February 2022
Market Report
Oregon and Washington
Industry News

  • Marketplace Special Enrollment Period
  • 1095-A and other Tax Forms
  • No Surprises Act
  • Medicare planning
  • Small Business Health Insurance Programs
  • Life Insurance
  • Disability Insurance
  • Program Spotlight
  • What we are reading
  • Connect with Laughlin Insurance

Agency News

  • WiredEnroll is our small employer quoting and enrollment system
  • HealthSherpa is our individual health and dental shopping site
  • Customer Ratings & Reviews for Laughlin Insurance
  • Welcome Katie and Rachel
Marketplace Special Open Enrollment Period

There is a new Special Enrollment Period (SEP) available to lower income consumers allowing them to enroll in Marketplace coverage anytime, if eligible. It is also possible that consumers who qualify for this SEP may also qualify for more savings the Advanced Premium Tax Credit (APTC), or Cost Share Reduction benefits (CSR). Consumers who have an estimated gross annual household income at or below 150% of the Federal Poverty Level (FPL), or about $19,320 for a household of 1 and $39,750 for a household of 4, in their state and are not eligible for Medicaid/CHIP may be eligible for this SEP.

People who are eligible for this SEP can enroll in a plan or switch plans at any time during the year, without having to experience a qualifying life event.
Starting around March 18th, people whose income is below 150% FPL will automatically get an SEP.

Check eligibility and get Individual Health and Dental Insurance Quotes HERE
1095-A and other Tax Forms

It is time to gather tax forms related to health insurance, and include them in your tax filing. If you are an Individual Health Insurance consumer on the Marketplace, then you will have a 1095-A. If you have health insurance thorough your job, Medicaid, other sources, or if you have a waiver, then you may have different tax forms.

If you are an individual marketplace consumer, then it is recommended that you keep tax returns current to avoid potential disruption of the Advanced Premium Tax Credit (APTC), or Cost Sharing Reduction benefits (CSR). The IRS announced that for tax year 2020, taxpayers with excess 2020 APTC, are not required to reconcile their APTC with the amount of premium tax credits. Read more HERE.

Form 1095-A is furnished by the Health Insurance Marketplaces to the IRS and to Individuals who enroll in a qualified health plan through the Health Insurance Marketplaces. The form allows individuals to take the APTC, and reconcile the credit on their tax returns with the advanced payments of the premium tax credit, and file an accurate tax return.

Form 1095-B is used to report certain information to the IRS and to taxpayers about individuals who are covered by minimum essential coverage and therefore are not liable for the individual shared responsibility payment.

Form 1095-C is filed and furnished to any employee of an Applicable Large Employer (ALE) who is a fill-time employee for one or months of the calendar year. ALE members must report that information for all twelve months of the calendar year.

Form 8962: This is the APTC reconciliation form that is used to reconcile your premium tax credit, on your tax return. This form will determine if you have excess APTC, or if you will have repayment for some or all of the APTC you received for the year. There are various APTC repayment calculators.

Advanced Premium Tax Credit Resources

No Surprises Act

Starting January 1, 2022, the federal No Surprises Act protects consumers from excessive out-of-pocket costs. Emergency services will continue to be covered without prior authorization, and regardless of whether a provider or facility is in-network.

Balance billing is an unexpected balance bill. This can happen when patients can't control who's involved in their care - say, in an emergency, or when they've scheduled a visit in an in-network facility but are unexpectedly treated by an out-of-network provider

Members are protected from unexpected balance billing for:

  • Emergency Services
  • Certain services at in-network hospitals or ambulatory surgical centers

The law also states that if treated by a telehealth clinician, you can only be billed the in-network rate.
Medicare Panning

Medicare is the Federal Health Insurance program for people who are 65 or older, certain younger people with disabilities, or people with end-stage renal disease (ESRD), and is managed by the Social Security Office.

