Posts Tagged ‘health insurance exchanges’

You Could Lose Your Health Insurance When Your Parent Dies

Sunday, July 13th, 2014

The last thing you are worried about when a parent dies is what will happen to your health insurance coverage.  But unfortunately for many young people, they also lose their health insurance coverage when their spouse dies.  This also holds true for spouses, including those with young children.  In the U.S. News & World Report Health article “What to Do When You Lose Your Health Insurance,” Geoff Williams offers up options for those who lose their health insurance unexpectedly.  The article gives the example of a 30-year old woman who lost her health insurance coverage when her father passed away in April.  She has ulcerative collitis, a bowel disease that could cause serious complications without her medication and doctor visits.  She found out that she had lost her health insurance when she tried to fill a prescription and her insurance was declined.  It cost her $200 out of pocket just to buy the four pills that she needs for one day.

It’s not common for a 30 year old to have health insurance coverage under her Dad’s plan, so the woman in the example was lucky to have such a perk.  In this particular instance, her Dad had carried individual health insurance with his carrier for so long that they allowed him to keep his daughter on his plan to age 31.  She would have had to search for health insurance soon anyways, so she was likely already researching her options.  If you don’t have health insurance coverage, you can shop for it at any time.  The Health Insurance Marketplace open enrollment period is from November 15 to February 15, but the government dates aren’t necessarily written in stone.  You can apply for a health insurance plan at any time when you have had a life change that took away your health insurance.  You can also apply for health insurance with an individual health insurance company at any time during the year.  Most companies have open enrollment periods similar to the government, but for a shorter period of time.  You can make changes to your plan during that time, unless you have a life changing event some other time during the year.

Life changing events include death, the birth of a child, marriage, divorce, a change of income, relocation, or the sudden loss of health insurance.  If any of these events happen to you, the government gives you a 60 day grace period to obtain health insurance in the exchange.  You can get health insurance quotes from multiple companies here.  You can also use an agent that works for one health insurance company or a broker that shops the health insurance marketplace for you.  The last option is similar to shopping the market for health insurance with  Medicaid and the Children’s Health Insurance Program are available to those with low income.  COBRA is a health insurance option for people who have just lost their jobs, and therefore their health insurance coverage.  If your parent dies and you lose your health insurance, there are options for you to find health insurance coverage.  The woman in the article was able to get her insurance plan extended until August 1 so that her daily medication is covered, so she had a couple months to search for her own health insurance plan.


Consumers Would Like to Know Premium Increases In Advance

Saturday, June 28th, 2014

Increasing healthcare costs have been a bone of contention for years.  This was long before the Affordable Care Act became law and it’s continuing after the ACA went into effect.  One of the biggest problems that many consumers have is that it’s just not clear where the extra money they have to pay is going.  The cost of health insurance premiums is rising much faster than our incomes, so healthcare is really taking a hit on consumer budgets.  Consumer Reports’ David Butler wrote an article for Fox Business titled “Make the pricing of health insurance more transparent.”  If consumers know why they are paying more money and exactly where their money is going, people might not be so angry about paying higher premiums.  Or it might make the health insurance industry function in a better way so that money is used wisely. Health insurance companies are already getting ready to set their premium prices for next year.

The open enrollment period for signing up for health insurance in the government exchanges is less than five months from now.  It would make sense that consumers get a taste of what premium costs are going to be before searching for health insurance plans.  Health insurance increases before the Affordable Care Act were often extreme and there weren’t any safeguards in place to prevent astronomical premium increases.  This is why millions of Americans chose to avoid purchasing health insurance and take the risk that they wouldn’t get sick.  President Obama’s goal in creating the Affordable Care Act was to get more Americans insured.  One safeguard that the law put into place was an oversight of premium rates at both the state and federal level.  The Department of Health & Human Services has the ability to review premium costs and increases that they deem unreasonably high.

