Health Plans for 2014: Why They're Different

Many of my small group and individual and family clients will be choosing a health plan for the next year that's new. Many of them may wonder why they can't just have the same health plan they're already enjoying. As you know, the Affordable Care Act (ACA) has meant many changes. It's a good idea to review some of the most significant ones that are driving changes in health plans.

• All small group and individual health plans must include the 10 essential health benefits. Many plans in the past included some, but not all, of these benefits.
• Four levels of coverage may be offered. These are often referred to as "metal levels" or "metal tiers" and they specify how costs are shared between health plan enrollee and health plan provider. In Washington state, there will be three levels of coverage offered in the market: Bronze, Silver, and Gold.
• Catastrophic health plans are no longer available to most people. They can only be purchased through the Washington Healthplanfinder—our state's online exchange marketplace—by someone younger than age 30 or someone who qualifies for a financial hardship.
• Health insurance cannot be denied for pre-existing conditions. This rule has been in place already for children, and takes effect for adults in 2014.

If you have or are on a small group medical plan (Employer sponsored plan) there will be some changes on January 1, 2014 but your plan won't "renew" and go through all of the changes until the contract year ends. Thus, if your plan renews every June for example, your exiting plan continues until the regular contract renewal date in June 2014. The only thing that can alter that date is to search for a new plan earlier than the contract renewal date, enroll to the new plan and terminate the old one.

Identity Theft Awareness and Solutions

Identity theft remains one of the fastest growing crimes today and it is not slowing down. Millions of people have been affected by this insidious crime wave and many have been financially ruined before they even knew a breach was taking place.

The Affordable Care Act may bring another wave of Identity Theft crime as part-time government employees will be assisting millions of Americans navigate the health insurance system being implemented on January 1, 2014. These "Navigators" will have access to your name, address, phone, email address, household income information and more during the enrollment process.

In other words, people who use this method of enrolling to a new health insurance plan will be providing all of this personal information to a complete stranger. We are told to trust the government, that none of the personal information will be leaked to anyone or any place outside the ACA system. Does that make you comfortable?

So what do you do? How do you protect yourself and your financial world from identity theft? Beyond watching your wallet and its contents, beyond carefully guarding who handles your credit and debit cards, who sees or handles your checks, what can you do?

First, check your homeowner's insurance policy to see if it extends coverage for identity theft. It may not be premier coverage but it's better than going bare.

Second, subscribe to an Identity Theft Protection service. You want one that covers everyone in your household, one that has a system for notifying you immediately if there is a breach recorded on any of the three credit reporting bureaus. You want a service that "goes to bat" for you if someone does steal your identity and creates havoc.

For example, I have an Identity Theft Protection plan that sends an email AND a text message the second something fishy shows up on Experian, Transunion or Equifax that has my name on it. The service has saved us from criminal invasion of our credit three times in the last ten years. And the service costs less than $25 per month. Do I think it is worth it? YES!

You can see all the details and enroll online at my website. Click on SHOP FOR INSURANCE and then LEGAL SHIELD & IDENTITY THEFT PROTECTION.

Pediatric Dental and Vision in the ACA

One of the 10 essential health benefits that must be included in all small group and individual health plans for 2014 is pediatric services for children ages 0-18. While many plans in the past did include pediatric services, what's new is the requirement to include pediatric dental services and vision coverage. The dental benefit has an extra twist. How these benefits are purchased depends on whether someone purchases a plan inside or outside of our state's online exchange marketplace, Washington Healthplanfinder. Here's the information that's important to share with your clients:

• If a plan is purchased outside the exchange, pediatric dental coverage will be included in the plan, and the coverage cannot be waived whether or not the purchaser has a dependent age 0-18.
• If a medical plan is purchased through the exchange—Washington Healthplanfinder—it will not include pediatric dental coverage. However, a pediatric dental purchase is required when members have dependents age 0-18. Pediatric dental coverage must be purchased from a stand-alone dental provider with Washington Healthplanfinder. The requirement is waived if the member has no age 0-18 dependents.

