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Trick or treat--Open Enrollment for individual plans starts November 1st

10-31-2017 by Colleen King

Okay, so here we are on 'All Hallows Eve'--what does this year's open enrollment for the individual market hold ?

Rate increases, yes--confusion, yes--do we all still need to be insured, yes. So far none of the 'repeal and replace' bills have gone anywhere, Trump has told the IRS not to enforce the penalties for being uninsured, but that's not official, so who knows? Of course we insurance agents will tell you you need to be insured, not just because that's how we make a living, but because we know that if something of any significance happens, you don't want to be stuck with a bill for thousands of dollars. So here goes...

The Tricks--There are a few things, not exactly tricks, but I'm using this as a 'label' for potentially negative things. Rates for the most part are going up. Anthem Blue Cross has pulled out of most of the California individual market for 2018. Three regions in northern California, they are still around. This does NOT affect anything group health insurance related or Medicare related.  This will impact most regions but particularly Ventura County, because that leaves only Blue Shield and Kaiser.

The Treats--okay, this may be a stretch, but it's a Halloween theme. Health Net in some areas is adding a 'narrow network' PPO. That could be helpful, we'll have to see as these things are case by case. 2017 they had no PPO in most of the LA area, so I'm hopeful. Oscar, the newer kid on the block, already in Los Angeles County, is expanding into Orange and San Francisco counties. This is an EPO plan, which means no out of network coverage outside of an emergency. The past couple of years they have had a very specific network, using mainly UCLA and Providence providers and facilities, but they are expanding their network. We always need to check to see who's contracted where but this could be food.

Anthem members--you MUST choose a new plan by December 15th in order to be covered January 1. If you have an older, grandfathered plan, you're fine, that's not going away yet.

Open enrollment overall will run through January 31, 2018 so if you miss the December deadline, you aren't totally out of luck. But seriously consider using an independent agent for your insurance shopping needs. There's no extra cost versus buying directly from the carrier, and we can help you figure this stuff out. And you only have one person calling to follow up, instead of one person from each carrier.

Happy Halloween!


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