Laughlin Insurance Newsletter
In This Issue
Affordable Care Act Update
Health Insurance Marketplace Updates
Helpful terms
Online Membership and Billing
Carrier News and other Resources
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Oregon | Washington 

 June 2015


Thank you for reading our agency newsletter.  We hope you find the information and resources to be helpful.  We focus mainly on health insurance for individuals and employers, but we also offer many other programs including disability income protection plans, and life insurance.  Read more here.

 

There have been many changes to health insurance resulting from the Affordable Care Act.  Most of the new requirements and improvements are now in place.  Please continue reading our newsletter and let us know your questions and how we can help you with your group or individual insurance needs.   

      
  
Affordable Care Act Update
 
The Affordable Care Act of 2010 has been mostly implemented.  Many of the new provisions are now commonplace including guaranteed issue plans, free in-network preventive care, a lower out of pocket maximum, and much more.  Many individuals and small employers are also receiving financial assistance from tax credits.  Read more  here. 

Below are some additional details about individual an employer health insurance.
  
Individuals

  • The 2016 individual health insurance open enrollment begins on November 1, 2015 and runs through January 31, 2016. Read more here.  Contact us for enrollment services.

  • Get ready to apply for 2016 health insurance coverage.  For instructions on how to prepare for enrollment, click here or give us a call for assistance.

  • The Advanced Premium Tax Credit can help pay your monthly health insurance premiums.   

  • Consumers may only purchase a qualified health plan during the January open enrollment unless they have a Qualifying Life Event. 

Employers

  • The Small Employer Health Options Plan (SHOP) web based health insurance system is not expected to start in Oregon for 2016.  Employers who want a health insurance tax credit must purchase a group plan through a qualified carrier, and have a qualified plan option.  A qualified plan certificate can then be requested by your health plan or the Oregon Health Insurance Marketplace to provide to tax advisor for final benefit determination.
     
  • Some Oregon health insurance carriers have approval to extend non-qualified small group options again for 2015.  These older plans may not include certain protections of the law and can be more expensive.
     
  • Employers with 50 to 100 are expected to be required to contribute to a basic health insurance package starting January 1, 2016.  We will have quick turnaround on rates and options for employers of this size, so give us a call for assistance.   
     
  • The employer health insurance group size rules may change for 2016.  The Affordable Care Act requires that a small employer be an employer with 1-100 employees starting January 1, 2016.  This federal requirement is undetermined.  Oregon may implement this new rule for 2016.  More details will be coming as the 2016 rules are clarified.

We are here to help individual and employers understand the new health marketplace, challenges and opportunities.  

 
Health Insurance Marketplace Updates

 

The Federally facilitated Marketplace (healthcare.gov) has been the marketplace for Oregon individual health insurance consumers for the 2015 plan year.  This new system is working well and we have had many successful enrolments happening at our office.     

 

Washington Healthplanfinder is the health insurance exchange for the state of Washington.  This exchange is working well for individuals and small employer plans are available also.  We will soon have the 2016 rates and benefits for individual and small employer health insurance for Washington.  

 
Helpful terms

 

Below are some terms related to individual health insurance that you may find useful;

  • Advanced Premium Tax Credit.  This is a tax credit that many consumers can get to help pay monthly health insurance premiums.  We can tell you if you are qualified for the tax credit.  The tax credit is based on household gross income, so you will want to have this information ready when you call in.  Read more here.
     
  • Cost Sharing Reduction plan.  This program is part of the Affordable Care Act and can help you pay for copays, deductibles, and out of pocket expenses.  Read more here. 
     
  • Special Enrollment Period.  After February 15, 2015, you can enroll in a 2015 health insurance plan only if you have a life event that qualifies you for a Special Enrollment Period.  Read more here.
     
  • We have a glossary of insurance available for you here. 
Online membership and Billing

Online membership and Billing is available at many insurance carriers.  Individuals and employer administrators can set up online accounts, complete necessary maintenance, setup bank draft premium payments, and more.  

There is an increased interest in the online resources and administration for policyholders.  Contact us today if you need help setting up electronic account for access to your health insurance programs.             
    
Carrier News and Other Resources
  
Some carrier and news updates are provided below;