Your Guide: Private Health Insurance Exchanges

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Today we’re going to look at “private health insurance exchanges.” This has been one of the biggest “buzz phrases” in the health insurance industry over the past couple of years for a number of different reasons. The biggest reason though, is healthcare reform. With the implementation of new provisions required in the Affordable Care Act, the way that employers offer health insurance to their employees is changing.

We’ll take a look at the structure of private health insurance exchanges. We’ll also describe the different components that make-up a private health insurance exchange, the types of businesses that should be taking the closest look at these exchanges, how private exchanges work, and why they’re growing in importance.

Private health insurance exchanges are exactly what they say they are: they’re exchanges that are set up privately through an employer. Many private health insurance exchanges utilize two important components:

  1. Technology and software: software programs help facilitate administration of private health insurance exchanges. Technology keeps private exchange administration simple for both the employer and the employee. One example is www.liazon.com. Liazon’s platform allows an employer to define a contribution (much like an allowance), and then employees select their own health benefits. Simply, it’s an employee’s money to spend how he/she wants. The software keeps track of funds spent, shows the employee what kind of health insurance options are available in the private exchange, and allows employees to select the plans they want.
  2. Group health insurance plans: in the past, many employers only offered one group health insurance plan. Administration of multiple plans could be a challenge. So to fix that problem, software companies (like Liazon) have arrangements with insurance companies that allow the employer to more easily offer multiple group health insurance plans, from multiple carriers. The important word here is multiple. With the software and technology that’s available, it’s not nearly as difficult to offer a selection of group health insurance plans anymore. This is important because one of the biggest goals of private health insurance exchanges is to provide choice. By utilizing a private exchange, employees now have choice.

There are additional ways to set up private health insurance exchanges, but businesses with +50 full time equivalent employees will almost always be utilizing the two concepts we’ve described above. And that’s who this article is intended for: businesses that are mandated to provide coverage. However, smaller businesses can also utilize this exact same strategy. If you’re a business that is at 20 employees or above, you’ll want to understand this concept.

Question: Why are private health insurance exchanges becoming more important?

Here’s why:

  • Private health insurance exchanges give employees choices. Instead of being “stuck” in one group health insurance plan, they can more efficiently choose which plans fit them best. Having choices is now more important than ever before, because dependents (spouses and children) need to have affordable access to coverage. In the past, sometimes it was flat-out too expensive for an employee to include their dependents. The private exchange concept helps alleviate that issue.
  • Businesses with +50 full time equivalent employees are mandated to provide coverage. A private exchange is a cost-effective and budgetable way for employers in the “large group” category to provide coverage. You decide on the amount (called a “defined contribution”), and then give that amount to each employee. They pick the plan they want. Simple.
  • Efficiency. If employees are making their own decisions and picking their own plans, the whole system becomes more efficient. Instead of you telling them what they get, they instead pick what they want. When consumers are making their own decisions, they’re more conscience about where money is being spent.

That’s the basic break-down of private health insurance exchanges. Unlike public health insurance exchanges (ie: state & federal exchanges), private exchanges are completely administered within the private workplace.

As mentioned, private exchanges can be an exceptionally important concept for those businesses in the +50 employee range. They accomplish three very important things: budgetability, selection, and flexibility. Those qualities will be very significant to businesses that are mandated to provide coverage. However, this same concept can work very well for smaller businesses too (in the 2-100 employee range).

We work with private health insurance exchanges at Policy Advantage Insurance Services. If you are an employer that fits into the “group-sizes” we’ve described, contact us anytime if you have questions.

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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Consumer Checklist: Helping Small Business Navigate Healthcare Reform

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Today we’re going to provide small businesses with some information about healthcare reform. We’ve put together a checklist, so you can walk through each important item one-by-one.

What does a checklist do? It helps you navigate. If you have a checklist of items, you’ll know exactly what you need and where to get those items. It’s just like running errands. By having a checklist, you won’t forget the important things either. The things that will save you time, money, and help you improve coverage.

Item #1: Determine if you’re a small business.

This is number one. You want to establish this right away. Why? Because there are costly tax penalties that may be incurred if you’re actually a “large business” and don’t provide health coverage to your employees. As it stands, “large businesses” are mandated to provide healthcare coverage to their workers. Small businesses are not.

