It's that time!
Some things are staying the same.
But there are big changes coming for 2018!
As Certified Covered California agents, we'll give you the inside scoop on changes, options, and opportunities.
You can always quote Covered Ca plans with tax credit calculation here:
One note...the new 2018 rates will show starting Nov 1st.
Let's break up the Open Enrollment Guide into easy sections:
Let's get started!
First, we'll start with what's new.
We'll update as info comes in!
Okay...let's start with the really big one.
This also applies to their off-exchange plans as well.
For existing members, they will have to switch carriers and plans if affected.
You can find more information on Anthem's notice to leave California in 2018 HERE.
Basically, it means that many Californians both in Covered Ca and off-exchange will have to pick a new plan!
Anthem's most popular plan type by far was their EPO plan.
It's a pretty good alternative!
One...the PPO is better than the EPO.
Shield has ramped up their network to bring on many of the big hospitals and they are becoming the defacto PPO carrier in the State now for individual/family coverage.
This will bring more doctors!
Especially when Anthem leaves in 2018.
Run your quote for Shield and other carriers available.
We're happy to help you understand the options available and make sure you get the most tax credit available.
As Certified Covered Ca agents, our assistance is 100% free to you.
Rates are going up in 2018
Before we scream, just a reminder!
It's not always an exact match.
One person's net cost will go up while another's might actually go down.
The main point is that the tax credit increase should eat up most of the rate increase.
Starting in November, you'll be able to see the net rates for your situation and we're happy to help you compare the options.
That only matters if you're the average.
It's important to run your quote starting Nov to see how your situation is affected.
There are many lower priced HMO's on the market which many people can't use to see their desired doctors.
There may be some hard decisions coming up.
Especially for Anthem Blue Cross members in the affected areas.
There are really three ways to offset rate increases:
Let's look at these in detail.
As with any open enrollment, this is the time to shop the market.
Bronze, Silver, Gold, Platinum...what's the best for you!
This is such a complicated question that we created an entire PlanFinder system here:
This tool will walk you through the questions we walk through 1000's of times every open enrollment.
Literally...1000's of times!
It gives you our 30+ years of expertise analyzing health insurance needs with clients.
Of course, we're happy to walk through the plans with you at 800-320-6269 or by email.
Our services are 100% free to you.
Starting Nov 1st, you can run your 2018 Covered Ca rates here:
We also have an article on how to shop Covered Ca plans with further insight.
If we can to keep the same level of benefit (Silver for example), we have have to look at a change of carrier.
There are many regional HMO's now that are well-priced.
SHARP. Western Health Advantage. LA Care. Molina.
The cost difference for these carriers can be significant.
Even against the HMO's from the Blues.
The first item is to ask what "Covered California"Ã‚Â carriers your doctor participates with.
When you run your 2018 Covered Ca quote, you'll find a "Provider search"Ã‚Â under each plan.
You can also ask your doctor's office.
We will have a 2018 Carrier Comparison soon with updated information!
Every open enrollment, we have to re-evaluate the networks.
Even more so for 2018!
Let's look at the big issue...Anthem leaving most of the market.
Most people who picked Anthem Blue Cross chose their EPO plan.
More info on EPO versus PPO here.
The closest equivalent plan to this is the Blue Shield PPO plan which is still available in most areas of the State.
We recommend this as well.
In terms of pricing, it may be cheaper. It may be more expensive.
Every area was different.
Health Net may offer a PPO in parts of the State but Shield is the strongest network for this type of plan in 2018.
Another consideration is a move from either EPO or PPO to HMO.
There are many strong, regional HMO's that have good providers.
SHARP down south.
Western Health Advantage in the Bay Area and Sacramento.
Both have great providers.
LA Care and Molina are also priced well but with smaller networks in Los Angeles.
We can help with this comparison.
Our services are 100% free to you as Certified Covered California agents.
Each year, the income ranges for tax credit adjusts according to inflation and the Federal Poverty Level.
Here are the new levels:
A few notes...
If you were just over the limit separating Medi-cal from the Silver 94 (number on left side), you may need to evaluate your income estimate or the system will probably automatically switch you to Medi-cal.
It's best to do this before Open Enrollment so you're not caught up in that system change.
Also, you may find you're now eligible for a tax credit for 2018 income estimate.