Pediatric vision coverage is also a requirement, but it is included in all plans, whether purchased in our out of the exchange.

I am registered to sell medical insurance inside and outside the exchange, or HIX as it is called. 

What will Obamacare cost you?

I found this chart in a Forbes article by Chris Conover (09-23-2013) that demonstrates the "promises" vs. "reality" of the Affordable Care Act. Keep in mind that every state will have different rates and yours may be higher or lower.

The important part to understand is that the average family of 4 will be paying a lot more for health insurance than ever before. Never mind the promises of a $2,500 reduction in costs that everyone heard during the run-up to the Affordable Care Act. That isn't going to happen.

Yes, there are some Americans who welcome the ACA including those who are for the first time able to obtain insurance benefits despite pre-existing conditions. There are also large numbers of people that will not be paying the higher costs due to premium tax credits and other subsidies.

With less than a week to go before open enrollment begins, be sure to check and see where your family is in regards to eligibility for premium tax credits. There is a link to the Washington calculator for health insurance costs on the home page of my website www.ekandek.com

Obamacare will question your sex life

This is why you don’t get government involved in anything. 

Check it out: ‘Are you sexually active? If so, with one partner, multiple partners or same-sex partners?” Be ready to answer those questions and more the next time you go to the doctor, whether it’s the dermatologist or the cardiologist and no matter if the questions are unrelated to why you’re seeking medical help. And you can thank the Obama health law. 

“This is nasty business,” says New York cardiologist Dr. Adam Budzikowski. He called the sex questions “insensitive, stupid and very intrusive.” He couldn’t think of an occasion when a cardiologist would need such information — but he knows he’ll be pushed to ask for it. 

The president’s “reforms” aim to turn doctors into government agents, pressuring them financially to ask questions they consider inappropriate and unnecessary, and to violate their Hippocratic Oath to keep patients’ records confidential.

Embarrassing though it may be, you confide things to a doctor you wouldn’t tell anyone else. But this is entirely different. Doctors and hospitals who don’t comply with the federal government’s electronic-health-records requirements forgo incentive payments now; starting in 2015, they’ll face financial penalties from Medicare and Medicaid. The Department of Health and Human Services has already paid out over $12.7 billion for these incentives.

Dr. Richard Amerling, a nephrologist and associate professor at Albert Einstein Medical College, explains that your medical record should be “a story created by you and your doctor solely for your treatment and benefit.” But the new requirements are turning it “into an interrogation, and the data will not be confidential.”

Lack of confidentiality is what concerned the New York Civil Liberties Union in a 2012 report. Electronic medical records have enormous benefits, but with one click of a mouse, every piece of information in a patient’s record, including the social history, is transmitted, disclosing too much. The social-history questions also include whether you’ve ever used drugs, including IV drugs. As the NYCLU cautioned, revealing a patient’s past drug problem, even if it was a decade ago, risks stigma.

On the other end of the political spectrum is the Goldwater Institute, a free-market think tank. It argues that by requiring everyone to have health insurance and then imposing penalties on insurers, doctors and hospitals who don’t use the one-click electronic system, the law is violating Americans’ medical privacy.

The administration is ignoring these protests from privacy advocates. On Jan. 17, HHS announced patients who want to keep something out of their electronic record should pay cash. That’s impractical for most people.

There’s one question they can’t ask: Thanks to the NRA, Section 2716 of the ObamaCare law bars the federal government from compelling doctors and hospitals to ask you if you own a firearm. But that’s the only question they can’t be told to ask you.

Where are the women’s rights groups that went to the barricades in the 1980s and 1990s to prevent the federal government from accessing a woman’s health records? Hypocritically, they are silent now.

Patients need to defend their own privacy by refusing to answer the intrusive social-history questions. If you need to confide something pertaining to your treatment, ask your doctor about keeping two sets of books so that your secret stays in the office. Doctors take the Hippocratic Oath seriously and won’t be offended.