Knowing whether-or-not you’re a small business will also help you determine your plan design strategies. Providing health benefits for yourself or your employees as a small business owner differs greatly compared to those of large businesses.

Question: What is the definition of “small business” with regard to the healthcare reform law? Answer: Small businesses are businesses with less than 50 fulltime equivalent employees for the previous calendar year. You’ll sometimes see “fulltime equivalent employee” abbreviated as “FTE.” This is a very important concept. Also, your FTE count DOES include part-time employees. A part-time employee is defined as working less than 30 hours per week, and there’s a calculation when determining their “full time equivalency.” If you’re anywhere near 50 FTE, you’ll want to make sure to have this all sorted out, because there are costly tax penalties for those employers that are over 50 FTE and don’t provide health coverage.

Item #2: Know the differences between individual health plans and small group health plans.

The second important item is to know the differences between individual coverage and small group health insurance coverage. If you know anything about health insurance, you’ll know that these are two parts of the industry are completely different. They have different characteristics. There are different rules. There are different eligibility criteria. There are different tax incentives.

Depending on your business, your objectives, your budget, and other considerations… you’ll need to determine what kind of health insurance plan you want to work with: A) Individual health insurance plans, or B) A group health insurance plan.

The good news: because of healthcare reform, it’s now easier than ever before to work with individual health insurance plans to provide coverage to your employees. And in certain cases, it might even make more sense. Know how individual health insurance plans and the health insurance exchanges can work for small business.

That being said, group health insurance can still be an important option for small businesses. Group health insurance plans also have the best tax incentives, especially if employees are contributing to the plan. Physician networks are also sometimes better when working with small group health insurance plans.

Additionally, there is now a group health insurance plan called SHOP (the Small Business Health Options Program) that is available through the health insurance marketplaces. SHOP can provide tax-credits to help with premiums for qualified small businesses.

Item #3: Decide if you’re going to provide health coverage for your entire group or just yourself. 

Remember: small businesses (less than 50 FTE) are not required to provide health coverage to their employees. However, if you’re not going to provide coverage, you and your employees will still need to find an individual health insurance plan somewhere on your own. The reason? Everyone has to have health coverage or pay a tax penalty.

Determine if you have a budget for your entire group. There could be strategies that are surprisingly affordable, especially based on the size and average income of your group.

Item #4: Understand the different planning strategies for small business.

There are a variety of different planning strategies that are available to small businesses. These different strategies can utilize individual insurance plans, or group insurance plans.

Health insurance is a very basic benefit that can help you attract and retain quality employees. If you determine that you’d like to help provide coverage for your employees, you’ll want to come up with a program that fits your objectives best. Here are a few of them:

Defined Contribution Strategy: “Defined contribution” is a retirement planning phrase. It’s been around for a long time. You can Google it and read all about it. Health benefits planners are now using “defined contribution” strategies to fund healthcare. And it’s simple. It’s exactly what it says it is: you “define a contribution” (ie: $300) per month, and employees then purchase their own individual health insurance plans. Employees can pick from insurance policies that are both on or off the public health insurance marketplaces (where they may also receive substantial subsidies, based on income). This strategy is budgetable, and gets business owners out of the business of making insurance decisions. Employees make their own decisions and purchase their own plan. Effectively, all it is is an after-tax stipend. A raise.

Consumer Directed Health Planning: This can also be referred to as account based or equity based planning. Small business owners can provide their employees access to a high deductible health plan (usually a group plan), and then pair it up with an HRA (health reimbursement arrangement) or HSA (health savings account). The HRA or HSA becomes an asset that builds equity over time. You retain funds that would normally go to the insurance companies in the form of premiums, and ownership of the account stays with either the employee or business, depending on your strategy.

Small Business Health Options Program (known as SHOP): This is a new program that has been made available on both the federal and state health insurance exchanges. It was specifically designed to help small businesses (under 50 FTE) provide a group health insurance plan to their employees. Depending on income and size of your group, you may also be eligible for a sizable tax credit (up to 50% of premiums).

Item #5: Know where you have access to products, advice, customer service, and consultation.