The government is trying to make health insurance premiums more transparent, so that consumers can see potential increases before they are hit with them.  Unfortunately the timing has not been quite right.  2013 information was recently released, although we are already paying for those premium increases.  Now would be a good time to see the potential increases for next year, before open enrollment and before health insurance decisions have to be made.  Making the information public before increases go into effect allows consumers and states to determine if the increases are justified.  Another problem is that some insurance companies say that their information is confidential, so we aren’t able to have access to any transparency.  It’s frustrating for consumers to feel in the dark and out of control when it comes to health insurance premium increases.  Consumer Reports hopes to change the system by requiring full transparency of health insurance premium increases before they come into effect.  If you are having a hard time finding affordable health insurance, search for quotes here.

Large Employers May Stop Offering Health Insurance Plans

Wednesday, May 21st, 2014

A lot of people who get their health insurance from their large group employers might just be searching for insurance coverage elsewhere soon.  While it certainly wasn’t the intention of the Affordable Care Act to make it more difficult for employers to offer insurance to their employees, that has been an effect of the health insurance mandate often referred to as Obamacare.  In the Forbes article, “Obamacare Increases Large Employers’ Health Costs“, Sally Pipes tells us about recent study findings.  S&P Captial IQ’s study determined that 90% of workers in America who currently have health insurance through a large employer will be searching for a policy in the government exchanges by 2020.  That figure seems extreme, but the harsh reality is that the taxes, fees, and added insurance mandates placed on large employers are hurting them.  Many of these employers simply don’t think that they can afford to offer health insurance if something doesn’t change.  They are currently mandated to offer you health insurance plans, so that is something that will have to be considered as well.

Group health plan sponsors pay a new fee to help fund the government sponsored Patient Centered Outcomes Research Institute (PCORI).  This organization tests the effectiveness of certain medical treatments and Medicare uses the results to determine what they will cover for their patients.  Some skeptics worry that results could be twisted to support lower cost treatments over more effective, but higher cost ones.  Another fee that large employers have to pay is a Temporary Reinsurance Fee.  This fee is supposed to stabilize premiums in the individual health insurance marketplace.  The American Health Policy Institute estimates that $15.3 million will be collected by this fee in just two years.  In 2018, large employers will start paying a 40% excise tax on health insurance plans that are deemed “expensive”.  Individual premiums above $10,200 and family premiums above $27,500 are considered “expensive”.  One company estimates that this excise tax will cost them $378 million over the course of five years.

In addition to the direct taxes, there are indirect tax increases for employers as well.  There is the mandate for companies to offer health insurance to full time workers within the next year or two.  If they don’t, they will pay a fine.  Companies also have to allow children to remain on their parents’ health insurance until the age of 26 now.  That last mandate alone has increased employer insurance costs between 1 and 3%.  Mandating full coverage of preventative care services, such as immunization and birth control is drastically increasing employer health care costs as well.  The AHPI survey estimates large employer health care costs to rise by 4.3% in 2016, by 5.1% in 2018, and increase by 8.4% in 2023.  This equates to hundreds of billions of dollars extra that large employers will have to shell out over the next decade or so.

Unfortunately, what this means to Americans with health insurance from their large employer is that their costs will likely increase as well.  More than 80% of large employers have already increased their employees’ deductibles, or plan to do so soon.  Some employers might stop offering health insurance altogether and pay the fine for not offering plans.  They might actually save money by doing that, although employee morale could decrease from such a move.  Companies may also offer incentives for sick employees to search for health insurance in the exchanges instead of using the company plan, saving both the employer and employee money.  But if all of the sickest employees head into the health insurance exchanges, costs within those will increase for everyone.  The potential destruction of employer health insurance plans was certainly not a goal of the Affordable Care Act, but it might just be a consequence.  If you are worried about losing your employer health insurance, you can compare health plans and rates here.

