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04-08-2017by Colleen King
Good question--One of the industry experts I heard speak on a conference call a couple of weeks ago said that anything around repeal is going to require 60 votes, and there are 2 chances of that happening--slim and none, and slim just left town. So the best we can hope for is amending, fixing, the existing law. Personally, I'd be okay with that, depending on what the fixes are.
Trump’s plan included serious cuts to Medicaid, aka MediCal in California. That’s a problem since about 30% of the state is on MediCal. There was some talk of revamping the premium rate structure, from a 3:1 to a 5:1 ratio—currently the highest rates cannot be more than 3 times the lowest which is part of what drives rates up for younger people, because health care costs for those of us for ‘a certain age’ are higher.
Plan designs need to be revised also—the Gold level and especially the Platinum level are for the most part are unsustainable, they cost a LOT to maintain. And not everyone wants all the bells and whistles included with the new designs.
So what happens to subsidies, plan designs,
eligibility—time will tell. Hopefully calmer heads will prevail.
12-02-2016by Colleen King
I have people ask me this everyday--Now that Trump has been elected President, what's going to happen to our health insurance? Is it going away, is it going to get more expensive, is it going to get less expensive? Are the subsidies going away, are we going to single payer?
Right now, nobody knows. The chant of 'repeal and replace' isn't entirely practical. This is going to take planning, it's not going to be something fixed, corrected or changed by Tweets. Rather than rehash a bunch of stuff, I ask that you check out this article which is an interview with Robert Laszewski, a highly respected expert, and what he thinks will, could or should happen. http://www.vox.com/policy-and-politics/2016/12/1/13807028/obamacare-repeal-delay-republicans
Take a few minutes to read this, it will give you some insight, and hopefully calm the concerns that it's all going away the day Trump takes office.
11-10-2016by Colleen King
In a word, NOTHING. It's November 9th, day after THE election. Sun came up, most birds were still singing, but as far as health insurance and the god awful rates we're looking at for 2017, nothing will change right now.
First of all, Trump doesn't take office until January. When he does I hope he will have been spending a lot of time on building teams to look at many areas, especially health care and how to fix the Unaffordable Care Act. In case he or any of his team catch my blog, I have some opinions of what could help. And no, I don't have the stats to back how much could be saved, or insurance costs could be cut--this is just gut instinct:
That's it for now. I'm sure there's more, like oh, cost containment in the pharmaceutical industry? I'm done....for now....
11-02-2016by Colleen King
One of the main reasons people tend to like PPOs, unless they've had a good HMO experience, is the freedom to choose which doctors they go to. You can see someone contracted with your health plan, or not. If they aren't contracted, you pay more of the cost. And there is no 'discounted,' contracted rate to help contain your costs.
So when Covered CA came out this year and dictated that even if you have a PPO you will be assigned to a primary care provider (PCP) agents were very alarmed, because we knew the phone would start ringing. No, you still have a PPO, you just have a PCP to go with it. Here are the points, good, bad or indifferent, that you need to know about this new thing for 2017:
So, is this going to make a difference, will it increase the use of preventive services? Dunno. Is it going to improve the quality of care? Maybe. Are patients and doctors going to like this? Remains to be seen. Just another change in our health care system that supposedly wasn't going to change once the ACA hit. So stay tuned....
10-27-2016by Colleen King
Okay, it's hit the news, yes my phone is ringing, and yes the email volume is definitely up. Nightly news came out yesterday talking about how rates were going to be going up 25% in 2017. This is true, and some are going up more--I have clients whose rates are going up as much as 35%. So now what?
Covered California, the health benefits exchange here it the Golden State, has been saying that the average rate increase is just over 13%, but that's okay, because about 90% of consumers received financial assistance. That's not what I'm seeing, nor my peers. While Covered CA is putting out a good effort, the reason why there's such a high number of enrollees that are subsidized is that most agents only put cases through Covered CA if their clients are potentially eligible for assistance. Otherwise, it's a more lengthy application to do, and there have been problems. Definitely an improvement over the fall of 2013 when this insanity started, but there are problems.
I'm being challenged on that statement by some, about subsidies, but I know how I do things, and a lot of my agent peers. And I've not seen the math on this 13% 'average' number. Is that factoring in the new MediCal enrollees, most of whom don't have a payment, not sure. But when you have a plan that is offered both on and off Covered CA, by state law, it has to be 'the same'--meaning same benefits, same network and same rate. So why are the 'off exchange' plans so high? Whether they are on and off exchange plans, or off exchange only, things are shooting up.
Long story short, you have to 'shop' your plan. We have fewer choices, but check with an independent agent in order to be sure you aren't paying more than you have to.