Thursday, January 25, 2018

A Peek Into 2018 Under Age 65 Health Insurance And Beyond



Alex Azar, Secretary Health and Human Services 
By Coleen Elkins  24-7Healthinsurance.com

The Senate has approved the appointment of the new Secretary of Health and Human Services Secretary Alex Azar.

This morning we are seeing reports of more executive orders planned for 2018 to provide additional exemptions for those seeking relief from the mandate to purchase health insurance. 




The individual mandate was repealed in the new tax law recently passed, but requirements to purchase coverage doesn’t end until 2019. 

The new hardship or exemption list has yet to be revealed and we will post it if/when it becomes available. 

States are already beginning to look forward to new health insurance offerings. Concerned about soaring health care costs, Idaho on Wednesday revealed a plan that will allow insurance companies to sell affordable policies that ditch key provisions of the Affordable Care Act. Idaho is believed to the the first state to take formal steps without prior federal approval for creating policies that do not comply with the Obama-era health care law. 

Idaho Department of Insurance Director Dean Cameron said the move is necessary to make cheaper plans available to people. Cameron went on to say “There are other states that have been talking about it, but we may me out in front. They may look to follow us should we be successful”. 

The Idaho plan will make it possible for insurance companies to offer cheaper plans that might be more attractive to people who have to buy their own insurance and do not have the benefit from the federal premium subsides offered under the Affordable Care Act. 

Under Idaho’s guidelines, insurers can offer plans that deny coverage for pre-existing conditions for up to 12 months unless the customer had continuous prior coverage. Insurers would no longer be required to cover pediatric dental or vision care, and though they would have to offer at least one plan with maternity and newborn coverage, other plans could exclude those benefits.

Insurance carriers can also charge people more based on where they live, their health history and their age, under the new Idaho rules. Insurers can cap their own costs at $1 million a year per individual, and can charge customers separate out-of-pocket maximums for different services. In other words, a customer could have a $7,000 out-of-pocket annual maximum for prescription drugs, another for doctor visits and another for hospitalization or mental health care.
Insurers offering such plans in Idaho still would have to offer policies that comply with the federal health care law for those who want them, Cameron said.

There is speculation whether Idaho can legally move forward. The state expects objections from Obamacare Advocates. 

“I’m not even afraid if it needs to be litigated, though that’s not my preferred course,” Cameron said. “The real question is, when does the federal agency act — if they act at all.”

Saturday, October 28, 2017

2018 Under Age 65 Open Enrollment Begins On Wednesday November 1, 2017

By Coleen Elkins   24-7 Health Insurance 





Under age 65 health insurance open enrollment will begin on Wednesday November 1st 2017 and ends on December 15th 2017. This enrollment does not involve or require action for anyone on Medicare. 

The open enrollment period applies to anyone needing to change a current ACA compatible plan or who needs to enroll in an Affordable Care act compliant plan.

We encourage everyone to take the time to carefully shop and consider all their offerings for health insurance.  

We will be able to you provide you a personal needs analysis and proposals beginning on November 1st. 

Take advantage of our 23 years experience assisting our clients find the best health insurance plan that meets their personal needs. We keep our finger on the pulse of all thing legislative that will impact our clients decisions. We are licensed in 12 states to assist you. You can learn more on our website www.24-7healthinsurance.com 

We promise our clients ongoing personal customer service once your policy is in place. 

We will only be presenting 2018 plans that are governed by the Department of Insurance in the state you purchase them. 

We will be offering the following options to insure your health for 2018:

  1. Affordable Care Act compliant plans outside of the exchange with private insurance companies. 

  1. Affordable Care Act compliant plans on exchange for those qualifying for a “tax credit” or a subsidy also known as premium payment assistance and possible cost sharing reductions. We will be able to determine your 2018 eligibility for a tax credit and enroll you. 

  1. Short term plans from multiple carriers in all 12 states we are licensed in that offer either a PPO or EPO nationwide network. 

  1. Small Group Plans for business owners with 2-50 employees. These plans are offered by A rated insurance carriers in all states we are licensed in. These plans have enrollment guidelines that vary by state.In some cases there can be a “group of one” enrollment.  
        