Medicare Advantage Prescription Drug Plans (MAPD), Medicare Supplement Plans (MediGap), and Medicare Prescription Drug Plans (PDP), are offered by private health insurance companies. Original Medicare pays for much, but not all, of the cost for covered health care services and supplies. This is why those eligible for Medicare usually purchased a Medicare Advantage Plan or Medicare Supplement plan to add to Original Medicare.

We offer numerous Medicare Advantage and Supplement plan options and are here to help when you are ready. The Social Security Office and Medicare can be busy, and it may take additional time for processing your Medicare and Social Security requests, due to the high volume of people enrolling in Medicare. We recommend that you begin planning and preparing for your Medicare, as much as 6 to 12 months in advance. Follow the steps below for a smooth transition to your Medicare programs.

  • Enroll in Medicare Part A (hospital) and B (doctor) by calling Social Security (800) 772-1213, or enrolling online at https://www.ssa.gov/.
  • Let Social Security know if you want to take your Social Security income, or if you want to defer it to a later date
  • Check your Medicare Part B or D fees HERE
  • Make a list of your doctors, prescriptions, preferred retail pharmacy location, and give this information to your agent
  • Sign and return the Medicare Scope of Appointment form for your agent, so they can give you details about Medicare Advantage Plans
  • Review options with your agent and submit enrollment request for the plans you want. Advanced submission of 3-4 weeks is recommended to allow for proper processing
  • Be sure to cancel or confirm termination of any plan that you are terminating and replacing with Medicare
  • If you have a spouse still that is not Medicare eligible, then we can help with individual marketplace plans and possible tax credit.

Other Medicare Information

  • If you become Medicare eligible and will continue to work, it will be important for you to know if your employer has 20 or more employees or if they have fewer than 20 employees. The number of employees at your employer affects Medicare.
  • If you are enrolled on an employer health plan, and the employer has fewer than 20 employees, then it is recommended and in your best interest to enroll in Medicare Part B and then enroll in the group Medicare plan, or leave the group health plan and purchase individual Medicare Advantage or Supplement/Prescription Drug Plan.
  • If you enroll in Medicare Part A and B and defer your social security income, then Social Security will bill you for Medicare Part B on a quarterly premium statement, but bank draft may be available
  • Travel benefits vary by Medicare program
  • Low Income Subsidy or other programs can help lower Medicare costs

Learn more about Medicare basics HERE.
Small Business Health Insurance Programs

Group health plans are employer sponsored plans that provide healthcare to employees and their families. With a group health insurance plan, you can provide your employees with health insurance benefits that they may not be able to afford themselves. Below are some benefits to having a small group health plan.

  • Small Business Health Care Tax Credit
  • IRS favorable tax treatment with 125b payroll tax savings
  • Easier access and enrollment for employees
  • Employee Contributions
  • Option to have a low cost plan, and possible buy up options
  • Employee hire and retention tool
  • Stable market, products, and pricing
  • Broad Provider Networks not usually available on individual plans
  • Tax deductible business expense for employers
  • Helps employees and owners avoid complex marketplace
  • Easy online enrollment and administration
  • Broker support

Let us know if you need a group health plan, or if you need a plan and cost review for an existing group plan, or if you want to learn more about the favorable tax treatment, and small business health care tax credit.
Life Insurance

Life Insurance provides cash to your beneficiaries when you die. This money helps to replace the income that you would have provided to the family during your working years, and also can pay for final expenses, family living expenses, debts, mortgage payments, education, childcare, and more. The benefit protects your family financially, and even a smaller life insurance policy can make a big difference. We offer numerous life insurance options for individuals and employers and can usually have proposals ready for you in 24-48 hours.

Individuals can usually purchase from $50,000 to $1 Million of life insurance coverage, and can usually purchase a life insurance benefit that is from 1x to 10 times annual gross income. Rates vary based on age, gender, health history, family history, tobacco use, and other factors. This type of life insurance is usually the lowest cost, and often lower than expected by those we help. An application and paramedical exam are usually required and decisions from the life insurance underwriters usually take about a week or two.

