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2017 Health Options

2017 Health Options

Here is the actual notification that we mailed to all of our health insurance policyholders this past week notifying them of their 2017 Health Options.  Please read carefully and if you have insurance through one of the companies listed below, depending on which state you live in, the information may vary.  Check with your agent or carrier direct if you are not our customer.

To:  All Health Insurance Policy Holders in various states – All Carriers
From:  Your General Agent Bonny Allbright & Staff at Freedom Benefit Solutions

It’s that time of year again to figure out your best options for Health Insurance coverage for 2017.  Unfortunately, we do not have near the options we had last year.

  • Several companies are not offering coverage at all for 2017
  • Some have limited their coverage to a few specific areas.
  • Everything has gone to HMO coverage. PPO’s are basically non-existent!
  • More doctors are accepting the HMO’s, but finding doctors is still a challenge
  • We are seeing an average of 30% – 42% rate increases for 2017
  • Several companies are discontinuing 2016 policies and you must enroll in another plan

Listed on the next page is what Action you will need to take with different companies, depending on who your coverage is with.  Most of them are discontinuing 2016 coverage and you must select another plan or option for 2017 coverage.

 (This information does not pertain to Group coverage thru an employer or Medicare policies).

The last page is showing some alternative options for Health Coverage in 2017 that may be a solution for some of our customers.  We will be ready to answer your questions and help you with any of your options.

Please call or email for alternative options for 2017:
 936-756-6199 or info@fbsagency.com

PLEASE READ CAREFULLY, YOU MUST TAKE ACTION.

 

United Health Care

You must take Action! UHC Has pulled all ACA plans off the market for 2017.  The exception is:  Short Term and Medicare plans.   For 2017, you must enroll in other coverage with another company, if you have a health plan with UHC other than a Short Term or Medicare plan.  Call us or go to 2017HealthOptions.com for plan info.

Humana

You must take Action! Discontinuance of all plans.  For 2017 you must enroll in new coverage.  Call us or go to 2017HealthOptions.com for plan info.

Aetna

You must take Action!     Discontinuance of all plans.  For 2017 you must enroll in new coverage.  Call us or go to 2017HealthOptions.com for plan info.

Scott & White

You must take Action! Your 2016 plans will end and you must enroll in a new plan either with Scott & White, or with another company. Call us for plan info.  Scott & White will only offer Bronze Plans for 2017 and their coverage area is primarily thru out Central Texas and some areas around Dallas – Ft Worth area.

Memorial Herman

You must take Action! Your 2016 plan will end and you must enroll in new coverage for 2017. Call us for plan info.

Cigna

You must take Action! 2016 ACA plans are ending.  For 2017 you must enroll in new coverage.  “Does Not” apply to Grandfathered plans. Call us for plan info.

Blue Cross Blue Shield of Texas

NO ACTION REQUIRED, unless making a plan change or updating your subsidy. FYI…the Producer number in your Renewal letter is “not” our direct number…the Correct number is (877) 740-8683.  BCBS is the “only” carrier, who will continue to offer plans in every county in Texas.  If you have current coverage with BCBS you will be auto-enrolled into a like 2017 plan.  Grandfathered plans will not be affected by this.

We suggest “not” contacting BCBS direct, but rather call us, your agent, at (936) 756-6199 or toll free (877)740-8683.  Last year several of our customers received incorrect information by calling direct.  There were payment issues, policies being cancelled, and some lost coverage completely.  We tried to help, but we were no longer their agent and they had to fix their own problems.

Going direct DOES NOT save you money.  Having a personal agent/broker is free.  When you have an issue we can be most helpful to you in getting it resolved without you having to be on hold those 2 – 3 hours with inexperienced customer service reps, who have difficulty solving any issues.  By having a broker, you receive personalized attention with any issues that come up in the future.  We will take care of your issues in much less time than any of the customer service reps can.

If you do call BCBS direct, please make sure you get the name of the person you talked to and tell them your agent is:  Freedom Benefit Solutions / Bonny Allbright.

It would be very helpful if you could let us know if you made a change “directly”, so we can make sure your change is processed and in effect.

For Your Specific 2017 Options go to:
www.2017HealthOptions.com

Group Insurance

  • Good for Small Business Owners
  • Must have at least two people with one being a W-2 employee
  • PPO’s still available on Group Policy
  • Rates will be about the same maybe a little less

Short Term Insurance

  • Coverage for up to a year at a time.
  • Major/Medical – Utilizes a PPO network – Some plans include doctor and prescription co-pays
  • Must be healthy – No Pre-existing conditions. **Guarantee Issue plans available.
  • Rates about 50% less than ACA plans
  • Not ACA qualified, so you may be subject to Penalty, but your overall savings will be less

Sharing Ministry Plans

  • They are not regulated by the state, so there are no guarantees
  • Must adhere to living a strict Biblical lifestyle (no smoking, no drinking, etc)
  • Membership can be cancelled anytime and sharing of medical costs can be refused.
  • No Pre-existing conditions are covered
  • Exempt from ACA rules and regulations, including the Penalty.
  • Cost considerably less than ACA plans.
  • We can enroll you, but will make sure you know pros and cons before taking this option.

