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Open Enrollment begins tomorrow! It's your once-a-year time to decide on your individual health insurance plan

11/15/14 - 02/15/15

Blessings to you all, 

We at A+ Insurance had a very busy summer. We practiced yoga, meditated, and prepared ourselves for the 2nd year of Obamacare Open Enrollment. We heard from you and kept the conversation alive. Now, we are

 gearing up to a new year and new rules. We are here for you, for any question you may have.

From now until 02/15/2015, when the period of Open Enrollment ends, we will be sending you occasional emails with all of the information you need to know about the changes in the healthcare industry. It is crucial to be informed about all aspects of the market, whether you are an individual or employer. Keep in mind that each client at A+ insurance will have a different transition for the best possible coverage for him or her. Read carefully and contact us to get an individualized offer.   We know that many people are still experiencing confusion. This is completely understandable.A lot has changed in our healthcare system since last year, and we are here to help you navigate through the changes. With grace and love, Naama  Important Health Care UpdatesPlease note: Obamacare and the Affordable Care Act (ACA) are exactly the same!  General Information for Individuals Open enrollment begins on 11/15/2014 and ends 02/15/2015.12/15/2014 is the last date to submit a new application or renew an existing policy for a 01/01/2015 effective date. If you submit after 12/15/2014 you will have an effective date of 02/01/2015. The following companies offer plans for individuals: Assurant/Aetna PPO – we are experiencing an increase of 33% in premium payments in 2015. We are now comparing all carriers in order to evaluate the options. The PPO network currently remains the same. Cigna – we are experiencing a 33% increase in premium payments in 2015 and less doctors will be available on network. PPO changes are occurring to the Local Plus network. Blueshield is moving to EPO and HMO networks. PPO options will no longer be available. Providence hospitals were added to the network effective 10/01/2014.    Anthem BlueCross expects between 15% to 25% rate increases in premium payments. The networks will remain the same. More doctors will be added to the current EPO network. The HMO network will also be available. Health net will continue to offer the HMO and PPO networks. The PPO network will only be available under the private market. Note – If you kept your Grandfather status that still offers full PPO network, you will be able to continue under the same policy for 2015.     Tips for individuals who don’t buy in the marketplace If your income is 400% above the federal poverty line, you are not eligible to receive financial assistance via the premium tax credits.·You should also consider the types of health care expenses you may incur over the next year beyond the premium price, such as deductibles, co-insurance, co-pays, and out-of-pocket maximums. Check which doctors and hospitals are covered on your plan, as receiving health care from out-of-network providers can be significantly, more expensive. If you anticipate using a lot of medical services, it is more ideal to select a platinum or gold plan. Although the premiums are higher, you will pay less out-of-pocket when it comes time to receive medical care. If you do not anticipate having a lot of healthcare needs, selecting a silver or bronze plan is more ideal to save money. Although there will be higher out-of-pocket costs when you do need medical services, you will pay a significantly lower premium. Choosing a health plan can be extremely confusing and overwhelming. We are here to help you understand the plans and pay as little as possible for coverage. Bronze is the most economical option available. Under the Affordable Care Act (Obamacare), you are required to have health insurance;   a tax penalty must be paid if you do not. This rule is called the “Individual Mandate” or “Individual Shared Responsibility Fee” which started in 2014. Coverage can include job-based health insurance, individual health insurance, or insurance through a government program such as Medicaid or Medicare. Important – how to avoid the Individual Shared Responsibility FeeThe penalty for not having “minimum essential coverage” is called the “Individual Shared Responsibility Fee.” This fee is either a flat fee or a percentage of household income, whichever is greater. The penalty increases over the first three years. Next year, the fee will increase from a $95 maximum fee for an individual to a $325 maximum fee for an individual. The maximum fee for a family will increase from $285 to a whopping $975. If you are purchasing coverage to be effective 01/01/2015, you must sign up by 12/15/2014.We strongly recommend that you set up automatic monthly payments for your monthly premium.  