Friday, December 16, 2016

Do Tax Payers Have An Extra $9.8 Billion To Spare?

By Coleen Elkins     24-7 Health Insurance

House Majority Leader Mitch McConnell promises to begin the repeal of Obamacare on January 3, 2017. The healthcare law was previously repealed by the House and the Senate in December of 2015, but vetoed by President Obama. Legislators can use the prior bill to move forward with some modifications to improve it. Many upcoming changes can occur on January 20th 2017 with the stroke of a pen. 

In the meantime is moving forward with enrollments as if nothing is looming in the future of Obamacare. 

The cost for subsidies has now has risen $9.8 Billion. This $9.8 Billion will be added to the current $32.8 billion making the total paid by the tax payers for 2017 $42.6 billion. 

Why the increase you ask? Because premiums have risen to 60 percent in many states and in the case of Arizona 116 percent for 2017. The benchmark to raise subsidies is based on the average premiums of the second highest cost Silver Plan. 

To make matters worse health insurance companies committed to insure those with subsidies are also receiving some grim news. New reporting from the Washington Post tells us health insurers which offer plans through Affordable Care Act marketplaces “are being paid less than 2 percent of nearly $6 billion the government owes them for covering customers last year with unexpectedly high medical expenses.” The article says the $96 million which insurance companies will receive “is just one-fourth of the sum that provoked an industry outcry a year ago, when federal health officials announced that they had enough money to pay health plans only 12.6 percent of what the law entitles them to receive.” The piece adds that CMS simply posted an online notice last month with this information, instead of making an announcement about the risk-corridors program as it did last year. The Post also points out that this “extreme scarcity of 2015 money is the latest chapter for a problem-ridden part of the ACA designed to cushion insurers from high-cost customers.”

Positive change is on the horizon for insuring America's health. We are staying on top of all the legislative issues to keep you informed.

Please visit our website and click on the "Blog" tab often or subscribe to our blog to receive news automatically. 

Wednesday, December 7, 2016

Insurers Are Working With Congress On The Repeal Of Obamacare

By Coleen Elkins   24-7 Health Insurance

The incoming administration and Congress are working with health insurers to make sure Americans are not impacted by the repeal and replacement of Obamacare. 

Insurers have said they are willing to give up the individual mandate to purchase health insurance if other rules and provisions are put into place to protect them from "adverse selection". 

As 24-7 Health Insurance attends webinars and speaks with insurance carriers we are hearing a very positive tone about the future of health insurance in America and shorter timelines than mentioned in the article for replacement plans. 

We believe the Trump Administration will use both the regulatory process and Executive Action to begin the repeal process immediately. This could lift the mandate and the penalties for not purchase an ACA compatible plan. 

From Bloomberg News:

Known as the “individual mandate,” the rule was a major priority for the insurance industry when the Affordable Care Act was legislated, and also became a focal point of opposition for Republicans. In a position paper released Tuesday -- the first since President-elect Donald Trump’s victory -- health insurers laid out changes they’d be willing to accept.
“Replacing the individual mandate with strong, effective incentives, such as late enrollment penalties and waiting periods, can help expand coverage and lower costs for everyone,” AHIP said.

You can read the entire article here: 

Health Insurers Will To Give Up A Key Obamacare Provision

We are licensed in 11 states. We look forward to being of service for all your health insurance and Medicare needs!


Coleen Elkins
24-7 Health Insurance

Friday, December 2, 2016

The Healthcare Principles of Donald Trump and the Republican Party

By Coleen Elkins     24-7 Health Insurance

The Healthcare Principles of Donald Trump and the Republican Party

1. Repeal and Replace “or Amend” the Affordable Care Act. How can that happen? There are three ways to complete the process. 

2. Return power to the states in regulating insurance markets, limit federal requirements on both private insurance and Medicaid, and reconsider costly mandates. 

3. Empower individuals and small businesses to form purchasing pools. 

4. Individuals with preexisting conditions who maintain continuous coverage should be protected from discrimination.

5. Allow the purchase of insurance across state lines. 

6. Promote Health Savings Accounts (HSA’s), price transparency and enact medical liability reform.

7. Reform the Food and Drug Administration. 

8. Block grant Medicaid and other payments, and assist all patients including those with pre-existing conditions to obtain coverage in a robust consumer market. 

