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Open enrollment is fast approaching, and with it, a slew of changes and updates on health insurance.

Many Large Employers to offer “skinny plans”

An article from NPR estimates that 16% of large employers will offer “skinny plans” to their employees.  These are mainly large employers of lower paid workers.  Most will be offered with one ACA  compliant plan so that the business is in compliance and will not have to pay a penalty.  Employees, because an ACA compliant plan is offered, are ineligible for subsidies.  Most will take the skinny plan because it is affordable and covers them for daily expenses such as doctor visits and prescription drugs.  This allows the employees to also avoid the tax penalty for not having coverage.  The downside is that the coverage is very inadequate for major health conditions that may occur.

Rate Increases

Health First Insurance, which offers fifteen plans under the ACA in Florida, has announced plans to institute a 23% rate increase in 2015.  This seems to be at the higher end of premium increases but increases will still will be significant enough that most people will want to re-investigate their options during open enrollment.

Obamacare Causing Cultural Changes

While this is only anecdotal evidence, an insured today said her and her husband were getting divorced “on paper” because they would save over $400 per month on health insurance.  Since our office spoke directly to the lady, it is direct evidence of change.  Other instances of this nature are being reported in the news.

Size of the Market for ACA Plans

Kaiser Foundation is reporting thatthereare currently over 17 million Americans eligible for subsidies to purchase their health insurance.  The total size of the market for ACA plans is in excess of 28 million.  It has been reported by a study group that 10.3 million people have enrolled in ACA plans to date.  Insurance carriers are saying a significant number of those included in that number never paid their premiums.

Who Pays the Penalty?

It appears that most people will not.  A new study says 25 million Americans without health insurance will not be charged a penalty.  If the total market is 28 million and 10 million have ACA compliant plans, then who pays the penalty?  Not many for sure.

New Carriers in the ACA Marketplace

The largest health insurer in the US, United Healthcare, will be in many markets in 2015 that they were not in 2014.  Assurant, who for many years was the largest provider of Individual Health Coverage in America, has also revealed that they will be on the exchange in over twenty states.  This will greatly increase the marketing outreach for the ACA and will inject a lot of competition in the market.  Open enrollment is fast approaching.

Obamacare has become the only game in town when it comes to individual health insurance, yet as most of us know, the rules of the game change almost everyday.  As we approach the fourth open enrollment period, there are a lot of significant updates and they will now be coming fast and furious.  Starting today, I will provide a compilation of the news that is relevant to Individual Health Insurance across the country.

Nevada

Nevada has decided to use the Federal Exchange to enroll those desiring individual health insurance coverage in their state.  The most significant recent news in this regard is that every person currently enrolled must re-enroll during the next open enrollment.  Yes, that is every person who purchased a plan in the open enrollment period for this year or during the year from a special qualifying event. It appears, at this time, that the special rules and accommodations that have been a part of the Nevada exchange will continue under the new arrangement.  One of the advantages of this is it appears that subsidies that may be in jeopardy in the federal exchange will not be in Nevada even though they will now be enrolling through the Federal Exchange.

Oregon

Oregon like Nevada is moving from a state based exchange to the Federal Exchange for enrollments in 2015.  It will however, like Nevada, keep its state exchange status and thus be fully able to have people in their state receive subsidies.

Maryland

Maryland is replacing their health insurance exchange IT platform with the one developed and successfully implemented in Connecticut.  Over 332,500 new people have now gotten on the Medicaid plan through the exchange.  Less than 80,000 have gotten individual health coverage.

Premium Increases

Florida is indicating that their premiums should increase approx 13% on average.  In other states it will also be very significantly.  The good news is many new carriers are entering the Marketplace and should bring renewed competitiveness to consumers.  They will have to aggressively shop with the help of an agent that can sell multiple products with all of the competitive carriers to find the best deal.  Most people who do this will be able to lower their costs next year is our belief.

Here at American Health, we’ve been overusing two words for the past few months. They are probably two words that you’re sick of hearing, but two words that we cannot stop stressing. These words are OPEN ENROLLMENT. Yes, there it is, I said it again. (Insert your cringing face here.)

In the past, Open Enrollment was something that typically only applied to group plans. (Also, Medicare and Medicare Supplements, but we’ll leave all of that for another blog.) It was the time of year that you were able to apply for your group health plan, discontinue your group health plan, or change your group health plan. If you didn’t apply during this time you were not able to get on your group plan until the next open enrollment.

