If "The Day the Music Died" as sung by Don McLean was when Buddy Holly crashed in a chartered airplane in 1959, we will be able to sing about a similar death of your health insurance that started in January of 2016.  Unfortunately, our healthcare system's death isn't one that will suddenly end in just one terrible event, our system's death will probably last several long and painful years.  The beginning of the end can be marked by Blue Cross Blue Shield's decision to terminate all PPO coverage for individual plans in Texas and replace it with a managed care HMO network.  Competitors of Blue Cross quickly followed suit, leaving Texans grasping at straws and hoping to find anything that could cover them with a large doctor and hospital network.  Unfortunately, many still don't understand how limited options are and won't until they need emergency health care.

Since the passage of the Affordable Care Act we've been writing that the law did nothing to control health care costs and thus was a waste of time and truthfully an effort to take people's money and subsidize others.  Oddly, things would have been better if the country would have simply offered free coverage to the poor rather than destroying the system that was actually working for many.  Now, we have a health insurance system that is offering small networks, higher deductibles, lower material benefits, and premiums that are almost 200% greater than just a few short years ago.  The worst part is that the pain is not over.  2017 will usher in a new set of significant actions that will further reduce choice, cost more, and result in an actual reduction in the number of insureds.

We're right on the cusp of the 2016 Open Enrollment Period that begins November 1st and we've received hundreds of calls from clients that found shocking news from Blue Cross, Humana, and even United Health stating that their plans are being terminated and they are being moved to an HMO plan!  While many of us are in disbelief, the truth is that all carriers in the Houston market and many other Texas markets won't have an available PPO plan offered by the major carriers.  In the vacuum left by these terminating PPO plans we'll need to examine the HMO network plan design.  While this process can be hard to understand, don't worry, we're here to assist you through this search.

April 30th will mark the end of the last Special Election Period that allowed citizens to extend the time to purchase health insurance in 2015.  This specific election period was approved by CMS and made available to people that never bought health insurance in 2014 and discovered that they would owe a penalty for the 2014 tax year.

I Just Bought A Plan I Could Afford!

I have had several conversations in the last few weeks with clients of other agents or purchasers of health insurance plans that dealt directly with the carrier that needed help.  In each instance the person lamented that they purchased a health plan based on the price and they didn't take much time to consider other important items in the plan like physician networks, deductibles, or co-pays.

Technical difficulties plagued the healthcare.gov signup process over the last few days of Open Enrollment.  As a result of these problems, CMS, the government body that oversees the Affordable Care Act, has extended the Open Enrollment deadline to February 22nd. Remember, if you don't obtain coverage that begins 3/1/15, you cannot purchase health insurance this year unless you qualify for the Special Election period (have a baby, get a divorce, or have some other qualifying life change event).  If you miss out on this last chance, you'll be locked out and won't be able to purchase an ACA plan in 2015.  Make sure to grab this last opportunity to buy coverage.

With only 4 days left in the 2015 Open Enrollment cycle the pace of calls into our offices has increased dramatically.  New clients and old friends that have never emailed or called us back suddenly want to talk about health insurance!  In order to help you in the final stressful days we wanted to provide you some key pieces of information to help you get your enrollment completed and finish this Open Enrollment marathon!

Call volumes are increasing as we get to the last few days of the 2015 Open Enrollment season.  I wanted to provide a few answers to questions we are receiving and wanted to put them in one post.  Can you believe that January is already in the rear view mirror?  We've had several great calls this week and all of them have common themes.  I spoke quite a bit about taxation and the impact changes of income will have on subsidies in last week's post.  If you have questions about these items, please refer to Taxing Questions for 2015.  Let's dive in!

There are only 18 days left until your opportunity to obtain health insurance is gone for the remainder of 2015.  "What?  Is that correct?" you say?  Yes, the end of Open Enrollment will lock you into a health insurance plan for the rest of the calendar year or lock you out of a qualified health plan until January of 2016.

Recently a fellow health insurance broker and I had a discussion about health insurance premiums and how they are increasing at a rate that will doom the industry in just a few years.  We lamented about rising deductibles and ever increasing costs and smaller physician networks.  We even ventured into the realm of taxation and how higher income earners will certainly be asked to carry a larger burden in the future.  Our howling about how bad things have gotten and how they were better in the old days, ok, just a decade ago, led us to a simple question about the deductibility of health insurance premiums and whether individuals and families could write off their health insurance premiums from their taxes.  Since we both had different opinions and we've both been selling health insurance for more than 10 years it is clear that clients need clarification and answers on this important subject.  Remember, I'm not a tax preparer or accountant, so these are general rules and you'll need to investigate whether they apply to your situation.  Consult your own tax advisor.

The healthcare system is now at a breaking point.  The ACA or Affordable Care Act is proving it is now created a situation that is unaffordable.  Clients have been pushed into situations where they must make tough decisions as they are now unwilling or unable to make premium payments for plans they feel are too expensive or simply lack enough benefits for the cost.  Many clients express what we've discussed for some time now that premiums are more than double what they used to pay and their deductibles are twice as high as well.  Finally, because the expense is so high, many are trapped in plans that offer no benefits other than catastrophic coverage at a very high price.  The truth is these clients are frustrated and searching for alternatives to their real financial problems.  In the last month, Texas Health Design has had conversations about Short Term Health Insurance with more frequency and it is important to describe the benefits, limitations, and potential nasty pitfalls of this approach.