Tag Archives: Marketplace

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.

 

2015 Texas healthcare open enrollment dates

Texas Healthcare Open Enrollment Dates

Texas are you ready?  It is almost that time of year again, the healthcare Open Enrollment period.  Since the Affordable Health Care Act (ACA) was passed, how you buy health insurance has changed and got lot of people confused.  The open enrollment period for the health insurance is the only time when you can apply for a new policy.  Because of this small window, we have provided some key dates so you don’t miss out on these important deadlines.

Texas Healthcare Open Enrollment 4 Key Dates:

November 15, 2014 — Open Enrollment begins.

You can apply for a new plan at this time, keep your old plan or change your coverage.

December 15, 2014 — Enroll by the 15th for January 1 coverage.

If you want new coverage that begins on January 1, 2015, you have until December 15th to make your choice.  If your plan is changing or you want to change plans, enroll by the 15th to avoid a lapse in coverage.

December 31, 2014 — Coverage ends for 2014 plans.

If you didn’t enroll by December 31st, you can still enroll up until February 15th, however your coverage may not start on January 1st.

February 15, 2015 — Last day to apply for 2015 coverage

If you do not apply by February 15, 2015 — before end of Open Enrollment, you won’t have another opportunity to enroll in an ACA plan unless you qualify for a special enrollment period.  This may result in penalties.

DON’T FORGET:

You do  have to apply during the healthcare open enrollment but you DO NOT have to apply on the marketplace or at healthcare.gov.  You CAN use an agent/agency to help you with the process and it doesn’t cost any extra to get advice from an agent.

You can always call us at 877-740-8683.

We are PPACA certified and premier agents with BCBS, Humana, Cigna, Aetna, Assurant, UHC, and many others.  We are also licensed in 28 states.

COBRA Special Enrollment Period

The Department of Health and Human Services recently announced a one time Special Enrollment Period for anyone who has COBRA continuation from Group coverage. This will allow anyone currently on COBRA to enroll in a new ACA plan until July 1st. The normal rules of only being able to enroll in a Marketplace plan when first eligible due to loss of coverage, or when COBRA was exhausted(or during the Open Enrollment), are suspended for this time period. The decision was made because many people were unaware that would no longer be able to leave COBRA coverage during the year, and enroll in an Individual policy. Prior to 2014, people used to be able to purchase Individual coverage at any time during the year, so they could leave COBRA at any time. Under the Affordable Care Act, people are no longer able to purchase Individual coverage during the year, unless they have a Special Enrollment Period. Since COBRA coverage is often very expensive, it always worthwhile to compare Individual Health Insurance prices, especially if you might qualify for a subsidy. Please give us a call at 877-740-8683, to find out if you qualify for a Special Enrollment Period.

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.

Don’t Delay Health Insurance

2014 Coverage Deadline

If you will need Health Insurance in 2014, don’t put off your purchase until the last minute. The absolute deadline for Enrollment in a Plan for 2014 is March 31st. The Marketplace website is again experiencing glitches, down times and waits. If you think you would be eligible for a subsidy, please call 877-740-8683, today to start the process. There will be more backlogs in the final days of the Open Enrollment, so secure your place in line now. You can also visit www.healthreformenrollmentcenter.com for additional resources. If you miss the Open Enrollment period, you will not be able to purchase a Qualified Health Plan for the remainder of 2014, unless you have a Special Enrollment Period due to a specific major life change, and you may be subject to a tax penalty.