This is a great time to re-evaluate your income estimate.
We can adjust income any time of the year for you.
The rates, benefits, and networks are the same in or out of network so it makes sense!
We can help with that whole process.
We created an entire Guide to the 2018 Tax Credit here.
You can see your expected 2018 tax credit through the quote below:
We get this question all the time..
"Is there a penalty anymore?"Ã‚Â
The answer is "Yes"Ã‚Â.
It's still on the books.
Earlier in 2016, there were news stories that the new administration had instructed the IRS not to process the health insurance piece of the tax filing.
This would include the tax penalty.
Here's the detail for that:
This is a big deal.
This is the Silver 70, 87, and 94.
The last two being really rich plans.
A large number of people we enroll qualify for these enhanced Silver plans.
The current administration had threatened not to fund this part of the law.
As of now, it's still up in the air.
This won't affect pricing but will affect out of pocket exposure on the plans.
We'll keep you posted.
For now, assume we have the enhanced Silver plans.
As we get new info, we'll continue to add them here.
Otherwise, we can expect pretty much the same for 2018.
We're here to help you since our assistance is 100% free to you.
Let's look now at some of the nuts and bolts of the 2018 California Marketplace Open Enrollment.
When you enroll can affect your effective date.
Here's the rule.
If you enroll by the 15th, you can get the following 1st of the month.
If you enroll after the 15th, you will get the 1st of the month AFTER the following month.
The earliest Open Enrollment effective date will be 1/1 no matter what unless you're losing coverage and enroll during November (will get 12/1 eff date).
Here are some examples:
We can help you navigate this effective date question and plan accordingly.
If you're confused by this (it's confusing), just email us your situation.
Let's look at each of these.
If you have not enrolled or were not able to prior, you can get coverage now.
There's no health underwriting (can't be declined based on health).
Many people miss the open enrollment and have to enroll during this time.
This is what usually happens.
People re-evaluate their plan options in the Covered Ca based on new rates and plans.
Each year, there are rate and plan changes that occur.
It's important to relook at the options and make sure you're on the best plan.
Networks can change as well with doctors leaving or joining networks.
Anytime after Oct 31st, you can run your online quote here:
We're happy to help with any questions at 800-320-6269 or by email.
You can find more on how to Compare Covered Ca plans in 2018 here.
Many people also take this time to look at their income expectation for 2018.
Income streams change year to year.
It's important to take this into account as it affects your monthly premium and potentially your benefits.
You can get more information on how to calculate your tax credit income here.
This can get tricky!
Feel free to reach out to us for a walkthrough.
This is a good time to add/remove or change plans for family members.
If you're not going to claim an older child for 2018 (tax filing in April of 2019), Open Enrollment is the time to remove him from the Covered Ca household.
It's probably also the time to create a separate account for your child (new household essentially).
You can enroll for 2018 Covered Ca coverage quickly here:
It's roughly the usual suspects as in 2017.
We don't have any additions.
Here are the carriers participating in 2018:
Keep in mind that some of these carriers are regional and do not offer coverage in every area.
The rest will either be HMO's or EPO's.
You can learn about the difference between PPO and EPO here.
Or between HMO and PPO here.
Each year at open enrollment, everything changes.
It makes sense to re-evaluate your options.
Any of these changes can prompt a review for 2018 Open Enrollment:
These are all good reasons to take a look at what's available.
Starting November 1st, you can quote the new 2018 rates and plans with tax credit here:
A new year.
Lots of changes!
It's tough with the Holidays being right smack in the middle of OE but don't delay.
It can affect your out of pocket expense for the rest of the year.
Definitely take advantage of our status as Certified Covered Ca agents.
Our assistance is 100% free to you. Seriously.
And we wish a wonderful and healthy 2018 to you and yours!
Again, there is absolutely no cost to you for our services. Call 800-320-6269 Today!
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20 years of experience in the California health insurance market has taught us one thing...Competent and experienced guidance is Invaluable
We can quickly (very important) size up your health insurance needs and clearly explain the options available to you. Our focus is finding the most coverage at the best cost to you.
We are licensed Covered Ca agents with in-depth knowledge of their plans, process, and tax credits.
Call us...you will be Pleasantly Surprised. 800-320-6269
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