The people who purchased private, individual health insurance, didn’t have to follow the Open Enrollment regulations. They were free to purchase, cancel, change etc… their health insurance at any time.

With the creation of The Patient Protection and Affordable Care Act, (PPACA) also known as the Affordable Care Act (ACA) in 2010, the insurance world began to change. In 2013, it changed even more dramatically when it implemented the Open Enrollment period for individual health plans.

What does this mean?

Well, in a nutshell, it means that if you want health insurance and you aren’t offered it through your employer, November 1st through January 31st is the only time you can apply. (Unless you have a qualifying event. You can read more about qualifying events here.) If you miss it, you’re out of luck.

Now, I know some of you are thinking, “Do I really need health insurance? I’m young and healthy and practically invincible!”

That may be true, but you still need health insurance.

Why? Well, for a number of reasons but mainly because there’s a mandate to have insurance and penalty if you don’t.

It’s fairly common knowledge that it’s now “illegal” to not have health insurance. Will you get thrown in jail? Not today, but will you be penalized? Oh yeah. Wanna know how much? I’ll tell you.

The penalty for not having ACA qualified health insurance in 2015 is (insert drum roll here…) 2.5% of your income, or $695 per adult and $347.50 per child – whichever is HIGHER.

Let’s break that down a little.

If you’re married with two kids and you and your spouse make $45,000 combined, 2.5% is $1125. The combined penalty for your household [$695 x 2 + $347.50 x 2 (another $695)] is $1820.00. You’re paying the $1820 to the government when you file your 2016 taxes. That could take a serious chunk out of the return that you wanted to use to take your family on vacation.

Now, for some people that might not sound like a lot of money, but if anyone in your family gets sick or has an accident (or any other health issue) during the year, you’re not just responsible for the penalty, but you now have a massive stack of bills on top of it. (An average visit to the ER can easily cost over $5000 and sometimes cost over $10,000.)

I know, I know, you’re not going to get sick, you’re not going to have an accident. You’ve already told me that you’re invincible. But, here’s the thing… you’re not.

Accidents happen. Illnesses happen. And rarely do they happen when you’re ready for it. They are unexpected and poorly timed.

Now, with anything, there are good and bad aspects to PPACA. One of the better aspects is the fact that you may qualify for a tax credit (subsidy) and/or a cost sharing reduction if you apply for your insurance through the Marketplace or the Exchange.

Huh?

The Exchange (or Marketplace) is where you purchase your insurance. It is a government website that shows you all the plans and carriers in your area and the price. There is the Federal Exchange for the majority of states, but a few states have chosen to set up their own exchange.

A tax credit, or subsidy, is an amount of money (based on your income) that the government will pay towards your monthly premium. For instance, if your premium is $100 and your tax credit is $50, you are only responsible to pay $50 a month towards your premium. Sometimes tax credits are so high that you could end up paying next to nothing for your monthly premium.

A cost sharing reduction could also be available to you, in addition to your tax credit. The cost sharing reduction reduces the out of pocket expenses on your health insurance plan. As an example, a $6000 deductible might be reduced to $750. That’s a huge difference!

Unfortunately, not everyone is eligible for a tax credit or cost sharing reduction. It is strictly based on your income. You can check to see if you qualify for a tax credit and cost sharing reduction here.

This information is only the bare bones of what’s happening in the insurance world.

Open Enrollment is quickly approaching and you need to know what to expect and what the best options are for you and your family. We can help with that.

At American Health, we have four licensed agents who are certified to sell insurance on the Federal Exchange and on most of the State Exchanges. We are knowledgeable and experienced and truly care about getting you the best plan for your situation.

Don’t waste a minute, because once Open Enrollment is over, it’s over. Call us today at 1.888.589.3000 to find out the best options for you and your family or request a free quote here!

Open Enrollment is days away and with it comes questions. Most of these pertain to tax credits, cost sharing reductions and premiums, however some people still need answers about Open Enrollment. What is Open Enrollment you ask? How does it affect you? You can find the answers to those questions and more by reading Why Open Enrollment is so Important.

Already know the Open Enrollment basics, but you’re curious about whether or not you qualify for a tax credit? You’re in the right place.

