Open enrollment begins November 1 for Individual/Family Insurance.

As we approach another open enrollment period, I wanted to share information that may help clients and friends make a decision about their health insurance. Premium rates and plan information is trickling in from carriers and it appears rate increases are again a reality. Please read your plan’s renewal packet carefully to learn how rate and benefit changes will affect you.

Important Dates
Open enrollment runs from November 1, 2016 through January 31, 2017. This is the period when you can change plans for the 2017 plan year. However, if you want to change plans for a January 1 effective date, you’ll need to enroll by December 15. If you do nothing at all, your existing plan will renew on January 1. Whether you choose a new plan or stay with your current plan, the first premium payment will need to be paid by December 31.

Here is a rundown of the major changes and announcements for this year’s open enrollment.

Rate increases
Expect rate increases for all plans. This is due to a number of factors, most notably:

  1. Two federal programs that have helped health insurers offset costly medical claims, and cover sick patients in general, are set to end this year. These programs were intended as a temporary cushion for insurers, who are now required to accept all applicants regardless of their medical histories.
  2. The rising cost of healthcare, especially specialty drugs.
  3. Adverse Selection. Some consumers waited to enroll in coverage until a health problem arose. This impacted PPO plans particularly hard.

Specific Carrier Details Continue reading

Open Enrollment Approaches

Starting November 1, open enrollment in the individual and family health insurance marketplace begins and will continue through January 31, 2017. This will be the fourth year of open enrollment under the Affordable Care Act (ACA) and many consumers are now familiar with the language and rules of reform, the types of benefit plans offered, and the deadlines that loom. But, a year is a long time (perhaps not long enough) to be away from the excitement of another health insurance enrollment anniversary. Continue reading

Consumers ultimately pay for drug cost increases.

When it comes to claims of price gouging, drug companies rarely flinch. But EpiPen makers (Mylan) have gotten an ear full and then some. This week, Mylan announced the release of a generic version of the EpiPen at half the cost ($300).  See Reuters Report.  But these spikes in drug costs are intended for insurance companies…not the consumer, right? Ultimately, one way or another, it is the consumer who will pay. Continue reading

To COBRA or not to COBRA, this is a frequent question.

First, COBRA is not health insurance. COBRA (Consolidated Omnibus Budget Reconciliation Act) is a federal law that governs how and when a qualified beneficiary can continue terminated group health insurance coverage for a specified period of time by self-paying the premium.  In short and in general, it’s a law that allows an ex-employee and /or their dependents to remain on the employer-sponsored group health plan for a period of time. When you leave employment you are mailed a COBRA Election Notice that includes all of the dates, deadlines, and rules for making an election. To learn more about COBRA, visit: Continue reading

Travel Insurance provides peace of mind.

Many travelers are under the wrong impression their domestic health insurance plan or the US government will provide assistance in the event of a medical emergency while traveling abroad. With international travel at an all-time high, more travelers are realizing the benefit of knowing they are covered by travel medical insurance should they become ill or injured while traveling out of the country.

Take some of the stress out of traveling by following these recommendations.

Before you leave:

  • Review your domestic health insurance plan to know what it does or does not cover while traveling abroad.
  • Purchase travel insurance and become familiar with your plan’s benefits and limitations. If coverage for a pre-existing condition is important, be sure it’s included in the policy you purchase.
  • If you’re planning high-risk activities (such as surfing, skiing, or climbing), be sure and add the appropriate riders.

While traveling abroad:

  • Bring along a record of your medical health history, including your primary doctors’ names and phone numbers, health conditions, as well as your prescription names and dosages.
  • Keep a copy of your travel insurance identification card with you, which will include the insurance company’s 24-hour hotline phone number.
  • Keep all receipts should you need to file a claim when you return.

For information and quotes on travel insurance, please visit OnlyHealthInsurance.

Phil Dougherty

Special Enrollment Period

The ACA reform has brought with it restrictions on when individual health insurance plans can be purchased. Every year there is an open enrollment period during which time those who are uninsured can enroll in a plan or those with a plan can make a plan change. The open enrollment period this year is November 1, 2016 through January 31, 2017. Outside of this open enrollment period, you’d need to experience a “qualifying life event” to enroll in coverage.

Continue reading

Keeping your health plan current.

A belated Happy New Year!

Now that your health insurance is in place for another year, I hope it provides you the peace of mind you were looking for and that you’ll have little need of it.

What’s important now is to keep your plan active. A plan termination due to an unintended non-payment can be costly, and not just for the potential exposure to high health care costs. If your plan is canceled, you could be unable to restart coverage until next January. In addition to lack of insurance, you could be fined for not having ACA-compliant coverage. Continue reading

Best ways to check if your providers participate in the network for “off-exchange”, non-CoveredCA plans.

Ensuring your “must have” providers are in your health plan’s network is not as easy as it should be. Some PPO carriers have gone to narrower networks (namely Anthem Blue Cross, Blue Shield and CIGNA) so it’s important to check provider participation. Although carriers each have a provider search tool on their website, search tools are not always easy to use or up-to-date.

Before finalizing your health insurance carrier and plan decision, you’ll want to take several steps to make sure your providers take your plan. Although the following suggestions are not fail proof, they can provide some peace of mind that your providers are likely “ in-network”. Continue reading

Open Enrollment starts November 1!

The annual health insurance open enrollment period is fast approaching! This is the time when individuals and families already enrolled in ACA-compliant coverage can review their health insurance and make a plan change, and when those without coverage can enroll as well.  This year, more than ever, it is important to be informed of the changes coming to your specific plan and California’s health insurance marketplace in general.  Read your carrier renewal packets thoroughly!

Continue reading