IRS and Department of the Treasury Release Guidance Related to Healthcare & Insurance

This week, the IRS and Department of Treasury released frequently asked questions to assist agents, brokers, and employers on provisions of the Affordable Care Act. The link below provides additional guidance on employer shared responsibility, seasonal worker coverage, minimum value, and small business healthcare tax credits. The new FAQs can be accessed, along with existing FAQs, from the IRS Q&A index page at the link below. The new questions are accessible in the employer shared responsibility, small business tax credit, and employer health care plans sections. http://www.irs.gov/uac/Newsroom/Affordable-Care-Act-Tax-Provisions-Questions-and-Answers If you'd like information regarding the Premium Tax Credits for Individuals and Families see the following link: http://www.irs.gov/uac/Newsroom/Questions-and-Answers-on-the-Premium-Tax-Credit   Centers for Medicare & Medicaid Services (CMS) has sent this Y1 AB MLN Curriculum Update. To contact Centers for Medicare & Medicaid Services (CMS) go to our contact us page.

Missouri Exchange Rates - A Snapshot

Many of my clients in MO have been wondering what rates for the new ACA compliant insurance plans will cost.  Here is a quick snapshot of what the rates currently look like.

Snapshot of Missouri Exchange Rates

Those who are eligible for a subsidy, would be able to have some help paying for these plans.  You can use the calculator below to determine how much help you might receive.  I've posted this before, but here it is again.

Kaiser Foundation Subsidy Calculator

Since Healthcare.gov hasn't been accessible, using the tools above may be a quick way to estimate what your premiums might be under the new system.

If you don't need the federal money, there are plenty of plans that you can buy "off-exchange" if you need to purchase insurance.

If you already have insurance, you may want to keep your current plan, if you are able to do so.

As always, my clients can always e-mail me or call with questions.

Should the Administration shut down Healthcare.gov?

Bob Laszewski asks that very question in his blog post today.  Another insightful entry from Bob about the computer system and its continued failing.

As I've stated before, if you do not need the federal subsidy money and can keep your current individual health insurance policy, do so for as long as you're able. Based on what I've seen, the new ACA compliant plans are more expensive overall in this geography (Kansas City metro).

If you do have to shop - there are plenty of "off exchange" plans (plans sold outside of the federal marketplace) where you can purchase an ACA compliant plan for individuals and families.  The carriers have plans up on most of their own websites now, and eventually, I'll be able to run side by side quotes for these new plans.  To date, it's been impossible to do so, since most data resources at the insurance carriers and other entities (like the quoting engines most agents use) have been overwhelmed. 

That said, I do believe visibility to plans outside of the federal marketplace will increase greatly during the coming month or so.  So - for those who have been unable to buy health insurance in the past due to medical conditions, you'll definitely be able to fulfill the requirement to carry insurance.  The jury is still out as to whether or not you'll be able to get online at the Healthcare.gov website.

Read Bob's blog post here . . . .

System Glitches? Really?

Haven't been able to get into the Federal Exchange to peruse pricing or see if you qualify for a subsidy?  Most people haven't.   The website & the press keep saying it's due to traffic and I say - not so.  Now, there's finally confirmation in print of what some agents have been saying all week. 

Read the Story Here . . . .

The Center for Medicare and Medicaid Services (CMS), who is running the Federal Marketplaces in 36 states could barely handle agent training, and then had a security breach after some agents completed the coursework - sending agent information along with related social security numbers "into the wind" by "accident".

I would advise anyone who feels they need Federal Subsidy money to pay for their plan, to wait and see through the month of October.  Wait to see how this plays out and to be sure that the systems are working and have some level of security before putting in all of your personal information.

You have plenty of time - if you want your insurance policy to take effect on January 1, 2014, you need to apply no later than December 15.  Then, you still have until March 31 during this initial enrollment for plans to begin with effective dates after that.

No hurry - believe me, they need time to work this out.

For those who feel they won't qualify for the Federal money, and still need or want to buy a new ACA compliant plan for 2014, the options are actually greater outside of the exchange.  You have more choices of companies and plans, and the plans have slightly different benefits than those on the marketplaces.

If you'd like any help in looking at those in MO and KS, I'd be happy to assist, as always.

Many Consumers With High-Deductible Plans Are Concerned About Health Law Changes

For those of you who didn't know - unless your current individual or family health insurance policy is considered to be a 'grandfathered' plan - meaning, the plan effective date was prior to 3/23/2010 (when the new Health care law was signed) - you'll have to make some changes for plans effective on 1/1/2014.  Read more here . . .

Different companies are taking different approaches to this "migration", as they are calling it.  Some are simply ending your existing coverage as of 12/31/2013, and requiring you to purchase a new policy during annual enrollment - which takes place beginning October 1, 2013 for plans that will be effective on 1/1/2014.

Other companies are going to allow you to stay on your current 'non-grandfathered' plan, and they'll simply add essential health benefits and other features to make the plan compliant.  In those cases, companies will simply have you agree to that and any price changes, through the use of an addendum that the insured will sign, and you'd keep your plan through the end of 2014.

I am beginning to contact my clients to let them know what the options will be this fall.  Unfortunately, no pricing is available yet, so I'm only able to discuss potential situations, not real choices.  Some people will qualify for subsidies through the exchanges - if you're an individual and make up to $45,960 annually, you'd qualify.  The guideline is that there will be subsidies available for those making up to 400% above the poverty level.  In some geographic markets, that is a good amount of money, so many may qualify.

You can play around with the subsidy calculator below to get an idea of whether or not you & others in your household might qualify for subsidies being offered to help pay for new plans effective next year.

Health Insurance Subsidy Calculator

Health Insurance Exchange Subsidies Will Be Granted on the Honor System!––Is There Something Wrong With "ObamaCare's" Federal Data Hub?

Author of the "Health Care Policy and Marketplace Review" blog, Bob Laszewski has reported a whopper of a story on his blog about a little known change to the requirements for determining whether or not an individual applying for health insurance through the exchanges will qualify for a subsidy.  Information on income for individuals was supposed to come from the Federal Data Hub, but now that information can effectively be "ignored" if it conflicts with what the applicant is telling the navigator at the exchange!  In other words, if I think I need/qualify for a subsidy, they'll just 'take my word for it'. . . .

I think everyone really needs to know & understand that the average, honest tax payer will end up paying for the "free money" that is sure to be given out once some people understand how to manipulate the system.  No subsidy money should be given unless incomes & eligibility can be accurately verified.

Read Bob's Post on his "Health Care Policy and Marketplace Review" blog . . .

Income -- Not Assets -- Will Determine Subsidies In Online Insurance Marketplaces

As the enrollment for health insurance plans that will begin in January 2014 rapidly approaches, information about subsidies to purchase the insurance that will be offered in the new insurance exchanges that the federal & state governments are setting up, is being clarified.

Kaiser foundation published a helpful blog entry today regarding that subject.  You can read more about it here:  Questions Regarding Subsidy Eligibility

The links within the article are "live", so further information is available there.

Keep in mind that the health insurance plans referenced are for individuals and families- not businesses or people who have Medicare coverage.

There will be plans offered outside of the exchanges or "marketplaces" provided by the government, but if you need to obtain a subsidy to pay for your insurance, you have to buy the insurance through the government run marketplace.