We have attended multiple carrier and legislative webinars and had private conversations with insurers. We are confident insurers along with the National Association of Health Underwriters are working with Congressional leaders around the clock to prepare for the 115th Congress being sworn in the first week of January 2017. 

Stabilize the health insurance market 
Improve health plan affordability and availability
Optimize conditions under the existing market
Work with President-elect Trump and congressional leadership to determine the best approach and timing for change in our healthcare system.
Continue to advocate for a strong private insurance market 

We promise to keep our readers updated as we learn more. Thank you for the opportunity to be of service to all that are interested in the future of insuring Americas Health. 

Thursday, November 17, 2016

Legislation To Begin The Repeal Of Obamacare Could Be Signed On Inauguration Day

By Coleen Elkins                  24-7 Health Insurance 

There are several articles recently published reflecting opinions on how Obamacare will be repealed and replaced.

The general Consensus among Republican legislators is they will begin on January 1 2017 to have bills ready for the signature of President Elect Trump after the Inauguration ceremony is complete.

"The original health care law itself was 2,700 pages, but there were also more than 40,000 pages of administrative rules, regulatory guidance, and even blog posts setting Obamacare policy" they wrote "A lot of this can be scaled back on Day One".

If the mandate is lifted the penalty for not purchasing "minimal essential coverage" will be removed as well.

Some insurance products have surfaced in the past few months known as "MEC" plans. To help you understand a MEC plan in simple terms the consumer is paying $55.00 to $85.00 a month to avoid the tax penalty.

The plans offer a wellness exam or hospitalization. None of them "insure" your health. The idea is to couple a MEC with supplement plans that pay cash to you if you become ill. The problem is none of those policies pay enough cash to pay for treatment of a catastrophic event such as heart disease or cancer treatment. Consumers can purchase substandard health insurance to couple with the MEC plan but many of these companies have poor quality ratings and past complaints against them from consumers.

At 24-7 Health Insurance we have the tools to provide our clients with an individual needs assessment. This way our clients can choose their health insurance from multiple options that helps meet their current needs. You may not get exactly what you would like to have immediately but your health will be insured.

We are now attending "post election" carrier and legislative seminars to be able to educate our clients on the future of health insurance for 2017 and beyond. If we can be of assistance please visit our website and contact us.

We are licensed in 11 states. If we are not licensed in your state we will help you find an agent to assist you.

You can read the full Political article quoted above here 

Saturday, November 12, 2016

Medicare Part A and B Premiums For 2017 Announced

By Coleen Elkins       24-7 Healthinsurance  and Medicare 4 Arizona 

November 10, 2016 
Contact: CMS Media Relations
(202) 690-6145 | CMS Media Inquiries

2017 Medicare Parts A & B Premiums and Deductibles Announced
Today, the Centers for Medicare & Medicaid Services (CMS) announced the 2017 premiums for the Medicare inpatient hospital (Part A) and physician and outpatient hospital services (Part B) programs.
Medicare Part B Premiums/Deductibles
Medicare Part B covers physician services, outpatient hospital services, certain home health services, durable medical equipment, and other items.

On October 18, 2016, the Social Security Administration announced that the cost-of-living adjustment (COLA) for Social Security benefits will be 0.3 percent for 2017. Because of the low Social Security COLA, a statutory “hold harmless” provision designed to protect seniors, will largely prevent Part B premiums from increasing for about 70 percent of beneficiaries. Among this group, the average 2017 premium will be about $109.00, compared to $104.90 for the past four years.

For the remaining roughly 30 percent of beneficiaries, the standard monthly premium for Medicare Part B will be $134.00 for 2017, a 10 percent increase from the 2016 premium of $121.80. Because of the “hold harmless” provision covering the other 70 percent of beneficiaries, premiums for the remaining 30 percent must cover most of the increase in Medicare costs for 2017 for all beneficiaries. This year, as in the past, the Secretary has exercised her statutory authority to mitigate projected premium increases for these beneficiaries, while continuing to maintain a prudent level of reserves to protect against unexpected costs. 

The Department of Health and Human Services (HHS) will work with Congress as it explores budget-neutral solutions to challenges created by the “hold harmless” provision.
“Medicare’s top priority is to ensure that beneficiaries have affordable access to the care they need,” said CMS Acting Administrator Andy Slavitt. “We will continue our efforts to improve affordability, access, and quality in Medicare.” 
Medicare Part B beneficiaries not subject to the “hold harmless” provision include beneficiaries who do not receive Social Security benefits, those who enroll in Part B for the first time in 2017, those who are directly billed for their Part B premium, those who are dually eligible for Medicaid and have their premium paid by state Medicaid agencies, and those who pay an income-related premium. These groups represent approximately 30 percent of total Part B beneficiaries.

