http://www.jsonline.com/business/tardy-tax-filers-at-risk-of-losing-health-insurance-subsidies-b99563280z1-322743301.html
In About-Face, Aetna Backs Away from State-Based Exchanges.
August 13, 2013 by
Aetna has dropped plans to offer health policies through the insurance exchanges in Ohio and its home state of Connecticut, the company revealed last week.
The Buckeye and Nutmeg state exchanges are the latest to join a growing list of local markets in which the carrier has reversed course and decided not to participate. Since June, it has also backed off plans to sell coverage via the exchanges in six other states, including California, Georgia, Maryland, New York, Tennessee and Texas.
In the case of Connecticut, at least, the decision was made “reluctantly,” according to a letter to the state’s Insurance Department signed by Bruce Campbell, Aetna’s senior actuary. “Please be assured this is not a step taken lightly, and was made as part of national review of our Exchange strategy,” Campbell wrote.
As in some other states, Aetna abandoned its plans after Connecticut regulators questioned the rates it proposed to offer through the state’s exchange, known as Access Health CT or AHCT. Three insurers will still offer individual coverage through AHCT, including Anthem, ConnectiCare and the nonprofit HealthyCT.
“The good news today is that consumers and businesses will retain several, high quality choices, and today’s decision also shows we at AHCT are doing our best to hold rates down,” Kevin Counihan, the chief executive of AHCT, said in a statement. “Our goal is clear: we want to bring affordable, quality health care to Connecticut’s residents and small businesses.”
The story is similar in Maryland, where the insurer said the state’s requirements for rate reductions would force it to operate at a loss. “Unfortunately, we believe the modifications to the rates filed by Aetna and Coventry would not allow us to collect enough premiums to cover the cost of the plans,” Aetna said in a letter to insurance commissioner Therese Goldsmith. Eight other carriers will continue to offer individual policies through Maryland’s web-based insurance market.
In Ohio, Aetna said it’s withdrawing from the individual exchange market for 2014, but plans to continue offering its individual products from its Coventry subsidiary on the exchange. The carrier also said it will continue to provide its individual product in Ohio’s off-exchange market.
Aetna’s decision will leave 12 companies offering 200 individual health insurance plans on the Ohio exchange.
New California Health Insurance Exchange Marketplace.
July 13, 2013 by
In the next few months you will be hearing about “Exchanges” for businesses & individuals on TV
and radio. The California health insurance exchange will begin to offer plans and enrollment after October 1st. with coverage taking effect January 1, 2014. The new marketplace will offer California Exchange and Off-Exchange health plans in addition to existing private plans. All new health plans will be offered on a guaranteed acceptance basis with all pre-existing conditions covered. More Exchange & Off-Exchange benefit details and rates should be available by August . It usually will only make sense for you to move to a health plan in the State Exchange if you are eligible for a tax subsidy. The Cal State exchange premium assistance offered is only for those who fall between 133% to 400% of the Federal Poverty Level based upon household income.
You can count on us! We’re your key health reform and exchange resource. We are ready to assist you every day–on the phone and in person providing you with time and cost saving programs. Please call us before you do anything with your current coverage and I will advise you on the best course of action that will provide quality coverage and save you money.
You may be better off keeping your existing health plan or alternatively consider the Off-Exchange and California Health Insurance exchange plans which may save you money and provide enhanced benefits. Our services will assist you in applying for a possible tax subsidy, selecting the best health plan, and enrollment process.
Thank you again for the pleasure of being of service and for your business!
Kind Regards,
Frank West
For fast online quotes, benefit details, & applications for health,
group health, medicare supplement, dental, and life insurance
please visit: https://frankwestinsurance.com
Frank West Insurance Services, LLC Ca Lic. # OG23770
“Service You Can Count On Since 1982”
P.O. Box 721090 San Diego, Ca 92172
800-726-9525 858-484-1894 Fax: 858-484-1668
Check Out The Following Informative Summaries:
Health Care Reform: What is a health insurance
exchange?
https://frankwestinsurance.com/health-care-reform-what-is-a-health-insurance-exchange/#comments
Individual Health Care Mandate Q&A
https://frankwestinsurance.com/individual-health-care-mandate-qa/#comments
Health insurance carriers fear many young people will opt to go without coverage.
July 9, 2013 by
Youth weighing a $100 fine against the cost of insurance.
Dan Lopez rarely gets sick and hasn’t been to a doctor in 10 years, so buying health insurance feels like a waste of money.
