Individual Health Insurance Marketplace Exchange Information for 2016_Post 3

When the open enrollment commences on November 1, 2015, there will be two avenues for enrollment on 2016 individual plans. The first avenue is “passive enrollment” for those who are already enrolled on an individual plan who are happy with it; they will basically do nothing, and just continue with the plan that they already have (read your renewal letter and look for changes that are highlighted in the letter). The vast majority of people choose this route, because they have already spent time in the past to carefully choose the plan that works well for them, and so they are perfectly happy remaining on that plan. The second avenue is “active enrollment”, for those who are just entering the individual market or who are already enrolled but would like to make a plan change. This avenue means that you must do something proactive to change your plan. Many of you have already contacted our office for assistance with this. If you would like help making a change because of your current plans price, scope of coverage, network, or personal health changes, please contact our office right away so that we can assist you with that change.

This year our office will be rolling out several helpful tools, including Health Sherpa, which will simplify the enrollment process on the exchange for you. We also have a wealth of tools available on our website to help you with all elements of your insurance and financial life. Make sure you check it out!

If you have not done so already, make sure you contact our office if you need assistance or want to make changes once the open enrollment begins. In your correspondence, be prepared to provide your zip code, the dates of birth and names of all of the people you want to cover, whether or not anybody uses tobacco, what insurance plan you have currently, what doctors and hospitals are important to you, and if you have any special needs from a medication standpoint. Also indicate whether or not you think you are subsidy eligible. By providing this information, we are able to narrow down the plans that you should be looking at.

Thank you for reading this message, and for preparing yourself for Open-Enrollment 2016. We look forward to working with you!


Individual Health Insurance Marketplace Exchange Information for 2016_Post 2

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: If you are eligible for a subsidy, the amount you will pay will likely be lower than the quoted rate.

Individual Health Insurance Marketplace Exchange Information for 2016_Post 1

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.

Ending April 30: Special Enrollment Period

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.