CMS also announced that the annual deductible for all Medicare Part B beneficiaries will be $183 in 2017 (compared to $166 in 2016). Premiums and deductibles for Medicare Advantage and prescription drug plans are already finalized and are unaffected by this announcement.
Since 2007, beneficiaries with higher incomes have paid higher Medicare Part B monthly premiums. These income-related monthly premium rates affect roughly five percent of people with Medicare. 

The total Medicare Part B premiums for high income beneficiaries for 2017 are shown in the following table:
Beneficiaries who file an individual tax return with income:
Beneficiaries who file a joint tax return with income:
Income-related monthly adjustment amount

Total monthly premium amount
Less than or equal to $85,000
Less than or equal to $170,000

Greater than $85,000 and less than or equal to $107,000
Greater than $170,000 and less than or equal to $214,000

Greater than $107,000 and less than or equal to $160,000
Greater than $214,000 and less than or equal to $320,000

Greater than  $160,000 and less than or equal to $214,000
Greater than $320,000 and less than or equal to $428,000

Greater than $214,000
Greater than $428,000

Premiums for beneficiaries who are married and lived with their spouse at any time during the taxable year, but file a separate return, are as follows:
Beneficiaries who are married and lived with their spouse at any time during the year, but file a separate tax return from their spouse:
Income-related monthly adjustment amount
Total monthly premium amount

Less than or equal to $85,000

Greater than $85,000 and less than or equal to $129,000

Greater than $129,000

Medicare Part A Premiums/Deductibles
Medicare Part A covers inpatient hospital, skilled nursing facility, and some home health care services. About 99 percent of Medicare beneficiaries do not have a Part A premium since they have at least 40 quarters of Medicare-covered employment.
The Medicare Part A inpatient hospital deductible that beneficiaries pay when admitted to the hospital will be $1,316 per benefit period in 2017, an increase of $28 from $1,288 in 2016. The Part A deductible covers beneficiaries’ share of costs for the first 60 days of Medicare-covered inpatient hospital care in a benefit period. Beneficiaries must pay a coinsurance amount of $329 per day for the 61st through 90th day of hospitalization ($322 in 2016) in a benefit period and $658 per day for lifetime reserve days ($644 in in 2016). For beneficiaries in skilled nursing facilities, the daily coinsurance for days 21 through 100 of extended care services in a benefit period will be $164.50 in 2017 ($161 in 2016).
Enrollees age 65 and over who have fewer than 40 quarters of coverage and certain persons with disabilities pay a monthly premium in order to receive coverage under Medicare Part A. Individuals who had at least 30 quarters of coverage or were married to someone with at least 30 quarters of coverage may buy into Part A at a reduced monthly premium rate, which will be $227 in 2017, a $1 increase from 2016. Uninsured aged and certain individuals with disabilities who have exhausted other entitlement and who have less than 30 quarters of coverage will pay the full premium, which will be $413 a month, a $2 increase from 2016.

Part A Deductible and Coinsurance Amounts for Calendar Years 2016 and 2017 by Type of Cost Sharing


Inpatient hospital deductible

Daily coinsurance for 61st-90th Day

Daily coinsurance for lifetime reserve days

Skilled Nursing Facility coinsurance

For more information on the 2017 Medicare Parts A and B premiums and deductibles (CMS-8062-N, CMS-8063-N, CMS-8064-N), please visit

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Wednesday, November 9, 2016

President Elect Donald J. Trumps Vision To Replace Obamacare

By Coleen Elkins     24-7 Health Insurance

President Elect Donald J. Trump's vision for the future of health insurance in America. 

5/4/2016 Healthcare Reform | Donald J Trump for President 3/3

Congress must act. Our elected representatives in the House and Senate must:

1. Completely repeal Obamacare. Our elected representatives must eliminate he individual mandate. No person should be required to buy insurance unless he or she wants to.

2. Modify existing law that inhibits the sale of health insurance across state lines. As long as the plan purchased complies with state requirements, any vendor ought to be able to offer insurance in any state. By allowing full competition in this market, insurance costs will go down and consumer satisfaction will go up. 