This is the last item on the list. Know where you can find help. Find effective advisers that can help you sort everything out. A “one-stop-shop” can help you save time, money, and a lot of hassle by “outsourcing” your small business health benefits planning. It’s like having your own human resources department.

And the good news: brokers are typically compensated by the insurance companies in the form of commissions. So you don’t have to worry about broker fees, etc. Compensation is built into every single health insurance plan regardless of whether-or-not you choose to work with an adviser.

Additionally, a broker will keep you “in the know” about new products, strategies, and reforms. They should offer a broad range of products and services that will make your planning very convenient for you. Here are some of the qualities you should look for in a broker/consultant:

  • Licensed, accredited, ethical. Find consultants that are licensed by the Department of Insurance to do business in your state. Take it a step further and find advisers that have professional designations. People with these designations provide advanced knowledge, and also adhere to strict ethical standards.
  • A strong selection of reputable product choices. Your broker/consultant should offer you a wide variety of choices from reputable insurance companies.
  • Advice and consultation in non-insurance products and services. Your broker/consultant should also be offering products and services that are considered “non-insurance products.” After-all, the goal is to fund healthcare efficiently, and there are important tools that can help accomplish this besides just insurance policies. Things like HRAs (health reimbursement arrangements), HSAs (health savings accounts), COBRA administration, knowledge of tax incentives, etc. Find a well-rounded broker.

And that’s it. That’s your healthcare reform checklist for small business. By understanding the points we’ve made, you’ll be on the right path to drafting a health benefits program that fits you or your business best.

We help individuals and businesses sort everything out at Policy Advantage Insurance Services. We can help you design an effective, efficient program that fits your objectives. Please contact us anytime for a free consultation.

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:

Home Page: https://policyadvantage.com

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Essentials: The “Need-to-Knows” About the New Individual Health Insurance Marketplace

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NeedToKnowWith the on-set of healthcare reform, the landscape in the individual health insurance marketplace has changed dramatically. In this article, we’ll describe what you need to know in order to navigate the new individual segment of the health insurance industry.

Before we get to the good stuff, let’s review a very short background about the differences between individual health insurance and group health insurance. Briefly: if you know anything about the health insurance industry at all, you’ll know that these are two completely different ballgames when it comes to plan design. There are different rules. There are different tax incentives. There are different eligibility criteria. The list goes on. That’s a whole different article.

As an individual or business owner, you’ll want to know the ins-and-outs of both the individual and group health insurance marketplaces… but let’s emphasize that we’re looking at the individual segment only in this article. For certain small business owners, that’ll be most important anyways.

Here are the “essentials” of the new individual health insurance marketplace. This is what you need to know:

Guaranteed Issue Mandate

This is probably the biggest “game-changer” of them all. For years-upon-years, if you were going to apply for an individual health insurance plan, you had to go through a series of health-related questions in order to apply for coverage. There were 50, 60, and sometimes 70 or more questions. If you’ve applied for individual health insurance coverage before 2014, you know what this all about.

Starting in 2014, these health-related questions are all gone. You heard that right: outta’ here. It’s still difficult for many to comprehend. There are no more health-related questions on individual health insurance applications anymore. This is what is called “guaranteed issue” in the insurance world (big insurance word). All “guaranteed issue” means, is that if you apply for coverage, you have got to be accepted.

Q: How does this change the ballgame? A: You don’t need to have access to a group health insurance plan (employer plan) anymore to apply for coverage. This is huge (especially for those with preexisting conditions).

It can’t be emphasized enough how much this has freed-up individual choice in health insurance plans. You can literally pick any individual insurance plan from any company, and apply for coverage now. And it gets better for some of you: if you’re eligible for subsides at the new health insurance marketplaces (exchanges), you could see some massive subsidies that will help you pay for your premiums.

This all sounds fine and dandy, right? It is. But there are some important rules that need to be understood, and that leads us into our next important topics.

Open Enrollment Periods

In the past (before 2014), you could apply for an individual health insurance plan at anytime during the year. You could go out, you could pick a plan, you could apply for coverage. But… you might be denied coverage because of a preexisting condition (which you now know is against the law). So these days (2014 and beyond)… there’s now an “individual plan open enrollment period.”

