Health Insurance

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2014-9-18: NHBR N.H’s Health Coverage Evaluation

 

 

 

This is the second of a series of posts we will publish between now and November 15, when the open enrollment for 2015 individual health exchange plan commences.  We will keep this site up-to-date as we receive further information from various sources.

Last year, Anthem was the only company offered on New Hampshire’s Health Insurance Marketplace, which means everyone who is currently insured through the Marketplace in NH, is insured with Anthem. We would like to make you aware of a few significant changes to Anthem’s individual provider network called, Pathway.  These changes affect all members on the Individual Pathway networks beginning January 1, 2015.

The following hospitals have been added to Anthem’s Pathway Networks Eff. 1/1/15:

• Alice Peck Day Memorial Hospital
• Cottage Hospital
• Southern NH Medical Center
• Valley Regional Hospital
• Upper Connecticut Valley Hospital

The following hospitals have left Anthem’s Pathway Networks Eff. 1/1/15:

• Elliott Hospital
• Littleton Regional Hospital

If you choose to remain with Anthem in 2015, you will lose access to Elliot Hospital, Littleton Regional Hospital, and their affiliate doctors. Bear in mind, that there will be transitional care available for those of you who are in the middle of a treatment on January 1st; however, it will be limited.

For those of you who are currently enrolled through the Health Insurance Marketplace (On-Exchange), you will receive two important notices about your health coverage prior to November 15, 2014. One will come directly from Anthem and the other from the Health Insurance Marketplace. [If you enrolled directly with Anthem (Off-Exchange), you will receive only one letter from Anthem.] Please note, at the time of enrollment, you may have requested that the Health Insurance Marketplace correspond with you via email; please be on the lookout for these notices. These notices will help you understand your choices for 2015, so it’s important to review them carefully and keep them in a safe place.

The notice you will get from Anthem will tell you, either:

• You will be automatically enrolled in your 2014 plan or a plan similar to it, or
• You won’t be automatically enrolled and need to enroll in a plan in order to have health coverage in 2015

If you are automatically enrolled in the same or a similar plan, Anthem will tell you:

• The plan you will be enrolled in
• Your 2015 monthly premium amount and estimated savings
• Any changes to your plan for 2015 – (Please make sure the network changes above will not affect you.)
• Your other coverage options, deadlines, and important information about your coverage

If you are automatically enrolled in the same or a similar plan, your Marketplace notice will tell you which one of the following applies to you; either:

• You’ll get the same premium tax credit and other savings you had in 2014 or
• You’ll lose your premium tax credit and other savings unless you update your Marketplace application and the new information shows that you qualify for savings

If you won’t be automatically enrolled in your current plan, your notice will explain:

• Your coverage options
• Enrollment deadlines
• Next steps to take
• Other important information

Even though the Health Insurance Marketplace may not require you to update your financial information we feel it is in YOUR BEST INTEREST to update your financial assistance information by November 15^th at www.healthcare.gov.  This will ensure that you get the correct subsidy and cost share for 2015, eliminating any potential problems at tax time. If your income has varied greatly from what you estimated for 2014, it is possible you could lose your subsidy entirely. Being proactive means that you will get an accurate subsidy.

Please note, you have the option to pick a different plan for 2015. This is true even if you enroll in a plan automatically. You can choose any plan available to you in 2015, no matter what kind of plan you had in 2014.  As we mentioned in the last email, there will be five insurance providers on the Health Insurance Marketplace for 2015; Anthem, Assurant Health, and Harvard Pilgrim, which are insurance companies, and Maine Community Health and Minuteman Health, which are Maine and Massachusetts co-operatives, respectively.  Each of these insurance providers utilize different plan designs and different networks which will be important to many of you.

As a reminder, the Open Enrollment Period will run from 11/15/14 to 2/15/15 and the enrollment dates are as follows:

• Enrollment dates 11/15/14 to 12/15/14 the policy would be effective January 1, 2015
• Enrollment Dates 12/16/14 to 1/15/15 the policy would be effective  February 1, 2015
• Enrollment date 1/16/15 to 2/15/15 the policy would be effective March 1, 2015.

If you would like to make changes to your present individual health plan or if you currently do not have health coverage then we encourage you to give us a call.  We cannot emphasize enough the importance that you work through professional brokers like ourselves. Last year was extremely difficult, and with all of the new carriers this year, it makes no sense to try to do this on your own. We urge you to work through our professional staff and keep us informed of your activity regarding choosing a health plan.

If you have any questions about any of this information please call our office.  You are important to us, and we will do our best to assist you in this ever changing environment.  Please feel free to share this information with friends, family, co-workers, or anyone you feel would benefit from it.

