We’re in the news! Follow this link below to read the article.

2015-10-2: Smaller firms, meet the ACA by Bob Sanders

This week we would like to paint the landscape of Individual Health Insurance Carriers for plan year 2016, as we prepare for the open enrollment commencing in a couple of weeks.

Anthem, is the largest carrier offered through the Marketplace Exchange measured by membership. Their plans use the Pathway Network, which include all but 5 of the 26 NH hospitals. They do not have Concord Hospital, Frisbee Memorial, Portsmouth Hospital, Monadnock Community Hospital or Parkland Hospital

Harvard Pilgrim Health Care, is a non-profit insurance company previously only selling group plans in NH, until 2015, when they joined the individual market in NH. They are offering two different plan networks. The HMO Hospital Network includes all 26 NH hospitals. The Elevate Health Hospital Network is a partnership Harvard Pilgrim has with Dartmouth-Hitchcock and the Elliot. This is a lower cost plan geared to individuals living in the southern NH counties and includes 17 of 26 NH hospitals.

Community Health Options, is a co-op of out Maine. The co-op includes all 26 NH hospitals and includes a nationwide First Health network (PPO). This co-op likes to be known for its Chronic Illness Support Program, which they believe are keeping their members healthy and reducing costs. They are the only individual company in NH featuring a national network.

Minuteman Health, is a co-op out of Massachusetts. They are available in all NH counties except Cheshire. Minuteman’s HMO network includes 13 of 26 NH hospitals. They will also allow the individual market access to the Lahey systems & St. Elizabeth’s Medical Center in Brighton, MA.  There is NO CONCORD, PARKLAND, or SOUTHERN NH HOSPITAL, to name a few. This is a very limited network, but it is very attractively priced.

Under ACA plans, you could possibly qualify for a subsidy to assist you with paying your premiums. Subsidies are based off of estimated adjusted gross income for 2015.  To see if you are subsidy eligible, visit:  http://kff.org/interactive/subsidy-calculator/. If you are eligible for a subsidy, the amount you will pay will likely be lower than the quoted rate.

The Individual health insurance Open Enrollment period beings, November 1, 2015, and ends January 31, 2016. Our office will be blogging regularly about Open Enrollment 2016. Our goal is to present you with relevant information to keep you abreast of the individual health insurance environment for 2016. Armed with knowledge, you will be able to make an informed insurance decision about what is best for you and your family.

If you are happy with your present plan and your network, you may choose to do nothing and allow your health insurance plan to automatically renew. As the old saying goes, “if it ain’t broke, don’t fix it.”

Conversely, if you are unsatisfied with your present plan due to coverage or network limitations, price, or any other reason, please let us know that you are interested in shopping during the open enrollment period. This is the only opportunity you will have to change your plan for the next year. We will do our best to assist you.

Lastly, we encourage you to forward this message to friends or family in the state of NH who may need insurance or would like the assistance of a broker during Open Enrollment 2016.

The Affordable Care Act permits young adults to remain as dependents on their parents’ group health plan until they turn age 26.

Losing coverage on a parent’s plan when you turn 26 is a qualifying event that triggers a special open enrollment period for individual health insurance, or enrollment in a group plan through your employer if you’re eligible. You have 60 days from your term effective date to enroll in a new individual plan (or 30 to 60 days to enroll in your employer’s group plan).

Have Questions????

Please call us and we would be happy to assist you; 603-647-9136.

The Health Insurance Marketplace may have sent you a notice requesting additional information to validate data on your application.  It is CRITICAL that you respond to the Marketplace with any additional information that they are requesting within the timeframe outlined in their letter.

Failure to provide them with the requested information may result in cancellation of coverage, changes to plan coverage, changes or loss in your current tax credits and possible impacts to your cost-sharing reductions.

Please Note: Termination of coverage due to failure to pay your premiums is not a Qualifying Life Event and would not constitute a Special Enrollment Period (SEP) outside the Annual Open Enrollment Period.

Anthem Blue Cross and Blue Shield in New Hampshire and Elliot Health System announced Elliot Hospital, Elliot Physician Network, Elliot Professional Services, and Elliot One Day Surgery Center will all rejoin Anthem’s Pathway Network of New Hampshire hospitals and providers currently serving the company’s Health Insurance Exchange customers starting May 1, 2015. If you would like additional information please select the enclosed link for Anthem’s official press release: http://news.anthem.com/bcp/assets/article/Elliot%20Pathway%20Final.pdf

Your 2014 ACA health coverage may affect your income taxes, particularly if you received a subsidy. You may have to complete additional tax forms and provide additional information when you file your 2014 federal income tax return. For those that didn’t have health coverage for some or all of 2014, you may be required to get a health coverage exemption or pay a tax penalty with your tax return.  The following links will provide you additional information on these topics.