Q: What’s an open enrollment period? A: It’s a time-frame when you can apply for health insurance coverage. If you’ve ever worked for an employer that has a company health insurance plan, you’ll know that you’ve usually got to apply for coverage (and make changes) during yearly enrollment. This is that exact same concept in the new individual health insurance marketplace. Except it’s a BIG enrollment: it’s the entire United States.

So, that being said, you’ve now got to apply during individual insurance open enrollment each year. This can be very important, because if you miss this enrollment period, you don’t get an opportunity to apply until the next Fall (unless you qualify for “special enrollment”… which we’ll cover soon). Need an appendectomy in the middle of the year? It’s too late.

The moral of the story: you want to make sure you know exactly when you can enroll in an individual health insurance plan: that’s during open enrollment each year. It’s a much different concept. And it’s important to note that open enrollment dates are the same for individual health insurance plans both on and off the new exchanges.

Special Enrollment Period

Now that you know what open enrollment is all about, the next thing that needs to be looked at is what is called a “special enrollment period.” A “special enrollment” is a time to enroll in the middle of the year (outside of the regular open enrollment described above), under specific circumstances.

Q: What are these “special enrollment” circumstances? A: They’re described as “life events” that can take place throughout the middle of the year. If you incur one of these “life events,” you’ll then be eligible to enroll in an individual health insurance plan outside of the regular open enrollment period. This is called a special enrollment.

Here are some examples of these “life events”:

  • You get married.
  • You get divorced.
  • You have a child.
  • You lose your coverage (changing jobs, etc).
  • You move out of the state where you currently get your health insurance.
  • You become a legal citizen or national.
  • … plus others.

You’ll want to make sure that you understand these qualifying “life events” if you ever need to utilize the “special enrollment period.” Additionally important: most events give you 60 days to enroll in a new plan from the time the “life event” takes place. However, a few of these events only give you 30 days. Make sure you know which event applies to you, and how much time you have.

Now that we know all about guaranteed issue, open enrollment, and special open enrollment… we want to take a brief last look at a few of the basic important concepts of the new individual health insurance marketplace. They are:

  1. Shared Responsibility
  2. Minimum Essential Coverage
  3. Essential Health Benefits

Shared Responsibility

“Shared responsibility” is a technical term that has been coined in the healthcare reform law. All it means is that everybody has got to be “in” in order to make these new reforms work: the federal government, state governments, employers, and individuals. The “shared responsibility” provision applies to most individuals (there are a few exceptions) of all ages, including children. Almost everybody has got to have a health insurance plan from somewhere.

Minimum Essential Coverage

“Minimum essential coverage” is the type of coverage that you have got to have in place in order to satisfy the requirements of the Affordable Care Act (healthcare reform). In other words, there is a standard of coverage that has to be met in order to meet responsibilities required under the Act. If you don’t want to pay the tax penalties, you’ve got to have this “minimum essential coverage.” There are health plans that are called “limited benefit plans” that do not meet the criteria of “minimum essential coverage.” In an instance where you only have a “limited benefit plan” in place, you’d be paying premiums for this plan that doesn’t conform, and then would also end up having to pay the tax penalty.

Additionally, if you’re one of those people that saw your rates go up in your individual health insurance plan over the past year (or even saw it cancelled), this is one of the reasons why. They’ve “raised the bar” on the required benefits in health plans (for additional info, read about the “metallic levels of coverage“). For this reason, rates have gone up. If you’re a higher earner that is not receiving a subsidy at a health insurance exchange, this can be burdensome.

Essential Health Benefits

These are certain new benefits “essential health benefits” that are mandated in the new “minimum essential coverage” plans described above. There is a series of them 10 of them. Count ‘em:

  1. Outpatient Care.
  2. Trips to the emergency room.
  3. Treatment for inpatient care in a hospital.
  4. Care before and after your baby is born.
  5. Mental health and substance abuse services.
  6. Prescription drug coverage.
  7. Services to help you recover if you’re injured or disabled: physical therapy, etc.
  8. Lab testing.
  9. Preventive services like counseling, vaccines, and screenings.
  10. Pediatric services which includes dental care.