If Aetna Leaves the Exchanges, Others Likely to Follow

Thursday, January 23rd, 2014

With all of the ruckus over the Affordable Care Act, there is one aspect that we haven’t considered yet in this blog.  Health insurance companies might start backing out of the exchanges if things don’t go as planned with enrollment.  So far, not enough young and healthy people have purchased insurance through the exchanges.  This puts the entire plan out of balance because young people help to keep the costs down for everyone involved, including the insurance companies.  According to CNBC’s Matthew Belvedere, “Aetna could be forced out of Obamacare: CEO.”  Aetna’s CEO, Mark Bertolini, worries that the age of enrollment and Medicare changes could force his company out of the health insurance exchanges.  They have to publish their health insurance rates in the exchange for 2015 by May of this year.  As of now, they don’t have enough information to decide whether they will have double digit gains, smaller gains, or have to leave the program altogether.

According to Aetna’s CEO, the majority of people who have bought health insurance in an exchange already had individual health insurance.  They just switched to an exchange to save money because of the available federal subsidies.  Right now, 11% of the people buying in exchanges were fully uninsured before the Affordable Care Act.  That statistic isn’t promising to support the claims that this act would help insure nearly all Americans in an affordable way.  Mr. Bertolini says that the exchanges need more choices in them.  More insurance companies need to offer plans in the exchanges in order for them to actually function like the marketplace they were supposed to.  This will bring more Americans into the exchanges to search for health insurance.  This could also bring more younger, healthier people into the exchanges.  These young Americans help keep rates down for everyone.  Plans from the Afforable Care Act only make up 3% of Aetna’s revenue, so they aren’t concerned about it making or breaking them.  It seems to me that the process is more of a headache to Aetna as it stands now.  Aetna’s CEO forecasts a large number of people using exchanges over the next 6 years, but says the majority of those will be in private exchanges rather than public.


Pay More Attention to the March 31 Health Insurance Deadline

Sunday, December 29th, 2013

There is a lot of false information circling around about Affordable Care Act deadlines.  If you’ve been told that the deadline for obtaining health insurance coverage is January 1, don’t worry if you haven’t found a plan yet.  January 1 is actually the first day that you can take advantage of subsidized health insurance coverage if you have signed up in time and paid your premium in time.  It is not a deadline, but an opportunity, according to Dr. David Blumenthal.  This information comes from Insurance News Net’s “The Big Deadline for Coverage is March 31.”  Much of the confusion about deadlines stems from the fact that they have been changing since this health insurance law took effect.  Even the January 1 deadline has been extended to the following Tuesday for consumers shopping on the website.

You have until March 31 to obtain health insurance coverage before you will actually be penalized for not having insurance.  Penalties will come when you file your taxes for 2014.  If you miss the January 1 deadline, which is  now January 10, you won’t be penalized for anything.  Basically, you just aren’t taking advantage of being insured with a federal subsidy as soon as you could.  But with millions of uninsured Americans, not all of them are searching for health insurance from the state or federal health insurance exchanges.  Not everyone will qualify for a subsidy.  If you do qualify for a subsidy, buying health insurance through a state or federal exchange is likely in your best interest.  There are many uninsured Americans who do not qualify for tax subsidies, so they don’t have to worry about the January deadline.  They do have to worry about the March 31 deadline though.  In order to avoid receiving a penalty when you file taxes next year, shop for an individual health insurance plan before the March 31 deadline.

Individual Health Insurance Mandate Changes

Saturday, December 21st, 2013

In Robert Pear’s New York Times article, “Another Rule in Health Law Is Scaled Back,” he tells Americans that even more people will be exempt from penalties for not buying health insurance.  The secretary of health and human services, Kathleen Sebelius, just announced this big shift that was put into place by President Obama.  He has been working to tweak the Affordable Care Act, which has drawn a lot of scrutiny because of Americans receiving cancellation notices from their health insurers.  Changes to the minimum health insurance requirements have forced insurance companies to send cancellation notices to a lot of people.  In most cases, they are offered a new plan that includes more benefits to match the minimum standards.  But the cost of those plans is much higher as well, a cost that some Americans say they simply can’t afford.

