Health care reform has had a dramatic effect on individuals and families. As you’ve seen on other pages about Obamacare, the effects may be positive or negative for you. It depends upon your specific circumstances.
What we’ll cover on this section is an overview of the changes you need to be aware in the following four areas:
- Initial Open Enrollment Period
- Health Insurance Cost Increases
- Inside The Exchange Or Outside The Exchange
- Solutions & Recommendations
This page will give you a good overview of the changes, and then point you to a more detailed page for the analysis and examples.
Initial Open Enrollment Period
The initial open enrollment period is six months long and starts October 1st, 2013 and ends on March 31, 2014. During this period you can apply for coverage and be guaranteed of acceptance into any plan you choose.
The primary purpose of this open enrollment period is to enroll as many uninsured people as possible. The state of California has been promoting awareness of the CoveredCA exchange since early September. Various community groups are doing outreach campaigns to educate people about health care reform.
The second purpose of the enrollment period is to enable the transitions of everyone that already has health insurance into the new Obamacare plans. These transitions are going to cause a lot of pain and worry for you.
The letters insurers are sending to you will show what the cost of the new plans looks like. Most of you won’t like the new cost or the plan. For more details about the letters you’ve received, and a strategy you can take to delay the health care reform price increases for another year, click here.
Health Insurance Cost Increases
As I just mentioned, the rates on the new health care reform plans are going up. These increases will impact almost everyone. So most of you are going to be unhappy about that. Okay, you’re pissed off about that. I understand.
There are reasons why the premiums have increased by 20% to 50%. Most are embedded in the rules and regulations of Obamacare. Not because the insurance companies decided to increase profits.
The main drivers of the health care reform cost increases are:
- Guaranteed issue – meaning you can’t be turned down or charged more
- Mandatory Essential Health Benefits required in all plans
- The new 3:1 Price Ratio limit
- Multiple fees and taxes that get passed on to us
Although this video is targeted at the North Carolina market, the concepts outlined apply everywhere, including California.
The new fees and taxes add over $20 per person to the monthly rates you see for health insurance. The biggest of those are the Health Insurance Tax which adds about 2% to your monthly premiums, and the Health Insurance Marketplace User Fee which adds $14 per month. This fee is used to pay for the operation of the state exchange in 2015.
For more details about the impact of all the cost contributors click here.
Inside The Exchange Or Outside The Exchange
This is actually one of the most important concepts that Californians need to understand. The decision regarding where to buy health insurance can have a great impact on the cost you pay, and the cost every person in California pays.
If you or your family will qualify for a subsidy, then you will want to get health insurance INSIDE the CoveredCA exchange. The exchange is the only place you can apply for coverage and get the premium reduction subsidies.
If you do not qualify for a subsidy, then you should get health insurance OUTSIDE the exchange. All of the plans that are available inside the exchange are also available outside the exchange. Along with those plans, the carriers have added a number of other insurance plans tailored for specific people.
Another difference is that some plans inside the exchange have very limited networks. So your physician may not be in that plans’ network. Outside the exchange there may an identical plan, but with a much larger network. Because of this, wanting to keep your current physicians might mean that you have to look for plans outside the exchange.
Whether you shop inside or outside the CoveredCA exchange, finding a plan with the right benefits, that your doctor accepts, and at an affordable price, is not going to be easy because of the Obamacare impact on families and individuals. If you would like assistance, or have questions, please call us and one of our advisors will make sure you get the answers you need.
Solutions & Recommendations
So how are you supposed to navigate this new health care reform system? We’ll give you a simple 3 step process and outline some key things to do in each step. Then we’ll give you some specific plan recommendations based on the plans and pricing that is currently available.
SPOILER Alert!! —> Only a few carriers have their plans approved yet (10/14/13). Stay tuned for updates once they happen.
Escape Health Care Reform In 2014 With Cigna
Because rates on the new metal plans are a lot higher than the plan you currently have, there is a potential solution to bypass Obamacare in 2014. Cigna is not participating in the CoveredCA exchange so they are not required to cancel all their existing plans on December 31st, 2013, like all the other major insurance companies in California.
As a result of this, you might find a lower priced plan from Cigna prior to Jan 1st, that would be lower cost than the metal plans. The Cigna Open Access Value 5000/100% plan has better benefits than the “Bronze” plans and tends to have a lower cost.
As we go through the 3 step process, you will want to compare the health care reform plan to what Cigna has available today.
Simple 3-Step Process To Find The Right Metal Plan
Here is the 3-Step process:
- The first step in this process is to determine if you will qualify for a Premium Tax Credet (aka Subsidy)
- Get a quote to compare benefits and prices to choose the best plan
- Apply for the plan Off-Exchange or On-Exchange
For more details about the selection process, click here.
The CoveredCA exchange does not allow you to easily compare plans BETWEEN the metal levels. You can only compare Bronze plans to Bronze plans, Silver plans with Silver plans. You can compare plans across all the metal levels by getting quotes from SPF Insurance. To see these comparisons run a quote by clicking on the Get Health Insurance Quotes link in the Quote Center at the top or on the button below.