Even though you may or may-not need some of these services, these benefits are now still required in all plans marketed in the individual health insurance marketplace. This is another reason that individual insurance premiums have gotten more expensive, and in certain cases, cancelled altogether. If you’re not getting any help with subsidies at the exchange, this can again be a “problem area.”

That’s it. Those are the basics of the new individual insurance marketplace. These are all of the “need-to-knows” so that you can begin to navigate this segment of the health insurance industry.

Additionally, you can coordinate various strategies within the new individual marketplace, so that you can put together a health benefits program for your small business that is affordable, and that your employees will appreciate.

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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COBRA: Enrollment Extension

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Recently, Covered California announced an enrollment extension for people that are on COBRA in California. If you’re currently enrolled in COBRA, you may already understand the costs associated with this type of coverage: it can be expensive. This enrollment extension could save you some BIG bucks.

We’re not going to explain COBRA in this post, we’re just going to explain how this recent enrollment extension works. If you’re currently on COBRA, you most likely already know what COBRA is all about.

Below the icon is some important info. If you’re on COBRA, you’ll want to know about all of this. *NOTE: Keeping it simple, if you’re currently on COBRA, talk to us so we can help you sort it out.

Here’s what you need to know:

  • This enrollment extension runs from May 15th, 2014 to July 15th, 2014.
  • If you’re currently on COBRA, you still have the opportunity to enroll in an individual or Covered California (exchange plan), as long as you do it between the above-listed dates.
  • This may save you some BIG MONEY, because COBRA extension coverage from your previous employer is expensive: you pay up to 102% of total premiums (your part + employer part + admin fees).
  • During this time, enrollment is open so you can switch from COBRA to an individual or Covered California exchange plan (either of which may be considerably less expensive than your current COBRA coverage).

If you’re currently on COBRA, here are two important questions you want to ask yourself:

  1. Am I eligible for subsidies on the Covered California exchange? If this is a “Yes” you may really want to look into switching over to an exchange plan from COBRA.
  2. If I’m not eligible for subsidies at Covered California, would switching to a regular individual plan save me money? Even if you’re not eligible for subsides on the exchange, the individual coverage you can find might be considerably more affordable than your current COBRA coverage. 

If you’re on COBRA currently, contact us so we can help evaluate your case. You could save some big money (thousands of dollars a year) by making a simple switch. Here is our CONTACT CARD. And you can call direct here: 424.442.0170.

Thanks for stopping by, we hope you found our information to be valuable sildentadal.com. 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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Covered California: Special Enrollment Period

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Thanks for stopping by today, we’re glad that you’re here. In this blog post we’ll be talking about Covered California’s “Special Enrollment Period.” To keep it simple, this is a period of time when people will be able to enroll in an individual or family health insurance plan outside of open enrollment if certain “life-changing events” are experienced.

Let’s review before we move on: open enrollment for the new Covered California insurance exchange recently finished up. If you’ve been following along, you’ll know that there are now open enrollment periods for individual and family plans both on and off of the new public exchange. In other words, in order to participate in an individual health insurance plan, you’ll now have to enroll during specific times each year. This is called open enrollment.

However, if you experience a qualifying “life-changing event” you may be eligible for a “Special Enrollment Period” in the middle of the year. In other words, yes: you may be able to enroll outside of open enrollment.

Here are some common examples of those qualifying “life-changing events” we described above:

  • Marriage or domestic partnership.
  • Childbirth, adoption, or placing a child up for adoption or in a foster home.
  • Changing your place of permanent residence, therefore gaining access to Covered California plans (this includes moving from another state).
  • Losing your health insurance (ie: losing or changing jobs, losing MediCAL coverage, or COBRA coverage expiration).
  • Changes in income. If you have an income change in the middle of the year, you may be eligible for more (or less) of a subsidy if you’re currently receiving assistance.
  • Becoming a citizen, national, or someone who is residing here legally. This event would only apply to those who were not previously a citizen, national, or legally residing here.
  • An “exceptional circumstance.” Covered California will determine on a case-by-case basis whether-or-not someone may be eligible to enroll via an “exceptional circumstance.”
  • American Indians or Alaska Natives. You are be eligible to change your plan (or enroll in a new plan) up to once per month even if open enrollment is over.
  • Your enrollment was wrong due to the misconduct or misrepresentation of your health insurance company, Covered California, or a Covered California entity (ie: a Certified Enrollment Counselor).

