriting and approval. But Cigna will renew your plan on Dec. 31st. They will add a 5.8% increase for ACA-related taxes and fees. Then allow you to keep the plan with full provider network (instead of the narrow 2014 networks up until 12/31/2014. This move allows you to delay your transition to ACA plans until 2015. Hopefully, there may be better options at that time.
Applying for a Covered CA On-Exchange Health Plan:
• Apply online at www.coveredca.com. Set up an ID and password. Find and designate me as your agent (Philip W Lee License #0795681) so that we may help you with this enrollment and continue to service you in the future. Please ask me for my Step by Step Application Screenshot instructions for setting up an account and designating an agent.
• Apply using a Fillable Paper Application. Please ask me for a copy of the fillable paper application where you can simply type you information on the form, print out, and send or fax to us for processing Print and Hand Complete an Application. Please ask me for a copy of the fillable paper application which you may print out blank, handwrite your answers on the form, and return to me. (Fax 925-284-5484 or email [email protected] or mail Lee insurance Services, 935 Moraga Rd., Ste. 240, Lafayette CA 94549)
Applying for an Off-Exchange Health Plan:
• Apply Online at Carrier Website. The following links to the insurers are encrypted with my agent info so that the insurer will recognize that we are helping you so that we may monitor and troubleshoot any problems for you.
Anthem Blue Cross: https://brokerportal.anthem.com/ehb/web/bkr/acc/agentconnect/PHILIPLEE_1
Blue Shield of California: https://www.blueshieldca.com/bsca/ApplyNow?xyz=I%2Bc68ZizpmLi
Health Net:
(Online link pending)
Kaiser:
(Online link pending)
Cigna:
(Online link pending)
Getting Paper Applications to Us
• Fax to us anytime at: 925-284-5484
• Email to: [email protected]
• Mail to: Lee insurance Services, 935 Moraga Rd., Ste. 240, Lafayette CA 94549
• Deliver in Person: We are open on Weekdays (except holidays) from 9 am to 5 PM. After hours, there is a mail slot at the door to our office. If you live nearby and find it more convenient to drop off your application, you may simply slide it through the slot. We will attend to it as soon as our office opens again.
It would give us immense pleasure to see that you are all taken care of before your respective deadlines.
Phil Lee
www.health-insurance.com
www.healthplantalk.com
800-286-7445
Will current Individual health insurance rates stay the same when Health Care Reform takes effect on Jan. 1st?
We do not yet know what the rates will be. But rates are expected to be announced by the carriers in Sept. Those rates will take effect on Jan. 1st when the bulk of the ACA (Obamacare) rules take effect.
What we do know is that individual rates, which have traditionally been low in California, will rise to the level of the higher group rates. Young people will probably see their rates skyrocket. Those in older age groups will probably see more moderate increases.
The increases will likely be due to these factors:
1) The half dozen premium taxes, fees and other charges that will be levied to pay the expenses of the Federal program and the State-sponsored Exchanges.
2) The age band ratio changes from 1:9 to 1:3. Previously, the ratio could be as much as 1 to 9 of a younger person’s rate to that of the oldest age group. Under ACA, that ratio will be compressed to 1 to 3. This will drive up rates for young people while moderating those for the older groups.
3) Guarantee-Issue will result in higher rates. Previously the individual plan “pools” consisted of people who were generally healthy when they enrolled. With guarantee-issue, carriers will have to take all comers including those with significant pre-existing health conditions who previously could not qualify for these plans. This will drive up claims, and therefore premiums.
The carriers and the Exchanges will open for enrollment on Oct. 1st for plans to start on Jan. 1st. Plans will be offered both inside the State Exchanges and outside. The selection of plans within the Exchange will be more limited, but will allow you to apply for low income subsidies. Plans outside of the Exchange will have a much wider selection but will not be able to offer subsidies.
Premiums for similar plans will be the same, inside or outside of the Exchanges.
The Open Enrollment and Guarantee-issue period ends on March 1st, 2011. In order to take advantage of this new law, children must be enrolled by March 1st.
Read details of this new law at:
Check rates for children at:
© Philip W Lee, www.health-insurance.com, www.healthplantalk.com
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© Philip W Lee, www.health-insurance.com, www.healthplantalk.com
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