5.   Ancillary Plans such as dental, accident and hospital plans.                              

Some important things you should know about 2018: 

With the ACA compliant plans the rate increase of the Silver plans nationally for 2018 is 34 percent. 


Very Important: A study found In 47 of 50 cities in 2018, the cost of Obamacare's lowest-priced plan would be deemed "unaffordable" by the Affordable Care Act's own definition, according to a study from eHealth, Inc.

Under the Affordable Care Act, health insurance becomes unaffordable when the lowest-cost plan costs more than 8.16 percent of a household's gross income. Usually people who fall in this category can get an exemption from paying Obamacare's individual mandate. Your tax adviser will be able to assist you with an exemption which allows you to consider other options without a penalty. Please take 5 minutes to read the entire article here to help you understand the possibility of an exemption. 

A recent executive order signed by President Trump on October 12, 2017 allows health insurance companies to sell short term PPO/EPO plans for up to 360 days. Rather than in 90 day blocks imposed previously. Some carriers have already announced they will be implementing the enrollment changes. These plans offer a very affordable nationwide network. They do require some underwriting and do not cover pre-existing conditions. We have some very nice short term plan offerings for 2018. There are varying timelines on the offerings of these plans. 



We want our clients to be protected. If you have a grievance with your health insurance company we want you to have recourse. Therefore we are only offering plans governed by The Department of Insurance in the state you domicile. 

Plans we will not be offering for 2018:


  1. Shared Ministry Plans. Shared Ministry provide the consumer an exemption however they are not insurance plans and they are not governed by the Department Insurance which provides consumer protections. The Texas state legislature defines Shared Ministry Plans here: “Notwithstanding any other provision of this code, a health care sharing ministry that acts in accordance with this chapter is not considered to be engaging in the business of insurance”.

  1. Association Group Plans (group health insurance for 1 person). A recent executive order signed by President Trump on October 12, 2017 opened the door for the new forming of (Association Group Plans). The Department of Labor, CMS and other regulatory authorities were directed to look into regulating association plans allowing people to purchase across state lines. This will take several months to accomplish. The intent and goal is for existing “associations” to be able to provide members a viable health plan. For example purposes only…perhaps the American Diabetes Association could create a plan that insures diabetics or The Association of Realtors allowing Realtors to collectively purchase a nationwide plan. Even though you may see reference to this executive order know this has yet to take place and no new insurance company sponsored plans are being offered for this purpose. Understand the difference between an existing Association being able to pool together to purchase health insurance and an Association formed solely for the purposes of selling you health insurance! Association plans are not new they have been available since the 1980’s. Associations cropped up solely for the purpose of selling their members insurance at the highest possible profit and the lowest possible risk. They may look and feel like real health insurance. You will be asked to pay a “fee” to enroll. These plans are not direct with the insurance carrier. The plans are administered by a 3rd party which are leasing a major insurance carrier provider network. AGAIN the carrier is not administering or managing your claims. If you purchase an association plan from a state you do not domicile you may be putting yourself at risk. The reason is the only regulation of that plan is overseen by the state the plan originated in. History shows consumers have ZERO recourse with the state regulators and insurance commissioners in the states in which the plans were domiciled - because those state regulators and commissioners said it wasn't their job to regulate insurance sold to non-residents in another state. Until the Department of Labor and other Federal and State governing entities set guidelines and regulations for Association plans we will not be offering any type of Association Plan. 

Remember we purchase health insurance because we don’t know what the future holds. We encourage you to be cautious. Know your protections. If you are considering some innovative way to insure yourself do your research. Google the EXACT name of the plan (not the network) in multiple web browsers. REMEMBER: If you begin researching options and enter your name and phone number requesting more information you just gave marketing companies permission to call you. The only way you can stop the calls is to tell each individual caller to stop calling you and block their number. 

There are currently legislative hearings on solutions to the Affordable Care Act in both The House and the Senate. We are following them very closely and if anything significant arrises we will notify you immediately. 


We look forward to being of service.

Sincerely,


Coleen Elkins,
Peace of Mind For Your Health Since 1995
Managing Agent
24-7 Health Insurance
1-888-337-1705





Friday, October 13, 2017

Important News For The Under 65 Health Insurance Market

By Coleen Elkins    24-7 Health Insurance




On Thursday October 12, 2017 President Trump signed an Executive Order created to improve access, increase choices and lower the cost of healthcare. 