The above listed are examples of common “life-changing events” that might make someone eligible for a “Special Enrollment Period” outside of open enrollment.

Question: How long do I have to enroll if I experience one of these “life-changing events?”

Answer: You have 30 to 60 days (depending on the event). For example, if you lose your job-based coverage, you have 30 days. However, many of the other events give you 60 days. Make sure you know which event occurred, and how much time you have to enroll. 

If you think you’ve experienced a “life-changing event” and are eligible for the “Special Enrollment Period,” please contact us anytime. As a “Certified Insurance Agent,” Policy Advantage Insurance Services is able to help you find plans both on and off of the Covered California exchange (please note: the “Special Enrollment Period” rules do also apply to plans off of the exchange).

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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Covered California: SHOP (Small Business Health Options Program)

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Thanks for stopping by today, we’re glad that you here. Today we’re going to talk about the Covered California SHOP program, otherwise known as the Small Business Health Options Program.

As you know, Covered California is the new state health insurance exchange in the state of California. The new exchanges were a major part of healthcare reform, and were designed to help extend health insurance coverage to eligible individuals and businesses. There are two different programs available at Covered California:

  1. Individual & Family Plans (IFP): these are plans that you enroll in outside of an employer (or group) plan. They are available with APTCs (or subsidies) at the exchange. These subsidies make premiums more affordable.
  2. SHOP (Small Business Health Options Program): these are group health insurance plans through Covered California that are available to qualified businesses. Depending on the size and average income of your business, you may be eligible for tax credits that can help reduce the cost of coverage. 

Many of you are probably familiar with the individual plans that are available through the exchange (option #1 above). A lot of you probably even enrolled — over 1.2 million people in California participated during the exchange’s first open enrollment period that just ended.

Even though you might be familiar with individual health plan enrollment at the exchange, this article is about option #2 above. Covered California can also help small businesses. 

SHOP

If you’re a small business owner (especially in a group with less than 25 FTEs), you may want to take a close look at Covered California’s SHOP. This program is specifically designed to help small businesses offer coverage. Here are some important facts about the SHOP:

  • It’s a new marketplace through the Covered California exchange designed specifically for businesses with 1-50 eligible employees.
  • Employers under 50 FTE are not required to provide health insurance, but this program could be a good option.
  • Important: unlike individual enrollment, Covered California SHOP enrollment is open all year in 2014. So, request information and a quote anytime this year.
  • An eligible full-time employee is an employee that works 30hrs per week or more for the month. An eligible part-time employee is an employee that works 20hrs per week or more for the month.
  • To be eligible for SHOP, an employer must provide a minimum 50% contribution to employee plans.

Question #1: What businesses are eligible for a tax credit?

Answer #1: Businesses that 1) have fewer than 25 FTE for the year, 2) have an annual average wage of less than $50,000 per FTE, and 3) who pay at least 50% of their employees’ premium costs.

Question #2: How much is the tax credit?

Answer #2: Starting in 2014, the maximum tax credit for businesses as a percentage of insurance premium expense is 50% (or up to half of your premium). The maximum tax credit for tax-exempt organizations as a percentage of insurance premium expenses is 35%. These premium subsides are available for two consecutive years.

As a small business owner, it’s a great idea to talk with a Covered California “Certified Agent” about this program. They can run a quote for you. You may be eligible for substantial premium savings. Policy Advantage Insurance Services is certified and can help you with your questions. Feel free to contact us anytime. For more information about SHOP, please visit their official FAQ page here.

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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#Advantage: Working with a Covered California “Certified Agent”

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“Covered California” is the new public health insurance exchange in the state of California. If you live California, you’ve probably heard quite a bit about it over the past 6 months. These exchanges are a new way to buy health insurance and are a major part of healthcare reform.

The California exchange opened back in October of 2013. Since then, hundreds of thousands of Californians have enrolled in individual insurance plans there. Many of these plans have been subsidized by Advance Premium Tax Credits (or APTCs). These APTCs can substantially reduce the monthly cost of health insurance.

