Category: PPACA

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.

 

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.