Obamacare

FAQs, Part I

^3957EAB73AB5DD5D7176CF849E79CFEE91E1E0C2B9026C039B^pimgpsh_fullsize_distrAs our clients grow into educated insurance consumers, we often get a lot of questions along the way. Here we’ve compiled a list of the questions we’re most frequently asked, so you can understand some of the complexities in shopping for insurance. Make sure to check our blog weekly for the latest videos and answers to your insurance questions. Click the question below to view the full post and video.

Q1: Are there fees for working with a Crosspointe Agent?
A1: No! There are no fees for working with an agent at Crosspointe! Whether you shop online by yourself or talk to one of our expert insurance advisors, your plan premium will be the same. Another benefit of working with one of our advisors is that you’re working with an educator, not a sales person. You’re getting an expert, focused on finding the right health plan that covers you and your family or your business based on your needs. We want to help you find the plan you need, and the best part is: It’s always FREE.

Q2: How does ACA impact Small businesses?
A2: In 2015, businesses with 50 or more employees will be required to offer health insurance, but those with less than 50 employees hold no similar obligations. Many small businesses find that health insurance is their largest expenditure (second to payroll). By offering employees a group insurance plan, they may be preventing them from taking advantage of premium tax credits. These tax credits are only offered to those who do not receive benefits from their jobs or are 400% below the poverty line. Because employees may be subject to these benefits, employees could receive Federal tax credits to help pay for their insurance premiums; employers could save money themselves by not offering group insurance.

Q3: Why do I need a health insurance broker?
A3: The Internet puts a lot of information at your fingertips, including everything you ever wanted to know about health insurance. While it’s nice to have this information available, finding the right health insurance plan is important and there are a lot legislative complexities to navigate. It can be very difficult for consumers to sort out their best option on their own. The new healthcare laws impact how tax credits work and without the help of an agent, it can be hard to figure out how to use them to your advantage. Crosspointe makes the process of finding the right insurance plan simple, guiding you through your entire enrollment process. Purchasing a plan with the aid of an advisor has NO ADDITIONAL COST, so there’s no reason not to consult an expert.

Q4: How are premiums calculated?
A4: In the past, it was necessary to answer questions about everything from family history, lifestyle, employment history—everything but the kitchen sink! With the new laws and the Affordable Care Act, premiums are calculated based on: Age, where you live, whether you use tobacco or not, and household income. If your household income is at or below four times the federal poverty level, the cost of your plan will be reduced to make it more affordable. You also won’t have to worry about seeing your rates increase or being denied coverage based on a pre-existing health condition. You cannot be turned down or charged more; only the above four factors apply.

Q5: How do I know if I qualify for tax credits?
A5: Tax credits are based on household size and income, and will come in the form of an immediate reduction on the cost of the insurance plan that you choose, allowing those eligible the freedom to choose the plan that makes the most sense for their lifestyle. If you are a small business owner, self-employed or don’t have coverage through your job, you may be eligible for a tax credit.

Q6: I don’t want to use Obamacare (Patient Protection and Affordable Health Care Law). What are my options with insurance?
A6: The Affordable Care Act is a collection of rules and regulations related to how health insurance operates in America. The ACA is not an insurance program. In the law, there are two main components that are meant to help make health insurance more affordable for the general population. The first ensures that you or a loved one cannot be denied or charged more for coverage due to a pre-existing health condition. The second element allows for tax credits for reducing health care cost depending on access to health insurance coverage, your income, and employment.

Check out our blog for more videos and more answers, coming soon!

How are health insurance premiums calculated?

Q4: How are your premiums calculated?

A: In the past, it was necessary for you to answer questions about your health and everything from family history, lifestyle, jobs you’ve had, to the kitchen sink! With the new laws and ACA, premiums are calculated based on: Age, where you live, smoker or not, and household income. If your household income is at or below four times the federal poverty level, ($46,680 for a household of one, $62,920 for a household of two, $95,400 for a household of four, etc.) the cost of your plan will be reduced to make it more affordable. You also won’t have to worry about seeing your rates increase or being denied coverage based on a preexisting health condition. You cannot be turned down or charged more. Only the above four factors apply.

Affordable Care Act and Small Businesses

Q2: How does the Patient Care and Affordable Care Act (ACA) impact small businesses?