This will avoid undue worries about late payments. Please contact us if you would like help setting this up! Covered California Individuals These days, 1.2 million Californians are renewing their health plans under Covered California for the first time. Be patient and remain positive! Service center, phone service, and online chat with an expanded capacity in Spanish hours will be: 8 a.m. to 8 p.m. Monday through Friday 8 a.m. to 6 p.m. on Saturday. The Service Center will be open every Sunday from 11/16/2014 through 12/15/2014.Important notice for individuals interested in Health Net: Health Net will not offer their PPO plans in 2015 for individuals and families who buy through Covered California. Health Net will continue to offer HMO and EPO Plans.The following plans will be available under Covered California:  Health Net: HMO and EPO Blue Shield: HMO and EPO Anthem/Blue Cross: HMO and EPO LA Care: HMO Molina: HMO Kaiser: HMOPlease note some important dates and mark your calendars: If you purchased health coverage for 2014, and now you are shopping and comparing your options for 2015, the last day to change your plan will be 02/15/2014. If you don’t take action by that date, you will automatically be renewed in your current plan and receive a bill with your new premium and tax credit lowering your monthly payment. Please make sure to respond to any letter from Covered California. 10/15/2014: Renewal begins. You should renew your coverage by choosing a new plan or staying with your existing plan. 12/26/2014: Premium must be received by your plan to avoid any gap in coverage.If you had a Private Policy and submitted an application for a Covered CA policy, you need to cancel your Private Policy.  We recommend that you wait until your payment has been received and cashed by the new Covered CA carrier before you cancel your existing policy. Notice for Medi-Cal clients: If you receive Medi-Cal, you should not renew on www.CoveredCA.com , but should wait to hear from Medi-Cal about the next steps to take.  General Information for Employers of Small and Large Groups: There will not be any changes to the provider networks for policies under group coverage. You will be able to keep your full provider network. While the Affordable Care Act (ACA) had established a 90-day waiting period that applies broadly to employers nationwide, California had established a 60-day waiting period. However, this is about to change. Beginning on 01/01/15, the waiting period for small and large-groups will also be 90 days in California. The best way to approach the new waiting period will be on the 1st of the month following 60 days. In the “old” world of health insurance, you and your employees would be able to receive prescriptions and have doctor appointments, even if your monthly premium payments were outside of the grace period.  Now, you must be sure that your payment is posted on time, or you may experience difficulty in receiving care. Beginning 02/01/2014, CaliforniaChoice will allow new and renewing groups to select two metallic plan tiers. If multiple tiers are selected, the tiers must be next to each other (Platinum & Gold, Gold & Silver, or Silver & Bronze).     If you employ over 100 employees (full time) – 30 hours or more – you will have to provide them with minimum essential coverage; effective date of 01/01/2015.   Effective 07/07/2014, small employers with old (grandfathered) health insurance policies have the option to renew the existing coverage for one year, rather than being required to move to new coverage by the end of 2014. This transition is called Grand-mothering. These small groups can continue their current coverage throughout 2015. Most groups will save money and should keep this status.   For IRS information for employers of over 100 employees, please click here.   For IRS information for employers of less than 100 employees, please click here.        SHOP  Covered CA has announced that SHOP will be offering group plans with dual tiers beginning with the effective date 10/01/2014. A maximum of two tiers will be available, and the tiers must be adjacent. For example, Silver and Gold plans can be offered together, but not Bronze and Gold.   Starting in 2014, tax credits are only available for businesses that purchase through SHOP.   SHOP has a minimum employer contribution of 50%.       We know this transition might be confusing for many of us. We at A+ Insurance will help you navigate the obstacles. We have a team of licensed professionals who are ready to help you with all of your questions. Best wishes for a beautiful rest of the week.  With gratitude,  Naama and the team @ A+ Insurance http://www.rightplan.com/          

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