The White House announcement says that those people who have had their current individual health insurance plans cancelled will have a new option.  They can enroll in a catastrophic coverage plan if they are eligible for a hardship exemption because more people will now be eligible.  This way they will not receive a penalty in 2014 for not carrying health insurance.  Catastrophic insurance plans can be bought through the government health insurance exchanges.  They were available before this change, but only to people under 30 or those who qualified for a hardship exemption.  They provide the most basic of health insurance coverage.  The White House says that any consumer who thinks that the health insurance options available in the exchanges are more expensive than their cancelled health insurance policy is eligible to get only catastrophic coverage.  Many insurers are surprised by this change and believe that it takes away from the individual mandate imposed by the Affordable Care Act.  If you are looking for a new health insurance plan, compare health quotes to see if you can find affordable coverage.

Health Insurance Plans Cancelled; Unintended Side Effect of Affordable Care Act

Monday, October 21st, 2013

An unintended side effect of the Affordable Care Act seems to be the cancellation of some individual health insurance plans by insurers.  Business Insider’s Josh Barro gives the main reasons in “Here’s Why So Many Americans Are Getting Letters Saying Their Health Insurance Is Canceled.”  There are 14 million Americans who have health insurance individually, either by choice of because they don’t have the option of employer sponsored insurance coverage.  President Obama told those Americans that they would not have to make any changes when the Affordable Care Act went into law.  While he likely believed that to be the case, Kaiser Health News has found that many insurance companies are sending cancellation notices to those people that their plans cover.  People are being forced to change plans for a couple different reasons.

Many health insurance plans don’t meet the new standards required by the health insurance laws.  All plans have to include coverage of 10 essential health benefits, have specific individual and family limits on out of pocket costs, and insurers have to pay a certain percentage of the costs their participants charge.  Plans that don’t meet the requirements will be cancelled and you’ll have to get a plan that does meet these new requirements.  Those plans will cost more, so make sure to see if you qualify for a government subsidy.  The other big grouping of plans likely to be cancelled are those with a large number of particularly high risk insureds.  Plans like that cost a lot of money, but now that there will be more choices for people with pre-existing conditions, the plans could be more affordable through exchanges than they have been outside of them.

Some have questioned why individual plans will even exist outside of the health insurance exchanges once the entire law is in effect since subsidies are only available through exchange plans and the laws are mostly the same.  One reason is that not everyone qualifies for a subsidy anyways, so they don’t necessarily need to shop in an insurance exchange.  There are some plans being grandfathered in that won’t have to follow all of the stipulations of the Affordable Care Act.  Those plans offered before March 2010 will likely be more affordable and will only be available outside of the exchanges.  Since the exchange websites have had some hiccups thus far, if you aren’t looking for a specific plan offered or a subsidy, you don’t have to worry about using that website and can shop outside of exchanges.

Health Insurance Exchange Knowledge to Be Shared

Tuesday, April 10th, 2012

The Sacramento Association of Health Underwriters, also known as SAHU, holds a luncheon monthly and next week they have a special guest.  According to a CHOICE Administrators’ press release, CHOICE’S CEO will be speaking at SAHU’s April meeting.  CHOICE develops and runs health insurance exchanges throughout the United States and they are the leaders in their industry.  CEO Ron Goldstein will be talking about health insurance exchanges as the country looks to develop more of them to meet government changes.  Goldstein is in high demand for his extensive knowledge of health insurance exchanges and has over 10,000 employers using CHOICE Adminstrators.

The Patient Protection and Affordable Care Act gives states until January 1, 2014 to operate their own health insurance exchange or have the government run a default exchange for them.  These exchanges are meant to help Americans find better health insurance rates, especially when they were previously uninsured.  Over the past nine months, Goldstein has spoken with all but two states and plans to share his discussions at SAHU’s monthly meeting.  His leadership is unparalleled in the health insurance exchange industry and many states will likely use Goldstein’s recommendations when creating their own exchanges.  He also plans to talk about how brokers will work with the California Public Exchange and give tips for brokers regarding the changes to health insurance exchanges.