This is the first of a series of posts we will publish between now and November 15, when the open enrollment for 2015 individual health exchange plan commences.  We will keep this site up-to-date as we receive further information from various sources.

The first thing we would like to emphasize is the OPEN ENROLLMENT PERIOD. This period will run from 11/15/14 to 2/15/15 and the enrollment dates are as follows:

•     Enrollment dates 11/15/14 – 12/15/14; the policy would be effective January 1, 2015

•     Enrollment Dates 12/16/14 – 1/15/15; the policy would be effective February 1, 2015

•     Enrollment date 1/16/15 – 2/15/15; the policy would be effective March 1, 2015.

If you would like to make changes to your present individual health plan or if you currently do not have health coverage then you will need to enroll between these enrollment dates.  Even though the open enrollment runs until February 15, we expect extremely heavy volume between November 15 and December 15, and that is why we are trying to get information into your hands as early as possible.

Unlike 2014, when there was only one carrier available on the federal exchange (Anthem), we are excited to tell you that there are going to be five companies available this year.  If you did not utilize us as your broker last year, we would strongly encourage you to do so this year, because there are going to be a lot more choices and things will be a lot more complicated than in the past.  In addition to Anthem, two insurance companies, Harvard Pilgrim and Assurant will all be available on the federal exchange next year. As well as two not-for-profit health co-ops, Maine Community Health Options and Minuteman Health from Massachusetts for a total of five companies on the federal health insurance exchange. As a result, it may be in your best interest to look into new coverage for 2015. If you currently have an Anthem individual health plan it will automatically renew for January 1st if you do nothing. However, this may not be your best option as there could be network changes and rate increases. 

For those of you who had subsidies on the federal health insurance exchange, it is essential that you make sure that your income information is up-to-date and accurate. The federal exchange will generally continue with the same subsidy you have been receiving, unless they receive updated information from you.  If you are receiving a subsidy that is too large for your 2014 adjusted gross income, you may have to pay a portion of that back on your 2014 taxes, and obviously you don’t want to end up in that situation in 2015 as well.  If you have created an account on the federal exchange website, you can log into your account and update your information online or, call 1-800-316-2596. We strongly recommend you do that before November 15. Whenever you update your account or otherwise interact with healthcare.gov by phone or internet, please make sure to indicate you are using us as your broker. Be sure to use our NPN number, which is 68433, and use “Raymond White” as your agent. Otherwise we cannot have access to your account.

If you have any questions about this information, I would encourage you to call our office prior to November 10.  You are important to us, and we will do our best to assist you in this ever changing environment.  Please feel free to share this information with friends, family, co-workers, or anyone you feel would benefit from it.

 

Announcement From CMS

There will be an “auto-renewal” process for those who hold individual health insurance purchased through the exchange in 2014. This is a change in direction, as it was originally planned that all individual exchange policyholders would have to reapply for coverage during the open enrollment period which begins on November 15, 2014. This new policy announcement means that people who do not make a change in their coverage will be renewed on their current coverage automatically without having to make some sort of affirming decision. In addition, subsidies will continue as they were in 2014, absent any updates in the income from the individual participant.

This should ease the burden on those that have been confused by the process, but were still able to obtain coverage despite the rocky roll out an enrollment process last year. They will at least be covered under the plan that they were used to, unless they seek out a different plan during the open enrollment process.

Although the individual exchange gets most of the press, there is a second exchange available for purchasing insurance, the SHOP exchange, which is designed for small businesses to purchase group insurance plans. The original vision for this exchange was that it would offer employees the opportunity to choose from multiple carriers and multiple plans, much like most 401(k) plans offered by companies, which have a complete menu of investment choices from multiple mutual fund companies.

Because of all the problems implementing the individual exchange in 2014, all work on the SHOP exchange was suspended, and it was launched as a paper application process only, with no website. It did not offer the employee choice feature, either. As a result, subscription to this plan in 2014 has been extremely anemic, although it is hard to tell how much of a disaster it has been, given the fact that CMS will not release any numbers to Congress, despite numerous requests for this data.

It was expected that in 2015, since CMS had an entire year to work on this SHOP exchange, that it would be implemented according to the vision of the 2010 legislation, with the employee choice model fully operational. In New Hampshire, this will not be the case, as we are one of 18 states who decided not to offer an employee choice feature until the federal website and infrastructure are in place, and can prove that it can function with a single carrier model. I feel this is an extremely wise choice by the state of New Hampshire, because the added complexity of employee choice would probably continue to doom this stillborn exchange to further failure. It is best to get the process working in a simplified way, and then expand upon it, rather than roll out something as clunky and disastrous as the individual exchange rollout proved to be last year.