The chart below outlines the income limits by household size for those who qualify for a tax credit and a cost sharing reduction.

subsidy
click chart to enlarge

Unfortunately, not everyone is eligible for a tax credit or cost sharing reduction. It is based solely on your household size and income. If you don’t qualify, don’t worry, we can still help you find the best plan for you and your family.

Have questions about this chart? Want to know more specifics on how much your tax credit is? Call us today at 1-888-589-3000 or request a free quote.


 *Chart courtesy of healthcare.gov

Group health care benefits have always been a great tool for business owners to recruit and retain employees. However, our experience has shown that many small business owners do not know what they are required under the Affordable Care Act to do with health care benefits for their employees. Is group health insurance truly a feasible option for employers? Is there a better option out there?

Here are three facts all small business owners need to know about group health care benefits:

 1. You do not have to offer group health insurance.

A little unknown fact about the Affordable Care Act’s “Employer Mandate” is that businesses with less than 50 full-time employees are not required to provide health insurance as a benefit to employees. Small businesses will not be fined a penalty if they do not offer health care benefits, as opposed to large group (50+ employees) businesses that will be fined a penalty for not doing so.

 2. Your employees will pay a fine for not having health insurance.

However, beginning this past January 2014, the Affordable Care Act implemented that all Americans are required to have health insurance, or face being penalized. If you choose to not offer health insurance to your employees, your employees are still responsible for obtaining health insurance on their own. This includes you, the employer. Health insurance outside of group health insurance is referred to as “individual health insurance.”

 3. Individual health insurance is better for your employees. 

 There are many advantages for choosing to not offer group health care benefits to your employees, and allowing them to purchase individual health insurance.

Advantages for your employees include:

•  All pre-existing conditions are covered. What used to be only possible in the group market, is now available in the individual market. Your employees cannot be denied coverage because of medical conditions thanks to the Affordable Care Act.

•  Individual health insurance can be discounted. Depending on your employees income and household size, they could receive a subsidy from the government to help them pay for their health insurance. In many cases, individual health insurance costs less than group health insurance.

•  Your employees can choose their preferred network and specify which deductible, co-pays, and co-insurances they would like.

Advantage for you, as the employer, include:

•  It saves you money. Lots of money.

There have been recent studies that show that group health plan premiums are skyrocketing, by 588% in some states. The reason being is that the Affordable Care Act has attached large excise taxes to group health insurance plans to help cover commercial underwriting restrictions and to ease the restriction on the insurance carriers because they are not allowed to vary premiums between young and old insureds  based on the actual costs of providing the coverage. All of these have substantially raised the price of the premiums.

So what should you do? We say, drop your group insurance, or if you are thinking about offering group insurance, don’t. Allow your employees to buy a individual health insurance product that allows them the freedom to choose which network they would like, what deductibles/ co-pays / co-insurances they like, and also they will get help paying there premiums via governmental subsidies if they qualify.

If you still want to offer a benefit to your employees, offer a benefit such as dental and vision insurance, life insurance, or long term disability insurance. Your options are unlimited, especially since you will be saving some serious $$.

Lastly, let us help you. Health insurance can be confusing, and we happen to know it like the back of our hands. We have a defined strategy on how to switch group health insurance to individual health insurance.  We happen to be quite good at it. Contact us today. We can go through detail by detail on how this is the right strategy for you, even offer you some quotes to prove it.

 

The world of health insurance is quite different these days. In today’s world we have crazy phrases that are confusing to many people, like open enrollment season, qualifying life event, special enrollment period… Say what?!

So what do these terms mean? More importantly, what do they mean for you, and how can they work in your favor?

What is a Qualifying Life Event?

Let me start from the beginning. In a nutshell, the world of health insurance is different today because of the passing of a new law called the Affordable Care Act.  During the months of October 1, 2013 – March 31, 2014, there was a season referred to as the Open Enrollment Season. This was a period of time mandated by the U.S. Government that all eligible Americans were allowed to purchase health insurance coverage for themselves and their family.

Since March 31, 2014, (after the Open Enrollment Season), Americans are not allowed to purchase health insurance  until the next Open Enrollment Season, which begins in November 2014. So, to make this understandable, there is a window of time that you are able to purchase health insurance, and there is a window of time that you cannot purchase health insurance.

So if you are thinking, crap… what do I do now? I missed my opportunity to purchase health insurance. Don’t fret. This is where qualifying life events come in.

