2016 Obamacare in NC Enrollment

As you may or may not be aware with the changes from the Affordable Care Act you can only purchase health insurance and/or change your coverage during the Annual Enrollment Period (AEP), unless you have a qualifying life event that triggers a Special Enrollment Period.

 

Well  2016 AEP for Obamacare in NC is almost here so if you need to enroll in coverage or change your current plan for 2016 it needs to be completed between Nov 1, 2015 – Jan 31,2016. Below is a chart that shows the date the new plan goes into effect based on when the coverage changes are made:

 

Change Date Policy Effective Date
11/1/15 – 12/15/15 1/1/16
12/16/15 – 1/15/16 2/1/16
1/16/16 – 1/31/16 3/1/16

Just to recap, to be eligible for health insurance with subsidies through the Marketplace you must meet the following eligibility requirements:

  1. Cannot have access to employer coverage…this includes through your employment and spouses employment.
  2. Must have Modified Annual Gross Income (MAGI) between 100 – 400% Federal Poverty Level.  See this page for the chart to see if you fall in the income range

We have helped thousands of North Carolinians successfully enroll in Obamacare in North Carolina and we can help you too.  Here is how we help you:

  1. Help you get qualified for your maximum subsidy amount allowed in the Marketplace.
  2. Consult with you on information needed to retain your subsidy
  3. Licensed by all the insurance carriers that provide coverage on the Marketplace so we explain to you the pros and cons of the different plans.
  4. Help you enroll in the plan that YOU choose making sure that you understand and receive maximum benefits offered.
  5. All this from never having to leave your home.  We handle everything for you via phone and internet…you don’t have to get dress up for us!
  6. Absolutely NO COST to you.  We are compensated by the insurance companies and by using us the plans DO NOT cost any more.

So if you are reading this and would like our assistance and you meet the 2 minimum guidelines listed above, please complete the contact form to the right of this page and we will contact you directly.

 

 

New Options for NC Obamacare in 2015

The annual enrollment period for 2015 coverage for NC Obamacare will be here before we know it…enrollment starts on November 15 and goes through February 15. In 2014 there were only two health insurance carriers that participated on the marketplace for subsidized premiums in North Carolina. In 2015, United HealthCare (UHC) will also offer a range of plan options to compete with these other two options. Since plans and rates for these three carriers have yet to be released to the public we don’t know a whole lot of information. We do know that the current two carriers plans will be very similar to what they were in 2014. We have heard that the plan options with UHC will be Health Maintenance Organization (HMO) based and will have plan options ranging from Bronze to Platinum. If you have used us in the past you will know that we strongly encourage a Preferred Provider Organization (PPO) based network over an HMO based network. A lot of times when people are looking over plans without a professionals assistance this may be overlooked because they are only looking at price. Some of the pitfalls of an HMO based product is as follows:

  • Primary care physician (PCP) coordinates all care
  • Referrals needed from PCP to see specialists
  • No out of network coverage….must remain within the HMO.  This is a high risk
  • Limited choice of doctors in network

This is just a few of the issues that we have with the HMO product.  You really have to evaluate your risk vs reward in choosing these plans and this is where we can assist you the most.  We give you an unbiased opinion on the plan options and ensure that you fully understand you benefits.  Best of all there is absolutely zero cost to you for our services!

Obamacare – Who will it help, who will it hurt?

With Healthcare reform, also known as Obamacare, quickly approaching (less than 48 days), our goal is to help you understand the impact the law with have on you.  The law will change how you access insurance in the near future.  Whether you are for or against the law, it’s important to understand how it will impact you.  Each person’s situation is different, so the law’s impact will vary.

obamacare facebook ad v4

 

Please note, this is a discussion on your coverage and premium impacts, not a political discussion on what effects this law may or may not have on the economy.

Below are some situations that will be affected either positively and negatively.  Although these are not all the possible scenarios, these will give you an idea of what may apply to you.

Who will it help?  The following will likely see rate decreases or will now have the ability to purchase health insurance.

  • Those who were declined previously and could not get coverage in the private market. – This group will be able to purchase health insurance without worrying about being declined because of health conditions (pre-existing).  There will be no waiting period for pre-existing conditions either.
  • People who were rated higher than the standard rate – Those who were not declined, but charged more for their coverage will lose that excess charge when the new law starts.  Companies have several rate levels that are higher than the standard quoted rate.  These people will see that rate charge dropped because the law will not longer allow for rate increases based on the customers health.
  • Older people (ages 55 to 64) – this group will likely see rate decreases because of the age banding the law requires.  The age banding requires the premiums of a 64 year to be no more than 3 times that of a child’s rate.
  • Those who qualify for a subsidy (subsidy chart) – If your household size and income fall somewhere on this chart and you do not have access to affordable group coverage, you will likely qualify for a subsidy.  This will offset the premiums costs for coverage under the new law.
  • Families with more than 3 children – The rating structure of the law allows for premiums to include the cost of the three oldest children.  For families with more than 3 children, premiums will only include the cost of the parent(s) and the three oldest children.

Who will be hurt by the new law because of rate increases:

  • Healthy people – If your current premium is discounted based on your great health, you will likely see a higher charge for coverage under the law.  Since the law requires no rating for those with health conditions, it will also not allow rate reductions for those who are very healthy.
  • Younger people whose income is outside of the subsidy chart – If your income is above the 400% Federal Poverty Level, you will not qualify for a subsidy and will pay the full cost of the coverage.
  • Single people with high incomes – Single people with high incomes and no kids will likely pay more for coverage under the law.  They will not qualify for a subsidy due to the high income and the lack of children will not allow them to get a lower
  • Dependents who have access to affordable group coverage – If you have a spouse that has group coverage that is deemed affordable, you will not qualify for a subsidy and will either purchase coverage through your spouse’s employer or purchase coverage outside of the exchange.

If you have any questions, you can message us on Facebook or contact us through our website.  Again, our intent to not debate the pros and cons of the law, but to give an unbiased review of what options North Carolinians will have once the exchange opens.  Will it be good for some and bad for others; yes, but it will be here October 1st.   North Carolinians will need to know what their options are.

The first Annual Enrollment Period (when enrollment starts) will run from October 1st to March 31, 2014.  In order to get a 1/1/14 effective date, applications must be submitted to your desired insurance company by 12/15/13.  If you decide not to enroll in creditable coverage, you will be locked out until next year’s Annual Enrollment Period.  Certain Special Enrollment Periods (married, lose job, etc) will allow you to enroll in creditable coverage mid year.

If you feel the need for additional help, please complete our “Reserve Your Appointment” form on the right hand side of the website.  We will add you to our growing list of people to contact once the exchange opens.