The Executive order provides directives to The Department of Labor, The Department of Treasury (IRS) and Health and Human Services. The Department of Labor’s secretary has been directed to consider proposing regulations or revising guidance to expand Association Health Plans (AHPs). The intent is to allow employers in the same line of business anywhere in the country to join together to offer healthcare benefits to their employees. This would be implemented to expand over time and lead to existing organizations and new ones created for the purpose of offering group health insurance. For example purposes only The Diabetes Association could work toward having a plan specifically to insure Diabetics. Associations with a common bond or purpose could choose to insure Association members to meet the needs of the members. State policy makers will have concerns that will need to be addressed as well. 

The secretaries of HHS, Treasury and Labor are to consider proposing regulations or revising guidance to expand short-term limited duration insurance. This directive would allow the agencies to revisit the rule enacted by the Obama Administration that limited the length short term plans could be purchased to three months. 

The Executive Order also opens the door to Health Reimbursement Arrangements for employer groups to assist their employees with the cost of healthcare expenses. 

The timeline is 60 days for the secretary of Labor to act within 60 days to consider proposing regulations or revising guidance on Association Plans. The Treasury, Labor and Has to act within 60 days to consider proposing regulation or revising guidance on short term plans and 120 days on Health Reimbursement Accounts. 

Within 180 days regulator agencies must report to the president on state and federal laws, regulations and policies that limit healthcare competition and choice, as well as on actions that federal and state governments could take to increase competition and choice and reduce consolidation in healthcare markets. 

On an action separate from the Executive Order the White House Confirmed Thursday that it will stop making federal payments for “cost-sharing reduction” payments to health insurers. These cost sharing reductions reduced the out of pocket costs for health care for those in certain income brackets by lowering deductibles and out of pocket expenses for them. A statement from Department of Health and Human Services confirmed the “cutoff would be immediate”. 

We have spoken to insurance companies and are told they are acting now to make changes to their systems to provide revised health insurance products and longer purchase durations ready for 2018. 

Coleen Elkins

24-7 Health Insurance 



Wednesday, September 27, 2017

No Vote - No Repeal of Obamacare

By Coleen Elkins   24-7 Health Insurance






No Vote - No Repeal of Obamacare 


On September 26th 2017 Senator McConnell declined to hold a vote on the Graham-Cassidy bill which would repeal and replace parts of The Affordable Care Act. The bill did not have the support needed to pass under reconciliation rules which expire on September 30th 2017. 




What is next? 

Prior to the vote a Senate formed committee HELP (Health, Education, labor and Pensions) held bipartisan hearings to discuss “actions Congress should take to stabilize and strengthen the under 65 health insurance market” for 2018. It is possible the bipartisan committee could resume efforts to achieve their goal. 

The Republican leadership can also begin the reconciliation process over again for 2018 fiscal year. Starting the process over would require a 2018 budget resolution with the appropriate instructions for reconciliation to pass both chambers of the House and Senate. Then 2018 bills would be drafted and voted on in both chambers. An identical bill must bass both chambers before President Trump can sign it into law.

Alternatively Congress or the Administration may pursue other ways to dismantle, replace or reform the ACA including regulatory action, non-enforcement or other options. 

In the meantime ACA Remains the Law of the Land

Ongoing compliance with the ACA is required unless and until official guidance to the contrary is issued. 

2018 brings new challenges particularly for employer groups with the implementation of the Cadillac tax, HRA, HSA and FSA funding parameters and more. 

We recommend individuals purchasing their own plans without a tax credit use the HC.gov website exemption tool to determine if they may qualify for an exemption from Obamacare for 2017. The exemption could avoid penalties for those that qualify. The 2018 tool will not be available until next year. Your tax advisor may be able to help you file the proper exemption form at tax time. 

Insurance companies have until the end of the day today (September 27)  to report their intention to stay in the market for 2018 and if they are going to insure what they will be filing for 2018 rates. Florida already has projected a 45 percent rate increase of this years rates in 2018 for under age 65 health insurance plans. 

Open enrollment for 2018 is drastically shortened to November 1, 2017 to December 15, 2017


Friday, September 1, 2017

Will Obamacare Really Fail?

24-7Healthinsurance.com 


We are carefully following all writing regarding the future of health insurance in America.