3. Allow individuals to fully deduct health insurance premium payments from their tax returns under the current tax system. Businesses are allowed to take these deductions so why wouldn’t Congress allow individuals the same exemptions? As we allow the free market to provide insurance coverage opportunities to companies and individuals, we must also make sure that no one slips through the cracks simply because they cannot afford insurance. We must review basic options for Medicaid and work with states to ensure that those who want healthcare coverage can have it. 

4. Allow individuals to use Health Savings Accounts (HSAs). Contributions into HSAs should be tax-free and should be allowed to accumulate. These accounts would become part of the estate of the individual and could be passed on to heirs without fear of any death penalty. These plans should be  particularly attractive to young people who are healthy and can afford high deductible insurance plans. These funds can be used by any member of a family without penalty. The flexibility and security provided by HSAs will be of great benefit to all who participate.

5. Require price transparency from all healthcare providers, especially doctors and healthcare organizations like clinics and hospitals. Individuals should be able to shop to find the best prices for procedures, exams or any other medical-related procedure.

6. Block-grant Medicaid to the states. Nearly every state already offers benefits beyond what is required in the current Medicaid structure. The state governments know their people best and can manage the administration of Medicaid far better without federal overhead. States will have the incentives to seek out and eliminate fraud, waste and abuse to preserve our precious resources.
The reforms outlined above will lower healthcare costs for all Americans. They are simply a place to start. There are other reforms that might be considered if simply a place to start.
 If they serve to lower costs, remove uncertainty and provide financial security for all Americans. And we must also take actions in other policy areas to lower healthcare costs and burdens. Enforcing immigration laws, eliminating fraud and waste and energizing our economy will relieve the economic pressures felt by every American. It is the moral responsibility of a nation’s government to do what is best for the people and what is in the interest of securing the future of the nation. Providing healthcare to illegal immigrants costs us some $11 billion annually.

7. Remove barriers to entry into free markets for drug providers that offer safe, reliable and cheaper products. Congress will need the courage to step away from the special interests and do what is right for America. Though the pharmaceutical industry is in the private sector, drug companies provide a public service. 
Allowing consumers access to imported, safe and dependable rugs from overseas will bring more options to consumers.

Providing healthcare to illegal immigrants costs us some $11 billion annually.

If we were to simply enforce the current immigration laws and restrict the unbridled granting of visas to this country, we could relieve healthcare cost pressures on state and local governments.

To reduce the number of individuals needing access to programs like Medicaid and Children’s Health Insurance Program we will need to install programs that grow the economy and bring capital and jobs back to America. The best social program has always been a job – and taking care of our economy will go a long way towards reducing our dependence on public health programs.

Finally, we need to reform our mental health programs and institutions in this country. Families, without the ability to get the information needed to help those who are ailing, are too often not given the tools to help their loved ones. There are promising reforms being developed in Congress that should receive bi-partisan support.

To reform healthcare in America, we need a President who has the leadership skills, will and courage to engage the American people and convince Congress to do what is best for the country.  These straightforward reforms, along with many others I have proposed throughout my campaign, will ensure that together we will Make America Great Again.

Tuesday, November 1, 2016

A Snap Shot Of 2017 Under Age 65 Obamacare Rates In Yuma County Arizona

By Coleen Elkins      24-7 Health Insurance

They say "A picture is worth 1000 words".

We hope you share this photo of a "sample" proposal we created today November 1, 2016.

This proposal is for a married couple each 60 years of age in Yuma County Arizona for under age 65 health insurance beginning January 1, 2017. This photo reflects a Silver and a plan option. Yes this is their MONTHLY health insurance premium owed.

Their only health insurance carrier option IS Blue Cross Blue Shield of Arizona. They are mandated to purchase this plan by the federal government because is is the only plan meeting the criteria of the Affordable Care Act. Pay attention to the deductible and out of pocket each of them would have to pay before the plan covers them 100 percent.

As of today we still are unable to quote for those living in Maricopa County because Blue Cross Blue Shield refuses to insure in Maricopa County Arizona and if there is another carrier available they have yet to post their rates.

Monday, October 31, 2016

Under Age 65 Health Insurance Have You Spooked?

Happy Halloween All! 

This Blog Post is directed to under 65 clients and future clients. 

We know many of your are feeling very anxious about your health insurance options for 2017.