Are such precautions paranoid? Hardly. WikiLeaker Bradley Manning showed how incompetent the government is at keeping its own secrets; incidents where various agencies accidentally disclose personal data like Social Security numbers are legion. And that’s not to mention the ways in which commercial databases are prone to hacking and/or exploitation.
Be careful about sharing your medical secrets with Uncle Sam.

Betsy McCaughey is the author of “Beating ObamaCare.”
 http://nypost.com/2013/09/15/obamacare-will-question-your-sex-life/

This is why you don’t get government involved in anything. Check it out: ‘Are you sexually active? If so, with one partner, multiple partners or same-sex partners?” Be ready to answer those questions and more the next time you go to the doctor, whether it’s the dermatologist or the cardiologist and no matter if the questions are unrelated to why you’re seeking medical help. And you can thank the Obama health law. “This is nasty business,” says New York cardiologist Dr. Adam Budzikowski. He called the sex questions “insensitive, stupid and very intrusive.” He couldn’t think of an occasion when a cardiologist would need such information — but he knows he’ll be pushed to ask for it. The president’s “reforms” aim to turn doctors into government agents, pressuring them financially to ask questions they consider inappropriate and unnecessary, and to violate their Hippocratic Oath to keep patients’ records confidential.
Read more at http://conservativebyte.com/2013/09/obamacare-will-question-sex-life/#U3jsxdruaml8Xfdh.99

Obamacare will question your sex life Posted on September 16, 2013 This is why you don’t get government involved in anything. Check it out: ‘Are you sexually active? If so, with one partner, multiple partners or same-sex partners?” Be ready to answer those questions and more the next time you go to the doctor, whether it’s the dermatologist or the cardiologist and no matter if the questions are unrelated to why you’re seeking medical help. And you can thank the Obama health law. “This is nasty business,” says New York cardiologist Dr. Adam Budzikowski. He called the sex questions “insensitive, stupid and very intrusive.” He couldn’t think of an occasion when a cardiologist would need such information — but he knows he’ll be pushed to ask for it. The president’s “reforms” aim to turn doctors into government agents, pressuring them financially to ask questions they consider inappropriate and unnecessary, and to violate their Hippocratic Oath to keep patients’ records confidential.
Read more at http://conservativebyte.com/2013/09/obamacare-will-question-sex-life/#U3jsxdruaml8Xfdh.99

Obamacare will question your sex life Posted on September 16, 2013 This is why you don’t get government involved in anything. Check it out: ‘Are you sexually active? If so, with one partner, multiple partners or same-sex partners?” Be ready to answer those questions and more the next time you go to the doctor, whether it’s the dermatologist or the cardiologist and no matter if the questions are unrelated to why you’re seeking medical help. And you can thank the Obama health law. “This is nasty business,” says New York cardiologist Dr. Adam Budzikowski. He called the sex questions “insensitive, stupid and very intrusive.” He couldn’t think of an occasion when a cardiologist would need such information — but he knows he’ll be pushed to ask for it. The president’s “reforms” aim to turn doctors into government agents, pressuring them financially to ask questions they consider inappropriate and unnecessary, and to violate their Hippocratic Oath to keep patients’ records confidential.
Read more at http://conservativebyte.com/2013/09/obamacare-will-question-sex-life/#U3jsxdruaml8Xfdh.99

Obamacare will question your sex life Posted on September 16, 2013 This is why you don’t get government involved in anything. Check it out: ‘Are you sexually active? If so, with one partner, multiple partners or same-sex partners?” Be ready to answer those questions and more the next time you go to the doctor, whether it’s the dermatologist or the cardiologist and no matter if the questions are unrelated to why you’re seeking medical help. And you can thank the Obama health law. “This is nasty business,” says New York cardiologist Dr. Adam Budzikowski. He called the sex questions “insensitive, stupid and very intrusive.” He couldn’t think of an occasion when a cardiologist would need such information — but he knows he’ll be pushed to ask for it. The president’s “reforms” aim to turn doctors into government agents, pressuring them financially to ask questions they consider inappropriate and unnecessary, and to violate their Hippocratic Oath to keep patients’ records confidential.
Read more at http://conservativebyte.com/2013/09/obamacare-will-question-sex-life/#U3jsxdruaml8Xfdh.99

How many health plans will there be in 2014?

