Ron Bliss: Medical insurance deadlines loom; some businesses dropping group plans
December 5, 2016
There are two key deadlines coming up for those who haven't dealt with their medical insurance for 2017.
First is the deadline for the Annual Enrollment Period — when those on Medicare Advantage can switch to another Medicare Advantage plan or go back to standard Medicare with gap insurance, and also choose a 2017 drug plan.
That deadline is this Wednesday, Dec. 7. If you are already in a drug plan, you will automatically roll over in that plan. But if you want to look at options, you need to call Medicare at 1-800-633-4227 before the end of the day on Dec. 7 to get options.
The other deadline looming is the Annual Open Enrollment period for major medical insurance for those not on Medicare. To be enrolled by Jan. 1, 2017, you need to make a decision by Dec. 15, 2016 – a week from Thursday.
If you are already in a plan and that plan is still being offered, you will be automatically re-enrolled as of Dec. 15 by your provider. But if you want a choice on what plan you have, you need to decide by Dec. 15.
Even if you get re-enrolled, you will be able to change for Feb. 1 by going back in to the Marketplace and changing plans by Jan. 15.
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The Open Enrollment period extends through Jan. 31, 2017. Those signing up Jan. 16 to Jan. 31 will have their coverage begin on March 1. Those who have no plan and do not sign up by Jan. 31 will face a penalty for not having credible coverage.
The agents at Affordable Healthcare Pros can help you with your medical insurance needs – whether it be Medicare or Major Medical. Call us at 775-224-7169 or 775-883-8414. There is no charge for our services. Our office is located at 2307 N. Carson Street in Carson City.
On another subject, the Affordable Care Act requirements for providing health insurance for employees extends to businesses of 50 employees and more in 2017. That's the law and those businesses must provide health insurance or get fined.
However, those with less than 50 employees are NOT facing a fine and should think twice before developing a SHOP health insurance plan for their employees. With the recent rise in rates for 2017, some with fewer than 50 employees are bailing out and letting their employees get insurance on their own – many with federal subsidies.
Those businesses that are not required to have plans could actually hurt their employees by having one because of the way the ACA reads.
Those employees who are offered health insurance by their company HAVE to accept it, if it is considered affordable.
What that does, especially if most of your employees are low-wage, is create an impossible situation for them.
We had a client last year decide to either quit her job or go to part-time because her husband was required to either buy insurance through her company's plan or buy it elsewhere – without subsidy from the government through the federal marketplace.
While her insurance was only $75 per month and was within the 9.5-percent or less limit for affordability based on her salary, the cost for her and her husband was $450 a month or 25 percent of their income.
The law reads that if the employee's cost is 9.5 percent or less of the monthly salary, it is considered affordable. And, if it is affordable for the employee, the spouse and dependents are not eligible for a subsidy on the Federal Marketplace.
The couple was caught between a rock and a hard place because if they chose not to pay the $450 per month they were facing a $1380 penalty. If just one person in the family is not covered, all are fined. The fine for adults is a minimum of $695 each this year. The fine for children is half that or $342.75 each. The fine limit for one family is $2080.
The ACA law needs to drop the spouse and family provision and give the spouse and dependents the option of either buying through the company or going elsewhere for affordable insurance, if the cost for the entire family exceeds 9.5 percent.
But until the law is changed – by the Trump administration — companies need to protect their employees by not putting a burden on them to buy unaffordable health insurance. ObamaCare will be in effect for 2017 insurance. No changes can be made until 2018, without causing chaos.
For advice on health insurance on your small business, come by and see us at 2307 N. Carson Street in Carson City or call us on our office number, 775-883-3414.
We are not limited to Northern Nevada. We can also do Covered California, for those who live in that state, or do policies on or off ObamaCare exchanges in both states.
Ron Bliss is a former long-time sports writer who has been doing health and life insurance since 2009. He is certified on both Covered California and the Nevada Health Link and can sell products on and off both exchanges. Affordable Healthcare Pros also offers a variety of dental plans to include dental-vision-hearing plans in both states, as well as a wide variety of Medicare supplements and other health supplemental products to include critical illness, disability, plans to cover in-home or nursing home costs, accidents and hospital indemnity policies. He can also refer individuals who cannot afford a supplement to Medicare Advantage plans. He can also give you the choice of a number of Life Insurance carriers, including those who offer Long-Term Care riders.