This blog post is about “voluntary benefits” and how they are poised to see significant growth in the post-healthcare reform environment. If you’ve been following along here at our blog, you’ll know that we’ve discussed the definition of voluntary benefits in the past. We’ve referred to these benefits as “supplemental health insurance.”

As we move forward with this concept, keep in mind that you may see this specific category of benefit worded in three ways:

  1. Voluntary Benefits (the verbiage we’re using in this blog post).
  2. Supplemental Health Insurance (verbiage we’ve used in the past).
  3. Ancillary Benefits (or: benefits that support existing benefits).

The above listed could all be considered “voluntary benefits.” Each are composed of a variety of different important products when designing employer health programs.

The big question: http://nzeft.org/location/nelson/http: What are voluntary benefits? 

Answer: voluntary benefits are exactly what they say they are. They are products that employees voluntarily participate in at work. In other words, employees typically pay for voluntary plans with their own money. The employer usually does not make a contribution.

The next big question: go to link What types of plans are available voluntarily? 

Answer: there are a number of different plans that are available on a voluntary basis. Listed below are a few of them.

  • Supplemental Health Insurance: Accident Plans, Cancer Plans, Hospital Plans
  • Ancillary Benefits: Vision, Dental, Life Insurance, Disability Insurance
  • Specialty Benefits: Pet Insurance, Legal Counsel, Law/Litigation Insurance

The last big question: Why are these types of plans poised to grow significantly?

Answer: there are two big reasons why voluntary benefits are poised to grow significantly in the post-healthcare reform environment.

  1. It’s expected that there will continue to be increased exposure to “out of pocket expenses” and “cost sharing.” In other words, deductibles, co-payments, and coinsurance will all continue to be common. And most likely, these types of out of pocket expenses will continue to increase over time. Voluntary benefits can help reduce exposure to these kinds of expenses. Read more here.
  2. Government money is now helping to pay for a considerable number of new health insurance plans. This is especially true for small businesses (under 50 employees). With the integration of the new health insurance exchanges into the insurance marketplace, the federal government is now helping millions of new people pay their premiums in the form of tax subsides. What does this do? It frees up money for products like voluntary benefits.

As you can see, voluntary benefits will be a very important component in the post-healthcare reform environment. According to a recent study by Met Life, 51% of employees are willing to bear more of their benefits costs in order to have better choices, and 58% of employers say providing voluntary benefits will be significant to their benefits strategy in the coming years.

Policy Advantage Insurance Services provides a broad range of voluntary and ancillary products. If you have questions, please contact us, and we can evaluate your situation (as a business or individual) to see exactly where these benefits can fit it, and how they can help. Continue to look for additional posts on this topic.

Thanks for stopping by, we hope you found our information to be valuable. Check back at our blog to get further information about funding healthcare. Also, please share with your friends, clients, colleagues, and family. Here are a few of our other information outlets:

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Yesterday (on 2/10/14) the Obama Administration announced an additional delay to the healthcare reform law’s “employer mandate.” This new announcement stated that medium-sized businesses (those from 50-99 employees) will now have additional time to cover their employees with a health insurance plan.

This is the second announcement of a delay with regard to the employer mandate. Back in July of 2013, the entire mandate (for those employers with 50 or more full time equivalent employees) was postponed until 2015. Now, the “medium sized” employers in that group (those with 50 to 99 workers) will be given an additional year (until 2016) to provide “minimum essential coverage” or face tax penalties.

With this new announcement, comes an additional “grace period” for employers that are at or above 100 employees. The employers in this group will still have to cover their workers. However, originally they only needed to cover 95% of their total full-time employees. Now, with the grace period, they will only need to cover 70% of their full-time employees in 2015. In 2016, they will need to cover 95% of their employees.

The main idea behind this recent delay: to provide a “dual phase-in” period for the employer mandate, and lighten the burden on those  employers in the 50 to 99 employee range that have not provided health insurance in the past.

Thanks for stopping by, we hope our information was valuable to you. Check back at our blog to get further information about funding healthcare. Also, please share with your friends, clients, colleagues, and family. Here are a few of our other information outlets:

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Believe it or not, it can save you money. One of the most important concepts in the post-healthcare reform environment will be giving employees choice when it comes to their health benefits selection. This blog post will explain why this is so important. A future blog post will explain the ways this can be accomplished. Your employees have questions right now… have good answers for them.