Senator Bernie Sanders is touring the country rallying for Medicare for all. It is very doubtful Medicare for all would pass any CBO analysis.

Today we would like to share with you one of the most comprehensive articles we have received from our business partner AHCP Sales. 

By now, everyone’s heard the news: the Republican efforts to repeal and replace the Affordable Care Act have failed in the Senate. After three unsuccessful votes—first on the Better Care Reconciliation Act, then on a repeal and delay bill, then on a skinny repeal—majority leader Mitch McConnell declared on July 27 that “it’s time to move on.” For now, repeal & replace is dead, though the efforts could certainly be revived sometime in the future.

While there is much disappointment among Republicans and their supporters at this apparent failure, members of both parties are now saying that they need to work together on a bipartisan solution. Of course, time will tell whether this can really happen, but many lawmakers are saying that they’re willing to give it a try. In fact, as USA Today reports, a bipartisan Senate panel will be holding hearings on September 6th and 7th on stabilizing the individual insurance market.



Meanwhile, President Trump is calling for his party to continue with the repeal efforts; after all, he says, Republicans have promised voters for the past seven years that they have a much better plan, so they shouldn’t give up so easily. His criticism of Majority leader Mitch McConnell has also increased in the past few weeks, leading to a rift that some worry will derail the GOP’s other legislative priorities.
Please continue reading here

Saturday, July 29, 2017

The Health Care Freedom Act Has Failed





By Coleen Elkins                  24-7 Health Insurance


A 48 hour attempt by the United States Senate to obtain a “skinny" version of the repeal of The Affordable Care Act also known as Obamacare failed by one vote.

This is what the Health Care Freedom Act would have accomplished. It would have eliminated the individual mandate penalty and temporarily repealed the employer mandate penalty and medical device tax along with providing states flexibility on certain ACA requirements. Earlier in the week, separate votes on the Better Care Reconciliation Act (the Senate’s alternative to the American Health Care Act) and the Obamacare Repeal Reconciliation Act (the “repeal and delay” option) also failed.

As of today over 80 insurance companies have left the individual market. The market is extremely unstable. Insurance companies have until September to notify CMS (Centers for Medicare and Medicaid Services) if they intend to leave or stay for 2018. Currently forty five counties in the United States will have zero insurance options in 2018. This number could increase. 

Note: This does not mean Medicare Plans are leaving. If you are on Medicare you may still be impacted. The rules in the Affordable Care Act will change Medicare over time if it is not revised or repealed. Such rules included bundled payments for providers. This is where providers would receive and share a bundled payment for a single episode of services provided by each of them to a patient. 

Both parties have indicated next steps may include bipartisan efforts to fix the ACA and stabilize the market. Specific plans and a timeline have not been discussed yet.

Republican leadership in Congress or the Administration may also pursue other ways to dismantle, replace or reform the ACA including regulatory action, regulatory non-enforcement or other options

Our office supported efforts that would bring bipartisan support to help stabilize the health insurance marketplace. We encourage you to reach out to your legislature and tell them what is important to do. You can achieve that in 10 minutes or less by visiting their website or getting their contact information HERE 

Our health insurance and Medicare insurance agency is a Member of the National Association of Health Underwriters and we are following legislative changes daily. We remain hopeful that resolution will come in time for the 2018 market to offer options to consumers. 

Please stay in touch with us as we do currently have options and ideas to help people find health insurance plans that meet their personal needs. 

Coleen Elkins 
Peace Of Mind For Your Health Since 1995 through ongoing customer service to our clients 
Individual, Small Business, and Medicare Specialist



Friday, June 16, 2017

Health Insurance Market Update

Offered by 24-7Healthinsurance.com 



Health Insurance is in a delicate state right now. Inaction is causing reaction on the part of insurance companies. The bottomline is the market is extremely unstable. 

This article is focused on the state of Texas, but it is a snap shot of what is happening in EVERY STATE. If you are reading this and are concerned please share the information and consider taking a simple action of contacting YOUR Senator's office via email or telephone to let them know your concerns. It will take you less than ten minutes.

Use this link: https://www.senate.gov/senators/contact/

Eight health insurers have formally exited Texas’ individual market for health coverage, a blow to competition in the Obamacare insurance exchange north of Dallas, in Cooke, Fannin and Grayson counties along the Texas-Oklahoma border.

