For independent health insurance agents, such as me, who don’t have access to an already established secure network through a large agency, we have to be more diligent in securing all the different parts of the internet communication puzzle.
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Kevin Knauss: Health, History, Travel, Insurance
Built into the Affordable Care Act is the loss of the health insurance subsidy when the household income exceeds 400% of the federal poverty line. For older adults whose income might be greater than 400% of the federal poverty line they face losing the Advance Premium Tax Credits that makes their health insurance premiums affordable. In some instances the health insurance premiums can shoot up to over 20% of their income.
One of the most baffling health plan descriptions is the 2016 Bronze 60 health plan that states that the member is responsible for 100% coinsurance after the deductible. Most people who read this immediately shake their head and think, “I have to pay for all of my health care services EVEN AFTER I meet the deductible?” There really is no reason to buy health insurance if it never helps with the costs. The second part of the equation, not always referenced, is the calendar year maximum out-of-pocket amount of the Bronze plan which does limit a health plan members health care expenses.
Blue Shield of California’s billing system that created major headaches for individuals and families in 2014 continues to stumble into 2016. Even through changes to the enrollment website, the simple tasks of determining an applicant’s eligibility and properly applying a premium still seems elusive to Blue Shield in several instances. For whatever reasons, several of the Blue Shield units – underwriting, eligibility, billing, member services, and IT- don’t seem to talk to one another.
The Department of Health Care Services (DHCS) has developed a Medi-Cal household size flow chart. The DHCS Guide for Calculating MAGI Medi-Cal Individual Household Size was originally developed to help county eligibility workers ascertain the actual household size under the new Affordable Care Act (ACA) rules. The newly expanded Medi-Cal eligibility under the ACA revolves around on IRS definitions for tax dependents and non-filer rules. Because families can be so diverse and the rules regarding what constitutes a tax family so complicated, the flow chart for determining household size was created.
Even those people who hate Obamacare come running to it when they need help. A person who contacted me to clarify that he could enroll in an Obamacare plan because his Christian health care sharing ministry wouldn’t cover pre-existing conditions shows how people use these sharing ministries to dodge Obamacare and reveal their hypocrisy when they do need real health insurance.
I screwed up big time on behalf of a man with a serious illness. The end result is that he will be without health insurance for the month of December. Even though there are other people who failed in this situation, I have to take the ultimate responsibility that he might have to shoulder thousands of dollars in health care expenses that would have been covered by health insurance. I broke the business rule of never following your heart, and always trust your gut.
UnitedHealthcare has alerted their appointed health insurance agents that they will not pay any commissions for individual and family plans sold after January 1, 2016. The abrupt cancellation of commissions applies to Marketplace state based exchange plans and health plans sold off-exchange directly through United Healthcare. Commissions on enrollments prior to December 31, 2015, will be honored.
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