If you’re an employer that is offering health benefits, you’ll want to understand that it’s now easier and more important than ever to give your employees a healthy selection of health plans at work. This is especially true for businesses that are in the “+50 Full-Time Equivalent Employee” category.

There are a number of different reasons why it’s now important to offer more selection. Here are a few of them:

  • “One size fits all” benefits plans are no-longer efficient. In the past, employers would typically offer their employees a single group health insurance plan. Imagine this… buying identical pairs of jeans for each person in the company. All the same size, all the same price. There’s going to be a good chance that pair of jeans you picked won’t fit everyone, and might be too expensive too. The same thing can happen with a health insurance plan. Which leads us into our next important reason it’s important to offer additional choices…
  • In most cases you (the employer) are the one choosing the plan for the group. So, not only are the “jeans too expensive and not fitting everyone right,” but YOU are the one who picked them out for your group. By offering a better selection of plans, people begin to make their own decisions. And when people are thinking about what they’re purchasing, they’ll become a better consumer. When people become a better consumer… it saves money all around. There’s a real concept that describes this phenomenon, and it’s called “Consumer Directed Healthcare.”
  • Dependent coverage can now be difficult to navigate. Now that everyone needs to carry health insurance, the way the dependents of your employees find their coverage is much more important. This is one of the “biggees” in the post-reform environment. For example, you may be offering the best plan to your employees, but their dependents may not be able to afford it (especially if you’re not making a contribution to health insurance for dependents, and it’s an expensive plan). You “mean well”… but this scenario can be big a problem, especially when it comes to eligibility for subsidies at the new health insurance exchanges. By having a better selection at work, dependents of employees can more easily (and affordably) navigate their options.
  • Individual health insurance plans and “defined contribution” health planning are two strategies that are growing in popularity. Why? Because they both allow employers to offer great benefits at maximum flexibility to employees and their dependents. An additional bonus: setting (or defining) a budget for health benefits has never been so easy.

Keep that last bullet-point in mind, because we’re going to get into both of those in more detail in a later blog post. That future blog post will help answer two important questions: “How can I offer more choices and flexible benefits to my employees?” and “How can it save me money?”

The good news is, it’s easier now that ever before. We can’t wait to tell you more. Continue to tune-in to our blog, and we’ll continue to share great information.

Thanks for stopping by, we hope our information was valuable to you. Check back at our blog to get further information about funding healthcare. Also, please share with your friends, clients, colleagues, and family. Here are a few of our other information outlets:

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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.

Thanks for stopping by, we hope you found our information to be valuable. Check back at our blog to get further information about funding healthcare. Also, please share with your friends, clients, colleagues, and family. Here are a few of our other information outlets:

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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:

  1. Group Health Insurance: purchased through and employer, union, association, or other group.
  2. 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):

  • Future Years (after 2014): October 15th to December 7th.

Policy Advantage Insurance Services is “Covered California Certified” and can assist you with your enrollment at the new exchange. If you have questions, or need assistance please contact us anytime (info@policyadvantage.com).

Thanks for stopping by, we hope you found our information to be valuable. Check back at our blog to get further information about funding healthcare. Also, please share with your friends, clients, colleagues, and family. Here are a few of our other information outlets:

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The first half of 2013 open enrollment is complete. It’s official: the new state and federal health insurance exchanges have opened up across the country. We’re now in the very beginning of the implementation of healthcare reform’s major provisions.

Over the past two and a half months, a lot has taken place. Some things not so good (you might even say bad). And some things good (in certain cases, really-really good).

For example, maybe you’re one of those people that found very affordable coverage at the exchange, and you’re thrilled. Or… maybe you’re someone who isn’t getting much financial help via the subsidies, and now you’re looking for a way to find coverage for yourself or your family that won’t break the bank. You could also be a person with a preexisting condition that finally got their much-needed coverage. Or… maybe you found out that you can’t keep that health insurance plan you liked.

Every person’s case is different, and we’ve made it through the first-half with you. We’ve helped people enroll in the new exchange. We’ve also helped people navigate plans outside of the exchange.

