Tag Archives: group health insurance

Health Insurance Open Enrollment Ends in Texas

The 2014 Open Enrollment Period for Individual Health Insurance has ended. You may still be able to obtain Health Insurance, if you have a Qualifying Life Event, or Special Circumstances, that would provide you a Special Enrollment Period.  Qualifying Life Events can include such things as loss of Group Coverage, birth, marriage and divorce. Please give us a call at 877-740-8683, or visit www.healthreformenrollmentcenter.com , to find out if you qualify. There are deadlines for each circumstance, so please don’t delay. Since there are so many rules in the new Marketplace, you need the help of an experienced Agent, now more than ever. Don’t go it alone.

Texas 2014 Small Group Definition

There is a new definition for a small employer for 2014.   This “small” change will affect a lot of people.

Today, a “small” employer is one who employed an average of at least one but not more than 50 employees during the prior calendar year, and who employs at least one employee on the first day of the plan year.

Employees are defined as individuals employed by an employer and include full-time, part-time, temporary and/or seasonal employees.

Before 2014, the “size of a group” was determined by eligible employees.  This number came from how many people were full-time (and had satisfied their waiting period), or were COBRA eligible.   Out of those that were eligible you could deduct the people that had a legitimate waiver.  This could be a person who was covered by their spouse’s insurance, or some companies allowed individual coverage to constitute a legitimate waiver.

As a small employer you must also meet a minimum participation to qualify for group insurance coverage.  You have to have at least 50% participation in the insurance.
For example:
In 2014 – if you have 20 employees – 10 must participate.
Before 2014 – if you had 20 employees and 10 were part-time or seasonal, you only needed 50% participation of the remaining 10 which would be 5.

Doesn’t sound so bad right?  Well here is the kicker.

The small employer has to pay at least 50% of the employee only premium.  So instead of paying 50% of 5 people (in 2013) … he now has to pay 50% of 10 people (in 2014).

Not to mention, as long as the group is under 50 total employees in 2014 the rates are community rated (not based on health).  However, once it goes over 50, it goes thru medical underwriting.

This will be the reason why you see more employers laying off people to either stay under that 50 employee mark – you will see them lay off part-time workers because maybe they can’t afford to pay insurance for a part-time employee – or you will see employers possibly not hiring a “visibly” sick or older person because unfortunately they will be more costly on their insurance.

We do not agree or disagree with what is going to happen, we are merely trying to outline the changes and shed some light on what is coming in our near futures because of the “change” in healthcare.

“Hassle Free” Insurance Application Process

We recently had a couple of experiences that reminded me just how important it is to the consumer to make the Insurance Application process as easy as possible. We had a returning Medicare Supplement customer that has trouble hearing on the phone. By completing most of the process by email, and making sure the Insurance Company understood the situation, we were able to complete the final voice signature in just a few minutes. Another Individual Health Insurance customer visited our website after being referred by a co-worker for Dependent Coverage options. She said the person that referred her to our company had really appreciated the fact that we were able to answer their questions, and help them find the right plan, by email. Then the final stage to complete the application was done in only a few minutes by phone. Whether you find it difficult to communicate by phone, or just don’t have the time, we can find a way to help. With most of our carriers, we are able to complete your application with a voice signature, or an e-signature by email, so we virtually eliminate paperwork. We always do our best to make sure your Insurance purchase is a ” No Hassle” experience. To speak to a licensed insurance agent, just call 877-740-8683, or visit www.freedomfreequote.com .

Employer Mandate Delayed in Health Care Reform

The Obama administration announced late today that they are delaying the Employer Mandate until 2015. The reason stated was due to reporting requirements. As we have known all along, there were going to be changes and tweaks in implementing the Affordable Care Act. This could be a significant change. Since employers are not required to report, they will also not be responsible for the shared responsibility payments. While the Treasury Department “strongly encourages” employers to maintain or expand Group coverage, they will not be required to do so until 2015. This could drive more uninsured into the Individual Health Insurance market. If the Individual Mandate were delayed, but other aspects of Health Care Reform were not, such as Guaranteed Issue, this could have serious consequences. We have recently seen both United Health Care and Aetna withdraw from the California Individual market. No matter where you stand on Health Care Reform, with change, there are consequences. This reminds me of one of the earliest “unintended consequences” of Reform. When children could no longer be denied Health Insurance due to pre-existing conditions, many Insurance Companies were forced to either stop offering Child Only policies, or make a limited plan selection available during a limited Open Enrollment. There are more rules and regulations being released on almost a weekly basis at this point. To stay informed, be sure to visit www.freedomfreequote.com

June is National Safety Month…Are you protected?

June is National Safety Month. According to the National Safety Council, 1 in 8 Americans received medical attention for a non-fatal injury in 2010. About 67% of emergency room visits are the result of accidents, and the annual cost of injuries is more than $730 billion. This figure includes medical costs,lost wages, and damages. An interesting fact is that about 78% of accidents happen outside the workplace. The top 5 causes of accidental injuries are motor vehicle accidents, poisoning, falls, choking and drowning. While many accidents can be prevented, they can happen to anyone, at any time. Many of our customers choose to purchase an Accident Policy, to help protect against the sudden, unexpected expenses that can occur after an accident. For more information, call 877-740-8683, or visit www.freedomfreequote.com .