Thursday, August 8, 2013

Why the Colorado Insurance Marketplace Could Be Your New Best Friend

As I mentioned in yesterday's video (above), Connect For Health Colorado is on schedule for opening October 1, 2013. Right now the biggest question still is "Will this save me money?" That should be answered soon.

The Colorado Division of Insurance has nearly completed their review of 750 individual and group plans that have been filed for approval. No small task for sure. The marketplace itself will have approximately 120 plans available depending on Division of Insurance approval. When you break that down further, we will have a much smaller number that will be presentable on the Western Slope, based on the physician network and affordability. The balance of plans approved will be available outside of the marketplace. Any plans purchased outside of the marketplace will not be eligible for any individual premium subsidy or employer tax credit.

Insurance brokers must be certified to sell plans in the marketplace. I am just now completing the online portion of this training and will be in the first two day classroom instruction on the 19th and 20th of this month. After the certification process is complete, any individual or employer group that would prefer the advice and assistance of a professional insurance broker (that would be me), will need to complete an agency agreement to represent them with their marketplace enrollment. Many others will continue their current insurance plans just as they do now outside the marketplace.

The marketplace for employers under 50 employees will be quite unique. You will have an opportunity, as an employer, to select one plan for all employees or offer multiple plans from different insurance carriers. Under a "Defined Contribution" plan, employers may budget a specific amount of money per employee to purchase the plan of the employees choice. Keep in mind that rates in the marketplace will be strictly age-rated only. Therefore a contribution of  $ xx.00 may be enough to pay for the choice of a younger employee but not near enough for an older employee.

I can not stress enough the importance that the premium subsidies will play for individuals and  families. For those that are not a part of an employer sponsored plan, the marketplace will certainly be your best friend. Keep in mind that the premium subsidies as well as the medical cost share subsidies will be strictly income based.

Good Health - That's the Plan!

Thursday, August 1, 2013

Obamacare Unplugged...A Deeper Look

As I mentioned in my recent video on this subject it was very difficult to express verbally what the delay in the employer mandate has caused. I am hoping the text of this blog will be more informative. I have been reading a multitude of articles regarding this subject and will be using a lot of  information from those reports in this blog.

One of the problems with the delay is the lack of reporting from the employers. Employers are being encouraged to "voluntarily" send the reports in anyway. I wonder how many will be doing that. Without that information the Federal Data Hub will not be able to determine who was eligible for a qualifying employer plan.

In addition they are not able to send an individuals income history to the State Exchanges to determine the amount of subsidy that individuals will be eligible for. Instead, state exchanges "may accept the applicants attestation form regarding enrollment in an eligible employer-sponsored plan...without verification". Also, for the first year of operation, "exchanges have discretion to accept an attestation of projected household income without further verification for subsidy eligibility. Do you see a potential for abuse here?

What might this delay cost?
  • The Congressional Budget Office estimates that the delay will result in $10,000,000,000 in lost employer penalties from those large group employers that were not going to provide coverage to their employees. Unfortunately, much of this money was earmarked to pay for the ACA subsidies.
  • It is also estimated that because of the delay 1,000,000 people will not be covered by employer sponsored plans. 
  • Half of those, however, will now be applying for subsidies at a cost of an additional $3,000,000,000. Three billion dollars that is not being collected from large employers.
The price tag here continues to climb...

I understand that most of you are waiting for the plan designs and pricing for the individual and small group exchange in Colorado. Today I learned that the Division of Insurance has postponed releasing those rates for another 2 we will all have to wait to see what the insurance premiums look like for January 2014.

Until next time...