A Qualifying Life Event is a change in your life that makes you eligible to enroll in and purchase health coverage outside of the Open Enrollment Period.

If you missed the opportunity to purchase health insurance coverage during the Open Enrollment Season, here are qualifying life events that  make you  eligible to purchase health insurance coverage outside of the open enrollment season:

1. Change in legal marital status.

This includes any of the following: marriage, death of spouse, divorce, legal separation, or annulment.

2. Change in the number of dependents you claim.

This includes  any change in the number of dependents you will claim on your taxes. For example: the birth of a child, the death of a child, adoption,  placement of a child for adoption / foster care, or a new appointment of guardianship.

3. Loss of employer-sponsored insurance.

This includes voluntary or involuntary termination of employment, or if the employer no longer offers group coverage.

4. A dependent who turns age 26.

Due to the Affordable Care Act, children are allowed to stay on their parent’s health insurance plan until they turn the age of 26. Upon their 26th birthday, they are required to purchase their own health insurance plan.

5. Change in full-time employment status.

This includes a change in working conditions, such as a change between full-time and part-time employment status of the employee.

6. Return from active military duty.

If this applies to you, Welcome home, Soldier! Thank you for your honorable service!

7. Gain of immigration status or citizenship.

8. Release from incarceration.

9. Permanent move to a new state.

10. Renewal of any individual major medical plan in 2014.

If you currently have a health insurance policy that was purchased during anytime before this year, it will renew in 2014. When you get a notice of renewal in the mail, this is a qualifying event.

11. Discontinuation of a current plan that does not meet health care reform requirements.

For example, there are some older individual major medical plans that do not meet the essential health requirements of the Affordable Care Act. If you currently have a policy, but are unsure if your plan meets the requirements, call us. We would be glad to help.

If you find that you fit any of these qualifying events, you are eligible to purchase health insurance. The important thing to note is that you have 60 days from the start of your qualify event to enroll into a health insurance plan.

If you have any questions, or need help in purchasing a health insurance plan that is a perfect fit for you, contact us! That’s what we are here for!

Do you not meet any of these qualifying life events? 

No worries, we have you covered there as well. A short term medical product would fit you perfectly. Contact us for more information.

Need Help? Contact Us

Otherwise, they team of writers will help you will not be in business long.

Have you ever wondered why missionary travel insurance is important?

Well, here’s why:

There’s a story going around of a young family who left the United States for a missionary trip to Zambia in Southern Africa. A small community in Zambia was in desperate need of a new school, and this family fit the bill in order to help build the school. The young father was a contractor and he had the skill sets needed to help this community grow. So the mom and dad, and their two sons, packed up and off they went.

A little time passes and the school was really coming along. The foundation had been laid, the walls were constructed, and it was time to lay the roof. The father was on the roof, and like any young son who wants to be like his dad, the father’s young son climbed his way up to the top of the roof.

I bet you can guess what happened next.

For a split second, the father took his eyes off of his son, and the young boy fell off the roof, breaking both of his legs. You can only imagine the questions that run through a father’s mind in that moment. Where do you take your son? Are there hospitals in Zambia- hospitals without dirt floors and skilled physicians? If so, how do I get him there? Will he be okay?

Important things, like missionary health insurance, can be overlooked, or considered unnecessary when in fact, it is not unnecessary at all. Missionary insurance might actually be the most important thing you purchase for your trip.

As a long term missionary myself (fresh off the mission field), I understand the importance of having missionary insurance. I’ve seen unexpected accidents and illnesses and personally recommend no one travel overseas without coverage. In fact, let me give you a few reasons why I think missionary insurance is necessary.

4 Reasons You NEED Missionary Insurance:

 1. Unexpected things happen, even when you’re careful

A friend of mine, who lived in Thailand with me, got extremely ill within the first month of arriving in the country. It turns out that he had contracted Dengue Fever, a sometimes fatal disease transmitted by mosquitos in tropical countries. He ended up spending several days inpatient at a private hospital. Getting Dengue fever was out of his control, and completely unexpected, and a weeklong hospital stay isn’t necessarily cheap, no matter what country you reside in.

2. Your local insurance may not cover out of country illnesses and injuries, or it may have a maximum dollar limit

I can’t tell you how many times I received phone calls working in health insurance customer service from clients who had been travelling and had required emergency care. Oftentimes without the proper documentation we weren’t able to process the claim, and other times, if it hadn’t been an emergency situation, the claim wasn’t covered.

