jump to navigation

Friday Free Read: Around the Web August 30, 2013

Posted by QUOTEBROKER in ACA, California Health Insurance, Health Care Reform, Health Insurance, Individual Health Insurance, Insurance, Insurance Quotes, Obamacare, QuoteBroker.
Tags: , , , , , ,
add a comment

A few choice articles on health care and health care reform for the week of 08/26/13


Is the California Health Insurance Exchange Right for Me? August 28, 2013

Posted by QUOTEBROKER in ACA, California Health Insurance, Employee Benefits, Health Care Reform, Health Insurance, Individual Health Insurance, Insurance, Insurance Quotes, Obamacare, QuoteBroker.
Tags: , , , , , , , , , , , , ,

Yesterday we discussed how you might enroll in the California health insurance exchange when it starts accepting applications on October 1 of this year.  But is the exchange really right for you?  Why might you want to avoid Covered California this fall?

  • Your income keeps you from qualifying for a subsidy – The California health insurance exchange is the only place to receive a subsidy from the government to help pay for your monthly premiums.  If you don’t qualify for a subsidy, obviously the exchange is not an option for you.  If your projected income for 2014 exceeds 400% of the Federal Poverty Line, or about $46,000 for individuals, $65,000 for couples, and $95,000 for a family of four, you will not qualify for a subsidy through the exchange.
  • Your employer-sponsored covered keeps you from qualifying for a subsidy–  If your employer offers “affordable” coverage, you will not be eligible for a subsidy.  “Affordable” has a specific connotation in this instance, which the Kaiser Family Foundation has done a great job of summarizing here.
  • You want more choices – Inside the exchange, carriers will be offering a strictly defined list of available plans, across the Bronze, Silver, Gold and Platinum range.  Carriers will offer “mirror” plans outside the exchange. These mirror plans are exactly what they sound like- they are duplicates of the plans available through Covered California,  While some carriers will limit their off-exchange offering to these mirror plans, other carriers will offer completely different plan designs, still falling into the metal tier categories, but with different combinations of copays, coinsurance, deductibles et. all. A consumer who wants more choice may choose to go off exchange to take advantage of this wider array of options
  • You want a stronger network – When insurance carriers designed their plans to fit in the California health insurance exchange, they were told what the limits on deductibles, coinsurance and other such features were. They were told they have to offer health insurance to everyone, and that they couldn’t increase anyone’s rates due to pre-existing conditions.  This left them with only one way to control the price of premiums- altering the network.  HMO customers are used to this phenomenon, however if you’ve had a PPO most recently you may not have ever even considered your network size or composition.  Many of the exchange offerings will be tied to “limited” or “exclusive” networks that do not offer the same choice you may have now when it comes to doctors and hospitals.  In order to purchase a full network that offers the name brand hospitals and doctors you are used to, you may have to shop outside the exchange.

If you fall into any of the above categories, you can continue to purchase insurance just as you do now– privately through the carriers, using the services of an agent at no extra charge.  In fact, you’ll have an even easier experience under Obamacare.  Because all plans are now guaranteed issue, it has been estimated that your application time will average under ten minutes.  The delay between applying and being approved will be shortened from an average of 14 days to one.  While you won’t receive a subsidy, there is still a lot to like about shopping outside of the exchange.

Health Insurance 101: How to Enroll in the California Health Insurance Exchange August 27, 2013

Posted by QUOTEBROKER in Affordable Health Insurance, California Health Insurance, Health Care Reform, Health Insurance, Health Insurance 101, Individual Health Insurance, Obamacare, QuoteBroker.

It’s the morning of October 1st, 2013.  You’ve done your research, you know Obamacare is here.  You have evaluated your options based on your current health plan, and you’d like to see what all the fuss is about with this California health insurance exchange.  How do you actually enroll?

The first step in enrolling in the California health insurance exchange is to evaluate whether or not the exchange is the best option for you.  Remember, the exchange is the only way for you to get a health insurance subsidy.  How do you qualify for a subsidy? Your household income must be less than 400% of the Federal Poverty Line.  Most people don’t have the Federal Poverty Line memorized, so luckily there will be sources to do this for you.  Covered California will have an iPad application and there will be calculators on the web, similar to this one from the Kaiser Foundation and this one from UC Berkeley.  Even better- your health insurance agent will complete these calculations for you.  The health insurance subsidy is based on family size and household income (line item 38 on your tax return.)  For 2014 enrollment, it will be a bit tricky as you must use projected 2014 income.  Your tax advisor will have some tips on how to properly estimate future income.

Once you plug in all the appropriate figures, you will be provided with a subsidy amount.  This is the figure you can take to the health insurance exchange- now it’s time to go shopping!  The Affordable Care Act stipulates that the health insurance subsidy amount will be based on the second-lowest cost Silver plan available.  This means if you want to drop down to a Bronze plan, you will likely get a higher percentage of the premium subsidized, and if you want to move up to a Gold or Platinum plan, you will likely have to pay more.  This is where your insurance agent will come in.  The best plan for you won’t necessarily be the lowest priced plan.  Inside the exchange, it will be very important to consider the available network of doctors, as well as the level of coverage as compared to any pre-existing conditions you may have.  Remember, all health insurance is now guaranteed issue, so while you cannot be declined for a previous condition you may already have, you will still want to match your condition, and thus your usage, with the plan best suited to cover that condition.

Once you have selected a plan and are comfortable with the coverage and the premium, all that’s left is the application.  You will be able to complete it either via paper form or online, and your coverage will be effective January 1, 2014.  Do not cancel your existing coverage in the meantime! You will still need coverage from October 1 through December 31.  If you happen to change your mind, not to worry, as you can repeat the process and change plans before the California health insurance Open Enrollment period expires.

Millions of people will be replicating this process during the course of open enrollment.  If you want to get a head start on your Obamacare subsidy calculations, you can pre-register here.  This will allow Quotebroker to have your information on file and save you time during California’s health insurance open enrollment this fall.

What happens if you do not qualify for the California health insurance exchange, or do not want to enroll inside the exchange?  Your guide to why you might want to avoid the exchange starts here.

**As always, this information is up to date as of the date of publishing.  As the law is still being interpreted, new regulations are passed down every day and this information is subject to change. Quotebroker will make all efforts to keep you informed of these changes.

*For further information or to speak to a licensed professional, please visit http://www.quotebroker.com 

%d bloggers like this: