This post is geared towards people who might qualify for a health insurance subsidy based on their income. What I wrote below is actually an email I sent to my clients who currently have an Exchange policy they purchased within the past year. I thought it might be helpful for others in a similar situation. If you know someone who needs health insurance, but they think they can’t afford it, please direct them to this post. Thank you!
I’m working on another post geared towards everyone who has (or needs) personal health insurance — whether they qualify financially for a subsidy or not. Check back in a few days (from Nov. 5).
It’s that time of year — Open Enrollment is quickly approaching.
In case you are not aware of this, every policy renews on January 1 regardless of the original effective date. So, if you purchased a policy in April or September, your policy renews at the same time: January 1.
Open enrollment begins on November 15 and goes to February 15. However, if you want to make a change effective January 1, then applications need to be submitted by December 15.
Premium increase Many people have received their rate renewal notice by now. If not, you will receive it within the next week. With most carriers, the plans will remain the same, you’ll just pay a higher premium.
Subsidy Redetermination
If you’re a Marketplace member who wants to have your subsidy amount (Advanced Premium Tax Credit) redetermined, you will need to that at healthcare.gov between Nov.15 – Dec. 7.
If you had a change in income during 2014 or anticipate a change in income in 2015, then you will want to do this. Otherwise, this can be reconciled when you file your tax return. You will either owe the IRS due to receiving too much of a subsidy or you will receive a refund if you underestimated your income. It’s always best to consult with your tax advisor since I’m not a tax or legal expert.
If your household modified adjusted gross income is between 100% and 250% of the federal poverty level, then you are eligible for Cost-Sharing Reductions based on the second lowest-cost Silver plan. To read more about this, please click here.
New Options for Coverage in 2015 — we don’t have the new rates yet!
The new plans and rates are not available now, but should be by Nov 7th. Some carriers have released rates on their websites, but we can’t run comparison quotes until sometime between Nov.7 – Nov. 15. The Marketplace has said new plans and rates will be available for “window shopping” on Nov. 7.
There will likely be only a few competitive carriers offering coverage On the marketplace in most counties: Humana, CoventryOne and BC/BS. From what I understand, Humana will be the only carrier offering a competitive POS plan. CoventryOne will have the most competitive, lowest-cost HMO product available.
If you’re okay with an HMO network, then this could be a good choice to save money. Please check out their Provider Network to see if your doctors and preferred hospital(s) are in their network. Search under the “CoventryOne HMO” network.
It is also important to check the carriers’ formularies to make sure your medications are covered and how much your copays will be. CoventryOne’s drug formulary is found here.
The Best Place to Shop and Purchase New Coverage
For those people who qualify for a subsidy, the best place to shop is at my website for marketplace plans: https://georgiahealth.
The On-Exchange application process will only take 15 minutes! This is much better than going to the government site. My site will connect you directly with the Marketplace and make the process seamless.
I will be glad to provide quotes and discuss your options, but the ACA Express site will be a big help to you.
For those who need Off-Exchange health insurance, I will prepare comparison quotes and let you know the best options for 2015.
If you go the healthcare.gov or end up applying directly with a carrier directly for some reason, please let them know you work with an agent and give them my info:
NPN: 3775832 FFM ID: gsanders
If you have any questions, please call me. I’ll be working extended hours from now until December 15.
Thank you for your business!
Greg Sanders
Peachtree Insurance Advisors
678.236.1600 tel
770.789.6400 cell
770.804.2074 fax
greg@insuranceadv.com
