Some observations about changes in health insurance products for individuals and families in 2015:
• Four insurance companies offer coverage for individuals and families – Assurant Health, BlueCross BlueShield, CoOportunity Health, and Coventry Health Care. Policies are available directly from the insurance company or through the Health Insurance Marketplace.
• BlueCross BlueShield and Golden Rule have extended their pre-ACA policies through 2015. Golden Rule is not selling new policies in Nebraska.
• At the beginning of 2014, some people actually saw their health insurance premiums go down because they were not being rated on pre-existing health conditions. There were rate increases for 2015. The second lowest cost silver plan is identified in each state as the “benchmark” plan. The southeast corner of Nebraska saw a 5% to 10% increase in the benchmark premium. The remainder of the state experienced an increase greater that 10%.
• Insurance carriers are developing options with provider networks that are designed to lower costs by using a limited group of doctors and/or hospitals.
• Coventry’s health insurance products for Lancaster County are an HMO (Health Maintenance Organization) that requires the policyholder to utilize a limited network with Saint Elizabeth Regional Medical Center
• Coventry has similar products in Douglas and Sarpy County, but offers traditional networks in the rest of the state
• BlueCross BlueShield offers the SelectBlue network in the Omaha metro that offers a higher level of benefits at a lower cost if you utilize the SelectBlue providers. This includes physicians and hospitals associated with the Methodist, Nebraska Medical Center, and Children’s Hospital systems.
• BlueCross BlueShield and CHI do not yet have a contract; meaning that the CHI hospitals are not an “in-network” provider for BCBS. Some agreements have been reached to provide “in-network” benefits in the absence of a contract.
• The Affordable Care Act requires us to have health insurance that complies with the law or pay a penalty. The penalty in 2015 is the greater of 2% of your household income or $325 per person / $975 per family.
• Those who received an Advance Premium Tax Credit in 2014 will be issued a form 1099-H to report the amount of APTC benefit received. This will be reconciled on your personal tax return. http://www.irs.gov/pub/irs-pdf/f1099h.pdf
• Open Enrollment continues through February 15, 2015. After that date, health insurance may only be purchased when a Qualifying Event has occurred that creates a Special Enrollment Period.
by Chris McPike, Vice President
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