In 2017 those UNDER AGE 65 not receiving a tax credit and not on a grandfathered plan will be experiencing rate increases averaging 25 percent. In states such as Texas it will be higher in the 60 percent range for most. In Arizona 116 percent rate increases have been announced. As it stands at this moment in some counties in the United States insureds may only have one health insurance carrier option. 

Unfortunately some of the rates provided by insurance companies and CMS (Center for Medicare and Medicaid Services) to us in the pre-enrollment preview are not accurate. As they are being downloaded to our quoting systems revisions are being received the next day and beyond. 

Open enrollment begins tomorrow November 1st 2016. We want to provide you with accurate information and details in our proposals. We don’t want you making decisions regarding your 2017 health insurance based on inaccurate information. This would be upsetting for you and time consuming for all of us. 

***Another very important point is the upcoming election on November 8th is going to drive the future of health insurance in 2017 and for years to come. We highly recommend you take NO ACTION until after the election. 

As licensed agents we are receiving invitations from multiple health insurance carriers to attend post election webinars the week after the election regarding the future of health insurance. We will be attending all of these webinars and providing information on what we learn so our clients can make informed decisions. 

Remember you have until December 15th to make your elections for January 2017. 

We will be updating our blog as we learn more (the link is on our website). 

Thank you very much for your business and the opportunity to be of service. 

Coleen M. Elkins

Tuesday, October 25, 2016

2017 Obamacare Explained In 400 Words

24-7 Health Insurance

Please follow the link to an article that sums up Obamacare for 2017. It is an easy read and makes clear what the future holds if the law remains. If you are in the 17 percentile mentioned in the article this is painful.

Read here

Wednesday, October 19, 2016

1.4 Million To 2.5 Million Consumers May Lose ACA Plans In 2017

By Coleen Elkins        24-7 Health Insurance 

Some of you may be feeling frustrated and confused by the upcoming changes in health insurance for 2017. Many people are going to get blindsided because they have not been paying attention at all.

Remember you are mandated by the Federal Government to purchase health insurance regardless of the options made available to you.

In some counties in various states there will be zero or one option for people under age 65 to insure themselves for 2017. What does that mean for most Americans?

The Federal Government is suggesting they will automatically move you to a plan of their choosing.

A few legislators are feverishly trying to write law to remove the mandate to purchase health insurance because of the flood of carriers leaving the market. This would open the market for consumers to enroll in plans such as short term plans (that do not meet the requirements of the law) without paying a penalty.

How will you be impacted for 2017?

1. Prepare to wait weeks to see a doctor and have a limit set on the time the doctor will spend with you. If you need a procedure if it is non-life threatening you could wait months.

2. You may very well lose your doctor. Doctors are not required to contract with any insurance company and within their contracts they can pick the network plans they want to contract. For example if your doctor is contracted with ABC insurance company they are not forced to contract with the network that insures individuals. They can choose to only see those with employer sponsored benefits.

3. Networks are narrowing and you may have zero benefits outside your service area.

4. Out of pocket maximums are increasing to $7300 per person in 2017 $14600 per family.

Sadly in many situations agents we may not be able to assist consumers at health insurance companies have cancelled agent contracts. Some are refusing to pay agents for the services they have provided consumer for years. However they will allow the agent to work uncompensated and enroll consumers. There are 100,000 health insurance agents in the United States impacted by this change. Some will be leaving the under age 65 market and some will be charging a consultation for to provide guidance and customer service to their clients moving forward.

Agents will not be able to share benefits or rates with you until on OR after November 1st. We can not provide you any specifics of availability because they have not been released by the Federal Government. 

Lastly: Buyer beware. There are companies cropping up and engaging in unethical practices praying on consumer fear. You may find yourself enrolled in a plan that does not meet the requirements of the law and be forced to pay a penalty on top of your premiums if the carrier can not issue you a 1095 tax form. People selling these products may not be fully disclosing this to their prospects.

Please take 5 more minutes and continue reading here.

Wednesday, October 12, 2016

An Outspoken Message Posted To Blue Cross Blue Shield Of Arizona's Website

By Coleen Elkins      

Blue Cross of Arizona has posted a very outspoken message to their own website regarding Obamacare.

Please read AZ Blue's Message here Their message has another article from Fortune Magazine dated August 28th that will provide you with more detailed information. Keep in mind however since that Fortune Magazine article Aetna has made the decision to only insure in a few counties in a handful of states "off-exchange".