With the second half of exchange open-enrollment coming up, we’ve put together a tip sheet for you, based on what we’ve seen so far. No politics. No opinions. Just facts. Here’s the latest:

  1. There really are some outstanding options at the new exchange for certain people. For example, if you make between ~$16,000 and ~$28,000 per year individually, there is a good chance you might really like your plan and premium at the exchange. People in this range also qualify for what are called cost-sharing reductions (in addition to premium subsidies). If you’re making between ~$16,000 to ~$28,000 per year, take a good look at the exchange. Additionally, those people making up to ~$44,000 per year may also qualify for subsidies.
  2. It’s true: you can’t be denied coverage for having a preexisting condition. Some people are still having a difficult time coming to terms with this concept. If you have a preexisting condition, apply for a plan inside or outside of the exchange: you cannot be denied at either place.
  3. Dependent coverage is too expensive at my spouse’s employer. Some of you who are needing to get insured are finding out that access to your spouse’s coverage through his/her employer is very expensive. If your spouse has access to what is called “affordable” coverage via their employer (affordable defined here), unfortunately, you and any dependent children are no longer eligible for subsidies at the exchange (even if the coverage in the exchange is considerably more affordable). This has been an area where we have had difficulty helping people find coverage. Our advice: shop for a more affordable plan on the individual market until the employer can make adjustments (they may need to offer a more affordable plan, or not offer employer coverage at all).
  4. My individual (or family) health insurance plan was cancelled. Your health insurance plan may have been cancelled because it did not conform to new healthcare reform standards. The bad news: you may not be able to get that plan back (so the best you can do right now is shop for another plan). The good news: recently, there was a tax penalty exception granted to people who lost their coverage. In other words, if your plan was cancelled, you won’t have to pay the individual tax penalty in 2014.
  5. My premiums got more expensive. Many plans in the individual market have seen premium increases. This is especially true for individuals that do not qualify for health insurance subsidies at the exchange (ie: individuals making more than $44,000 per year). One of the reasons you’re seeing these increases is because of the newly mandated 10 essential health benefits. Our advice: have a broker shop with you for a more affordable plan.
  6. Check your physician and hospital networks. This is especially true if you’re participating in a plan from a public state exchange. If you’re looking for access to a specific doctor or hospital, make sure to check and see what plans they are accepting. Some doctors and hospitals are not accepting plans from the public exchange at all.

The above listed are some of the things we’ve run into while helping people enroll during the first half of exchange open enrollment. If you’ve participated at the exchange, you may be familiar with what we’ve discussed. If you’ve not yet enrolled, our biggest goal with this post is to get you some tips about what to expect.

The entire second half of 2013 open enrollment has just begun. Don’t forget you have until March 31st, 2014 to enroll this year. If you have any questions about enrolling in Covered California, please contact us. Policy Advantage Insurance Services is Covered California Certified.

Thanks for stopping by, we hope you found our information to be valuable. Check back at our blog to get further information about funding healthcare. Also, please share with your friends, clients, colleagues, and family. Here are a few of our other information outlets:

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This Fall, hundreds of thousands of non-compliant health insurance plans began to be cancelled throughout the nation. These plans did not comply with the new requirements set forth in the new healthcare reform law, and for that reason, were deemed not “legal.” As a result, these non-compliant plans needed to go. For more information about why, see this blog post.

However… last week, in light of these cancellations, the Obama Administration made the decision to allow insurers to reinstate these cancelled non-compliant plans. This would allow those plans to be continued for at least the remainder of 2014.

During his campaign to promote healthcare reform, President Obama reiterated that “If you like your plan, you can keep your plan.” However, in this example (the cancellation of these non-compliant health plans), this did not hold true. For this reason, the administration felt it was responsible for not “honing up” to the promise that it made. As a result, Obama decided that those plans that were cancelled needed to be reinstated for at least an additional year.

However, California was one state that did not agree with the Obama Administration’s decision to reinstate these cancelled policies. The executive board of Covered California (the new state health insurance exchange) unanimously voted to continue to move on with reform implementation, and not reinstate cancelled health insurance policies. This decision was on-par with many state insurance commissioners, and also with certain insurance company executives within the industry.

Here are some of the reasons why some states, insurance commissioners, and insurance executives thought policy reinstatements would be a bad idea:

  • Insurance Companies: Reinstatement of cancelled plans would contribute to the destabilization of an already turbulent insurance market.
  • Covered California (the new state exchange): Covered California was already leading the way with exchange enrollments. Nearly one-third of those enrolled in the first month at both the state & federal exchanges (in other words, nation-wide) were Californians. It made little sense to slow down.
  • Insurance Commissioners: Being this far into the implementation of reform, various insurance commissioners throughout the country also felt that it was inappropriate to reinstate health insurance plans that had been cancelled.

