Obamacare is coming! In just a few short weeks, Covered California, California’s state-based health insurance exchange, will begin accepting applications for new Obamacare-compliant health plans that will start in January of 2014. This guide is designed to help you, the California consumer, match your current situation to the choices you will have when enrolling in your new plan this fall.
First, let’s address those of you who are uninsured or considering going uninsured in 2014. One of the major provisions of the Affordable Care Act aka Obamacare is the individual mandate. This is the requirement to obtain a qualified health insurance plan, or pay a penalty tax. The 2014 tax is $95 or 1% of income, whichever is GREATER. If you make more than $9,500 per year in household income, this means the tax will be at the 1% rate rather than at the often-quoted $95.
Now for those of you who currently have individual insurance policies in California- you will fall in one of three categories
1) You have a carrier that is leaving the California market (AETNA, UnitedHealth/Pacificare)
Whether your plan is grandfathered or not, your plan will expire on 12/31/13, and your carrier will no longer insure you in any way in 2014. In the meantime, you can continue to use the plan just as you would normally. Starting October 1, you can enroll in a guaranteed issue plan with another participating carrier, meaning you can’t be denied for having a pre-existing condition. This plan will start January 1, 2014- right when your Aetna plan is expiring. You can secure this plan as you do now- privately, directly through a new carrier other than Aetna, or you can secure this plan through the newly-created state-based exchange.
Unless grandfathered, your plan will also expire on 12/31/13, however your carrier will still be active in the California market. You will be able to continue with your current carrier, but must move to a new, Obamacare-compliant plan. You can get this plan privately and directly through the carrier as you do now, or you can go through Covered California, the state-based exchange. The exchange is the only place to get your government subsidy. If you’re not eligible for a subsidy, you may want to continue purchasing privately. Some carriers will even automatically map you on to a new plan and allow you to continue on without filling out a new complete application. Whichever route you choose to go, enrollment will begin October 1 for a January 1, 2014 effective date.
Blue Shield has released further information on the 2014 transition at their 8/20/2013 ACA rollout event.
- You will be receiving a letter in mid-September outlining your specific options.
- Non-grandfathered plans will be mapped to a new ACA-compliant plans.
- Grandfathered members can keep their plan.
- Off exchange: The plans are robust and the application process will be simple to execute, and we at Quotebroker will walk you through the process when the time comes.
- On exchange: The plans and application process can be more involved. Quotebroker will be there to assist you in the entire process of qualifying for subsidies (involving tax info), choosing the right plan, selecting a network, applying the subsidy to your chosen plan and enrolling in that same program.
3) You have a carrier not participating in the exchange that will allow you to keep your plan until renewal (CIGNA)
If you bought your CIGNA policy before 2013, this section does not apply to you- see answer number 2. If you bought your CIGNA policy in 2013: You will be given the opportunity to keep your plan through December 31, 2014- one year longer than anyone else. At that point, you will have the same options as those in answer number 2. If you would like to switch to a new Obamacare compliant plan- either inside or outside the exchange, you are welcome to but do not have to. Once open enrollment begins, you are encouraged to compare new plans available under Obamacare both to one another and to your current plan to evaluate your best course for 2014.
Millions of individual policyholders will be scrambling to make changes and secure 2014 coverage this fall. Quotebroker strongly encourages you to participate in our Obamacare Preregistration Program, as it will allow us to better assist you during open enrollment. Simply fill out the form at the link attached and your case will be assigned to a representative who will follow up and take you through the entire process from subsidy qualification to obtaining ID cards. Don’t be left behind!
*While Quotebroker maintains an up-to-the-minute working knowledge of the Affordable Care Act, regulations have been known to be delayed, changed, or eliminated entirely. All information current as of 08/12/2013.
**For further information or to speak to a licensed professional, please visit www.quotebroker.com