Statewide, though, the eight companies comprise only 4 percent of the individual market, said Texas Department of Insurance spokesman Ben Gonzalez.
Still, because the withdrawals are effective for at least five years, they amount to a near-permanent shunning of a potentially lucrative book of business, both inside and outside the exchange, in the nation’s second most populous state.
The exits are likely to stoke the already sky-high anxiety of consumers and providers as well as insurance company officials about which insurers will remain in Texas’ individual market, to what extent and at what cost.

Blue Cross Blue Shield of Texas is the anchor of the state's Obamacare exchange -- and appears to be sticking, despite questions about continued federal subsidies for low-income customers.

Secretive talks in the U.S. Senate over the American Health Care Act, the proposed bill to replace Obamacare, and uncertainty about whether President Donald Trump’s administration will continue paying subsidies for low-income purchasers’ out of pocket costs have raised many questions about market stability.

Insurers have already begun scaling back options in other states, once again citing millions in losses from the Affordable Care Act.

Experts said Texas, where state GOP leaders have staunchly opposed the law and refused to run or encourage residents to buy in the exchange, is not immune to the attack of nerves.

The 'blues' are sticking

However, in a boost to the Texas exchange’s stability, it appears that the largest player, Blue Cross Blue Shield of Texas, which is the only carrier selling in every county, will remain in the Marketplace.

Blue Cross has submitted proposed products and rates for 2018 to the state insurance department, though it won’t finalize decisions on them until “early fall,” company spokesman Gustavo Bujanda said.
“We hope to again participate in the individual market, but haven't made any final decisions concerning our level of participation,” he said in a written statement.

However, top Austin health insurer lobbyist Jamie Dudensingstrongly signaled Blue Cross will be back.
In a statement decrying how the eight carriers’ formal withdrawal notices “demonstrate deep instability in the individual market,” she noted the situation could be worse.

“Unlike some other states, every county in Texas will have at least one health insurance option,” said Dudensing, who is chief executive of the Texas Association of Health Plans.

Bujanda, asked if the carrier will sell exchange products in all 254 Texas counties next year, declined to comment.

Continued participation by Blue Cross is vital, said Cynthia Cox, who conducts economic and policy research on the Affordable Care Act for the nonpartisan Kaiser Family Foundation.
She noted that 45 counties in Ohio, Missouri and Washington face the prospect of having no insurer in those states’ exchanges next year.
In Texas, only two of the eight departing insurers, Humana and Prominence HealthFirst of Texas, were still selling in the state exchange this year, Cox noted.



No 'zero-insurance counties’

Assuming Blue Cross keeps selling border to border and no other insurers bail, there would be 97 counties with just one insurer in 2018 — up from 94 this year, she said. But there are no "zero-insurance counties" on the horizon yet, Cox said.

Along the Red River, Cooke, Fannin and Grayson counties would have just Blue Cross. Fourteen other counties, in the Panhandle and South Texas, would go from having three insurers to two, she said.
"It's a mixed bag, but it still would be a better situation than some other states are in," she said.

Potentially more than offsetting the recent departures is the prospect that two insurers, Centene Corp. and Oscar Health, will expand their Texas footprint. Both have indicated they will, though vaguely.

On Tuesday, St. Louis-based Centene said despite market uncertainty, it is seeking regulatory approval to sell health plans in Texas and a handful of other targeted states in 2018. About 90 percent of its key demographic is eligible for subsidies, the announcement said. Nearly a year ago, when it appeared Fort Worth would have just one insurer in the exchange, Blue Cross, Centene expanded into Tarrant County.

New York-based Oscar, which was co-founded by the brother of White House senior adviser Jared Kushner, withdrew last year from the individual market in the Dallas-Fort Worth area. But it continued to operate in San Antonio and is scrutinizing new Texas markets.

Dudensing, the industry’s state trade group chief, said the individual market supplies coverage for about 1.5 million Texans. About two-thirds of them buy in Obamacare’s federally run Marketplace, she said. The rest purchase policies that comply with the federal health law but outside the exchange. In addition, there’s an unknown number of Texans with “grandfathered” policies they began buying before the federal law passed in 2010.

