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.
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.
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.
There are plenty of frustrations to go around when it comes to dealing with the Federal Facilitated Exchange for Indiana. HealthCare.gov has been the portal that has not lived up to expectations. If you have experienced difficulties with the site, you are not alone. Almost every Hoosier is in the same boat. For the month of October, only 146 Hoosiers have been able to complete applications on line. Out of the 146, only seven have elected health plans.
It took me three days to reset my password with CMS. Even the people that are trying to help enroll people are extremely frustrated.
On the bright side, we do have time. December 15 is our last day to get applications in for the January 1 start date. We are expecting to go live on November 8; this is when we should have a coordination of health insurance and the Federal Facilitated Exchange Marketplace. At that time you should be able to apply for subsidies and elect a health plan. You should have enough information at that time to make an informed decision.
Currently, we have copies of plan designs, subsidy applications and networks. Please contact us if you want that information. This information is key to making an informed decision.
Another week has gone by and the health care exchanges are still not up and running. This is starting to get very frustrating for everyone in the equation. Here at Nefouse & Associates, we have been pulling as much information as we possibly can for you.
Anthem looks to be the only carrier being proactive and not reactive at this point. So far, we have Anthem plans designs and the Anthem Pathway Network.
The network is a critical aspect of any health plan. The pathway network is at least 35% smaller than the Anthem traditional PPO network. This is going to create a tough decision for potential policy holders. Do I take the exchange plan with much lower premiums and have to switch doctors?
We are still waiting for master contracts on the health care exchange plans. The contracts will go into detail on what is covered and what is not. The drug formulary is another key component of any health insurance plan, and something we are still waiting on.
Usually all of this information is out before you go live.
The online enrollment process has had huge issues. We are hearing that initial applications for enrollment through healthcare.gov are not complete. There is rumor that 99% of the applications originally submitted do not have enough information for the insurance carriers to issue a policy. This was reported by CNN but there has been little coverage there after. If you applied thought Healthcare.gov, I think you should call the insurance carrier you applied with to make sure you have coverage starting January 1, 2014.
It looks like we will not be live until November. If you want network info or plan design info please contact us. We are happy to provide this information!
There has a been a lack of information coming out about the Federal Facilitated Marketplace (FFM). The FFM is the solution for all the states that did not want to develop a state-based exchange. Here in Indiana, this will be the main platform for enrollment for Health Care Reform. The broker community will use the FFM to submit applications.
We really don’t know what to expect when the FFM opens. What we have seen so far would lead us to a negative opening. We are still waiting on networks to be released on the exchange plans since the insurance companies have had issues getting the correct data out.
Another issue that has to be resolved is subsidy estimators. Right now, you have multiple sites quoting multiple numbers. We are hearing rumors that the subsidy estimators will not be corrected until mid-November.
Even with all of these issues, the exchanges could give a lot of Hoosiers access to health care. We have been talking to people that have been priced out of health insurance for the last five years. A lot of people with current health conditions will benefit.
The opening of the Federal Facilitated Marketplace for Indiana this week has not been a very good one. It has turned out to be an overall negative experience for those who have tried to use it. In fact, the FFM will not be active until October 11 now. The FFM is the platform that the government has developed for all the states that choose not to set up a state-based exchange. We are waiting for October 11 to start submitting exchange business.
The insurance companies have had their share of problems, too. We have not seen the full network for the exchange policies. Do not buy a policy until you research the network! There are some carriers that have not even released their plan designs for Indiana. No master insurance contracts have been released yet, which are very important because they list exclusions. We also have not seen any drug formularies for the exchange plans, which determine what drugs are covered at each tier.
The Web Base Entities (WBE) which are rate engines certified by the Federal Government and none of them working correctly. We currently have access to 3 different engines and none of them are working.
Through all of the negativity, there has been one positive aspect about this week: HOOSIERS! We have had the opportunity to talk to Hoosiers from all over the state, from every walk of life. It’s been great to hear the different views on the new law. There have also been some Hoosiers that have been shocked to find out that they are eligible for a zero-premium policy. It does not matter how you view the new law; when you hear that a policy will cost you nothing, that is a topic of conversation! There have also been some people that have been frustrated this week…us included. Some folks are really mad and we want you to know that is okay. Our entire health care industry is going through huge changes and people are going to be upset.
We can only hope that October 11 goes smoothly and we are able to provide all the information we can to Hoosiers so that they can make an informed decision.
October 1 was opening day for the Health Insurance Marketplace. We think it’s fair to say that it did not live up to expectations. We fielded thousands of emails and a heavy load of phone calls. Through all of that, we kept hearing the same thing from the Hoosiers contacting us. “It’s nice to speak with someone,” or, “you were fast with responding to my email.” The reason we are accessible is that we believe in customer service. We believe that it’s our job to help people find the best health policy solution.
We were in shock about people buying exchange policies on Tuesday. We did not have access to the networks or all of the plans. So I was curious how a navigator would have access to all of this information when we did not. The actual health plans had just been released. Did the navigators have time to study all of the plan designs and the networks for Indiana? Without proper time to for studying the health plans, how does one explain the best option to the future policy holder? We really don’t know.
We have some concerns that Hoosiers, along with the rest of the country, might have bought a health insurance policy without actually knowing what’s in that policy.
Our job as a Federal Facilitated Marketplace broker is to inform you of your options. We must know the plan and the network inside and out so we can give you the best advice. This is a serious decision. Your health services start with the purchase of a policy. You should want someone advising you that takes this role seriously.
Here at Nefouse & Associates, we have embraced the Health Insurance Marketplace because we know many Hoosiers can benefit from it. We are a for-profit business; the insurance carriers compensate us for placing business with them. Since we are for-profit, we will work harder for you than anyone else. We have to earn your business! We will prove to you that we are worthy to be your broker with our high level of knowledge of products, market conditions and servicing after the sale. Being a broker means we work for you and we want to continue to work for you down the road. By using a broker, you get the ability to fire them if you are not happy with their service.
We are entering a difficult transition in the health insurance industry. We want to work for you!
On October 1, t the Federal Facilitated Health Insurance Exchange will open. At this time, we are not sure if we will have full capabilities.
We believe that the rates will be available, but we are not sure that the subsidies process is going to be set up. There may be a delay for this process that lasts a few weeks to be established with the exchange carriers and the government.
We should have access to a subsidy estimator, which will give you an idea of the amount of tax credits you are eligible for. Then you should be able to review plans on all of the metal tiers. Really, this is a good starting point for every Hoosier. Get familiar with what option you have inside the exchange.
Will the Silver plan be the best fit for you and your family? Now you have four different Silver plans to choose from.
Get familiar with the exchange networks. These networks are going to be the hospital and medical providers you will have access to. This may be a big adjustment for Hoosiers that are accustomed to having a large PPO network to choose from. To get a reduced monthly premiums, you may have to switch doctors, which is the reality of the exchange plans.
Here is a copy of the Subsidy Application. This is the information that the government is going to use to determine your eligibility for subsidies. We are not sure if the government is going to accept paper applications initially, so you will have to go to www.healthcare.gov and apply online.
The exchange policies do not go into effect until January 1, which gives the insurance industry and government plenty of time to work things out.