Was quoted in an on-line article about open enrollment!
Zinser Benefit Service - Small Business Insurance
Individual Insurance, Group Insurance and Employee Benefits, small business insurance
Was quoted in an on-line article about open enrollment!
This is always a popular topic; it seems we get calls about this weekly. Â Here are three common questions. Â
1 – When Should I Apply?
Medicare eligibility begins when a person turns 65, or has a qualifying disability. Â
Applicants should start applying for Part A of Medicare the three months prior to a client’s 65th birthday, as well as that month, and three months after. Â However, if you’re already receiving Social Security, you will automatically be enrolled. Â
2 – Do I Need Part B?
When to apply for Part B is a bit more complicated. Â Late enrollment into Part B may result in paying a higher premium. Â Â
If you don’t have employer group coverage, then you should apply during your seven-month initial enrollment period.
If you are covered under a group health plan, you may qualify for a special enrollment period. Â If this is the case, you can delay enrolling in Pat B until your group health coverage is terminated, and avoid the late enrollment penalty. Â Â
The eight month special period starts the month after the end of either employment or the group health insurance coverage based on that employment – whichever happens first. Â
Please remember, COBRA coverage doesn’t qualify as employer coverage, and won’t allow you to escape the penalty for delayed enrollment. Â
Another thing to keep in mind is that some employers (mostly small) may require Part B coverage to be integrated with their existing insurance plans. Â Large employers may not have this requirement. Â
3 –Â SupplementÂ or Advantage Plan? Â
Medicare Supplement policies provide additional benefits that can reduce out-of-pocket costs when combined with Parts A & B. Â They’re provided by private insurance companies and require additional premium payments. Â These typically exclude prescription benefits, so for this reason you may want to pick up a Part D plan. Â
Advantage plans combine Medicare Part A, B and sometimes D. Â These policies bundle coverage into a single Medicare approved health plan offered by a private insurance company. These plans tend to feel more like traditional employer health plans. Â
I hope this helps!
On Wednesday, March 5th, the Obama Administration announced a 2 year extension to the policy that if your individual or small group plan was due to be cancelled in 2014 as a result of the essential health benefit benchmarks and other market reform requirements imposed by PPACA, you would be able to keep it, as long as your state insurance commissioner and the carriers in your state say it’s ok.
This policy only applies to existing policies. Â All newly sold coverage will have to meet all of the market reform requirements and other benchmarks imposed by PPACA (or ACA or ObamaCare).
Here in Kentucky, when this was announced last November for the first extension, we were allowed to do so. Â However, the state of Indiana didn’t allow it. Â We are still waiting to hear from our carriers if this will be allowed a second time.
Â This is a political move by the Democrats with the mid-term elections coming up. Â Pricing for renewals will be coming out in July/August of this year, which probably won’t be favorable. Â Plus, if last week’s Florida election was any indication, then it may be too little too late.
Starting in 2014, there are new charges on health insurance companies and on individual taxpayers to fund the ACA (PPACA or ObamaCare).
The first one is known as HIT – the health insurance tax. Â This is an assessment on some health insurance companies based on their market share. Health insurers oppose the tax because it will lead to increased premiums, which is what health care reform wants to avoid. Â A study by the consulting firm Oliver Wyman confirmed the tax will increase premiums by more than $2,800 per person and $6,800 per family over 10 years.
The second tax is on individuals making more than $200,000 and couples making more than $250,000. Â They will pay a 3.8% tax on dividends and capital gains when they file their 2013 returns this year. Â This income group also saw a 0.9% Medicare wage tax increase in 2013.
For the next three years, insurers will pay $63 per health insurance recipient; this is known as a reinsurance fee. Â The $12 billion collected will be used to spread out risk so insurance companies that end up taking on the sick will be protected.
The penalty for being uninsured begins this year. Â Individuals won’t have to pay it until they file their 2014 returns, the penalty this year is $95 or 1% of income, whichever is greater. Â Next year, the penalty rises to $325 or 2% of income.
The last fee is on insurance companies that sell their health plans on healthcare.gov; they will pay a monthly user fee of 3.5% of the premiums for health plans sold on the website.
This information was taken from an email I received from Humana.
I read in some online publications today that President Obama’s administration finally released some enrollment numbers of citizens enrolling in medical insurance plans for January 2014. I have my own questions about these numbers.
Some of this information is taken from articles across the Web, but most of it is from Ezra Klein’s blog, which is linked here:
There are 2.2 million Americans that signed up for private insurance. Of these 2.2 million, roughly 25% are the desired age group of 18-34. According to Ezra Klein’s blog, the Obama Administration, along with others, wants 38%.
The next set of numbers show that 55% of the sign ups were between the ages of 45-64.
These numbers don’t include the state exchanges of Minnesota, Oregon and Nevada.
The most popular metallic level plans are the silver level, with 60% of enrollees selecting these.
Most of the people enrolled haven’t paid yet. In my opinion this is a big deal. If you sign up and don’t pay, you don’t have insurance. As of right now these numbers are just citizens that have signed up, not paid.
Lastly, no Medicaid numbers have been released yet. These should come later this month.
A question I have about these numbers, are they reflective of what the insurance companies thought they would get, which in turn directly impacts the premiums that they charge.
Of course there are two sides to each argument, one side stating that a “modest” increase of 2.4% could be in store for next year. The other side states that if more young and healthy individuals don’t sign up, then it could be much higher.
Only time will tell…
Some questions that come to mind –