Robots Will Not Stop Calling!

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As health insurance open-enrollment season continues in California, automated phone calls offering Affordable Care Act or other health plans are spiking — and driving many consumers to the brink. California residents may have it worst, due to its open-enrollment period being twice as long as those in other parts of the country.

“It’s at epidemic levels at this time of year,” said Aaron Foss, founder of Nomorobo, who estimates his spam call-blocking service, based in Long Island, N.Y., headed off more than 850,000 health-related robocalls in October alone — nearly five times their interceptions for September, Foss said.

Almost all of these calls are illegal, according to rules published by the Federal Trade Commission in 2009. Under federal law, calls using prerecorded messages are legal only for such things as doctor appointment reminders, flight cancellations, credit card fraud alerts and political candidates. Calls to sell products and services are not.

Many of these calls offer skimpy health plans that don’t cover what you might need, insurance regulators and consumer advocates say. Others, they say, are downright fraudulent, with unscrupulous insurance “brokers” taking payment and promising insurance that never comes through.

Most of what’s sold through these automated calls are so-called skinny plans and don’t comply with Affordable Care Act requirements, or are short-term insurance plans, which typically offer coverage for only a few months and often don’t cover preexisting conditions or prescription drugs. Such plans have been outlawed in California, starting Jan. 1.

Despite state and federal crackdowns, robocalls aren’t going away anytime soon. So the best thing for consumers to do when they receive one is to just hang up or, not respond to unfamiliar numbers, advises the Federal Communications Commission.

Clearly, working with a reputable insurance agent helps to provide you and your family with the right coverage. Don’t have an agent?

Since 1984 we’ve been working with individuals, families and small companies throughout California to provide complete and unbiased information, so you can make an educated decision for your health insurance needs. I hope you’ll feel free to contact us anytime.

Nick Whitney

CA Lic #0M47855

ABenefitStore.com

Fixing Obamacare’s “Family Glitch”

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The Affordable Care Act (Obamacare) has been widely accepted throughout the country and expands health insurance coverage to millions of Americans. However, a small segment has been left behind.

The problem is called the “family glitch.” It’s deeply rooted in the health law’s weeds. And fixing it could cost taxpayers a bundle.

Under the ACA, people who meet a particular income threshold can get a federal subsidy to help buy insurance through Covered California. One of the conditions of eligibility is the consumer doesn’t have access to “affordable” coverage through work — that is, the employee’s share of the cost for their own coverage would cost no more than 9.86 percent of the employee’s household income.

The sticky part: calculating affordability considers only the cost of insuring one family member, even if the person’s spouse and children also would be covered through that health plan. So, while the cost of individual coverage might sound feasible, adding the rest of the family could quickly cause financial strain.

One solution is for the employer to revise their company’s health insurance plan to allow for only employees to enroll on the plan and not their dependents. If an employer doesn’t offer coverage for dependents, the dependents can apply for their coverage through Covered California and receive a federal subsidy to help pay for their coverage, assuming the household income is below the federal threshold.

Not every health insurance plan for small companies offers the option to allow for employees only, but it can be done. For more information, you should contact your current agent.

Don’t have an agent, or would like a second opinion? Since 1984 we’ve been working with individuals, families and small companies throughout California to provide complete and unbiased information, so you can make an educated decision for your health insurance needs. I hope you’ll feel free to contact us anytime.

Nick Whitney

CA Lic #0M47855

ABenefitStore.com

Small Group Open Enrollment

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In our post last week, we covered some of the advantages of small group health insurance plans, compared to the available plans for individuals and families. Many small employers are reluctant to provide health insurance for their employees, because they have several employees who don’t want to pay for their share of the coverage, or the employer may not be able to contribute toward the cost of the employee’s coverage.

Fortunately, the Affordable Care Act (ACA) requires health insurers to offer a one-month Special Open Enrollment Period, where eligible small groups can enroll in coverage without having to meet standard employer-contribution and/or employee-participation ratios. This Special Open Enrollment Period occurs from November 15th through December 15th each year, allowing eligible small groups to enroll for coverage effective January 1st.