It is our opinion the future of health insurance is going to be driven by the results of the November election. Mrs. Clinton plans to "fix" Obamacare. Mr. Trump plans to repeal and replace it.

Whether you believe Obamacare is redeemable or broken please make your voice is heard by voting. This ensures you have had your say in the future of YOUR healthcare in America.

Tuesday, September 27, 2016

Farewell Nashville, Memphis and Knoxville

By Coleen Elkins     24-7 Health Insurance 

90 percent of the people in Nashville, Memphis and Knoxville just lost their health insurance!

How can that happen? It happened because Blue Cross Blue Shield of Tennessee decided to exit the market in those cities. The carrier is taking drastic measure to recover losses sustained over the last 2 years of insuring under the mandated benefit guidelines.

Safeguards were not put into place to protect insurers from abuse during enrollment.

Consider this example. The average stay in a drug and alcohol rehab center is $30k a month. Drug and alcohol rehab is a mandated covered benefit. Anyone watching television must have noticed the commercials cropping up that your insurance will cover your recovery from your addiction. That is an admirable added benefit that has been completely abused. An uninsured person is able to change their address when they moved to rehab. This created a special election period allowing them to enroll in the insurance plan of their choice. The carrier is forced to cover the expense of their stay for the duration. If they relapsed they got to go back again and have the insurance company pay additional claims on their behalf for any readmissions.

Carriers can still exit the market for 2017 and we expect to see that happen. Blue Cross of Nebraska announced yesterday they will not be insuring ACA Plans. CIGNA has not announced any intentions either way. If CIGNA decides to leave the market it could leave some counties in the United States without an insurance carrier option.

You can read more about Blue Cross of Tennessee's decision here.

Thursday, September 15, 2016

Six Things You Need To Know About The Future Of Your Under Age 65 Health Insurance

By Coleen Elkins

What you need to know about the future of you health insurance and why it is drastically changing for 2017! 

Choice of Carriers

The big topic this year—the “breaking news” if you will—is that many of the major carriers (as well as a lot of the smaller ones) have made the decision to exit most ACA marketplaces in 2017. This summer, UnitedHealthcare, Aetna, and Humana all announced plans to stop offering marketplace plans in a number of markets across the country, leaving consumers with fewer options than they had during the first three open enrollment periods. Other regional carriers have made similar decisions.

On top of that, Anthem is moving forward with its plans to purchase Cigna while Aetna and Humana are moving forward with their merger plans as well. Both deals are facing legal and regulatory hurdles as the Department of Justice has sued to block both of the proposed mergers.

Long story short, the available carrier and plan options is decreasing for most marketplace clients, and as Bloomberg reports, some consumers will have no marketplace options at all.
Smaller Provider Networks

If the mass exodus of carriers is the big news this year, the shrinking provider networks was the big news during last year’s open enrollment period. In many markets, the majority of carriers reduced the size of their provider networks while eliminating any non-emergency out-of-network option. HMO plans as well as other network-only plan designs have taken over the individual market, leading some to question President Obama’s promise that “if you like your doctor, you can keep your doctor.” That’s no longer true for many of our clients, particularly those who see multiple health care providers. It’s difficult if not impossible to find plans with broad networks that won’t cause a disruption for our individual customers, and there’s no sign that that’s going to change in 2017.

Higher Out-of-Pockets

This is a trend that was occurring before the Affordable Care Act but that has accelerated since 2014. Next year, the out-of-pocket limit on ACA-qualified plans will be $7,150 for single coverage and twice that amount—a whopping $14,300—for people with family coverage. Compare that to a maximum out-of-pocket of $6,550 single / $13,300 family for “High Deductible” HSA-qualified plans. It’s ironic when high deductible plans provide better out-of-pocket protection than the new-and-improved ACA plans.

Along with the higher out-of-pockets, we’ve also seen up-front copayments for doctor visits and prescriptions go away on many individual plans, particularly those in the bronze and silver levels. That means that, aside from preventive care, consumers have to spend thousands of dollars before their insurance coverage kicks in and helps pay a portion of the bill.

Reduced Formularies

Speaking of prescriptions, we’ve seen a lot of carriers make changes to their prescription drug coverage. Many plans now have preferred and non-preferred generics; some drugs have been moved to higher copay tiers (if the plan still has copayments); an increasing number of drugs are being classified as non-formulary; and the highest tier drugs often require the member to pay a coinsurance percentage rather than a fixed copayment. Additionally, some plans now have preferred and non-preferred network pharmacies, requiring consumers to change drug stores if they want to get the best price.

