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Crosspointe & Obamacare: What You Need to Know

What does Crosspointe Insurance Advisors have to do with the “Affordable Care Act,” also known as “Obamacare?”

First off, we are not Obamacare. In fact, other than being fully certified through the state and federal health insurance marketplaces, we aren’t affiliated with Obamacare in any way. Our guiding mission has been to help people find, understand, and enroll in health insurance coverage for the past six years.

Unlike other insurance agencies, our company started with a passion and primary focus to help individuals and families navigate the difficult challenges of shopping for health insurance. We are proud to have helped thousands of people to date choose and enroll in a health plan that makes sense for them.

Our job is not to offer a political commentary on Obamacare. Truth be told, like any reasonable person who looks at the new law, we believe there are clear advantages and disadvantages as it stands.

Most people would agree it’s a good thing to see those who were previously denied coverage based on their health history gain access to the coverage they need. However, we’re left scratching our head at the fact gross premiums have dramatically increased in the face of a law named, the “Affordable Care Act.” We also have deep questions about the economics and sustainability of the subsidies that are designed to make coverage affordable for household incomes falling below 400% of the federal poverty level.

While we continue to be a voice to our lawmakers advocating for necessary changes, we maintain our primary role is to help people navigate current realities. If you work for a large employer (50+ employees), you can expect to see very little change in your coverage and cost. However, if you fall in one of the following three categories, a short conversation with one of our advisors could make a dramatic impact:

1. Individuals and families who purchase their own health insurance coverage and expect their 2014 household income to fall below 400% of the federal poverty level.*
2. Individuals and families who purchase their own health insurance coverage and expect their 2014 household income to exceed 400% of the federal poverty level.*
3. Business owners and employees of companies with less than 50 employees.

The strategies for each group above differ greatly, but it is urgent to deploy the right game plan for each situation now, as the clock is ticking. Our experienced advisors are equipped and available to make the entire process smooth and simple. You can view real-time quotes and find more information at www.crosspointeinsurance.com or by calling us at (888) 788-1565.

Josh Mushlock
Co-Founder, Crosspointe Insurance Advisors

*Federal Poverty Level Chart
Federal Poverty Level Chart

According to the Kaiser Family Foundation:
“About half (48%) of people now buying their own insurance would be eligible for a tax credit that would offset their premium. Among those who will be eligible for tax credits, the average subsidy would be $5,548 per family”

 

Obamacare: What You Need to Know

Obamacare open enrollment begins October 1, 2013

The new health-insurance exchanges open for enrollment on Tuesday, October 1st, but a new Kaiser Family Foundation/NBC survey shows most Americans are still worried and confused about what it all means. Here’s what you need to know before day one of Obamacare:

Why bother? Isn’t the government going to shut down and stop this? Won’t Congress delay Obamacare anyway?

Even with a government shutdown, the exchanges will open as scheduled on Oct. 1. The money the federal government is using to run them doesn’t rely on appropriations from Congress. It’s far more likely that the government will shut down for a few days and then both sides will agree to keep cash flowing without bringing the health-reform law into it. Further, the Supreme Court has ruled Obamacare constitutional and it is now the law of the land.

Got insurance already? You don’t need to worry.

Most of us — 58 percent of non-elderly Americans — get health insurance through an employer, and 32 percent get government-sponsored insurance such as Medicare or Medicaid. The U.S. Census Department says about 15 percent of Americans don’t have health insurance and these are the people who should be either buying health insurance on the new exchanges, or getting it through Medicaid in the states that are offering it to more people.

The opening of the exchanges doesn’t affect anyone who already has insurance. The law does change some of the rules regarding health insurance, but the only thing happening Tuesday is the opening of the exchanges. Other changes go into effect January 01, 2014.

Some news reports have highlighted the cases of employers who have decided their workers will be better off buying insurance on the exchanges. This may be because the federal subsidies would actually lower costs for them. If you have workplace-sponsored insurance, your employer must give you a letter detailing what your options are.

What are these exchanges?

The exchanges are a new way to buy health insurance that let people compare the plans available to them and to also see, within minutes, whether the federal government will pay for part of the premiums. They’ve been compared to online sites such as Travelocity or Expedia, where people can compare the prices of airline flights across different carriers. At the same time, the sites check to make sure people are telling the truth about their income and employment.

How much will it cost?

The prices vary based on the different plans — a lot like employer-provided insurance works now. There are four tiers of coverage: bronze, silver, gold and platinum. The bronze plans usually charge lower premiums, but then you’ll be charged a higher co-pay, which means you pay each time you see a doctor or other provider, each time you fill a prescription, or each time you have a procedure. The platinum plans charge the highest premiums but provide much more care before the patient has to pay a share. In some places, young adults can also buy bare-bones catastrophic insurance for people who really think they’ll only need health care if they have an accident.

