A couple of months ago, we posted three “done for you” letters that you could copy and paste into an email to your small group, individual, and Medicare clients. Here’s another “done for you” email that you can send to your individual clients and prospects to let them know about three important changes for 2019.

Subject Line: Three important updates about your health insurance coverage

Hi! As we enter the annual open enrollment period in the individual market, I wanted to send you a quick email to let you know about three big changes that could impact your health insurance coverage. Over the next few weeks, I’ll be in touch so we can review your renewal offer, discuss your specific options, and determine what’s best for you and your family. In the meantime, please let me know if you have any questions about the below changes or anything else.

Individual mandate

As you’ve probably heard, the tax bill passed last December reduced the individual mandate penalty to zero starting January 1, 2019. Obviously, you have had minimum essential coverage and have not had to pay a shared responsibility penalty, but the elimination of the penalty will allow us to look at other options that could be a good fit for you and your family members this year. With no requirement to purchase a particular type of policy, we can consider other plans that may offer similar coverage, lower premiums, or both.

Out-of-pocket limit

The Affordable Care Act limits the cost-sharing amount you are responsible for on a qualified health plan, but that amount goes up every year. In 2018, the out-of-pocket limit was $7,350 for single coverage and $14,700 family coverage. For 2019, it increases to $7,900 for single coverage and $15,800 for family coverage. That’s a lot of money, and it’s why health insurance alone may not be enough. When we visit to discuss your coverage options, we’ll also discuss the possibility of supplementing your health insurance with an accident and/or critical illness policy. These affordable supplemental insurance policies can help offset the big out-of-pocket exposure on today’s health plans.

Short-term plans

I mentioned the other types of plans we can consider now that the individual mandate penalty has been eliminated. One of those is a short-term plan. Short-term coverage does not meet the definition of “minimum essential coverage” and therefore would not have protected you from a penalty in the past (Note: the penalty still applies for the 2018 calendar year). Still, short-term plans can offer medical coverage (with lower deductibles and out-of-pocket limits) at a lower premium. We can discuss all of the pros and cons, but here are a few things to know about short-term plans:

  • These plans are generally not guaranteed issue, which means you will have to answer a few medical questions and you could be declined.
  • Even if you are approved, short-term plans do not cover services related to pre-existing conditions. They are meant to protect you against future injuries and illnesses.
  • Short-term plans do not cover all of the essential health benefits required by the Affordable Care Act and do not provide 1st dollar coverage for preventive care.
  • Unlike plans sold in the individual market, short-term plans can have annual and lifetime dollar limits.
  • These plans can last for up to 364 days and can be renewed for up to three years (if allowed by the carrier). If we determine that a short-term plan is right for you, we would set it up for a January 1, 2019 effective date. If you do not have any medical issues during the year, we can likely renew it for 2020 at this time next year. If you do develop a medical issue during the year, we can move you to a guaranteed-issue short term medical plan during the next open enrollment period, but that plan will not cover pre-existing conditions.

It’s important to go through the pros and cons of short term medical plans with your clients so they can make a decision that works for them and their families.

Thank you for continuing to put your faith in our agency. We’ll continue to do our best to find you the best possible coverage at the lowest price possible. I’ll talk with you soon.

Obviously, you can change the above wording any way you see fit, but if you like the message, feel free to send it to your individual health insurance clients. Good luck!