3. IMG offers a translator to help you understand the medical care you’ll be receiving

While living in Thailand, I had a friend that ended up in the hospital several times for accidents. The last time he was in the hospital, he had a broken hand, but the doctors didn’t cast it fully. They attempted to explain to us why they weren’t casting it fully, but it was extremely hard to understand their, at times, broken English. Having a translator, especially in an emergency situation, can make all the difference when understanding your care.

4. Medical evacuation is covered under most plans

In the unlikely event that you are injured or ill and the facility where you are located cannot treat you at the standard of care required, you will be airlifted to the closest network hospital where you can receive the treatment you need.

Luckily for the little boy who had fallen off the roof, his father had purchased IMG missionary insurance before they had left the United States. The father was able to call IMG and receive evacuation for his young boy to a qualified surgeon to repair his broken legs. IMG did it all on the behalf of the family. All the father had to do was comfort his son, IMG did the rest.

The odds of falling ill or being seriously injured while on a mission trip are low, however, the peace of mind that you will be covered if something were to happen is invaluable.

Planning on travelling overseas and need missionary insurance?

Sign up for an IMG international policy today, or contact one of our representatives.

View Missionary Insurance Products Now

Next Tuesday, October 1, 2013, marks the first day of open enrollment for President Obama’s Affordable Care Act. The expectation is that 7 million uninsured Americans will be enrolling into a qualified health plan over the next six months of the open enrollment season.

It is a requirement from the federal government that all agents and brokers be registered and certified in the Federally-Facilitated Marketplace to help uninsured Americans enroll and purchase qualified health insurance plans through the Marketplace.

The agents at America’s Health Insurance have completed the required training and have passed all of the required exams to become registered and certified agents to assist and sell in the Federally-Facilitated Marketplace.

Consumers who are shopping for health insurance in the states that have deferred to the federal government exchange will be able to purchase health insurance plans through America’s Health Insurance as their registered and certified agent in the Marketplace. Agents at America’s Health Insurance will be able to help assess a consumer’s eligibility for a qualified health plan, assess the consumer’s eligibility for subsidy, and assist in the enrollment and purchasing of a qualified health plan.

America’s Health Insurance has been in the health insurance industry for over 30 years. They are one of the top three health insurance producers in the United States. As the Affordable Care Act approaches, they are working hard to bring the best possible health care coverage for their clients, and to help alleviate any confusion in the process of enrolling into a qualified health plan through the Marketplace. America’s Health Insurance can be reached by phone 1-888-589-3000.

This article was first published as a national press release. Please view our original press release here.

Fort Wayne, Indiana (PRWEB) August 19, 2013

As the Affordable Care Act approaches full implementation, America’s Health Insurance is taking the first steps to become a registered and certified agent in the Federal Health Insurance Marketplace Exchange. They will be able to assist customers in purchasing health insurance through the healthcare.gov website.

According to HHS, all insurance agents and brokers must complete an online training course available through the Health Insurance Marketplace. This training must be completed by agents and brokers to be able to enroll clients through the federal exchange on the healthcare.gov website. The fulfillment of training will make an agent Health Insurance Marketplace certified. There are three separated courses that need to be completed for group and individual exchange participation.

Upon completion, clients who are shopping for health insurance in the states that have deferred to the federal government exchange will be able to purchase health insurance plans through America’s Health Insurance as their registered and certified agent.

States that have deferred to the federal government exchange are as followed: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Louisiana, Maine, Michigan, Mississippi, Missouri, Montana, Nebraska, New Hampshire, New Jersey, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, Wisconsin, and Wyoming.

America’s Health Insurance intends to have all of their agents trained and certified for the Federal Health Insurance Marketplace Exchange where they market business. They will be able to assist new and current clients in receiving the maximum amount subsidy possible and help enroll clients in a quality ACA health insurance plan.

America’s Health Insurance is currently in training for certification and will announce when certification has been obtained. Stay informed at http://www.ahifw.com.

America’s Health Insurance is a nation-wide health insurance agency located in Fort Wayne, Indiana. They are one of the top three health insurance producers in America. As the Affordable Care Act approaches, they are working innovatively to bring the best possible health care coverage for their clients. They have a strong relationship with the top insurance carriers in the country, which enables them to be on top of the health insurance market. This allows them to provide the absolute best products for their clients.

View original press release here.