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Health Reform Plan Enrollment Help Connecticut

This post will explain some things about Health Reform Plan Enrollment Help Connecticut.  Crowe and Associates is an insurance agency that works with clients to help them find the best health reform plan available.  We provide quotes to clients, review the options as well as discuss plan benefits. During this process we point out the different plan types (Bronze, Silver and Gold) and  the companies that are offering them.   It is also important to take the clients situation into consideration when selecting a plan.  This can include but is not limited to checking doctor participation as well as coverage of specific medications.  There are many factors to weigh when choosing the best health care plan for you.  This is a very personal decision and includes things such as cost and amount of coverage you feel you need.

Once you choose a plan

We guide clients through the enrollment process on the Access Health website from start to finish.  This includes guidance on the steps to take once the online enrollment has been completed.   At times it may be to a clients advantage to shop for a plan off the exchange.   When this is the case, we are able to quote and enroll in any available off exchange plan as well.

We do not charge any type of fee for our services.  The insurance carriers pay us a commission directly and your monthly premiums are the same whether you work with our agency or not.    The commissions we receive are level which means we are paid the same regardless of the insurance company you choose or the amount of premium you pay.

If you need a quote or would like help enrolling in a plan you may either call our office at 203-796-5403 or email us at Edward@croweandassociates.com.    If you would like to come to our office, please contact us for an appointment.  Our address is…

Crowe and Associates

304 Federal Road, Suite 107

Brookfield, CT 06804

Access Health Reform Plans Connecticut

This post has some information about the Access Health Reform Plans Connecticut.  Access Health is the administrator of health reform plans through the Exchange in Connecticut.  They administer as well as oversee the enrollment process for those applying for a health reform plan through the health exchange. (Also known as Obama Care) Anyone can apply for insurance through the exchange but not all people are eligible for a premium subsidy.

This post will provide an overview of health reform plans, the enrollment process and premium subsidies in Connecticut. Please note this information is only applicable to Connecticut and is not applicable to any other state.

If you need a quote, want to enroll or have questions not addressed in this blog CLICK HERE   or call us at 203-796-5403

Health Exchange Plans – Important Things To Know

• Three companies participate in the Individual Exchange. They are Anthem BCBS, Conneticare and Healthy CT.
• You must go through the Access Health Website in order to apply for a plan through the exchange.   www.accesshealthct.com
• Premium subsidies are available to those that make below the income thresholds.  Premium subsidy simply means the Government/state will pay a portion of your monthly premium.
• These premium subsidies are only available to those on the Exchange
• The lower the applicants 2014 income, the higher the monthly subsidy they will receive. (Rates are based on your 2014 income)
• If income falls below minimum levels, the applicant and/or dependents may be placed on Husky A,B,C or D

Network Information

• The networks for the plans participating are NOT the same as their networks off the exchange.  For example:  You can not assume you doctor participates with Anthem on the Exchange just because he/she participated with Anthem off the Exchange.
• The Husky A and B network (Children enroll in A and B) has many more providers than Husky C and D (Adults enroll in C and D)

Enrollment Information

• You must apply through the Access Health website in order to apply for a plan on the exchange.
• Married couples must file a joint return in order to be eligible for a subsidy.
• Income will be verified in 2015.  If you under report your income, you may need to either pay back a portion or all of the income subsidy that you receive during the year.

If you need a quote, want to enroll or have questions not addressed in this blog either CLICK HERE ,  call us at 203-796-5403 or email us at Edward@croweandassociates.com.

Applying For Health Insurance In Connecticut

This post will give you information about Applying For Health Insurance In Connecticut.  Connecticut residents that do not have access to health insurance through an employer have two choices to obtain Care.  They can either apply for coverage through the health exchange or they can apply with an insurance company outside of the exchange.   Which option is better?  It depends on your specific situation but the following points below should help guide you.

Applying on the Exchange-

Applying through the Exchange is the only way to determine if you are eligible for a premium subsidy.   Subsidies are not available outside of the exchange.  In Connecticut, Access Health runs the exchange.  They run the application website, determine subsidy levels as well as send enrollment information to the carriers.   The Exchange will determine the amount you receive for your premium subsidy by using your annual 2014 Adjusted Gross Income as a base.  The income level increases for every additional family member.  For Example, a single person making $50,000 a year is not eligible for a subsidy but if they have a spouse and the total family income is $50,000 they would be eligible.  Pre-existing health conditions are not taken into consideration when applying.

Applying off the Exchange- 

A number of companies offer plans off the exchange such as Aetna, Connecticare, Anthem BCBS, United Healthcare and Cigna.  Premium subsidies are not available off the exchange. Medical underwriting is not allowed which means they can not decline someone or raise a persons rates due to poor health.   In general the rates off the exchange are similar to the rates on the exchange. However, the on exchange rates are dramatically lower for those that qualify for a premium subsidy.   One advantage of applying off the exchange is that it provides access to a larger physician network.

If you would like help with a quote or applying on or off the exchange, please give us a call at 203-796 5403  or by email at Edward@croweandassociates.com.  We do not charge any type of fee for the service.   Your rates will not change if you decide to work with us.

