Indiana Health Insurance Exchange The Unofficial Health Exchange Resource Site
Over the years, health insurance has been a major obstacle for those who want to retire before the age of 65. Many people have not had the option of retiring early because of underwriting or the cost of health insurance policies.
With the new health care reform law, people now can retire early. Once underwriting is eliminated, a door opens up to many people to obtain a health policy. Then, with the Federal Facilitated Marketplace (exchange), people can qualify for subsidies. When you are in your late 50′s or early 60′s, these subsidies can be huge. The law states that if you qualify for subsidies then you will only pay a percentage of your household income towards health premiums.
We have had a real life situation where a couple was approved for a $1,600 per month subsidy, which leaves them with a $100 per month premium. The best part of it was when the gentlemen saw his estimated subsidy and said, “hell, I am going to retire early!” This was a great moment for us because I saw first-hand the positive impact of the law. This couple was lucky that all of their doctors were in the network.
While retiring early was not previously an option for many people due to health insurance restrictions, the door is now open for more people to consider. This is just another postive outcome of the Affordable Care Act.
Subsidies are tax credits available through state-based exchanges for middle-income people under age 65, who are not eligible for coverage through their employer, Medicaid, or Medicare. Subsidies can mean that some low-income people will pay almost nothing for insurance, while higher-income people will pay the full market price.
We have had clients get approval through the healthcare.gov site and over the phone. The current administration vowed that the website would be fixed of glitches by November 30, although we are starting to see it work for some clients. It looks like there might be a bit of light at the end of tunnel.
Our subsidy estimates have been very close to what has been issued to our clients. This is also a bit of relief since the government subsidy calculator does not work. After you have an estimate of your subsidy and narrow down your health plan, you can move forward with the subsidy application.
The first step is to run plan designs with estimated subsidies. Then, we choose the health plan option that best fits your needs. I will send you a copy of the subsidy application to prepare you for the questions that will be asked.
Once your subsidy eligibility is determined, healthcare.gov will send that information to the insurance company for the plan you elect. This is call the 834 transaction. The last step is paying your portion of the premium to the carrier and then a policy number should be issued.
Have questions about the Affordable Care Act? Give us a call at (317) 803-4220 and let us find the best rate for you and your family.
The numbers have been released by HHS on actual sign ups for the federally facilitated marketplace. HHS is stating that over 700 Hoosiers bought a health policy through the exchange.
This is very different than what I am hearing from the carriers participating in the exchange. One carrier told me they had 56 people sign up and another carrier told me they had 169. This would indicate the other two carriers has over 500 sign up with them. I guess it could be possible…?
The subsidy application part of the exchange is nothing less than screwy. There is no better word to describe it. Once you have answered all of the financial questions, you must pick a plan before you can submit the subsidy application. In this situation, how would you know what your monthly cost is? How did these 700 people know what kind of plan they were buying? How did they know what network they had? How did they know if their prescriptions were covered?
This kind of information has been released very slowly. In the month of October, we had access to none of this; we have just gained access in the last couple of weeks.
I am very concerned that these 700 Hoosiers bought plans that they had very little information on. When they start having claims, they will have no representation to help them. If you are one of the 700 people that have purchased an exchange policy through the exchange, please read your policy carefully.
One complaint we have been hearing from many people is that they are having major problems with the subsidy application. Without taking in account the operating system for applying, I wanted to shed some light on the actual process.
We are getting feedback that the end user cannot complete the subsidy application without selecting an exchange plan. The determination process is stopped until you choose a health plan. Most people have no clue what type of health plans are being offered; they don’t even know what network is being offered. Also, the plan designs are all over the board, even in the bronze category.
So here is a possible solution.
We are able to run manual rates for the exchange with estimated subsidies. Allow us to run rates and send them to you for review. Then, we can discuss how the plan will work and if it is the right plan for you. Next would be reviewing the networks. You may not be able to keep your current doctors. If you have multiple prescriptions then I would want to look up those drugs up on the drug formulary to see if they are covered. Once we discuss these issues in detail, then you are ready.
When you get online to submit the subsidy application, you will know what plan you are going to elect, allowing you to finish the process. We understand how frustrating this situation is. Let us help you! At the least, we give you information.
According to the White House, the federally facilitated exchange site should be up and running by November 30. We have seen multiple dates set with promises that problems will be solved, but we have yet to see that resolution.
There must be some valid reason why the government is setting November 30 as the date. They must have enough reason to believe they can fix most of the issues on the site by that time.
At that point, you should be able to go in, submit your subsidy application and get approval in a very timely manner. Then, you should be able to transfer your information to the carrier of your choice.
In the meantime, everyone looking for an exchange plan should be doing research. Research the plan designs carefully because these plans are very different than what has been offered previously in the individual market. Research subsidies and cost-sharing reductions. If you qualify for both, then your plan is going to look very different than what you have seen so far.
Get a copy of the subsidy application so you know what the government is going to ask of you before you apply. At this time, we can help you with all of your research so that you will be adequately prepared to apply for the exchange. Give us a call at (317) 803-4220.
If you’re planning on signing up for health insurance through the federally facilitated exchange, we have some news on premium payment options from Anthem after initial enrollment.
Monthly Automatic Premium Payment Program:
- Members can choose debit dates on the 1st through the 6th of the month.
- Premiums will be debited for the current month.
- The “Payment Methods for Individual Applications” form allows existing members to select either “checking” or “savings.”
- An authorization will be required to be completed when choosing this option. These forms are available on the broker and member websites.
