Compro: Open Enrollment 2017: What’s a Person to Do?

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Open Enrollment 2017: What’s a Person to Do?

It’s true – health insurance premiums are going up 50% for those who buy their own policies and there will be fewer options to choose from. Nebraskans are not alone. There are steep increases in health insurance premiums across the country. So what’s a person to do? Make sure you have the facts.

  • BlueCross BlueShield will offer a Catastrophic and a Bronze HSA plan off-market only.
  • Medica offers the broadest plan choices and is available through the Marketplace and off-Market.
  • Aetna, the parent company of Coventry, will offer Marketplace plans. There are no HSA plans. Someone who qualifies for an off-market plan because of income will have to enroll through Healthcare.gov. There is no off-market enrollment process for your agent to use.
  • What is the maximum out of pocket expense that you could be responsible for?
  • Networks have changed. Be certain to find out if your doctors & hospital are in the network.
  • Does the plan have a closed network of providers such as an HMO or is it a broad based PPO?
  • Are out-of-network benefits provided?
  • Drug formularies have changed. Always check the formulary to find out if a name brand drug is covered.
  • What additional services are offered? Virtual health, nurse lines, customer advocacy, price comparisons for medical services (transparency), member portals?
  • What services are being changed or reduced? One of the companies will not be sending insurance cards, except on request. You are expected to download an electronic card to a smartphone or tablet.

Marketplace Eligibility

Be certain to know if you qualify for a Premium Tax Credit on the Marketplace. You may be eligible if your income is between 100% and 400% of the Federal Poverty Level. Here is a link to the 2016 Federal Poverty Level Table: http://www.comproins.com/wp-content/uploads/2013/09/2017-FPL-Table-1024×791.jpg.

If your income falls within the guidelines, you can estimate your premium tax credit. http://www.comproins.com/individual-benefits/under-65/

The change in Premium Tax Credit from 2016 to 2017 is about 50% when based upon the same income. This means that those who enroll through the Marketplace may not have to deal with the extreme rate increases.

Other Options

Are you self-employed or employed by a small business that does not offer employee benefits? For the first time EVER, group insurance premiums will be less than individual premiums. Historically, small employers may not have offered benefits because it was less expensive for their employees to buy their own coverage. That is no longer true. Many small businesses are taking another look at implementing group insurance programs.

Health insurance is complicated. A professional health insurance agent is your best resource for finding the best solution for your family or your business. If you need an agent, please contact ComPro.


by Chris McPike, Vice President
ComPro Insurance

402-488-5100 | www.comproins.com


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