On Dec. 19 President Obama offered stopgap options to those people whose health insurance plans were canceled for not meeting the robust Affordable Care Act guidelines of coverage.  Health and Human Services Secretary Kathleen Sebelius said she will use authorities in the law to issue an exemption from tax penalties to those who received cancellations and are not able to find new coverage. In addition to the penalty exemption, the administration is allowing anyone, regardless of age, to sign up for catastrophic (bare bones) plans originally designed for people under the age of 30.  This will allow people to save on premiums if they are willing to assume more potential risk for cost of care.  Lastly the Department of Health and Human Services is setting up a dedicated hotline for those who got cancellations at 1-866-837-0677. These moves are not being well received by the insurance industry.  Many are worried that this will increase the instability in the marketplace and lead to further confusion and disruption.  On Dec. 18 the insurance industry had announced its own accommodation to ensure people get effective coverage by offering a 10-day extension of the final date to receive premium,  pushing the deadline back to Jan. 10 for plans starting January 1.   If a significant number of people, especially the young, choose not to sign up or use an exemption, many are worried that not enough healthy people will be paying in and premiums will have to be aggressively adjusted for the 2015 calendar year. We are living in a very interesting time for healthcare in this country.  If you can afford coverage we strongly advise you find coverage that will protect you and your loved ones against the real risk of shattering health care expenses.  The federal marketplace is improving in performance and functionality.  We are always available to assist you in making sense of the multitude of coverage options available to you either in… | Read More »

Wisconsin’s high risk insurance program known as HIRSP  is ending on December 31, 2013.  This is due to one of the main provisions in the Affordable Health Care Act (more commonly known as Obamacare), which states that insurance companies are no longer able to decline or rate individuals based on pre-existing conditions. Any policy purchased with an effective date of 1/1/2014 or later is guaranteed issue, which means no one can be denied coverage for pre-existing conditions. This covers all policies purchased on the Federal Marketplace at Healthcare.gov or off the marketplace. The only difference between policies on or off the marketplace is that on the marketplace you can get federal tax credits/subsidies to lower your insurance premiums if your adjusted gross income falls in certain ranges. If you do not qualify for subsidies based on your income level, you can still purchase insurance on the marketplace, but the incentive to do so doesn’t exist for you and you may even find a better deal off the marketplace. Anyone currently on HIRSP must complete an application for individual insurance on or off the marketplace by 12/15/2013 to have coverage by 1/1/2014.  This can be a confusing issue and we’re glad to help clear things up for you. If you or anyone you know is currently on HIRSP, feel free to call to schedule an appointment today to review insurance options available to you.

The fact that Obamacare actually stands for the Patient Protection and Affordable Healthcare Act of 2010 illustrates the complexity of this massive initiative. More than three years later, as the program moves toward implementation, confusion reigns. In the next few weeks, we’ll dissect Obamacare and answer questions related to how this act will affect you. For specific questions regarding your own policies, please feel free to contact us. We would be glad to review your options. We’ll start with an overview and, in future posts, we’ll delve into the exchange process, coverage options, lifetime limits, individual responsibility, the effect of Obamacare on your premiums and tax implications of the act. Obamacare requires all Americans to have health insurance no later than March 31, 2014, or they will be subject to a penalty tax. The opportunity to compare plans on a health insurance exchange begins on October 1, 2013 and ends March 31, 2014, with coverage beginning January 1, 2014. Exchanges will be offered at the state level, although some state, like Wisconsin, will use the federal exchange at healthcare.gov. Approved plans must cover these 10 essential health benefits: Ambulatory patient services Emergency services Hospitalization Maternity and newborn care Mental health and substance use disorder services, including behavioral health treatment Prescription drugs Rehabilitative and habilitative services and devices Laboratory services Preventive and wellness services and chronic disease management Pediatric services, including oral and vision care However, if you have insurance already and your coverage began before March 20, 2010, your policy may be grandfathered in. Definitely take the time to compare your policy with those offered on the exchange (also, and more appropriately, called the marketplace). We can help you with that, so please feel free to stop in. Note: The government is releasing and retracting information as the process continues. We will continue to monitor the information and keep you as up to date as possible.