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What’s the latest on the Cost Sharing Subsidies?

With all of the news about the CSR (Cost Sharing Reduction) payments, which President Trump halted on October 12, your clients are probably asking you to explain what exactly happened and, more importantly, how it affects them. It’s easy to understand why they might be confused—this is a political issue, so many of the reports on the topic are one-sided arguments from people who may have their own agenda.
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Don’t Forget About the Individual Mandate!

It’s now been a year since the 2016 presidential election and nearly ten months since inauguration day. By now, most of us expected major portions of the Affordable Care Act to be repealed and thought the individual mandate would be one of the first parts to go. That hasn’t happened, of course, which means that our clients are still required to purchase health insurance or face a penalty under the ACA’s shared responsibility provision.
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Will they really let Obamacare fail?

By now, everyone’s heard the news: the Republican efforts to repeal and replace the Affordable Care Act have failed in the Senate. After three unsuccessful votes—first on the Better Care Reconciliation Act, then on a repeal and delay bill, then on a skinny repeal—majority leader Mitch McConnell declared on July 27 that “it’s time to move on.” For now, repeal & replace is dead, though the efforts could certainly be revived sometime in the future.
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Is the Individual Mandate Going Away? (and what happens if it does?)

There are a lot of really good reasons to purchase health insurance:
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The Individual Mandate’s Tax Filing Requirements

As we approach the end of tax season, there’s a lot of confusion about the tax filing requirements under the Affordable Care Act’s individual mandate, largely because Americans have received mixed messages about what the rules actually are.
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Humana Pulls Out of Insurance Marketplace

Humana’s been making a lot of news lately. On January 23, a federal judge blocked the proposed $37 billion merger between Humana and Aetna. On February 14, the companies announced that they wouldn’t appeal the ruling and that that they were walking away from the deal they’d been working on for the last year-and-a-half. Then, later that same day, Humana made news once again when it announced that it would not be participating in the Obamacare exchanges in 2018. While the company will presumably continue to offer plans outside the Marketplace, it won’t be selling individual health plans eligible for a government subsidy through the federal or state exchanges.
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A Look at the New “Simple Choice” Plans

After warning for months that consumers will have fewer choices when shopping for individual coverage this fall, in this article we’ll discuss some new options that may be available for the 2017 open enrollment period.
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Don’t Take Your Individual Clients for Granted

This seems like an obvious statement, doesn’t it? In fact, it’s almost insulting – the idea that you might not be doing whatever’s necessary to earn your clients’ business every single year. We don’t mean it that way. The truth is that most agents reach out to their clients at renewal time each year, but most of the time no changes are necessary. If your customers are happy with their plan, their family situation and health status hasn’t changed significantly, and the renewal offer is reasonable, most people would rather stay put than to shop around and go through the hassle of changing their health insurance.
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It’s time to set expectations for your Marketplace clients

For the past few months, we’ve commented several times that we’re not sure what’s going to happen with the individual market this fall while continuing to point out that it could be a mess. If you’ve kept up with the news over the past several weeks, now you see why. A number of major carriers have announced that they won’t participate in the federal or state marketplaces in 2017, and those that remain are making a number of premium and plan design adjustments that our clients won’t be too happy with. That’s why it’s probably time for a “sit down” with your individual clients, particularly the ones receiving a premium tax credit. You need to set expectations for them as we head into the ACA’s fourth annual open enrollment period.
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What you need to know about the ACA grace period

As many agents are discovering, health care providers may think twice when treating patients enrolled in ACA-qualified individual plans and receiving an Advance Premium Tax Credit (APTC). If you haven’t studied the ACA grace period rules, you may not understand why. In this post, we’ll provide a quick overview of those rules.
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