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Health & Fitness

Preparing for Health Reform

You will most certainly be affected by Health Reform unless you have a solid company group plan that will meet the new requirements for coverage.  Here’s a snapshot of the status (Individual market) and what we need to plan for:

Exchanges:   Now called marketplaces they are to be up and running for enrollment by October 1, 2013 through March, 2014 with a first effective date of January 1, 2014.  To date I understand Blue Cross/Blue Shield, Humana, Kaiser, Alliant, and Peach State are signed up.  Some major carriers are not offering federal exchange plans.  Those not in the exchange would be offering plans privately.  Note…You must hit your enrollment period!

Individual Subsidies/Tax Credits:  If your income is between 100 – 400% of the federal poverty level you may qualify for these.  However, you must buy from the federal marketplace to obtain these.  It is estimated 70% of us could qualify.

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“Compliant Plans”:  That is the plan complies with the individual mandate which includes the Essential Health Benefits and adequate benefits to hit actuarial values (catastrophic, bronze, silver, gold, platinum plans).  If you don’t have a compliant plan you could be subject to a penalty (tax?).

Your Current Insurance:  Many carriers are extending enrollments through December 30 of next year.  It is likely most carriers will then only offer compliant plans.  If you obtained your health insurance before March, 2010 you may be grandfathered and good to go. 

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Professionals:  Health Insurance Agents need to pass certification training to help consumers with the marketplace.  This is in addition to normal licensing.  Navigators may also become available.

Time is approaching to plan for next year and make decisions based on a complete review of your options.  This includes:

1.       Obtaining data from your carrier on existing or compliant plan options.

2.       Assessing your income or potential penalty.

3.       Assessing your insurance needs.

Still Unknown:

·         Final plan designs and new premium data (late September).

·         Any political mid-course changes.

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