For these reasons (and others), a handful of states made the decision to tell the Obama Administration “thanks, but no thanks” when it came to reinstating policies. Certain states continued to move along with reform implementation as-is, and California was one of those states.

As a result, individuals now have more time to enroll in the state health insurance exchanges. The original open enrollment deadline for a 1/1/2014 plan start was 12/15/2013. This has now been moved back to 12/23/2013. 

Thanks for stopping by, we hope you found our information to be valuable. Check back at our blog to get further information about funding healthcare. Also, please share with your friends, clients, colleagues, and family. Here are a few of our other information outlets:

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Today’s blog post is about how healthcare reform can help businesses in the restaurant and dining industries. There are a few really good reasons that these industries should take a close look at what’s going on with regard to reform. In many cases, employees may now be able to access better coverage at much more affordable prices.

In the past, restaurants and diners have had a tendency to be challenging groups to work with when it comes to health benefits for a number of different reasons. Some of those reasons will be addressed in this post. We’ll then offer some solutions about how healthcare reform can help.

 

Here are why restaurants and diners (especially those under 50 employees) should take a close look at healthcare reform:

  1. Many workers are part-time. Part-time workers are usually: A) not eligible for health insurance at work because of their part-time status, or B) not making enough money to want to contribute to health insurance premiums. For these reasons, part-time workers are usually more difficult to help insure. Healthcare reform fits the part-time worker to a T. There is a good chance many part-time workers will be eligible for financial assistance in the form of tax subsidies. 
  2. Many workers are younger. The employees of these groups have a tendency to be younger. Many employees at diners and restaurants hold positions like servers, hostesses/hosts, bar-tenders, waitresses, cooks, etc. Healthcare reform plans can be very affordable for those in the “30 and under” age category (ie: certain plans for younger people who are eligible for subsidies based on income can cost well under $100/month).  
  3. Healthy employees are important in the diner and restaurant industry. If you’re serving people food and drink, you want your employees to be healthy. Employees who have good access to doctors and medical services can be a very valuable asset to business owners in this industry. It can also help with the group’s overall morale.

The above reasons are why healthcare reform can be very important in the restaurant and diner industries. The new healthcare reform law (ie: the state health insurance exchanges) can give these kinds of employees excellent access to good coverage, at very affordable prices. 

Recommended: make a “Covered California Certified” insurance agent available to your employees. Allow he or she to help your employees navigate the new reform laws, and find health plans that make sense both cost and coverage wise. Employees can now make individual decisions on their own at the exchange, without any employer contribution. In other-words, with the proper guidance, they can take care of it themselves. And in many cases, exchange plans can be better than typical small-business employer plans. 

Educate your employees about these new options at no cost to your company. Policy Advantage Insurance Services can help you with healthcare reform, and can help your employees navigate it. If you have further questions about how healthcare reform can fit businesses in the restaurant and diner industry, please contact us any time.

Thanks for stopping by, we hope you found our information to be valuable. Check back at our blog to get further information about funding healthcare. Also, please share with your friends, clients, colleagues, and family. Here are a few of our other information outlets:

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Over the past couple of weeks, you may have seen in the news that many individual and family health insurance policies were set to be cancelled across the country as a result of healthcare reform. The reason that these policies were going to be cancelled was because they do not conform to new healthcare reform standards. As a result, insurance plans that do not meet certain criteria set forth in the law can no longer be offered, and those that are currently in place need to be changed. This resulted in the cancellation of millions of policies across the nation.

There are a series of newly mandated requirements that all health insurance plans must comply with by January 1st, 2014. If health insurance plans do not adhere to these new requirements, they will no-longer be considered “legal” plans (and will therefore no longer be able to be offered). Here are a couple of the important new mandates that health insurance plans must contain starting on January 1st, 2014:

  1. “10 Essential Health Benefits”: Starting on January 1st, 2014 all plans must contain the “10 Essential Health Benefits,” whether policyholders need them or not.
  2. Minimum Actuarial Value: In addition, on January 1st, 2014, all plans must meet a “minimum actuarial value” of 60%/40% (or Bronze Level Coverage). If plans do not meet this minimum value, they will be considered out of compliance. You can read about the Metallic Levels of Coverage here.