Significantly Higher Premiums

One of the things the Affordable Care Act was supposed to do is make health coverage more affordable. That’s not necessarily the case anymore, though. Carriers across the nation have lost millions and in some cases hundreds of millions of dollars during the first three years of guaranteed-issue individual policies, forcing them to request significant premium increases for 2017. And while HHS can require insurers to “justify” any rate increases over 10%, it turns out that the increases are in fact justified.

For clients not receiving a premium tax credit, this is obviously a problem. Their health insurance premiums are significantly outpacing their wage growth and are now cost-prohibitive for many people. And while the tax credit does go up each year to help offset rising premiums for people receiving government assistance, keep in mind that amount of the credit is based on the second-lowest-priced silver-level plan in the marketplace. If the member is covered by a different carrier whose renewal rates are higher, his or her share of the monthly premium could increase quite a bit, particularly if the benchmark carrier’s premium increases are more stable.

Most of our clients are on a budget, and many have already selected the lowest-priced plan available to them. If they see another increase this year of 20, 30, or 40 percent, will they be able to hang on to their health coverage? Unfortunately, the answer for many is no.


The reality is that the marketplace, more than ever, is primarily for those receiving a premium tax credit; for everyone else, there are off-marketplace options. Many of the carriers exiting the federal and state marketplaces are still offering individual off-exchange coverage. According to HHS, 83% of people with a plan purchased through the marketplace are currently receiving financial assistance, and those clients will need to determine if the government subsidy is more important than choice and plan flexibility. The other 17% would do well to explore the many off-exchange options that are available.

We will be Certified for 2017 to assist our clients and future clients.  Open enrollment begins on November 1st and ends on January 31st. Please share our blog with your friends. 

The Blues Are Feeling Blue Over Obamacare - Will They Stay Or Will They Go?

By Coleen Elkins       24-7 Health Insurance 

As we await open enrollment to learn what carriers will participate in the Affordable Care Act Blue Cross Blue Shield Association speaks out about the possibility of eventually leaving the market. In some counties in Texas they are the only remaining insurer.

The article in this link by The Hill explains the Blues Views and some possible solutions to the failing Affordable Care Act.

Click here to read the entire article:

Blue Cross Blue Shield May Exit Exchanges If Conditions Continue To Deteriorate

Tuesday, September 6, 2016

A Clear Perspective On Obamacare From The UK

By Coleen Elkins        24-7 Health Insurance

Watching the decline of our healthcare system from an agents perspective has been very difficult task. As agents assisting the under 65 market we are able to see the warning signs much sooner than the general public does.

Ironically the most informative and clear view of the Affordable Care comes from the United Kingdom. Here it is in it's entirety.

Obamacare On the Cusp Of Falling Apart

Wednesday, August 17, 2016

Aetna Announces Departure From Obamacare

By Coleen Elkins   24-7Healthinsurance

There are two ways to purchase health insurance if you are under age 65.

1) If you qualify for a tax credit also know as a premium subsidy you purchase "On-Market" through an exchange such as the Federally Facilitated Marketplace. 2) If you do not qualify based on income for a tax credit or premium subsidy you purchase "Off-Market" directly from and insurer.

Aetna announced on Monday they will be leaving 11 of the 15 Obamacare Exchanges they currently participate in. In two states Oklahoma and Alaska this will leave one insurance carrier offering for all beneficiaries seeking health insurance through the marketplace.

The good news from some Aetna insureds is "Off-Market ACA plans" will continue to be available in a vast majority of counties where 2016 ACA plans were offered. However, Aetna will only offer on-market products in Delaware, Iowa, Nebraska and Virginia.

In the state of Arizona specifically Maricopa County which covers greater Phoenix and surrounding suburbs Aetna, UnitedHealthcare, Blue Cross Blue Shield of Arizona, Health Net and Humana have made the choice to leave the market. Some insurance companies are leaving completely and some will remain insuring "Off-Market" insured. This may leave only one option for "On Market ACA" enrollees in Maricopa county. 

There still could be some major game changing announcements yet to come. We are following all the industry announcements daily and promise to keep our clients up to date as important announcements are made. 

Open enrollment begins on November 1st please mark your calendar to give a call, so we can help you with you 2017 benefit options! 