If you’ve taken a look at Covered California, you’ll know that there are various ways in which to enroll. Some of them include:

  • Online. You can set up an online account and enroll via the internet. You can also assign a Certified Insurance Agent to your case through your online portal.
  • Over the phone. You can call Covered California’s phone number and enroll with a service agent.
  • In person. You can enroll in person with A) Certified Enrollment Entities, B) Certified Enrollment Counselors, or C) Certified Insurance Agents. 

The purpose of this blog post is to explain some of the advantages of enrolling with a Certified Insurance Agent. 

Advantage

Here are some really good reasons to work with a Covered California “Certified Insurance Agent”:

  • Certified Agents are Licensed Professionals: Any insurance agent that is certified with Covered California is also licensed with the state department of insurance. Many of these agents also have years of experience and know the industry well.
  • A Single Point of Contact: This is one of the biggest advantages. You’ll have a single point of contact if you enroll with a certified agent. You can pick up the phone or send an email to that person anytime. If you need to make changes or have questions in the future, you’ll have someone familiar to work with.  However, if you enroll with a Covered California customer service rep over the phone, or a Certified Enrollment Counselor, you may speak with different people each time.
  • Certified Agents are Appointed Directly with the Insurance Companies: Insurance agents are appointed and have a direct relationship with the insurance companies. This can help with quick, effective, and efficient customer service.
  • Certified Agents Have Passed Rigorous Certification Requirements: These are people that have gone through extensive training and testing to obtain their certified status.
  • No Cost. You can work with a Covered California “Certified Agent” at no cost to you. Compensation is built into every insurance plan, regardless of whether-or-not you decide to work with an agent.

As you can see, there are a number of good reasons to work with a Covered California “Certified Insurance Agent.” Look for this badge when searching for assistance from an agent or agency:

CCCertified

Policy Advantage Insurance Services is certified. Please contact us if you have questions, or need ongoing help at Covered California.

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:

Home Page: https://policyadvantage.com

Twitter: http://www.twitter.com/PolicyAdvantage

Facebook: http://www.facebook.com/PolicyAdvantage

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Policy Advantage Insurance Services: How We Can Help

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Today’s article is about how Policy Advantage Insurance Services can help you with your health benefits planning. As you know, we’ve written a few blog posts about this topic in the past. If you’re new, we’d encourage you to catch up here:

Policy Advantage Insurance Services literally has the ability to help you with your health benefits planning, no matter what your current situation is. This blog post intends to specifically identify where we can help.

WeCanHelp

  • Employers of Any Size: We have the ability to help any size employer, large or small. If you’re a business owner or executive, you probably know that there are some important differences between businesses (especially your number of full time equivalent employees), when it comes to healthcare reform. We can help employers with 2, 20, 80, 500, or even 1000’s of employees. We can help you design an effective, efficient, and budget-conscience health plan that will fit any business.
  • Individual Health Insurance Plans Off of the Exchange: Are you self-employed or not offered a health insurance plan at work? It’s now easier than ever to “shop” and find individual health insurance. If your income is too high to qualify for exchange subsidies, we can help you find a plan off of the exchange. These are plans that are purchased directly through the insurance companies.
  • Individual Health Insurance Plans On the Exchange: If you’d don’t currently have access to an affordable health insurance plan, and your income is between 100% and 400% of FPL, you may qualify for help with your insurance premiums through the new health insurance exchanges in the form of “Advanced Premium Tax Credits” (or APTCs). These credits can significantly reduce the amount of your monthly premiums. Policy Advantage Insurance Services is “Covered California Certified” and can help you select plans on the new exchange.
  • SHOP Plans On the Exchange: The “SHOP” program is the new “Small Business Health Options Program.” This is a new program on the exchange that is specifically designed to help small businesses (under 50 employees) expand health insurance options to their employees. Those businesses that have less than 25 employees may see significant tax-credits to off-set the cost of premiums. The SHOP program is a group health insurance plan.

As you can see, Policy Advantage Insurance Services has the capacity to help you in any circumstance. If you are a business, individual, or self-employed, we can help you find a plan that will fit your situation. One of our biggest goals is to help our clients save money and improve coverage. Contact us today, and we’ll help you sort it all out.