If a small company can meet the contribution and participation ratios, they can change the group health plan any month throughout the year. Otherwise, the special open enrollment period should be considered, because small group health plans offer:

  • More insurance companies to choose from
  • Greater stability
  • More available plans
  • Lower rates
  • Pre-tax employer contributions
  • Pre-tax employee contributions
  • Access to full PPO and HMO networks

If you have a small business and haven’t considered a small group health plan, or if you already have a small group health plan for your company and would like to review the plan to make sure the rates and benefits are still competitive, you should contact your current agent.

Don’t have an agent, or would like a second opinion? Since 1984 we’ve been working with individuals, families and small companies throughout California to provide complete and unbiased information, so you can make an educated decision for your health insurance needs. I hope you’ll feel free to contact us anytime.

Nick Whitney

CA Lic #0M47855

ABenefitStore.com

Why Go Group?

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During open enrollment most will review their health insurance options, which include individual and family plans through Covered California, or direct with the insurance company. In prior posts we pointed out the cost difference between purchasing a silver level plan through Covered California and purchasing the same plan, outside of Covered California, with the insurance company.

But what about small group plans? Turns out, health insurance plans for small companies are usually less expensive than plans for individuals and families.

If we compare the cost of a Gold level PPO plan, for a 40-year-old here in Orange County, the monthly cost is $558.45 for 2019, when purchased as an individual. The same plan, with the same insurance company, has a monthly cost of $497.95 when purchased in a small group plan. Saving $60 a month is significant and when we add the cost for dependents, the monthly savings is even greater.

In addition, the PPO network for this particular plan has about 35,000 to 40,000 participating providers in California, when purchased as an individual. The PPO network for the same plan, when purchased through a small company, has over 100,000 participating providers.

Getting more and paying less is uncommon when it comes to health insurance, but that’s clearly the case when comparing small group and individual plans.

If you have a small business and haven’t considered a small group health plan, or if you already have a small group health plan for your company that would like to review to make sure the rates and benefits are still competitive, you should contact your current agent.

Don’t have an agent, or would like a second opinion? Since 1984 we’ve been working with individuals, families and small companies throughout California to provide complete and unbiased information, so you can make an educated decision for your health insurance needs. I hope you’ll feel free to contact us anytime.

Nick Whitney

CA Lic #0M47855

ABenefitStore.com

Open Enrollment Begins

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Here in California open enrollment for individual and family health insurance plans began on October 15th and ends on January 15th. This is the time of year to enroll on a new plan or change your current plan for 2019.

While the individual penalty has been reduced to $0 beginning January 1, 2019, I know most people realize the real penalty is needing coverage and not having it. If you choose to not enroll for a 2019 health insurance plan, you will not be able to enroll again until open enrollment begins for 2020 plans, without a qualifying life event.

To enroll for a new plan that beginning January 1, 2019, you’ll want to submit your application by December 15th. If it’s submitted between December 16th and January 15th, your new coverage will begin on February 1, 2019.

Insurance companies offer the same plans if you apply with them direct, as they do through Covered California. Many also offer additional plans that are not available when applying through Covered California. Depending on your situation, going through Covered California may be the best solution, or it may benefit you more to apply direct with the insurance company.

Our goal is to provide you with enough information about the various options to make an educated plan decision and assist you through the application process. ABenefitStore.com has been updated with the most current plan and rate information for 2019, so you can compare plans side-by-side, get more detail about the benefits each plan provides and look up each plan’s participating providers.

Once you’ve decided on a plan, simply add it to your cart and apply online directly with the insurance company. If applying through Covered California is a better choice, we can help there too, by completing your application for you over the phone.

Now that open enrollment has started, it’s a good time to contact your current broker. If you don’t have a broker, or would like a second opinion, I hope you’ll feel free to contact us anytime.

Nick Whitney

CA Lic #0M47855

ABenefitStore.com