A: In 2015, businesses with 50 or more employees will be required to offer health insurance, but less than 50 holds no similar obligations. Many small businesses (less than 50 employees) find that health insurance is their largest expenditure second to payroll. By offering their employees a group insurance plan, they may be preventing them from taking advantage of premium tax credits, only offered to those who do not receive health benefits with their job and meet certain guidelines on household income. Both employers and employees may benefit from individual insurance plans.

For more information about the Affordable Care Act and your small business, contact Crosspointe Insurance Advisors.

Q: So What’s the Truth, Can I Keep My Current Health Coverage or Not?

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Q: So what’s the truth, can I keep my current health coverage or not?

A: Well, there’s a very technical term we use in the insurance industry as a response to this question … “kinda sorta.”  All kidding aside, there has been a lot of mention in the media over the past week about people receiving letters from their insurance carrier notifying them their coverage is ending.

In some cases you can take this at face value.  There are carriers who have decided not to offer plans that comply with the new Affordable Care Act guidelines.  In this case, you will be forced to make a change in your coverage and timing is everything.  If you determine you are not subsidy eligible (you can read more about that here), it is important to change to a new plan before January 1st, 2014.  If you are going to be eligible for a federal tax credit subsidy, you’ll likely wait to start your coverage until January 1st to capture the additional savings.

The carriers that are not offering ACA compliant plans in 2014 are in the minority.  In most cases, you will have the option to elect an early renewal for your current plan which will extend the ability to keep your current coverage in place through the end of 2014. For individuals and families who are not subsidy eligible due to income or access to coverage through their employer, this will likely be the preferred option.  This is because new ACA compliant plans will be significantly more expensive than current costs. Unfortunately, we can only delay the inevitable rather than avoid it entirely. Everyone will be forced to change to an ACA compliant health plan in 2015, but we are optimistic there will be some legislative fixes to provide relief by then.

Decisions like these are complicated and the stakes are VERY high to make the right call.  We specialize in helping you put the right strategy in place and keeping the process simple.  Don’t fight through the headaches of Healthcare.gov and the state marketplaces, we can do it for you quickly and easily … and we don’t cost you a dime.

Health Insurance – What to do now?

As we’re sure you’re aware, the Federal Marketplace Website has been having significant issues not allowing people to view quotes and enroll in coverage as advertised.  Hopefully, it will be fixed in the next month, but there’s plenty of work to do now.

At a very basic level, the law can be boiled down to two main changes:  

  • Your eligibility for coverage and rate you pay will no longer be determined based on your health.  All plans will be “community rated” and priced according to the following three factors: Age, Area of Residence, and Tobacco Use
  • If your 2014 household income is below 400% of the Federal Poverty Level and you do not have health coverage available through your employer, you will likely be eligible for a federal tax credit subsidy to offset some or all of the cost for your plan. The following graph illustrates where the household incomes fall based on household size (up the left) and percentage of the federal poverty level (across the top).

Chart

If you are subsidy eligible, we can help you enroll in a plan that takes full advantage of the federal subsidies available to you once the marketplaces are operational.  If you decide on a plan and are able to start and application on your own, you’ll find my broker information below.  It doesn’t cost you anything to add an agent to your policy, but will be very valuable in helping you navigate questions, coverage issues, etc.

If you determine from above that you and your family are NOT subsidy eligible, YOU SHOULD NOT use the marketplace website.  There are likely better options available for you outside of this marketplace.  Many major insurance carriers have opted not to participate in the marketplace and you will not see those options available if you search there exclusively.

You have until December 15th, 2013 to make the right decision.  If you don’t have the right information you could end up paying thousands more for your coverage.  That’s where we come along side and advise you on the best strategy for your situation … and our compensation comes directly from the carrier at no cost to you.

If you decide to start a new application on healthcare.gov or kyenroll.ky.gov (in Kentucky) without me, please add my information on the page that asks, “Tell us if you’re getting help from one of these people.”  Select “Agent or Broker” and fill in all four of the applicable following fields:

  • First Name: Joshua
  • Last Name: Mushlock
  • FFM User ID: jmushlock
  • NPN Number: 8181538

 

Actively working for you,

Josh Mushlock

Co-Founder, Crosspointe Insurance Advisors

 

 

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”