Employers may also purchase group life insurance. The group life insurance is typically flat $25,000 or $50,000 with matching Accidental Death 7 dismemberment coverage. Some employers may purchase life insurance benefits equal to 1-3 times employee salary, or more.

Although Term Life Insurance is most common, there is also Universal Life Insurance that requires more premium, but benefits ;may last longer, and there may be guaranteed values in this type of policy.

Request Individual Quotes HERE.
Request group Life Insurance Quotes HERE.
Disability Insurance

Many Americans can't afford to miss a paycheck, but most of us are not financially prepared in the event of an emergency. Disability insurance protects your paycheck by replacing a portion of your income if you are not able to work. We offer many disability programs, and can help find the best program to protect your income.

Individuals may purchase individual Disability Income policies that will replace about 66.75% of pre-disability income, and will be tax free income. There are numerous optional riders that you can select to enhance then coverage. Request your Individual Disability Income Replacement proposal HERE.


Employers can sponsor group Long-Term and Short-Term Disability insurance for employees. This program is usually paid 100% by the employer. This program typically pays about 60% of employee pre-disability gross income, and is taxable. Since the employer group disability benefit usually pays at about 60% and is taxable, the employees are encouraged to confirm if the net benefit will be adequate for their income replacement needs, or if they may want to consider purchasing a private partial disability policy, that can give additional tax free cash, to go with the employer benefit.


We are here to help you review your disability income protection needs, and provide you with solutions that can meet this often overlooked gap in most peoples insurance needs.

Request Individual Disability Quote HERE
Request Group Disability Quote HERE
Agency News

  • WiredEnroll is our Small Employer quoting and enrollment system. If you are a small employer and want quick turn around for small group health plan rates, live web based spreadsheet comparisons, and online web based enrollment, then we can help you with easy online small group reviews and enrollment.

  • HealthSherpa is our individual health and dental shopping and enrollment service. Check out our individual health and dental shopping site here. When you use our eligibility, shopping and enrollment website, be sure to watch for any emails from noreply@healthsherpa.com for information and information about your quotes, or enrollment activity.

  • Katie Ostgarden and Rachel Laughlin have joined our agency team, and are bringing additional licensed agent support to help meet the growing demand for our specialized services from employers, individuals, and Medicare Beneficiaries. Katie graduated from Warner Pacific University with a Bachelors Degree in Business Administration, and a Minor in Marketing. Rachel graduated from Portland State University with a Bachelors Degree in Health Science. Rachel and Katie are both licensed, Marketplace certified, and have credentials to help you with Medicare, and to continue to provide the high quality of services that we have been providing since 1997.

  • Positive Customer Feedback Continues. Read Customer Ratings & Reviews for Laughlin Insurance, Inc., and leave your own feedback HERE.


Program Spotlight

Coredocuments.com is a compliance document vendor for employers. They provide ERISA Wrap Document, 125b Pre-tax program services, and other compliance services for employers for reasonable fees. There are a lot of administrators that offer different levels of service and fees, but Core Documents is an affordable solution for your compliance needs. We can help employers with Core Document programs and setup. Read more about Core Documents here.

What we are reading
Connect with Laughlin Insurance

Paris Laughlin, President, Agent
(503) 282-0827 Office
(503) 936-0891 Mobile

Stuart Ouellette, Agent
(503) 282-0827 Office
(503) 730-9022 Mobile

Rachel Laughlin, Agent
(503) 282-0827 Office

Katie Ostgarden, Agent
(503) 282-0827 Office

503-282-0827 Office | (503) 282-0830 Fax | (877) 779-0788 Toll-Free

Laughlin Insurance Market Report is a periodic publication featuring the latest news of interest to employer, individual, and Medicare health insurance consumers throughout Oregon and Washington.
Laughlin Insurance - Since 1997

provided herein.