Health Reform Companies Connecticut

This post will give you some information about Health Reform Companies Connecticut.  There are three companies participating with the health exchange in Connecticut as of January 1, 2014.  They are as follows,  Anthem BlueCross BlueShield, Connecticare as well as Healthy CT.   Anthem and Connecticare have both been operating in Connecticut for many years.  Healthy CT is a new not for profit that is run by the State of Connecticut.

All three companies offer Bronze, Silver as well as Gold plans in the state of Connecticut. Because the benefits these companies offer are standardized by the insurance industry, they  must all have consistent plan designs. This helps  to make your decision a little easier. You just have to see which arrier offers the best pricing and used the providers you prefer .  There has been some discussion about Platinum level plans but they are not available in Connecticut this year.  Although United Healthcare does not participate in the individual exchange,  they are available through the small groups exchange however.  (Small Group Exchange is called SHOP Exchange)

Access Health operates The Connecticut Exchange.   They also operate the website that clients use in order to apply for the plans.  Access Health will also determine if applicants are eligible for a subsidy to help them pay for their coverage.

CLICK HERE TO LEARN MORE ABOUT HEALTH INSURANCE ON AND OFF THE EXCHANGE IN CT

If you have any questions, you may either email our office at Edward@Croweandassociates.com or call us at 203-796-5403.  We are here to help you make the right choice for your insurance needs.  Each person has  both different financial as well as health care needs.  Crowe and Associates wants to make you feel confident with your choice of health care options.

Aetna Health Insurance Quotes Online

This post will give clients a way to get Aetna Health Insurance Quotes Online.  Aetna has lowered their health insurance rates.  This gives them a substantial rate advantage over most other health carriers.   They offer a number of copay based plans that provide up front coverage for doctors visits with the need to pay a deductible first.   A quote engine has been provided through this blog that allows anyone to obtain a quote on their own. You may also apply for coverage through this same link if you choose.

CLICK HERE FOR AETNA HEALTH QUOTES

Note:  After you click the link, you are taken to the Crowe and Associates website.  Click on the “Aetna Health” link on the right hand side.  This link will take you directly to the Aetna quote engine.  Once you are on the Aetna quote engine, you enter any data that Aetna requires.  Afterwords, Aetna will give you a quote for the cost of each plan you choose.  When you have completed this step you can make an informed decision as to which plan is best for your needs.

If you prefer to use a paper application you may obtain it here:

CLICK HERE FOR AETNA HEALTH PAPER APPLICATION.    Once you have finished filling out your paper application, you can submit it to our office.  You can submit application to our office  either via fax at (203)567-6235 , email Edward@Croweandassociates.com or mail (Crowe and Associates, 304 Federal Road, Suite 107, Brookfield, CT 06804).

TIPS: Here is a list of the more popular Aetna plans:  CT Managed Care Open Access Value $3,000, CT Managed Care Open Access $5,000, CT Managed Care Open Access $2,500 as well as the CT Managed Care Open Access $1,500.  These plan values are subject to change annually.

If you have questions, please feel free to contact us.  You can reach us either by email at Edward@croweandassociates.com or by phone at  (203)796-5403.

Access to doctors with health reform

This post will give you information about your Access to doctors with health reform.  The new health reform plans that are created and will be ready to go either through the State or Federal Exchange by January 1, 2013.   The plan designs have been decided by  the carriers who participate.   In fact, the criteria that the carriers use to determine rates is  established.  So what will the provider network look like?

Read more

The major changes with Health Reform will be enacted on January 1, 2014 which will create change for small and large group employers.  While small groups are not mandated to offer coverage (There is not an inadequate or unaffordable coverage penalty for small groups) they will still see changes. Health plan renewals for 2014 will be increased 30% to 50% over the normal renewal making it very difficult for many employers to offer coverage.  The individual and small group (Called Shops) exchanges will also be available.   Ultimately, small groups will have five options for health care offerings in 2014.  All five options are reviewed in depth below. Read more

Small Groups will be eligible to buy insurance on the Exchange through a SHOPs (Small Business Health Options Programs) starting in January 1, 2014.   A small group is currently defined as a group with less than 50 equivalent full time eligible employees.  This number will change to 100 full time eligible equivalent employees on a state by state basis starting in 2014 to 2016.  Each state can choose when they will move to the 100 full time equivalent rule.  There is not any information on the small group exchange currently available (As of June 2013).  We have not been told which companies will be available, types of plans or premiums.  I will update this post when the criteria has been determined.

Small groups are not subject to any penalties for not offering care or failing to meet the minimum benefit and premium guidelines.   Employees may go and purchase plans through the individual Exchange regardless of if the small group is offering benefits or not.

In order to determine the number of full time employees,  seasonal and part time workers must also be taken into consideration.  Assume an employer has 20 full time employees and 40 part time employees, each of whom averages 90 hours of service per month.  Each of the 20 employees averaging 35 hours of service per week are counted as full time employees.  To determine the part time employees take the total hours of service of the part time employees (90) multiply by the total number of part timers and then divide by 120.  (90 x 40 divided by 120 =30)  This means that the employer has 30 extra full time employees for a total of 50 employees.