ACA Health Insurance Plans

  • This is the standard Health Insurance coverage most of you have been on for years.
  • Guaranteed Issue – Full Coverage – Subsidy qualified – ACA qualified

Thank You for allowing us to be your agent and please contact us if you have any questions or concerns about your insurance now and in the future.

PPO, HMO, EPO

Obamacare 2016

Today more than ever, people need help when buying insurance.  Some say they want Obamacare, some say they don’t want Obamacare.  Here is the skinny on Obamacare.

Plan Benefits

Obamacare is not an actual plan.  Obama made the laws and it has been coined “Obamacare”, but you still get the insurance directly from the insurance companies, however if you buy it ON EXCHANGE through healthcare.gov then you may qualify for a subsidy or a reduced premium.  In addition, when you buy on the exchange you have a longer time to pay your premiums than if you buy OFF EXCHANGE.  Therefore, THAT is why a lot of the doctors are not taking Obamacare/ON EXCHANGE plans because in theory, you could use the 3 month grace period to pay your premiums and still get care during that time.  The doctors could get stuck with treating you and never getting paid by the insurance company, or getting paid 3 mos later.  THAT is why they don’t want to take it.  Problem is, most of the companies sell the same plans ON and OFF EXCHANGE so the doctors have no idea if the person has 3 mos extra to pay or not — so they are all saying we won’t take any insurance!!!  Can you see what is going on now?

The benefits of the plans are still great, the problem this year is who will take the insurance you buy.  So make sure you look up your doctor to see if they are in network or not.

Networks

This year the networks are the key to everything.  Instead of shopping benefits, you are essentially shopping networks of providers.  A lot of companies have done away with offering PPOs entirely and are only offering EPOs and HMOs.  Again, there is nothing wrong with the benefits of either of these plans, in fact the benefits of an HMO are typically better than a PPO, however you are restricted to a certain network of doctors and those doctors are not the doctors you have seen for 20+ years.  The reason for that is, on an HMO the doctors in essence get paid less each time they see a patient than if they were to file the claim through a PPO.  In addition, there is a whole lot more paperwork to keep up with when filing a claim on an HMO too.  So a lot of the doctors who have been in business for a long time, don’t want to change how they do things (with good reason).  Therefore, the result is, you have newer “hungrier” doctors on the HMO networks.  The doctors possibly fresh out of medical school or the ones still trying to build their practice.  This doesn’t make them bad doctors, again, just not the doctors you have seen for 20+ years.

Changes

So because of all the changes within the Affordable Care Act, ACA for short, a lot of doctors are getting out of the practice.  This year, you will probably have to change doctors and will have to pay more for your insurance so be prepared.  If you decide to go without insurance entirely, there is a penalty, and it did increase for 2016.  Be aware of all of your options, and it is still FREE to have an agent help you.  They are still the most knowledgeable resources available.

What is a PPO HMO POS EPO

Is it an acronym city or the abbreviations you put behind your name! Health insurance plans are categorized by a few main ways: PPO, HMO, POS, and EPO.

Depending on which plan you buy, depends on if your care is covered when you see a network provider or any doctor. In addition, you may have larger deductible or coinsurance, and/or you may have to get a referral if you want to see a provider out of network

PPO (Preferred Provider Organizations)

PPOs give you the choice of seeing providers in network or out-of-network. You pay less if you use in network providers. You’ll pay more if you want to go out of network for doctors, providers, and hospitals. You may have higher out-of-pocket costs too. If you have a PPO plan, you can visit any doctor without a referral.

POS (Point-of-Service)

POS plans let you go to both in-network and out-of-network providers. With a POS plan, you will have to choose a PCP or primary care doctor from a list of participating providers in network. Your PCP will refer you to other in network providers as needed. If you choose to go to an out-of-network provider, you’ll need a referral and you may pay higher out-of-pocket costs.

HMO (Health Maintenance Organizations)

HMO plans usually require you to seek care from in network providers who work for or contract with the HMO. An HMO generally doesn’t cover or has limited coverage if you go out-of-network except in an emergency. If you choose to see a doctor or facility that isn’t in the HMO network, you may have to pay the full cost. Like the POS plans, HMO members usually have a PCP and must get a referral to see a specialist.