These links are to the IRS and Healthcare marketplace websites.

 http://www.irs.gov/Affordable-Care-Act/Individuals-and-Families

 https://www.healthcare.gov/taxes/

There is a special enrollment period (SEP) available for those who owe a fee on their taxes for not having health coverage in 2014 and don’t yet have health coverage for 2015. If this describes you or someone you know, there may still be an opportunity to enroll on a health insurance plan in 2015.

The Health Insurance Marketplace is providing individuals and families who are subject to the fee when they file their 2014 taxes with one last chance to get coverage for 2015.

If this describes you or someone you know, now is the time to act. Those who don’t have coverage for the remainder of 2015 will risk having to pay the fee again next year for the portion of this year that they don’t have coverage. The fee for people who don’t have coverage increases in 2015 to $325 per person or 2% of your household income – whichever is higher. Please call our office today at 603-647-9136 and we will go over your options with you.

This is the third of a series of posts we will release between now and November 15, when the open enrollment for 2015 individual health exchange plan commences.  We will keep you up-to-date as we receive further information from various sources.

Through this post, we would like to prepare you for open enrollment by providing you with a brief introduction to all five carriers that will be offering individual medical insurance through the Marketplace Exchange.

Anthem, is the largest carrier being offered through the Marketplace Exchange, and the only carrier offered this past year (2014). Their plans will continue to use the Pathway Network, though there have been some notable changes to that network. Elliot Hospital and Littleton Hospital have left; though 5 others have joined, including: Alice Peck Day Memorial Hospital, Cottage Hospital, Southern NH Medical Center, Valley Regional Hospital, and Upper Connecticut Valley Hospital. Anthem will be offering four bronze plans, three silver plans, two gold plans and one catastrophic option.

Harvard Pilgrim Health Care, is a non-profit insurance company currently selling group plans in NH but, until 2015, has not been in the individual market in NH. They are offering two different plan networks on the Marketplace Exchange. The HMO Hospital Network includes all 26 NH hospitals. The Elevate Health Hospital Network is a partnership Harvard Pilgrim has with Dartmouth-Hitchcock and the Elliott. This is a lower cost plan geared to individuals living in the southern NH counties and includes 12 NH hospitals. Harvard Pilgrim will be offering two bronze plans, four silver plans, and two gold plans.

Assurant Health, is another national carrier. They are currently selling individual insurance plans in NH, though 2015 will be the first year on the Marketplace Exchange. Assurant has often been considered the “Lexus” plan of individual plans in NH. They are high priced, but their plans offer a nationwide PPO plan through the Aetna Signature Network. This kind of a plan is especially attractive to business travelers, “snowbirds”, really anyone who needs access to out-of-state or specialized providers (like those at the Lahey Clinic or Boston and Florida as examples). Assurant will be offering a total of 6 plans through the Marketplace Exchange.

Minuteman Health, is a co-op out of Massachusetts. They will be available in all NH counties except Cheshire. Minuteman’s HMO network includes 13 of 26 NH hospitals. They will also allow the individual market access to the Lahey systems & St. Elizabeth’s Medical Center in Brighton, MA. Minuteman will be offering four bronze plans, two silver plans, one gold plan and one catastrophic option.

Maine Community Health, is a co-op of out Maine. Maine Community Health originally planned to sell only in Rockingham, Strafford, Carroll and Coos counties. The co-op has since included all 26 NH hospitals in their network so they now will be statewide. This co-op likes to be known for its low premium rates and it’s Chronic Illness Support Program, which they believe are keeping their members healthy and reducing costs. Maine Community Health will be offering three bronze plans, five silver plans, one gold and one catastrophic.

As a reminder, the Open Enrollment Period will run from 11/15/14 to 2/15/15 and the enrollment dates are as follows:

• Enrollment dates 11/15/14 to 12/15/14 the policy would be effective January 1, 2015
• Enrollment Dates 12/16/14 to 1/15/15 the policy would be effective  February 1, 2015
• Enrollment date 1/16/15 to 2/15/15 the policy would be effective March 1, 2015.

Heathcare.gov is now live, and you can look at quotes now by visiting there. You cannot apply for coverage however until 11/15/2014. If you do apply yourself, please indicate you are working through a broker and include my name-Raymond White and my broker code 68433 so that we can assist you if there are any issues. Send us an email if you do this so we can track everything.

If you would like to make changes to your present individual health plan or if you currently do not have health coverage then we encourage you to give us a call.  We cannot emphasize enough the importance that you work through professional brokers like ourselves. Last year was extremely difficult, and with all of the new carriers this year, it makes no sense to try to do this on your own. We urge you to work through our professional staff and keep us informed of your activity regarding choosing a health plan.

If you have any questions about any of this information please call our office.  You are important to us, and we will do our best to assist you in this ever changing environment.  Please feel free to share this information with friends, family, co-workers, or anyone you feel would benefit from it.

We’re in the news! Follow this link below to read the article.

2014-10-30: NHBR Evaluating N.H.’s Expanded Health Plan Options