A lot depends on where you live. In some counties, a family of four with an income of $50,000 may pay $11 a month for a low-level silver plan. In other places a similar family might pay $280 a month for the same plan. This is because care costs more in different places.

Will the plans be expensive — more than plans cost now?

Some of the bare-bones plans are likely to cost more than the minimal-coverage plans on the market now, but that’s because you get much more coverage. Many of the plans available now don’t provide much coverage, and can stop paying for services once patients start running up bills. The Affordable Care Act requires insurers to provide a basic level of care, which includes free preventive services such as vaccines, mammograms and wellness checkups. They cannot cap your coverage and they can’t charge you more just because you are a woman, for instance.

Can people get help paying for the insurance?

Many people can get a federal government subsidy. It depends on how much you make and your family size, but the subsidies can be very generous. It’s a complicated formula but families with incomes of up to $94,000 might get a subsidy. There’s a calculator here that you can use to estimate what it might cost.

There’s a big exception for people who make very little money. The law assumed that states would expand Medicaid to cover people who earn less than 138 percent of the federal poverty level, which works out to $16,000 for an individual or $32,500 for a family of four. But the Supreme Court ruled that states don’t have to, and many states won’t. These people also don’t qualify for subsidies if they make less than the federal poverty level, and right now they are stuck. They’ll either have to pay full price on the exchanges, or go without insurance.

If your employer offers adequate insurance but you decide to go to the exchanges to buy some anyway, you can’t get a subsidy. But you may qualify for one if the insurance you have now isn’t adequate.

What if I don’t want to pay?

Technically, you’ll have to pay a fine, which varies depending on your income. The argument is that people without health insurance cost everyone money because they do get sick or hurt and they do go to emergency rooms and someone has to pay in the end. The Supreme Court says it’s a tax. The IRS can take the money out of any refund you have coming. In reality, it’s not clear how hard the federal government will go after holdouts.

What if I’m already sick?

That’s called a pre-existing condition. Right now, insurance companies can refuse to cover you if you’re sick, or they can refuse to pay for care for some condition, such as diabetes, if you had it before you bought insurance. Not any more. Now insurers have to cover everyone, regardless of their health or previous illnesses.

What about if people are too busy to sign up Oct. 1?

Tuesday’s just the first day that the exchanges are open for business. People have six months to sign up for health insurance during what’s called open enrollment. If you get signed up by December 15, 2013, you can start using your insurance on January 01, 2014.

So where do I go to get started?

Crosspointe Insurance Advisors can help you get started today! Click here and complete the simple, no obligation quote request and we’ll help you find plans and rates from some of the top insurance providers in the nation, all online and in minutes.

You can also call us at 1.888.788.1565 and and one of our experienced agents can help answer your questions and make recommendations.

*Excerpts originally published September 30, 2013 on NBCNews.com

Obamacare & Small Business Healthcare

The Health Care Marketplace could help you save on your group healthcare plan.

You are among America’s number one job creators, small businesses. We know you have questions – How will Obamacare affect my bottom line? What are my options? What are the important dates and deadlines?  Review the information below or contact Crosspointe Insurance Advisors for more information.

Affordable Health Care Act – Small Business Coverage

Obamacare is designed to help small businesses provide their employees with better quality healthcare coverage that includes the new rights and protections provided by the Affordable Health Care Act.

A few important items you need to be aware of include:

  • The Small Business Health Options Program (or SHOP) is part of the Health Care Marketplace, where small businesses with fewer than 50 full-time employees can shop for group health plans starting October 1st, 2013. Starting in 2017, those with 100 full-time employees or less will also be able to use the SHOP.
  • The SHOP exchanges are state-specific online marketplaces opening October 01, 2013 where employers can purchase employee insurance in a controlled market giving them the same buying power as larger firms.
  • SHOP exchanges provide all employers with equal access to quality healthcare.
  • Small businesses with fewer than 25 full-time equivalent employees with average annual wages below $50,000 can get tax credits to help pay for employee premiums.
  • Small businesses with more than 50 full-time employees with annual average wages above $250,000 must provide health coverage to full time employees beginning in 2015. This is sometimes referred to as “the employer mandate”.
  • Taxes and tax credits are based on the number of full-time equivalent employees (FTE) and their average annual wages not solely on the number of full-time employees
  • While 96% of employers won’t pay additional taxes, there is an increase to the current Medicare tax, paid by 3% of businesses.

If you are thinking about offering group health insurance benefits, or are reevaluating your insurance needs, Crosspointe Insurance Advisors can help you decide which group insurance benefits are right for your business and your employees. Click here to get a free, no-obligation quote today or call us at 1.888.788.1565 and one of our agents can help you with any questions you may have.