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Insurance Blog

Health Insurance Open Enrollment

Affordable Care Act / Obamacare Open Enrollment 2018 is right around the corner and there are a few essential steps that we can help you take in order to ensure a smooth process. It is important to know when you can enroll, how you can effectively enroll and what you will need at the time of enrollment.

Enrollment for 2018 will only last 45 days, from November 1, 2016 to January 31, 2017. You can enroll, switch plans, and get subsidies on plans that start January 1, 2018 (apply before December 15, 2018).

Unless you qualify for a special enrollment period, Open enrollment is the only time that you can enroll in a plan, change plans, or apply for your advance premium tax credit. Under the Affordable Care Act you may be eligible for financial assistance which is calculated based on your household income. Are you eligible for a tax credit? Click here to calculate your subsidy.

All private health plans share the Health Insurance Marketplace’s open enrollment period, while other types of plans such as employer based coverage, Medicare and Medicaid have their own unique enrollment periods. Short term health insurance plans are available if you need to fill a gap in coverage.

Signing up for an ACA / ObamaCare plan happens in a few simple steps. You can enroll, switch plans and get subsidies on the plans online or over the phone. You will be asked some basic information in order to identify if you qualify for Obamacare savings, and which plans are available in your area. You will be asked questions, for each person in your household, such as gender, date of birth, if you have used tobacco products, and if you/they are currently insured.

Qualification and Enrollment may require the following:

  • Proof of Income – It is essential to remember that in order to qualify for a subsidy your estimated income for 2017 will be considered. If you have other coverage available, you may not be eligible for a subsidy. Be prepared to provide your employer and income information for every household member who requires coverage. This includes any family member who has a W-2. It is beneficial to have pay stubs, W-2 forms, and tax statements available.
  • Social Security Number – be prepared to provide the social security number of each member of your family that you claim on your taxes. Even if the family member you are claiming are not applying for the government subsidy, have their numbers ready.
  • Proof of Immigration Status – it is required that you MUST be a residing in the US lawfully. You will need to prove your legal immigration status or your citizenship by providing naturalization numbers, green cards, work visas etc.
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Resolving Inconsistencies in your Application

Once you have completed your application for an Obamacare subsidy at the Marketplace; an Eligibility Report is generated. This report will inform you of any inconsistencies in your application and provide you with clear instructions on what to submit and how. The Health Insurance Marketplace will typically contact you through mail, email and/or phone. Under these circumstances, you will be required to provide copies of specific documents to verify that your information is accurate. Be careful of inbound calls, make sure you know who you are talking to before you give them personally identifiable information.

Certifying immigration status and/or verifying income are critical parts of the actual process. In order to resolve this you will need to either mail in the requested documents or upload them electronically. It is essential that you submit the necessary documents in order to ensure that you stay covered through the Marketplace and subsequently ensure your premiums and cost-sharing. The Marketplace will then typically contact you once they have completed the review letting you know that the inconsistencies have been resolved. This process can be complicated and certainly can be made easier should you seek the support of your agent. Upon completing the application with the guidance of your agent; he/she will be able to help you identify the documents required and can subsequently submit them on your behalf.

It cannot be emphasized enough that there is a deadline for submitting completed applications and failure to do so will inevitably lead to cancellation.

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Marketplace Required Documents

Health Insurance Marketplace” asks specific documents to verify your identity and the information in your subsidy application. This was a big problem after the open enrollment period ended. Make sure you get these ducumnets uploaded. If you mail them in don’t forget to include the barcode from your Eiligibility Report. Documents are required primarily to confirm/establish Identity, Legal Status, and Income.
Proof of Identity:

  • Drivers License
  • Passport

Proof of Legal Status:

  • U.S. Passport
  • Birth Certificate
  • Citizenship Certificate
  • Naturalization Certificate
  • Foreign Passport with Valid Visa
  • Permanent Resident Card

Proof of Income:

  • Pay-stub
  • Letter from your Employer
  • Bank Statement
  • W-2 Income Statement

You will need at least one of the documents from each category to successfully apply for the subsidy and enroll in a health plan.
There are other documents you can use as a substitute, but these are the most common.

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Health Insurance

What’s new in 2015?

United Healthcare and Assurant Health will be offering new products on the Health Insurance Marketplace. The big difference between the big carriers is going to be their networks. We are hoping to see better networks with United Healthcare and Assurant.
Coventry has improved their provider network adding hospitals and other providers. In Broward they added the Memorial hospital system to their network.
Molina is the lowest cost carrier in many markets across the country and is expected to be the most popular plan in Dade county.
It could be a big price difference. Checking rates every year is always a good idea. After all Molina has lowered premiums 12%, Aetna dropped 5%, and Sunshine 10%.

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Health Insurance Premiums for 2015

2015 Health Premium

Every year, all the insurance companies change their rates. Occasionally we see rates decrease. Most companies will increase their rates about the same amount. Sometimes we are surprised with decreases, this year we had three insurance companies lower their rates.
In 2015 premiums in Florida will be changing:

  • Aetna – 5%
  • Molina – 12%
  • Sunshine Health – 10%
  • Florida Blue + 18%
  • Cigna +17%
  • Coventry +14%
  • Humana +14%
  • Preferred Medical +14%

This is the average increase or decrease, changes to your plan could be more or less depending on your age and where you live.
These premium changes will also affect the subsidy amounts. Call us to review your options every year.

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