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Health Care Reform

Democrats Call For Mandate Delay

Zinser · November 9, 2013 · Leave a Comment

Nine House Democrats have proposed a delay in the individual mandate penalties until 120 days after the inspector general certifies the healthcare.gov website is completely functional. Meanwhile, 10 Democratic senators – seven of them up for reelection in 2014 – sent a letter to Health and Human Services Secretary Kathleen Sebelius saying they are “discouraged and frustrated with the problems.” They also asked for a delay in enforcing the individual mandate.

“You’re going to see more calls for delay,” Jan Crawford of CBS News predicted last weekend on Face the Nation. “But that raises its own problems. Because you’re going to have the sick people, who have been so anxious for this insurance because they’ve been denied coverage…they’re the ones who are going to get it.

“But what has to happen is that the young healthies…they’re the ones who have to sign up to make this whole thing work. If they don’t sign up – and they have no incentive because there’s no penalty; the hammer’s been taken off the table – then you get this concern about the death spiral.”

A New York Times editorial comes to the same conclusion: “Any delay past March 31 would disrupt the basis on which premiums were set for the new policies going into effect next year. … If the enrollment period is extended for a significant period, the sickest people are most likely to sign up early and the healthiest will likely hang back, driving up the costs for insurers and making premium increases likely the following year.”

The industry group America’s Health Insurance Plans also opposes a delay. Extending the enrollment period would have “a destabilizing effect on insurance markets,” spokesman Robert Zirkelbach said.

Both the President and Sebelius have said a delay isn’t necessary. If the website is fixed by Nov. 30, as the administration believes it will be, customers will still have four months to sign up.

Individual Mandate Delayed

Zinser · November 3, 2013 · Leave a Comment

Individual mandate penalty delayed

October 30, 2013

The part of the Affordable Care Act (ACA or health care reform law) with the biggest impact – the individual mandate – is getting a lot of attention lately. Under the law and regulation as written, people who buy health insurance as individuals (an individual plan) can go three months without health insurance and not have to pay the individual mandate penalty. Now that individual market open enrollment goes until March 31, 2014, coverage can start as late as May 1. The Obama Administration felt like it needed to fix the problem where someone who buys insurance in the last 45 days of open enrollment still would have ended up paying part of the penalty. Because of a change to the regulation this week, this will no longer be the case in 2014. As long as people buying individual plans are signed up for insurance by March 31, 2014, they will not get hit with the penalty.

The Centers for Medicare and Medicaid Services put out guidance on October 28 that gives more information on the “hardship exemptions” for the individual mandate penalty. The Department of Health and Human Services is putting such an exemption in place for people who sign up for insurance before the open enrollment period ends on March 31, 2014. Without this exemption, individuals would have had to be covered by health insurance by March 31, meaning they would have had to sign up for it by February 15, 2014. Now, people who have signed up by March 31 will be able to claim a “hardship exemption” (without asking for it from the marketplace) on their taxes and not pay the penalty for the months in 2014 that they did not have health insurance.

A regulation with more detail should be released very soon. We will share more news when we have it.

Kentucky Health Benefit Exchange

Zinser · September 24, 2013 · Leave a Comment

We are a week away from the Kentucky Health Benefit Exchange.  I’m in the process of completing the training in order to sell in the exchange.  Hopefully rates will be available soon.

kynect.ky.gov

 

 

Voluntary/Worksite Benefits

Zinser · June 27, 2013 · Leave a Comment

I was published!

 

http://www.benefitspro.com/2013/06/12/brokers-turn-to-supplemental-plans-to-combat-ppaca?eNL=51b8c999150ba0232f0002e9&_LID=80575373&t=Consumer-Driven&page=3

Modified Community Rating

Zinser · May 25, 2013 · Leave a Comment

This week’s Business First of Louisville had an article about Modified Community Rating.  Director of Government Relations Lawrence Ford is quoted throughout the article.

Here’s the link:

http://www.bizjournals.com/louisville/print-edition/2013/05/24/modified-community-rating-system-is.html

Mr. Ford does a good job of explaining how this will impact Kentuckians rates.  He highlights two issues.  The first is younger people subsidizing the older population.  Insurance companies aren’t going to bring down older folks rates, they’re going to push the young population up to help offset the older population claims.  He also talks about the lack of a substantial penalty for those who don’t enroll.

Still something needs to be done about letting individuals buy whenever they get ill.  The way it’s currently set up that is what could happen.  I know there are talks about it, but we need something done soon before Jan 1, 2014.

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Zinser Benefit Service - Small Business Insurance

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