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California health insurance  -  Health Exchange in California  -  Pump Fake 

The California Health Reform "Pump Fake"

The ability to grandfather plans has passed.  To request a quote for the new ACA plan, click here.

The Pump Fake involves locking in old plans/rates with late 2013 eff date (detail below)
Requires good health to change plans (detail below)
Will likely not make sense for Grandfathered plans and those that qualify for subsidy

As we get more information on the health reform roll-out, some interesting new strategies are popping up. One of them could save you quite a bit of money during 2014 and I think we might be first to bring it to light for our readers. It all has to do with a recent update on the change over dates to the new Health Exchange plans in 2014 and anniversary date. Let's take a look at how we might be able to game this rule to our advantage.

The six month crunch for Health Reform

Originally, the State was looking at an open enrollment window from Oct 1st 2013 to March 31st, 2014 for essentially all eligible California enrollees (newly applying and existing members) to switch over to one of the new Health Reform plans which we all must move to eventually. This would have been a nightmare. How would the carriers address the onslaught of enquiries, applications, and requests with so much activity. As licensed California health agents, we were also dreading the sheer volume of activity as both new and existing clients would all have to shop the new health insurance market at once. It would have been a nightmare and luckily, the State also realized this. We then got the new rule.

Changes will occur at Anniversary date

In order to spread out the activity, a person would not have to switch over the new Health Exchange plans until 12 months from their anniversary date. For example, if your original effective date was 3/1 (of any prior year), you would not have to switch to one of the new plans until 3/1/2014. This brought up an interesting point. What if you change plans 12/1/2013 assuming you're in good health and do not benefit from the subsidies or grandfathering (we'll discuss these later)? You could essentially avoid what is expected to be much higher rates with the new plans for 12 months or almost all of 2014. That could means 1000's of dollars in savings. Let's first discuss the two points of above that might prevent this move.

Grandfathering, subsidies, and pre-existing health issues

First, we would need to be in good health in order to change plans. Health insurance is still medically underwritten until Jan 2014 except for children. If our current coverage was originally started prior to 3/23/2010, you might have grandfathering status which means you can keep your coverage. Unless the pricing picture changes considerably or you qualify for subsidies (next), it probably won't make sense to lose this grandfathering. You won't have to change to the new plans anyway (which is the point of the pump fake). Subsidies is a different deal. If you make under 400% of the Federal Poverty Level, you will receive subsidies towards the new plans starting Jan 1st 2014. It will likely be hard to get better rates when considering these subsidies. We can provide you the ability to compare health reform plans with subsidy versus current plans around October of 2013. Otherwise, the pump fake is an attractive option unless they change the rules, we expect many people to do this. The new health reform plans are expected to be much more expensive than current plan options. The health reform pump fake offers us 11 months of respite. Of course, were happy to walk through your situation as we get closer to find the best coverage for the lowest price. That is the goal after all.

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