As of today, Friday August 6th, the Washington Health Insurance Exchange will be offering 42 health plans in 2014. The  heat has been turned up and both the Office of Insurance and the Exchange Board have been busy in the last few days.

Three weeks ago we thought we'd be seeing the number of health plans somewhere in the low to mid twenties. They another 8 or 9 were approved and then two more companies were given the green light on August 5th.

That is a lot of options for folks to survey. Some of the carriers are specializing in Medicare level plans. Excuse me, the new "branding" is Washington Apple Health which is doesn't sound like the welfare end of health plans. But it is.

Other carriers are aiming for the middle of the road plans, mostly Bronze, Silver and some Gold plans. It doesn't look like any carrier will be offering a Platinum plan.  We believe most individuals and families will settle on a Silver plan.

As of today, there are 23 more days until the Health Insurance Exchange website is to be open for enrollment. The ride may be bumpy for some and more than a few people will delay or procrastinate until December. Keep in mind if you need/want a new plan for January 1st you must choose one no later than December 23rd.

If you delay until after Christmas you'll have a February 1st start date. If you wait until after January 23rd you'll have a March 1st start date. If you wait until after March 23rd you'll have an April 1st start date. Get it? Do not delay.

Health Insurance Open Enrollment begins October 1st

In just a couple of weeks the curtain goes up on the new health insurance plans for individuals and families under the Affordable Care Act, aka, Obamacare. The website you want to visit is  http://www.wahbexchange.org 

It may seem counter-intuitive to refer you to Washington Healthplanfinder, our state’s online exchange marketplace. You may be thinking: “Why would Richard tell me to go there when he sells health insurance?”

The reason is that sending people to the Healthplanfinder can benefit them and you. Here’s why.

As part of the ACA, many individuals will qualify for financial help from the government with their premiums. A family of three can earn up to 400 percent of the federal poverty level, or $78,120, and still be entitled to some financial assistance. But the only place that they can get that financial assistance is through Washington Healthplanfinder.

If you believe you may be in an income category that qualifies for help, it's worth having a conversation about your options. I encourage you to use the online calculator to help determine whether you may qualify.

If you do qualify for assistance and choose to buy your health plan through Healthplanfinder, keep me in mind and use the FIND AN AGENT/PRODUCER tab. I am certified to sell health plans inside the exchange and can even help you enroll no matter where you live in Washington. You can find me by name - RICHARD EK - or by zip code -98208.

Feel free to mention this to family or friends that live in Washington State. Or, have them call me at 425-338-1000 or contact me by email Richard@ekandek.com

An IRS Audit is the last thing you want to trigger

Just weeks before the October Open Enrollment was to begin you may have heard the news that income verification was going to be on the "honor system" in the first year of Obamacare. The government is unable to verify actual income of health insurance applicants in order to grant premium tax credits.

The government actually said that stated income for individuals and families would NOT be verified in the 2014 year of the Affordable Care Act. This news caused widespread joy in some circles. In other words, an individual may indicate a lower than actual income in order to receive a premium tax credit. It is dishonest and irresponsible but some have taken the attitude that they are "owed" a discount on their health insurance and since nobody is checking, why not try to get away with under reporting income and take advantage of an opportunity.

Don't try it in Washington State, the model for all other state-run health insurance exchanges. Since Washington got started early to get the exchange set up they had plenty of time to install the income verification system. In other words, an individual in North Dakota may get away with defrauding the system but if a person in Washington fibs on the enrollment forms, it will automatically trigger an IRS AUDIT. You do not want the IRS on your porch!

Please tell your friends and neighbors that Washington State will be checking income tax returns on all applicants seeking premium tax credits. They have the system in place and will catch those who try to defraud the government.