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:

Home Page: https://policyadvantage.com

Twitter: http://www.twitter.com/PolicyAdvantage

Facebook: http://www.facebook.com/PolicyAdvantage

YouTube: http://www.youtube.com/PolicyAdvantage

Pinterest: http://www.pinterest.com/PolicyAdvantage

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Important Outreach: Only 10 Days Left in 2014 Open Enrollment

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If you’ve been following along at our blog, you’ll understand that there are now “open enrollment” dates each year for Individual and Family Plans (IFP). 2014 open enrollment is coming to a close soon. This very important blog post is for everyone: individual clients, group & employer clients, potential clients, friends, co-workers, family, and anyone else.

**Individual and Family Plan (IFP) open enrollment is coming to a close on March 31st, 2014. There are only 10 days left in 2014 to enroll. 

10days

Here are some important notes:

  • Open enrollment applies to all individual insurance plans on and off the new exchange.
  • Those who don’t have a plan by March 31st, 2014 will not be able to enroll after this date until next Fall, unless there is a “qualifying event” (an example: loss of employer coverage).
  • Good reasons to look into enrolling in a plan: health insurance can be very important, you may be able to find a good plan at a good price, and there is also a tax penalty this year for individuals who have not enrolled in a health plan.
  • Policy Advantage Insurance Services has the capacity to help with all plans: on the exchange, off of the exchange, and group/employer plans. Regardless of your situation, we can help.

We’ve helped many people enroll since last Fall (both on and off of the exchange). If you know of anyone: friends, family, co-workers, or anyone uninsured… please contact us (or share our info) and we can help them sort it out online, over the phone, or in-person.

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:

Home Page: https://policyadvantage.com

Twitter: http://www.twitter.com/PolicyAdvantage

Facebook: http://www.facebook.com/PolicyAdvantage

YouTube: http://www.youtube.com/PolicyAdvantage

Pinterest: http://www.pinterest.com/PolicyAdvantage

Word Press: http://www.policyadvantage.wordpress.com

Last Leg: Final Two Weeks of IFP Open Enrollment

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We’re about to enter the last leg of 2014 IFP (Individual & Family Plan) open enrollment. As a result of healthcare reform, there are now yearly open enrollment periods for individual and family health insurance plans.

What does this mean? This means that if you plan on participating in a non-group (or non-employer) health insurance plan, then you’ll need to enroll during this new enrollment period.

This year’s IFP enrollment has been extended until March 31st, 2014. The reason for this extension is because we’re in the very first year of enacting healthcare reform’s major provisions. In years after 2014, open enrollment will end sooner. LastLap

Entering the final leg of 2014 IFP open enrollment, here are some important notes:

  • The latest numbers show that nearly 4.2 million Americans have enrolled in health insurance plans through the new exchanges across the country. The Obama Administration says that this will be enough participation to maintain stability within the insurance markets.
  • The last day to enroll in any individual or family health insurance plan (on or off of the new exchanges) is March 31st, 2014.
  • If you have a “qualifying event” after open enrollment ends on March 31st (ie: the loss of an employer health insurance plan), you can enroll mid-year in a special enrollment.
  • If your plan is subsidized through the exchange with an “Advanced Premium Tax Credit” (or APTC), make sure that your income is correctly reported, and that you keep the exchange updated with any income changes throughout the year.
  • There is a tax penalty in 2014 for not carrying a “minimum essential coverage” health insurance plan. This tax penalty is $95 or 1% of household income (whichever is greater).

With that, we’re into the anchor leg of our first healthcare reform open enrollment period. Expect to see some additional late participation in these past few weeks, that will most likely push the total first year enrollment up over 4.2 million Americans.

If you need help enrolling, Policy Advantage Insurance Services is “Covered California Certified” and can assist you with plans on or off of the exchange. Please feel free to contact us with your questions.

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:

Home Page: https://policyadvantage.com

Twitter: http://www.twitter.com/PolicyAdvantage

Facebook: http://www.facebook.com/PolicyAdvantage

YouTube: http://www.youtube.com/PolicyAdvantage

Pinterest: http://www.pinterest.com/PolicyAdvantage

Word Press: http://www.policyadvantage.wordpress.com