Even after the federal health overhaul takes full effect next year, the 24-year-old said he will probably decide to pay the $100 penalty for those who skirt the law’s requirement that all Americans purchase coverage.
“I don’t feel I should pay for something I don’t use,” said the Milwaukee resident, who makes about $48,000 a year working two part-time jobs.
Because he makes too much to qualify for government subsidies, Lopez would pay a premium of about $3,000 a year if he chose to buy health insurance.
“I shouldn’t be penalized for having good health,” he said.
Persuading young, healthy adults such as Lopez to buy insurance under the Affordable Care Act is becoming a major concern for insurance companies as they scramble to comply with the law, which prohibits them from denying coverage because of pre-existing conditions and limits what they can charge to older policyholders.
Experts warn that a lot of these so-called “young invincibles” could opt to pay the fine instead of spending hundreds or thousands of dollars each year on insurance premiums. If enough young adults avoid the new insurance marketplace, it could throw off the entire equilibrium of the Affordable Care Act. Insurers are betting on the business of that group to offset the higher costs they will incur for older, sicker beneficiaries.
The nonpartisan Congressional Budget Office estimates that about 6 million people of various ages will pay the tax penalty for not having insurance in 2014, the first year the law championed by President Barack Obama will be fully implemented.
It’s hard to estimate how many of those will be the young and healthy adults that insurers are trying to reach, but that subgroup makes up a very small portion of the overall market. Even though it’s small, experts say it could be enough to throw the system’s financing off-kilter.
About 3 million 18-to-24-year-olds in the U.S. currently purchase their own insurance. Many pay high prices for scant benefits, with high deductibles and co-pays because they make too much to qualify for Medicaid and have no coverage options from their employers or parents. The Urban Institute estimates that the majority of adults in their 20s will qualify for government subsidies under the Affordable Care Act.
Premium hikes could be a disincentive for young people weighing their options. Premiums for people aged 21 to 29 with single coverage who are not eligible for government subsidies would increase by 42 percent under the law, according to an analysis by actuaries at the consulting firm Oliver Wyman. By comparison, an adult in his or her early 60s would see about a 1 percent average increase in premiums under new federal health rules.
“The key to keeping health care affordable is you really want to balance the pool, where you have enough young and healthy people to balance off the care of the older, sicker people who are likely to utilize much more health care services,” said Justine Handelman, the Blue Cross and Blue Shield Association’s vice president for legislative and regulatory policy.
She said younger people use about a fifth of the services that older beneficiaries do.
Jonathan Gruber, an economics professor at the Massachusetts Institute of Technology who helped craft that state’s law, said he thinks the first-year federal penalty should be higher.
The penalty under the Massachusetts law, which served as the model for Obama’s overhaul, was $218 the first year in 2007. Gruber said that amount proved effective.
“People hate paying money and getting nothing for it,” he said.
Francois Louis, a 20-year-old college student in South Florida who works part-time, can’t remember the last time he went to the doctor and gets by on over-the-counter medication whenever he’s sick. He’d love to get a checkup, but says it’s too expensive on his income of less than $15,000 a year.
“I probably would do the $100 fine because it’s just cheaper and you don’t have to worry about paying off monthly costs,” said Louis, a student at Broward Community College near Fort Lauderdale.
By Kelli Kennedy
The Associated Press
Boehner: Obamacare ‘Train Wreck,’ ‘Unworkable’.
July 3, 2013 by
The announcement tonight of the delay of part of the implementation of Obamacare prompted Speaker of the House John Boehner to release this statement, saying the entire bill is a “train wreck” and “unworkable.”
“The president’s health care law is already raising costs and costing jobs. This announcement means even the Obama administration knows the ‘train wreck’ will only get worse. I hope the administration recognizes the need to release American families from the mandates of this law as well. This is a clear acknowledgment that the law is unworkable, and it underscores the need to repeal the law and replace it with effective, patient-centered reforms,” the statement reads.
The Tax Penalty Won’t Push People to Buy Health Insurance.
June 27, 2013 by
The Tax Penalty Won’t Push People to Buy Health Insurance
Two-thirds of people surveyed by HealthPocket say a $95 IRS penalty for being uninsured won’t motivate them to buy insurance. Nearly 30% are not sure whether the penalty will motivate them to buy insurance, and only 8% say it would.
Beginning in 2014, the Affordable Care Act requires consumers to buy health insurance or face a tax penalty, with some exceptions for people with financial hardships or religious beliefs that preclude them from purchasing health insurance, among others.
