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Hold on to your old California health plans

We're starting to get a glimpse of what awaits Jan 1st 2014 and beyond.

Granted, many things will change between now and then but we can see the vague outlines. There are still many people who are on the old grandfathered plans (effective date prior to 3/23/2010) and were getting questions from them regarding what they should do. This is very important as the rates and plans available to them will likely be very different than what they have and once they make a change, their grandfathered status is gone forever.

Let's take a look at this situation and how to approach the upcoming changes.

If indeed you have a grandfathered plan, our initial guidance is to not make any changes till see actual rates and benefits which should be available around summer of 2013 since we can't reverse and go back to our original plan. These plans (grandfathered health plans in California) are locked which means that no new people can join them other than family members on an existing health plan. Outside of adding family members, any change to the plan will make it no longer an option for you. Usually, locking a plan to new enrollment is the kiss of death for California health plans but this is the rare exception.

What makes this so different?

Grandfathered Plans

The old grandfathered plans are not subject to many of the mandates brought about by health reform. Because of this, they are less expensive in most cases for comparable coverage. Personally, we have an HSA $3500 plan from Anthem Blue Cross and the equivalent plans on the market are much more expensive (50%) every time I run an instant health quote to see what's available. This will probably continue until the old plans are just not viable due a slow loss of members (getting group coverage, etc). In the meantime, making any change to a new plan even now would result in much higher premiums.

There are a few very rich older plans which might make sense to compare with currently available plans even if this results in losing our grandfathered status.

We're happy to take a look at the market in this situation for you.

We just send us your ages, zip code, current plan, and monthly rate.

Pre-Health Reform Days

We're in an interesting window right now until we get the new rates summer of 2013. It doesn't make sense to make changes (other than in the rare situations mentioned above) until we can see what's available. So what do we foresee for the new Exchange plans? There are two important considerations here.

First will be the actual rates and benefits offered. Each carrier will offer up to four California health plans (the Metallic plans) and a lower priced one for young adults.

The baseline benefits for these plans have already been picked in California with the Kaiser $30 copay plan as a guideline for all available plans on the individual and Small Group California health insurance market. These plans will likely be quite a bit more expensive than what we've had on the market (I know...it's hard to believe that's possible) but guaranteed issue (regardless of health). On the face of it, it doesn't look promising if you have a grandfathered plan now. Here's the second wrinkle to the equation.

 If your income is between 150 and 400% of poverty (roughly $90K for family of four at 400%), you should receive some subsidy in the Exchange to offset premium cost on a sliding scale.

As we get closer to being able to see rates (officially can enroll October 1st, 2013 for Jan 1st, 2014 effective date) and the effects of these subsidies, that's the time to make a decision on whether the grandfathered status is advantageous. Of course, we're happy to help with this decision.

 

You can run your Covered California Plan Quote Online to view rates and plans side by side from the major carriers...Free.

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