Because of these new mandates, a few things are set to happen:

  • In certain cases, because of new “minimum actuarial value” (#2 listed above)… some current plans’ deductibles, co-payments, and co-insurance are going to go down (ie: there will be less cost-sharing for the policyholder).
  • Secondly, additional benefits will be contained in new health insurance plans (#1 listed above: the “10 Essential Health Benefits) making them “richer” plans, which in most cases, will make premiums more expensive outside of the new marketplaces. Explained another way: plans that are purchased without the help of exchange subsidies (off of the exchange) could be more expensive.
  • Lastly, health insurance plans that do not meet these new requirements need to be “phased out.”

The latter of the above listed is one of the unintentional early consequences of the law. Because these “old” plans don’t contain the new mandates, and need to be phased out, many (if not all) of these “old” plans were set to be cancelled.

However, on November 14th, the Obama Administration announced that these old plans could be kept (and reinstated in certain cases) for an additional year (up until December 31st, 2014.) As a result, many people will now get to keep their “old” health insurance plan for an additional year. 

There may be additional changes to come with regard to this concept. There are currently bills being sponsored in Congress that would not only allow policyholders to keep their old plans for an additional year, but also allow insurance companies to continue selling these “old” plans (in addition to the new plans with the new mandates).

There is also speculation that there may be effects on the individual mandate as a result of the cancellation of these plans, and the other additional “hiccups” (ie: problems with the website) while rolling out the law. Some are wondering if these issues will cause the individual mandate to be delayed for an additional year. Be advised to continue to keep up with this topic over the coming weeks and months. 

Thanks for stopping by, we hope you found our information to be valuable. Check back at our blog to get further information about funding healthcare. Also, please share with your friends, clients, colleagues, and family. Here are a few of our other information outlets:

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Welcome back to another edition of “Phrases Made Easy.” This series at our blog aims to help make all of those long, drawn-out insurance phrases easier to understand. One thing we notice when talking about health insurance (and health benefits in general) is that the concepts can be “wordy” and boring. We emphasize fixing that here!

Today we’ve selected the phrase “Cost Sharing Reductions.” The primary reason we’ve selected this phrase, is because it can be a very important concept for certain people in the new Covered California state health insurance exchange. Like many other phrases in our “Phrases Made Easy” series, this one sounds difficult, but it’s really not that bad at all.

If you are shopping in the health insurance exchange, you may start to see the phrase Cost Sharing Reduction (or CSR). Here is what a Cost Sharing Reduction is:

Cost sharing reduction plans are offered through Covered California for consumers whose income is between 133% to 250% of the federal poverty level (FPL). These plans offer lower cost-sharing to reduce your clients’ out-of-pocket costs when accessing medical care. These plans are available only through Covered California.

Quite simply: Cost Sharing Reductions reduce your out-of-pocket expenses. If you purchase what is called an “Enhanced Silver Level Plan” through Covered California, and are eligible for Cost Sharing Reductions, you will get help with your co-payments, deductibles, and other out-of-pocket medical expenses.

————————————————————————————————————

Question: What is the criteria for Cost Sharing Reduction eligibility?

Answer: There are two criteria:

  1. You need to purchase an “Enhanced Silver Level Plan” on the Covered California state health insurance exchange.
  2. Your yearly income must be between 100% and 250% of FPL (or approximately $11,490 per year & $28,725 per year for individuals).

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Here are the three tiers of Silver Level Plans that include Cost Sharing Reductions (or CSRs) in the new state health insurance exchange in California. A standard Silver Level Plan without Cost Sharing Reductions has 70% actuarial value:

  • Enhanced Silver 94: 100% FPL to 150% FPL (94% enhanced actuarial value)
  • Enhanced Silver 87: 150% FPL to 200% FPL (87% enhanced actuarial value)
  • Enhanced Silver 73: 200% FPL to 250% FPL (73% enhanced actuarial value)

Essentially, these are additional benefits that help people who make less, reduce their out of pocket costs. If you have additional questions about “Cost Sharing Reductions” (or CSRs), and how they may apply to you, please contact Policy Advantage Insurance Services. We are “Covered California Certified” and can help you with your questions when navigating the exchange.

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