The tax penalty starts at $95 per individual or 1% of household income, whichever is greater. By 2016, the penalty rises to 2.5% of annual household income or a minimum of $695 per person, whichever is greater. Bruce Telkamp, CEO of HealthPocket said, “The law will be most effective if consumers see real value in obtaining the insurance coverage. Only insurers that offer high quality and affordable health plans should expect to see significant new enrollments this fall.”
The tax penalty is not the only strategy that Obamacare will use to promote enrollment. Some premium and out-of-pocket assistance is available for individuals making less than 400% of the federal poverty level or $45,960. However, 63% of consumers who fall in this income band say a tax penalty will not motivate them, indicating that that they need more outreach. For more information, visitwww.HealthPocket.com
Individual Health Care Mandate Q&A
May 15, 2013 by
Beginning in 2014, the Affordable Care Act includes a mandate for most individuals to have health insurance or potentially pay a penalty for noncompliance. Individuals will be required to maintain minimum essential coverage for themselves and their dependents. Some individuals will be exempt from the mandate or the penalty, while others may be given financial assistance to help them pay for the cost of health insurance.
What type of coverage satisfies the individual mandate?
“Minimum essential coverage”
What is minimum essential coverage?
Minimum essential coverage is defined as:
- Coverage under certain government-sponsored plans
- Employer-sponsored plans, with respect to any employee
- Plans in the individual market,
- Grandfathered health plans; and
- Any other health benefits coverage, such as a state health benefits risk pool, as recognized by the HHS Secretary.
Minimum essential coverage does not include health insurance coverage consisting of excepted benefits, such as dental-only coverage.
How does “Minimum Essential Coverage” differ from “Essential Health Benefits”?
Essential health benefits are required to be offered by certain plans starting in 2014 as a component of the essential health benefit package. They are also the benefits that are subject to the annual and lifetime dollar limit requirements.
This is different than minimum essential coverage, which refers to the coverage needed to avoid the individual mandate penalty. Coverage does not have to include essential benefits to be minimum essential coverage.
What is the penalty for noncompliance?
The penalty is the greater of:
- For 2014, $95 per uninsured person or 1 percent of household income over the filing threshold,
- For 2015, $325 per uninsured person or 2 percent of household income over the filing threshold, and
- For 2016 and beyond, $695 per uninsured person or 2.5 percent of household income over the filing threshold.
There is a family cap on the flat dollar amount (but not the percentage of income test) of 300 percent, and the overall penalty is capped at the national average premium of a bronze level plan purchases through an exchange. For individuals under 18 years old, the applicable per person penalty is one-half of the amounts listed above.
Beginning in 2017, the penalties will be increased by the cost-of-living adjustment.
Who will be exempt from the mandate?
Individuals who have a religious exemption, those not lawfully present in the United States, and incarcerated individuals are exempt from the minimum essential coverage requirement.
Are there other exceptions to when the penalty may apply?
Yes. A penalty will not be assessed on individuals who:
- cannot afford coverage based on formulas contained in the law,
- have income below the federal income tax filing threshold,
- are members of Indian tribes,
- were uninsured for short coverage gaps of less than three months;
- have received a hardship waiver from the Secretary, or are residing outside of the United States, or are bona fide residents of any possession of the United States.
Health Care Reform: What is a health insurance exchange?
May 15, 2013 by
In case you haven’t heard, big changes are coming in October 2013. Big changes for a lot of people. The Affordable Care Act is expected to help increase access to health care. Health insurance exchanges will be an important part of that.
Most people get health insurance through their employers. But people without this option will now be able to shop for health insurance on exchanges, as an alternative to buying coverage directly from individual health insurers. Exchanges are new and easy to use. And they’ll be open for business in October 2013, allowing consumers to shop for health plans that will begin on January 1st.
Experts predict that by 2016, more than 25 million people will use exchanges to buy health insurance.
So what are exchanges? How do they work? How will things change? And why is this important?
Let’s talk about it!
Think of an exchange as an online marketplace. It’s a website where shoppers can research all their options and then buy health insurance.
There are different types of exchanges… first let’s talk about a public exchange.
The Affordable Care Act requires every state to offer an exchange to its residents. States have a few options:
- A state can choose to create and run its own exchange.
- If a state decides not to run its own exchange, residents of that state can shop on an exchange that will be run by the federal government.