Some brokers say carriers such as Humana no longer will offer the old, pre-Obamacare policies. The brokers complain they have too few exchange plans to offer customers. In no Texas county is more than four offered; and in 219 counties, just one or two, according to Kaiser’s Cox.
On Monday, the federal Centers for Medicare & Medicaid Services, which run the Obamacare exchanges in most states, reported that about 963,000 Texans enrolled in a Marketplace plan late last year or early this year and have followed up by paying their premiums.

Of them, 86 percent received a premium tax credit to assist with payments. Sixty-three percent received “cost sharing reductions” — the subsidies for low-income consumers that U.S. House Republicans have contended lack explicit legal authorization. Their future under Trump has been unclear.

Sticker shock

Last year, several Texas health insurers requested steep rate hikes for 2017. Blue Cross sought increases of 56 percent to 59 percent on exchange products, while another insurer’s increase exceeded 70 percent. Because of the federal subsidies, most though not all consumers didn't feel the higher premiums' bite. 

With continued federal funding of the cost sharing reductions uncertain, some states such as Iowa have requested waivers to revamp their Obamacare exchanges. Others such as Alaska and Minnesota are pushing ahead with state “reinsurance” programs that would limit rate increases. Texas leaders continue their hands-off approach, irking Dudensing and other industry figures.

Conservative Dallas health economist Devon Herrick, meanwhile, has predicted more trouble ahead for the Texas exchange.
“It’s essentially a poor risk pool, and with poverty comes health issues,” said Herrick, a senior fellow with the National Center for Policy Analysis. “So you have some populations that are inherently unprofitable.”
No one state has the entire solution, Herrick said.

"The overarching problem is that the current market is very unstable," he said.

Liberal health insurance expert Stacey Pogue of the Austin-based Center for Public Policy Priorities said Washington is responsible for the turbulence.

“Uncertainty being sown at the federal level — by the Senate writing a health care repeal bill in secret and the Congress and administration’s unwillingness to ensure payments due to insurers — is hurting consumers in Texas,” she said.

Find your county

To see which insurers participate in each county in the Obamacare exchange, by year, click on this Kaiser Family Foundation tool and select Texas and the year. "HCSC" is Chicago-based Health Care Service Corp., which owns Blue Cross Blue Shield of Texas.
EPO is exclusive provider organization. Like a preferred provider organization or PPO, it lets you seek services without going through a gatekeeper doctor, which is the hallmark of a health maintenance organization or HMO. But a PPO can cover some out-of-network visits, while an EPO and HMO do not, except in an emergency.
In 2016, there was one complete withdrawal, by Humana Insurance Co., and five “partial” withdrawals, in which the carrier pulled off the Obamacare exchange but did not make a full exit from the Texas individual insurance market. The partial withdrawals were by Aetna, Allegian, All Savers, Southwest Life & Health Insurance Co. and United Healthcare Life Insurance Co.

What they said …

Kaiser Family Foundation analyst Cynthia Cox: "It's a large number of companies exiting. Even if they are small companies, it's significant. It could be worse.”

Blue Cross Blue Shield of Texas senior media manager Gustavo Bujanda: "We're working with regulators at the state and federal level to achieve a stable and sustainable market.”

Centene Corp., on its expansion plans in Texas and four other states: "We are still working through the filing and review process. We will not have specific details until the review is complete.”

Oscar Health chief executive Mario Schlosser: "We're confident that in the end, there will be a stable individual market next year. We're actively looking for ways to serve more members in new markets, including in the state of Texas.”

Texas Association of Health Plans chief executive Jamie Dudensing: "Other states are proposing state-based solutions to address the stability of the market before the market goes from bad to worse. ... Moving forward, state policymakers need to examine state-based solutions in the wake of the federal government's inability to act.”

Center for Public Policy Priorities senior policy analyst Stacey Pogue: "The companies that have announced plans to stop selling insurance to Texans not covered through their jobs cover a small share of the market today. But we may not yet know the full extent of how uncertainty caused by federal inaction will weaken the Texas market.”

National Center for Policy Analysis senior fellow Devon Herrick: "The architects of the Affordable Care Act and the American Health Care Act are trying to fix the market. It's in our best interest to have a functioning market. We all have the same goal. But we have different ideas for how to achieve it."