Volume 2, Number 6
Individual and Family Health Insurance News
IN THIS ISSUE...

  • OPEN ENROLLMENT ENDS DECEMBER 15
  • CVS TO ADD HEALTH SERVICES AT TEST STORES EARLY IN 2019
  • SMART TAX MOVES TO MAKE NOW
OPEN ENROLLMENT ENDS DECEMBER 15
Unless CMS extends the deadline due to last minute activity that overloads their systems, Open Enrollment for Affordable Care Act plans ends on December 15 for the Federal marketplace. Seven exchanges have expanded the deadline in their jurisdictions (DC, RI, and NY—December 31; MN--January 13; CA and CO--January 15; and MA—January 23.

Carriers offering off-marketplace (i.e. direct with the carrier) enrollments are permitted to establish different dates for open enrollment. Most carriers offering off-marketplace enrollment mirror the enrollment periods for the exchange (marketplace) that operates in their state.

Although there is some lack of clarity, it appears that Florida Blue will be offering off-exchange enrollment through December 31.  HOWEVER, just to make sure that there are no problems in enrollment we advise all clients who are considering enrolling in an off-marketplace plan with Florida Blue to complete their enrollment by December 15.

As has been the case in prior years, we expect both on- and off-marketplace systems to be overloaded the last week of open enrollment and advise clients to complete their enrollments by the end of the first week of December.

Although clients will automatically be enrolled in their existing or most similar off-marketplace plan if they don’t take action and will also be automatically enrolled in their existing on-marketplace plan IF they have a 2019 application on file (it’s critical that anyone with an on-marketplace plan contact us at 877-734-3884 to verify that they have a 2019 application on file and this application is updated for projected income and other changes like address, changes in dependents, etc.), we recommend that ALL clients contact us concerning their 2019 plan choices and that they take active action to re-enroll.

We’ve found instances where on-marketplace applicants do NOT have 2019 applications on file. If these individuals don’t actively re-enroll they will NOT have coverage for 2019. Also, healthcare.gov is requiring income and other verification even in instances where there are no changes from last year. Generally, individuals have 93 days to submit this verification. If income or other verification is required and individuals don’t update their applications and/or check their eligibility verification notices, they won’t know to submit verification and as a result will lose their 2019 subsidies and possibly even their insurance coverage.

In some cases carriers are not offering existing plans for 2019, so in these cases it is very important that individuals contact us for assistance; otherwise they will be enrolled in what the carrier considers the most similar plan, but this may not be the most appropriate plan for some people. In other situations, some carriers are not offering coverage for 2019. For example, AvMed will no longer offer coverage in Palm Beach County next year (AvMed offers only non-marketplace plans; they do not participate in the marketplace and will continue to offer coverage in Broward and Miami-Dade counties).

Please note that dental plans, accident plans, critical illness plans, and hospital indemnity plans are not subject to open enrollment requirements and that these plans are offered year-round. Hospital indemnity and accident plans are inexpensive and can be used to reduce or eliminate ACA plan deductibles for covered expenses covered by their accident and/or hospital indemnity plans. Contact us at 877-734-3884 for details and help in enrolling in one of these plans.

Note: unless individuals experience a qualifying life event, they generally will NOT be able to enroll in an Affordable Care Act plan after December 15. After open enrollment their choices will be limited to:

·         Short-term health insurance plans
·         “Limited benefits” defined benefit plans
·         Medical cost sharing plans
CVS TO ADD HEALTH SERVICES AT TEST STORES EARLY IN 2019
CVS Health finalized its acquisition of Aetna on November 28. Larry Merlo, CVS Health CEO, said the combined entity "will transform the consumer health experience and build healthier communities through a new innovative health care model that is local, easier to use, less expensive and puts consumers at the center of their care." Merlo said Aetna's abundance of financial and clinical data will permit the combined company to better engage patients in medication adherence, preventive care and chronic disease management, and CVS stores will become "more of a health care destination."

See this video for details about CVS's vision for health care's future:
Initial efforts will focus on test stores and involve members of Aetna's Medicare and individual and group plans. CVS intends to expand the concept to all stores and involve other carriers and partners.
SMART TAX MOVES TO MAKE NOW
We are not tax accountants nor do we provide tax advice, but many of our clients perform year-end tax planning. This article by Bruce Horowitz in the October 2018 AARP Bulletin contains some excellent tax planning tips.
About Paul Cholak
Paul has over forty years of benefits experience and has been Director of Employee Benefits for large companies, as well as a benefits consultant with major consulting firms. He understands the health and life insurance needs of individuals and families of all ages. He also has considerable experience in selling health and life insurance to employer groups.

We guide you through the steps of getting health and life insurance, and remain available to help you AFTER you've made your purchase decision.
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