Small groups with less than 25 employees are currently eligible for a 35% premium tax credit.  The credit is 35% of the monthly premium the employer contributes toward the health insurance costs.  This number will move to 50% in 2014. In order to be eligible for the tax credit, groups must fall within the following guidelines.

• Fewer than 25 full time equivalent employees
• Average employee wages of under $50,000 annually
• Employer must cover at least 50% of the cost for health insurance.

Groups will only be eligible for the tax credit when they purchase insurance through the SHOP exchange. Groups are not eligible if they purchase a plan directly from an insurance carrier. (Insurance carriers will still be offering plans)  Only small business owners and small business employees will be able to purchase insurance through a SHOP plan.

Other Options –Small groups that want to continue offering standard group employee coverage can certainly do so.  The negative is that health reform is likely to drastically increase small group rates (outside of the SHOP) in 2014.  Estimates range from 20% to 50% on top of the normal renewal.  Such increases will make it difficult for many small group employers to continue offering standard small group insurance plans.  As a result, many small group employers will use the SHOP plans or have their employees simply buy on the individual exchange.

Alternate funding methods may also come in to play in 2014.  Small groups do have the option of experience rating their groups which would circumvent many of the health reform mandate rules and avoid the drastic rate increases as a result.

Health Reform (Affordable Care Act) will have a major impact on most Connecticut residents.  The mandatory changes will be taking  place in Connecticut on January 1st, 2014. How will health reform effect you?  It mostly depends on how you access health care. Those on Individual health plans will have major changes while people on large employer plans may not notice much change.

Health Exchange- This term is widely used when describing Health Reform.  The Health Exchange is a place where individuals (There will be a group/company exchange as well) can go to find a health care plan.  The plans in the exchange will all be similar from a benefits standpoint and companies will need to meet minimum benefit and pricing standards to have an offering.  There is a link below which provides more information on the Exchange.  There is very little information available on the group exchange.( Called SHOPs -Small Business Health Options Programs)  Small groups will be eligible for the premium credit through the group exchange only.

Each state has decided if they will administer the new program  on their own or use the Federal Government to do it.  The initial thought in congress was that most states would be running their own Exchange which turned out to not be the case  As it stands today, 50% of the states have opted to have the federal government run the Exchange.

We have broken down the changes into categories below with  a summary of changes for each group effected.  Click on the links to learn more about each section.  If you have additional questions,  you may call our office or send me an email any time.  Emails may go to Edward@Croweandassociates.com

CATEGORIES- CLICK BELOW FOR INFORMATION ON TOPICS

Health Reform for Individuals and Families Connecticut

Health Reform for Small Groups Connecticut

Health Reform for Large Groups Connecticut

Health Reform (Affordable Care Act) uses state and federal exchanges to organize health care offerings.   Each state had to choose to offer their own exchange or instead, utilize the federal governments exchange.  Connecticut decided to create their own as did about 50% of the states.

Start Date:  The Connecticut based exchange will be up and running on January 1, 2014.   The enrollment period will start on October 1, 2013 for a coverage start date of January 1, 2014.

Who Can Get A Plan?: Just about any Connecticut resident under the age of 65 can get a plan starting in January.  There are no exclusions for health conditions and pre existing conditions and not be taken into consideration.

What are the Benefits?: There will be 4 plan types offered in the exchange called Bronze, Silver, Gold and Platinum.   The Bronze has the lowest benefits and they increase by plan with the Platinum having the best benefits.  Basic benefits levels are 60% coverage Bronze, 70% Silver, 80% Gold and 90% Platinum.

Kaiser summarized the benefits in this manner:

• Households between 100 percent and 150 percent of the federal poverty level can get a plan that covers 94 percent of costs (more than a platinum-level plan would) with an out-of-pocket spending cap that’s one-third of the standard HSA level.
• Households between 150 percent and 200 percent of the federal poverty level can get a plan that covers 87 percent of costs (more than gold, less than platinum) with an out-of-pocket spending cap that’s one-third of the standard HSA level.
• Households between 200 percent and 250 percent of the federal poverty level can get a plan that covers 73 percent of costs (just above the silver level) with an out-of-pocket spending cap that’s one-half of the standard HSA level.
• Households between 250 percent and 300 percent of the federal poverty level can get a silver plan with an out-of-pocket spending cap that’s one-half of the standard HSA level.
• Households between 300 percent and 400 percent of the federal poverty level can get a silver plan with an out-of-pocket spending cap that’s two-thirds of the standard HSA level.

How Much Does It Cost?: The amount of premium that an individual or family pays is based off the federal poverty level.  The poverty level for an individual in 2012 was $11,170 and increases with each additional family member. The plan rates are reduced for those within 400% of the poverty level.  Those earning over 400% will not be eligible for a subsidy and will pay the full premium.  The subsidy is based on a percentage of income that can be paid.  NOTE:  There are examples at the bottom of this post giving examples of the actual monthly cost.