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What do I do about a ‘child only’ health insurance policy in California?

2011-01-24 by Colleen King


When health care reform was voted in last year, one of the first items that when into effect September 23, 2010 was the guarantee issue of plans to kids under age 19 without regard to pre-existing conditions. Problem with that was that insurance carriers had no idea what the liability was going to be so instead of risking a big financial hit, several opted not to write ‘child only’ policies since obviously, the most likely people to try to get coverage were those who had medical needs.

Well, the California Legislature passed a bill requiring carriers who wanted to sell in the Individual plan market in California has to participate in an ‘open enrollment’ period for kids under age 19. This all came about fairly late, there are things still to be determined but in a nutshell, here are the basics:

Open enrollment is January 1 to March 1. If you miss this time period, there is also the month of the child’s birthday.

These parameters may change in the future. These time frames do not apply to having kids on your family’s insurance plan. There are a few other circumstances so call me if you have questions.

So if you need coverage for your kids, or if you have friends with kids, please share this information with them. Call me, call your agent if you have one other than me, just get the ball rolling because time is limited!
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Category: Uncategorized



Health care reform compliance, and the IRS is going to be the monitor?

2011-01-14 by Colleen King

I came across an article recently published by USA Today that reminded me of the big wake up call we have coming in 2014 when the bulk of the health care reform measures go into effect. Check out this article by Sandra Block, “IRS lack clout to enforce mandatory health insurance.”

This article lists estimates of needing 16,000+ IRS agents to enforce this eventually. The Congressional Budget Office is estimating the cost at $5-10 billion to administer this. And that’s just the start.

My concern along with other agents in California is the price tag on all the changes. Even though people aren’t happy with rates in LA and Ventura counties, you are definitely paying less than places like Massachussettes, New York and New Jersey. And now that you are looking at eventually subsidizing people, not excluding for pre-existing conditions, rates will soar. But the IRS can’t apparently enforce these new provisions in the law.

For example–30 year old male in New York City, hospital only plan would run $176/month. No deductible, but no coverage for office visits, most outpatient care or prescriptions. Which is more of what a 30 year old would need. You could get something comparable in the SFV area for $78-99/month, but there would be a deductible.

The same 30 year old, wanting a more comprehensive plan, opts for a $2000 deductible, $30 office visits, 80/20 coverage, sounds great right? Are you willing to pay $529.06/month for that? That’s a real figure for the 10009 zip code. I can find $2500 deductible, 70/30 plans with three office visits per year with generic and brand coverage for $111/month here in the Los Angeles area.

So you might want to look for coverage now, while it’s affordable in California. No one really knows what will happen once all this starts to kick in. Pretty scary!

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What? The plan for ‘uninsurables’ is filling up? What now?

2011-01-01 by Colleen King

Geez, now this is a drag–the Pre-existing Condition Insurance Plan (PCIP) which was supposed to be such a panacea for the uninsurable apparently was too popular–in 2 months, the program might be stopping enrollment because, get this–the claim costs were 3 times higher than anticipated. Big surprise! You have to realize that when you offer ...read more