Thank you for the opportunity to be of service. Please remember to bookmark our website in your favorites 24-7 Health Insurance

Wednesday, August 10, 2016

Preview Individual Health Insurance Rate Increases For 2017

We know UnitedHealthcare will not be participating in the Affordable Care Act in 2017, Humana will only be participating in a very limited market. Blue Cross Blue Shield of Arizona will only be insuring in certain counties not the entire state. Some insurance companies will be completely eliminating "certain plans" which have yet to be announced. For those remaining this is a sampling of what consumers will see in rate increases for 2017.

Thursday, July 28, 2016

House Ways And Means Committee - 3 Ways GOP Health Care Plan Improves Lives

By Coleen Elkins   24-7 Health Insurance 

Dear Readers,

As the November election draws near we will be receiving more documents and information provided by the Federal Government in the form of public Notices. We are posting this for the purposes of keeping our readers informed. Any citizen can request these notices from the government to be delivered to their personal email.

This is not a political statement.

This Summer's health care headlines have not reflected what Americans were promised in 2010.

Premiums are rising, insurers are leaving the market, and too many individuals and families cannot get the care they need.

They’re sobering reminders that our health care system and the Affordable Care Act continues to fail too many Americans. 
As Ways and Means Committee Chairman Kevin Brady (R-TX) described it:
“Americans today are trapped in a system where bureaucrats in Washington make our health care choices for us. Under Obamacare … patients not only face dramatically higher health care costs, they’ve also lost the power to choose the options right for them.

“Millions of Americans have been forced to pay more for an inadequate plan with fewer options for treatment.” 

House Republicans refuse to settle for a broken health care system and believe Americans deserve a better way.
In June, we proposed our plan to finally provide Americans with high quality and truly affordable health care. Our plan is based on what patients want, not what Washington prescribes. We recognize that individuals and families have unique needs and we make it easier for them to access the care that’s right for them at the price they can afford.
Explaining the premise of our plan, Chairman Brady wrote in USA Today:
“We know that a single 28-year-old in Washington, D.C., a family of four in Huntsville, Texas, and a retired grandpa in Tampa, Fla. have very different health care needs. But we also know that, regardless of their needs, everybody deserves to have the same access to a robust and vibrant health care market with affordable, quality options.

“Americans have asked for years for an alternative to Obamacare. Commonsense, portable, affordable, personalized, high-quality health care is our answer.”
Here’s how our plan improves the lives of all Americans:
  • It expands access to health care: Our plan strengthens employer-sponsored insurance, Medicare, and Medicaid. But for those who do not have access to those coverage options, our plan provides an advanceable, refundable tax credit — in other words, portable financial support — for individuals and families to purchase the insurance plan of their choosing. We also preserves patient protections that increase access to health care, including allowing dependents to stay on their parents’ plan until they are 26; prohibiting health insurers from denying coverage to patients based on pre-existing conditions; lifting lifetime caps on medical care; and ensuring standard rates for individuals who have maintained continuous coverage. These policies help ensure all Americans have access to coverage.
  • It increases health care choices: Our plan makes it easier for Americans to find the health care plan that works for them and take it with them — from job to job, state to state, or home to start a business or raise a family. Under our plan, consumers would not be limited to coverage options available only in their state. They can shop across state lines to purchase coverage that meets their needs. Our plan also promotes and strengthens consumer-driven health care options, such as Health Savings Accounts, which empower individuals and families to make their own decisions about how to spend their health care dollars. Additionally, we bolster support for Medicare Advantage — a market–based program proven to expand high-quality, affordable options for our seniors — and move Medicare toward premium support to unleash the power or choice and competition. These policies help ensure all Americans have access to the care and support they need when they need it.
  • It reduces health care costs: By expanding access and increasing choices, our plan spurs competition and innovation — essential drivers for reducing health care costs. For example, our plan incentivizes states to craft premium-reduction programs to make health care more accessible and affordable. Additionally, we remove policies that drive up costs by repealing Obamacare’s most harmful mandates, eliminating layers of federal bureaucracy, and putting control back in the hands of patients and doctors — not politicians and special interests. These policies, combined with the right incentives for individuals to have and keep their coverage, will decrease premium rates by double digits in the individual market, as well as help ensure all Americans can afford to purchase coverage.
Over the next few weeks, the Ways and Means Committee will roll out a series of blogs showing how real Americans will benefit under House Republicans’ health care plan.