- Or a state can partner with the federal government. In a partnership model, the state and federal government share responsibility for operating that state’s exchange.
No matter what each state decides to do, an Exchange will be available to residents in every state.
Public exchanges will exist for both individuals, who are buying insurance for themselves, and for small group employers, who can buy insurance to offer to their employees. The small group exchange is called SHOP – short for Small Business Health Options Program.
Why are exchanges expected to be so popular? There are a few reasons:
- The Affordable Care Act no longer allows insurers to deny coverage or charge people more based on their health status or pre-existing conditions. So, many people who were unable to buy coverage in the past will now start shopping for a health plan.
- Starting in 2014, individuals are required to buy health insurance or face penalties. This is called the “individual mandate.” Although the penalty for not buying coverage is initially low, it will grow over time. As the penalty goes up, so will participation on exchanges.
- The Affordable Care Act will provide tax credits and subsidies for individuals who qualify, to help make insurance more affordable, when they shop on a public exchange.
Many individuals who shop on exchanges will be new to health insurance. To help make shopping easier, health plans on a public exchange will be labeled platinum, gold, silver or bronze. The metallic level helps shoppers understand the level of coverage a plan offers – how much they will need to pay and what the plan pays.
Platinum plans will have the lowest out of pocket cost for members but the monthly premiums will generally be higher. Bronze plans, on the other hand, will have the highest out of pocket costs for members, but will typically feature lower monthly premiums.
All plans on an exchange have to offer some core benefits – called “essential health benefits” – like preventive and wellness services, prescription drugs, and coverage for hospital stays.
Public exchanges are designed to help shoppers choose a plan that fits their needs and their budget.
So that’s the public exchange – offered by the government – either state or federal, or both.
There are also private exchanges. Private exchanges are not part of the Affordable Care Act. They are created by private sector companies – for example, by a health insurance company or a brokerage or consulting firm. A few private exchanges exist today, but they are becoming increasingly popular.
Like public exchanges, private exchanges can sell to both individuals and employer groups.
Unlike public exchanges, private exchanges are already open for business.
For employers who are trying to keep the cost of offering health benefits manageable, private exchanges offer an interesting solution. Employers can give their employees a set amount of money and then direct them to a private exchange. There, they can shop for a health plan and other benefits, like dental, based on what the employer has selected as options.
Public and private exchanges are likely to appeal to different audiences. Individuals who do not have access to affordable health insurance today are more likely to shop on a public exchange because of the subsidies, which are not available through private exchanges. Employers are more likely to send their employees to a private exchange. And both individuals and small employers will still be able to shop for coverage as they do today, directly from health insurers.
So to highlight a few key messages about exchanges:
- Exchanges give people additional access and more opportunity to buy insurance.
- A public exchange may be run by the state or federal government, or by the state and federal government working together.
- Every state will have a public exchange available to its residents.
- Subsidies and tax credits will help make insurance affordable for many individuals who shop on the public exchanges.
- Small group employers can buy and offer insurance through an exchange, as well.
- Private exchanges are not run by the government but by a private sector company, like a health plan or a consulting firm.
- These exist today, but they will become more popular as employers look for new ways to offer affordable benefits to their employees.
One thing is certain: Exchanges are going to change the way millions of Americans view their health insurance – whether it’s how they shop for a plan, what plan they decide to buy or how they use their benefits.
Here at Aetna, we’re ready to do our part to help make health care easy to shop for, easy to understand and easy to use.
HHS Resurrects ‘ACORN’ Through ObamaCare.
May 11, 2013 by
ObamaCare provides millions of dollars in grants to hire community activists and others as “navigators” to assist individuals enroll in health insurance provided by state or federal exchanges and, according to recent reports, register people to vote. In a new rule proposed Wednesday, HHS lays out numerous guidelines for these “navigators”, including paying them up to $48/hour for their work. The rule, guidelines and voter registration effort are a potential vehicle to resurrect ACORN or an ACORN-like entity.
One organization expected to take a lead role in distributing the funds and overseeing hiring is Enroll America, a new non-profit headed by Anne Filipic, a former Obama White House official under Valerie Jarrett. Filipic was also a senior staff member at OFA director and a former Obama campaign director. The organization was founded, in part, by Families USA, a far-left advocacy organization that lobbied aggressively for ObamaCare, a source at HHS told Breitbart News. Filipic has said she expects. Enroll America to spend $100 million on the enrollment effort. A large percentage of this is likely to come from federal funds.