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Obamacare Enrollment – What You Need to Know

Obamacare Enrollment for 2014

obamacareOpen enrollment starts October 2014.  You can enroll online, by phone, in person or by mail.  The cost is the same if you choose a Licensed Agent or Broker, or go direct to the Covered California website.  Agents and Brokers will help consumers enroll through an exchange website and assist in securing an eligibility determination and in selecting a plan.

Have the following ready before you start to enroll:

  • Number of people being enrolled
  • Birthdates of each person
  • Home zip code
  • Most recent income tax filings, including dependent tax information and head of household status (if any)
  • Legal immigration information, such as your immigration number (if applicable)
  • Information about your status as a member of a federally recognized tribe

Are all Insurance Companies offering the same?

If a carrier participates in Covered California, they must also offer the same plans or “mirror” those plans off-exchange.  But participating exchange carriers can also offer some alternative plans.  For example, Anthem will offer 8 Bronze plans and 4 Silver plans off-exchange that do not mirror the exchange plans.  Of course, they still have to be ACA-compliant and conform to the actuarial values for each level.  Blue Shield, on the other hand, will be offering no alternative plans off exchange, only mirrored plans.  Cigna, who does not participate in Covered California, will be offering only alternative plans off-exchange.

H S A’s and the Subsidies

We have not seen anything definitive as to how the H S A plans will qualify for a subsidy for the premiums.  We doubt the IRS will allow for a double tax benefit and they may come to some accommodation for a partial reduction of the H S A contribution.

How soon can you get a quote for the ACA compliant plans?

Insurance Companies are taking steps to handle this.  Blue Shield announced recently that they will stop accepting online applications for their current portfolio of plans on September 25th and will begin displaying and quoting ACA-complaint metal plans on September 26, 2013 with October 1st the first day to submit applications for ACA-complaint plans.  Only paper applications for the existing portfolio will be used between 9/26/13 through 11/15/2013 with the last effective date of 12/1/2013.

Husband and Wife with 2 children in college.

The husband is on Medicare and the wife is not.  The children live at home and currently have student health insurance through the college.  The household income is about $ 50,000.  The household income is used regardless of the number of members to be covered and you can enter only one person to be covered.  The children can stay on their college insurance because it qualifies as minimum essential coverage.

Pediatric dental coverage in 2014

Covered California announced today that insurance companies will be offering pediatric dental coverage in 2014 in both the Exchange’s individual and the small-group employer markets. They offer stand-alone plans for children’s dental coverage in the first year of the new health benefit exchange, which will open for enrollment Oct. 1.

Dependent in Another State

Covered California has yet to publish comprehensive guidelines for “household” determinations, but we will go out on a limb for you.  If you child is a full-time resident of another state, he or she may apply for that state’s exchange coverage and be eligible for premium assistance.  You would not count this childe as part of the household in California regardless of tax status.  Your child must be a full time student or disabled to be claimed as a dependent over the age 18 and that expires in the year he or she turns 24.

If your income changes after you get a Subsidy-

You can avoid advance tax credit repayments by reporting income changes as soon as possible.  The government figures if no families report income changes during a single year, 30% of those receiving subsidies would owe the government a median of $857.00 each.  If families report income changes in a timely manner, only 23% would owe money to the government and those that do would pay a median of $ 343 each.

Can we see the Provider Networks being offered in Covered California plans?

The provider networks are not expected to be published prior to the start of open enrollment.

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