Payments by check or money order:
- Paper payments should be sent with the identification number written on the check or money order and accompanied with the monthly invoice.
- Payments must be submitted to the address provided on the notice.
Payments over the phone:
- Payments can be made through the automated IVR payment system.
- Payments can be made through a customer service representative.
- Check or credit card payments are accepted via phone.
- There is no limit to the number of payments a member can make via phone.
- Members can register online at www.anthem.com to make payments online.
You’ve heard the facts, statistics and opinions about the Affordable Care Act, but have you heard about real life examples of people signing up for the Exchange? We’d like to give you some real world scenarios of different experiences people have had dealing with the Health Care Exchange.
Let’s start with a father and son signing up for the Exchange.The father is in his early sixties and is a highly experienced welder. He would be considered a master welder; with his experience and work ethic he is one of the best.
His adult son is also a welder and has a family of his own. He is following in his father’s footsteps, and while he is skilled, he also has a lot to learn.
Both the father and son work for the same small company. This company employees less than 50 employees. The owner has provided group benefits to his employees, but with the new law, his group health plan is getting too expensive. At this point, the majority of the employees cannot afford to carry their dependants on the plan. Under the Affordable Care Act, many of the employees will be eligible for subsidies, so the owner decides to drop the group plan.
The father and son now explore their options under the new health law with a skilled broker, aka Tony from Nefouse & Associates. We first took look at the exchange. The father makes too much money to be eligible for a subsidy, but the son is eligible for a very large subsidy.
The son is very happy about the level of subsidy he is eligible for, because he is looking at an $835/month tax credit, which gives him the option of a zero-premium policy.
On the other hand, the father is looking at a policy off the exchange that does not have the coverage he is used to and it will cost him about $1,000/month. That is $300 more per month than what he has been paying.
The master welder that has worked his entire life at his career will now be paying more for health insurance. Now, he is purchasing a policy that will give him additional access to facilities. His son, who is getting his career started, is benefiting by being able to get coverage at no monthly cost to him. His family has not developed relationships with their doctors, so they are wiling to switch their primary care providers.
This is the future of health policies.
Even though our rates engines are not working correctly, we have been able to manually run rates with exchange rates from Anthem. We are using the subsidy calculator from Kaiser because all other calculators are not working, including the government’s calculator.
So the question on everyone’s mind is who is going to benefit from the subsidies in the Indiana Health Insurance Exchange?
- Single moms have been getting large estimated subsidies. We are estimating premiums ranging from $1.55 to $32 a month for the Bronze plans.
- Early retirees. Someone that is 61 years old and wants to retire now can. With their income dropping all of sudden, the exchange plans are affordable. These Hoosiers may be looking at $200/month premium after subsidies for a Bronze plan.
- Large families that have to purchase their own coverage. We are seeing large subsidies for this group, especially families that only have one source of income. A family of four under $300/month.
- The 20-somethings that are in an industry that has low compensation. These people are looking at zero premium policies.
If the exchanges get up an running correctly, then we should have a lot of Hoosiers that will have the option of getting health care.
We all know that the federally facilitated Exchange has been plagued with problems. We have glitches and design flaws that are working against anyone trying to apply for a subsidy. We also know that the majority of people who have signed up were for Medicaid. In Indiana, it’s estimated that only seven people have actually signed up for an exchange plan.
In addition to these issues, there has also been a huge problem with federal government sending information to the insurance carriers.
Even though this is all very disheartening, don’t panic!
We know there is a full court press to try to resolve all of these problems. The administration is now bringing in third parties to address these issues and the insurance carriers have their IT departments working around the clock to fix their issues.
November 11th, which is a Monday, should be the day we go live for the federally facilitated Exchange applications.
If by the middle of November the Exchange is not full operationa,l we will shift gears away from the online exchange. We have had a few people submit subsidy applications by phone and we will adapt to get applications submitted.
Have questions? You can call us at (317) 803-4220.
Guest post from Michele Trivedi, MHA, Manager at The Arc Insurance Project
Some good news for the Indiana Autism Community!
Yesterday, Mr. Logan Harrison, Chief Deputy Director of the Indiana Department of Insurance (IDOI), presented information on the Indiana federally facilitated Affordable Care Act (“Obamacare”) insurance marketplace to members of the Indiana Autism Commission. The Indiana Autism Commission is a legislative commission that serves to provide legislator-led oversight of issues affecting people with autism in our state. It then makes recommendations to the full legislative body regarding autism specific legislative initiatives.
Mr. Harrison confirmed that all four carriers that will offer the ACA health insurance plans will be required to follow the Indiana Autism Mandate, including no age caps or dollar limits, and no visit limitations on ABA services. Further, the plans will have to follow Bulletin 136 and Bulletin 172 – also good news for the autism community! These bulletins guide care plan and medical necessity issues.
When asked by Commission members if the IDOI would be supervising compliance with the Autism Mandate under the ACA plans, as there are currently issues with insurers in the commercial market who are not following the mandate appropriately, Mr. Harrison stated that the IDOI would work directly with the advocates from The Arc and ASI to address issues, and encouraged subscribers to file complaints with the IDOI. He stated that needed corrective action would be taken.
Over the next week, The Arc Insurance Project will be posting more details on this and other aspects of the ACA that affect people with autism, DDs and IDs in Indiana on The Arc, Autism Society of Indiana, Indiana Resource Center for Autism and other advocacy and support group websites – please take a look and pass them along!
Please send questions to Michele Trivedi at firstname.lastname@example.org.