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Health Reform Plan Questions and Answers Connecticut

Here are some  Health Reform Plan Questions and Answers Connecticut.  These are some of the more common questions that we get on a daily basis.  The questions are regarding health reform plans in Connecticut.  If you have questions that are not on this list, need a quote or want to enroll, please feel free to either call us at 203-796-5403 or send an email to Edward@croweandassociates.com

Question:  What is the difference between Obama Care and the health exchange in Connecticut?

Answer:  They are the same.  Different names clients use to describe buying insurance through the exchange or also know as “Obama Care”.

Question: Can I get help paying for my premiums?

Answer:  Yes, if you purchase a plan through the exchange and meet the income requirements. You can not get help with your premiums off the exchange.

Question:  Can anyone get insurance through the exchange?

Answer:  Yes,  anyone can apply and get a plan.  Not everyone can get help with the premium however.  The exchange will base that decision on your annual income.

Question:  Are there are underwriting/health question on or off the exchange?

Answer:  No.  In fact, health questions are not allowed on or off the exchange.  You can not be denied for any health condition after January 1, 2014.

Question:  I applied for a health reform plan and then received a notice saying I was denied for Husky.  What does this mean?

Answer:  It is only applicable to you if you actually applied for Husky. If you applied for a standard health reform plan, the notice is not applicable to you and has nothing to do with your enrollment.

Question:  How do I know if my doctor participates in the health reform plan I want to enroll in?

Answer:  There is a doctor search function on the Access Health website.     CLICK HERE FOR THE SITE.      After you receive a quote, there will be a button to hit in order to check doctors for each plan.

Question:  Are the networks for the Exchange plans the same as the networks off the Exchange?

Answer: NO- they are different. Don’t assume you doctor is in the network just because he or she was in network on your old plan.

Question:  How do they determine how much I pay for coverage?

Answer:  The exchange will base the amount you pay on both your age and gender.  Although, the biggest influence on  your rate is the amount of subsidy you receive.  The Subsidy you receive is determined by the amount of income you enter when you get a quote.

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.

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

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

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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.