Saturday, December 9, 2017

Open Enrollment Ends December 15, 2017

Unlike prior years, open enrollment ends Friday, December 15, 2017.  If you need to make changes to an existing plan, update household information for subsidy purposes, or just enroll in a plan for the first time, don't wait.

I recommend completing the enrollment process by December 14th.  Too many wait until the last day which can cause system issues and delays.

If you want to chat, please feel free to click on my schedule link.  Slots are filling fast.  If you don't see a time that works for you, call me at 704-436-4136 and I'll do my best to accommodate your schedule.



Tuesday, December 5, 2017

Mission Health Is Back

Mission Health will be back in the Blue Cross and Blue Shield of NC network effective December 15, 2017.  This means that members will be able to resume receiving in-network care at Mission Health facilities.

This is good news for our members in Western North Carolina.  More providers means more choice.  I'm glad to hear Mission Health, Park Ridge Health and other providers will continue to be available in 2018.


Wednesday, October 25, 2017

2018 Open Enrollment is Nov 1st - Dec 15th 2017

Open enrollment for individual/family medical plans is November 1st through December 15th 2017.  New enrollments and renewals must be completed during this time for a January 1st start date.  In the past, open enrollment was extended, allowing for start dates in February and March.  That is no longer allowed unless you are eligible for a special enrollment period.  

If you have a grandfathered plan ending at the end of 2017, you may be eligible for an SEP.

BCBSNC has consolidated their ACA offerings for 2018.  While they are still offering different networks depending on your county of residence, the metallic levels have changed to four options.

  • Bronze 6650
  • Silver 7000
  • Silver 4000
  • Gold 2500

The number in the name is your deductible.  Deductibles go into play when you have diagnostic services like MRIs, X Rays, special blood panels, or a hospital stay.

The out of pocket maximum, which is established by the government and the Centers for Medicare and Medicaid, has increased from $7150 in 2017 to $7350 in 2018 for in network charges.  Your out of pocket maximum includes your co-payments, prescription costs, and deductible.  In other words, if you have an in network hospital stay for a week, the most you'll pay, according to the law, is $7350 for 2018.  Once you reach that, as long as you make your premium payment, your carrier will pay the rest of your in network covered medical expenses for the rest of 2018.  [*Covered medical expenses must be considered a medical necessity and prior approval may be required.]

However, your deductible and your out of pocket maximum may be lowered considerably based on your income.  I can help you find out if you're eligible for these additional cost share reductions.  

If you have an HSA (Health Savings Account) eligible plan, your out of pocket is capped at $6650 hence the name "Bronze 6650" above.

Please feel free to reach out to me with questions.  I'm happy to help you navigate your options.






Thursday, October 19, 2017

Mission Health is Out of Network for BCBSNC

Customers in Western North Carolina may be impacted by Mission Health's decision to terminate their contract with BCBSNC®.   

There are other provider options available, including Park Ridge Health.  Customers may qualify for a continuity of care program but must contact customer service by November 19, 2017.  And as always, in an emergency, members should always go to the nearest hospital.



Wednesday, October 18, 2017

CaroMont Health joins Blue Value Network 2018


Members in Cleveland, Gaston and Lincoln counties were limited to three networks in 2017: Blue Advantage, Blue Select and Blue Local.  Blue Advantage and Blue Select are larger networks which require higher premiums.  And Blue Local, with the lowest premium, is limited to Carolina's Healthcare System only. 

Members could only see providers in the CaroMont Health network if they paid the higher premiums for the larger networks.

Beginning in 2018, CaroMont Health will be added to the Blue Value network which means members have more choices and may pay a lower premium if they are willing to go with a limited network.   If all of your providers are in the Blue Value network, it may be worth making a change in 2018.

This is great news!


  



Monday, October 9, 2017

Grandfathered Plans Expiring December 31, 2017

BCBSNC will no longer offer its grandfathered health plans as of January 1, 2018.  If you have kept your grandfathered plan, you will need to transition to an Affordable Care Act (ACA) plan during open enrollment beginning November 1, 2017.

BCBSNC will attempt to match you to a plan with similar benefits.  Depending on your area, you may find yourself with a limited network moving forward.  In the Charlotte Metro area, there are two networks - Blue Local with Carolina's Healthcare System and Blue Value which includes Novant and other participating providers.  In the Raleigh-Durham area, there are two networks - Blue Local with Duke Health and WakeMed and Blue Value which includes UNC Health Care, REX Healthcare and other participating providers.

You can also expect rate increases which you'll be notified about in writing.  You may be eligible for a subsidy depending on your household size and income.

If you'd like assistance navigating your options, feel free to reach out to me if there is no agent listed on the notices you receive from BCBSNC.



Thursday, February 2, 2017

Open Enrollment Ended January 31st

The next open enrollment begins November 1, 2017.  As I receive updates on new legislation, I will keep you posted.

You can still enroll in a BCBSNC® plan as long as you qualify for a Special Enrollment Period (SEP) due to a Qualifying Life Event (QLE).  Here are a few examples:
  • Getting married
  • Having a baby, adopting a child or placing a child for adoption or foster care
  • Losing other health coverage
  • Moving to a new residence
  • Gaining citizenship or lawful presence in the US

If you’re not eligible for the special enrollment period, consider enrolling in a short term plan.  Short term plans do not provide minimum essential benefits required by the Affordable Care Act, but many of my clients use this option if they missed open enrollment or if they only need it as a stop gap before their employer coverage begins.  Coverage can begin within 48 hours and there are a number of plans to choose from including ones with copayments to see primary care physicians.

Reminder:  Without an ACA plan, you may have to pay a shared responsibility payment (penalty) when you file your tax returns next year. Please speak with your accountant for further details.

Monday, January 2, 2017

Open Enrollment Ends January 31st

Open Enrollment ends January 31, 2017.  If you haven't already enrolled in a plan for 2017, there is still time.  Without credible coverage, you will be responsible for paying the tax penalty.  You must have your plan for 10 of 12 months in 2017 to avoid paying the penalty.

  • New plans chosen by January 15th will have a February 1st start date.
  • New plans chosen between January 16th and the 31st will have a March 1st start date.

After January 31st, open enrollment is over and you can only get a plan if you are eligible for a "special enrollment period."