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By now, many of you have received a notification from your current insurance carrier letting you know one of two things – either your rates are going up, OR your current policy is going away and you must find a new one, which will most likely be more expensive. Why is this happening?

Several large insurance carriers have plans that were not grandfathered and are not compliant with the current version of the Affordable Care Act (ACA). These were written after March 23, 2010 and while they did incorporate some of the earliest ACA mandates, the mandates made after the plans were implemented have now made them no longer compliant. The Administration extended these reform plans for two years ending in 2015; however, it is up to the carrier as to how long they wish to facilitate these plans. Many have opted to remove them at the end of 2014 due to rate increases matching or exceeding the cost of ACA plans.

OK, so now what? Keep calm. Plano-based Alkali Insurance is here to help and can provide you with information on the best path. For example, we have a webinar coming up on November 20th at 9 AM that you can sign up for to get details on how to handle all these changes. You also have the option to consider an individual healthcare policy from the Healthcare Exchange (one of the topics we will cover during the webinar), which leads us to the next item we wish to cover so that you can be well-informed.

Open Enrollment is Coming

You have choices and while we all enjoy having the opportunity to pick what we want, when it comes to individual health insurance coverage, that task can seem daunting. There are many decisions to be made, including:

  • Do you take your employer’s coverage?
  • Do you cover your family with your employer’s coverage or consider other options?
  • How do you find the best coverage if you are in-between opportunities?
  • How do you decide the right path based on your circumstances?

These are all excellent questions to answer as you are deciding on health insurance coverage for you and your family. If you are going with investigate a plan on the Healthcare Exchange, there are some important dates and details you need.

  • Open Enrollment begins November 15th and ends February 15th.
  • You must select and enroll in a plan within that time frame to receive coverage.
  • The only way to get coverage outside this time frame is due to a qualifying event.
  • If you select coverage in November or December, your effective date will be January 1, 2015.

Now let’s talk in-network doctors for ACA plans.

In the past there were challenges with some doctors accepting plans from the Exchange. Most of these issues have since been resolved. However, just like any plan change, it is important that you find out if your doctor is accepting the plan you intend to choose. If not, is there a comparable doctor in the network you can choose. It will take a little detective work, but will be worth it and avoid unpleasant surprises later.

OK, so you have plenty of choices, even if your current health insurance policy is going away. That is good news. There is one more fact that I think is important to clarify before you make a decision.

Everyone Must Have an ACA Plan

Don’t freak out! The truth is that every health insurance policy, unless it’s Grandfathered, must be ACA compliant; therefore, in order to have health insurance, either through your employer or purchased individually, you will need an ACA compliant plan, or risk paying the penalty. The good news is again you have choices for individual health insurance coverage. You can choose to look at options on the Healthcare Exchange or you can choose off-Exchange which is the private coverage route.

You have the right to choose whatever is best for you, your family and your beliefs. If private coverage is what you prefer, there are plenty of good individual healthcare policies available to meet your needs. We are happy to assist whether you want to pursue options on the Healthcare Exchange or private market plans. Both are widely available and we are able to provide good information so you can make the best choice.

Of course, there is the option to take the to tax penalty over purchasing insurance. There is more to consider than the cost of taking the penalty versus the cost of purchasing ACA compliant insurance. For example, what if something significant happens and you have no coverage? There are options and while these are not ACA compliant and would still require you to pay the penalty, you would have some coverage for a catastrophic need. It’s important to discuss your situation with a qualified insurance benefits specialist who can walk you through all the pros and cons.

What Are the Next Steps?

As usual, there is a lot to understand and absorb, so we have distilled it down into these simple tips:

“I’m losing coverage. What should I do next?”

  1. Check your medical expense spending.  Which benefits are an absolute “must have” in your new plan?
  2. Are employer benefits available?  If so, gather information on plan rates, benefits, and the carrier.
  3. Consider both on/off exchange plans.  Subsidies may be available for plans purchased on exchange.
  4. Keep calm and call ALKALI!

”All my options are expensive and I’m not sure I can afford my employer’s insurance for me or my family. How do I decide what is best?”

That is very simple. Keep calm and call Alkali! And remember to sign up for our webinar covering all the upcoming healthcare changes.

We are here to help our local community and help you sort out the details to make the best decision. But don’t delay. We want to help everyone, but with the large volume of calls and requests, we are scheduling calls in advance and are unable to take your call immediately. Please contact us today to reserve your spot so we can provide advice and ensure you are on the right path to select the best individual health insurance coverage for you and your family!

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