2014 - Page 3 of 3 - PolicyAdvantage.com

Recently, many who have applied for a January 1st, 2014 plan start at the new state health insurance exchange have learned that it’s taking some time for the insurance companies to process your plan. This is currently a common occurrence, as they continue to sort through 10’s of thousands of new applications (literally). Our advice right now: be patient.

Although you may not have received your plan documents and your member ID card yet, if you sent in your “binding payment” on time, you should be retroactively covered:

In California, the “binding payment” is due (in-hand at the insurance company) by January 15th, 2014. This may vary from state-to-state and insurance company to insurance company, so make sure to check.
“Retroactively covered” means that if you incur medical charges before your plan is processed (and as long as your “binding payment” was received on-time), you will be retroactively reimbursed for covered charges.

Be assured that the insurance companies are doing everything that they can to take care of your policy as quickly as possible. You’ll see across Twitter that they’re actively communicating with their new members. Here are some Tweet examples of what we’ve seen to customers:

Blue Shield of California, 1/9/2014:

We’ve extended customer service hours to meet the higher demand and tripled online bandwidth to make payments. Thanks for hanging in there.

Health Net, 1/6/2014:

@justex07: You should get your ID card in approx. 5 business days, but you can go to the doctor before then and file a claim after if needed.

Anthem Blue Cross of California, 1/11/2014:

@mobilefilmclass: Also, we hired 100s of new cust service folks for 1/1, cancelled vacays & pulled 100s other people from other jobs to help.

So although you may have waited on hold for hours, or no one is returning your email inquiries, or you’re just frustrated in general because you haven’t received your packet or ID card yet… stay patient. They’re working diligently to take care of your policy.

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There are some important new dates coming up with regard to individual and family plan health insurance open enrollment. These dates apply to plans both inside and outside of the new state health insurance exchanges.

Before we move further with this blog post, we need to explain a fairly simple concept: the ways in which health insurance is typically purchased. Generally speaking, there are two predominant ways to purchase health insurance:

Group Health Insurance: purchased through and employer, union, association, or other group.
Individual & Family Health Insurance: purchased individually, outside of a group… on your own.

Now that we know how health insurance is usually purchased, it’s important to understand that many more people are applying for individual health insurance plans this year. There are a few different reasons for this, but here are the big ones:

It’s now easier to shop for health insurance on the individual market (ie: no more preexisting conditions).
Many people are qualifying for federal assistance to help offset the costs of their health insurance premiums (via the new state health insurance exchanges).

Due to the changes listed above, there are new rules governing enrollment in individual and family (IFP) plans. In the past, you could apply for an individual (or family) insurance policy at anytime throughout the year. Starting in 2014, you can’t. In other words: you can now only apply for individual and family insurance coverage at certain times during the year.

Why? Because insurance companies can no longer deny people access to coverage for having a preexisting condition. The ACA (Affordable Care Act, ie: Obamacare) does not want people applying for coverage throughout the year after they get sick or hurt.

As you know, 2014 is the first year of the implementation of healthcare reform’s major provisions. For this reason, there are extended dates for individual and family plan open enrollment. Here are the important dates to remember this year (for plans both inside and outside of the state health insurance exchange):

Enrollment for coverage starting January 1st, 2014: October 1st, 2013 to December 15th, 2013.
Enrollment for coverage starting February 1st, 2014: December 16th, 2013 to January 15th, 2014.
Enrollment for coverage starting March 1st, 2014: January 16th, 2014 to February 15th, 2014.
Enrollment for coverage starting April 1st, 2014: February 16th, 2014 to March 15th, 2014.
Enrollment for coverage starting May 1st, 2014: March 16th, 2014 to March 31st, 2014.

As mentioned, we’re in an extended enrollment this year. But in a typical year, here are the individual and family plan (IFP) open enrollment dates (both inside and outside of the health insurance exchanges):