EPO (Exclusive Provider Organizations)

EPOs are much like the HMO in that they generally have coverage only if you see a provider in the EPO network (except in an emergency). Health plans generally can’t require higher copayments or coinsurance if you get emergency care from an out-of-network hospital, no matter what type of plan you have. However, providers may bill you for some additional costs.

BCBS PPO ACA

BCBS of TX PPO Members

Urgent ALL BCBS of TX PPO Members must read the following notification just released by BCBS of Texas.  This Notice affects all members who have an ACA (Affordable Care Act) PPO plan with Blue Cross Blue Shield of Texas.

As of December 31, 2015, BCBS of TX will no longer be offering their PPO insurance plans for the individual under 65 block of business going forward.  This means if you currently have one of the new ACA plans purchased after Jan 1, 2014, and it is a PPO, it will no longer be offered for 2016.   This means you must change plans for 2016!

According to BCBSTX, they have filed a new product that should give members a flexible choice.  Bottom line, their PPO network for new ACA plans is going away.  The 2016 plans are currently not available, but as soon as they are released, we will be contacting you.  You can count on us to make sure you see all options available to you, from All Insurers and that we will make this transition as smooth as possible for you.

According to BCBSTX, the reason for this is because for the past 2 years, they have been the only insurer offering individual PPO plans in all TX markets and due to anti-selection, they find the PPO product is unsustainable at an affordable price.  The will continue to offer other plan options in all 254 counties, on and off the Marketplace.

There are about 367,000 members who will have their PPO plan discontinued in 2016.  If this is you, click here.

There are about 148,000 members who are in a Grandfathered PPO plan who WILL NOT have their plan discontinued and will be able to continue to use the Blue Choice PPO network.

This does not affect Employer Group customers or Medicare members.

The Blue Advantage HMO Network will remain and BCBSTX is working to expand the number of providers in that Network.

According to BCBSTX, they paid out $400 million more in claims than it collected in premiums in 2014. Losses that high are unsustainable, and they must adjust offerings, as most of the other insurers have done also, in order to be sustainable in the new market reality.

As a Broker, who represents all the major Health Insurers, we are seeing many changes taking place in this entire market, which can have major effects on many consumers!  According to different Insurance News publications, it appears that Aetna is in the process of acquiring Humana and Anthem in the process of acquiring Cigna.  Acquisitions like this, mean less Insurers in the market, less competition, thereby creating less choices for our customers.  We realize this is not good for anyone, but we will help you find the best products that are available in the market.

Remember…A Broker works for YOU….not the Insurance Company!  It is ultimately our ONLY goal to make sure you have the plan that fits your needs best.  There are more things to take into consideration when choosing a plan, other than just the cost.  Many people found this out this year!

You will never pay more for your premium by working with a Broker, than you do by going direct with the Insurance company or by going direct to the Marketplace.

To shop for 2016 plans now, click here.

 

No Obamacare

What is Obamacare

Everyone is asking … What is Obamacare?

Most people don’t want Obamacare because their doctors will not take it.  I want to clarify something …

Obamacare is NOT an “insurance plan”. 

The term “obamacare” is referring mostly to HMO plans, and there are very few doctors taking the HMO plans (with any insurance company).   The reason why most doctors don’t want to take the HMO or Obamacare as it’s called, boils down to money.  Basically the insurance companies pay the doctors less money to treat patients who have those policies.  In addition, there can be more restrictions to the types of treatment the doctors can provide even to the extent that someone at the insurance company may determine what is “medically necessary” NOT YOUR DOCTOR.

The insurance you buy “on the exchange” at healthcare.gov is still insured by the insurance companies.   It is the same insurance that you would buy “off the exchange” either direct with the company or through an agency like us.  Same price, same benefits, same networks.  We generally tell people only buy “on the exchange” if you are applying for a subsidy or want help paying the premiums for the insurance.  Otherwise, just buy direct with the insurance companies through and agent and then your information isn’t being sent to the government.

The Obama administration made the laws that all the insurance companies have to follow.  Therefore all insurance plans have to provide certain benefits.  The doctors are kind of misleading the public by saying they won’t accept Obamacare, but I think it is more of an education issue rather than intentionally misleading.

When purchasing your insurance this year, you want to make sure to check the networks.  If your doctor is listed in the network for that insurance company then he takes the insurance.  If you need help determining which plan to choose, or which plan your doctor will accept, go to www.FreedomFreeQuote.com and get help.

If you are still confused, just stick with a PPO plan, you shouldn’t have any doctor calling it Obamacare!