Procrastination

I’ve been meaning to get around to it. It was a great article in Time magazine, I learned some interesting facts, and I wanted to express my appreciation. It was an article on Procrastination and it appeared in 1979. And I will get that letter off to them soon. I know I will.

Open Enrollment, your chance to purchase individual health insurance, ends March 31, 2014. That’s it. We have two weeks left, according to the Patient Protection and Affordable Care Act (PPACA or Obamacare) to get a policy. On April 1^st the doors are closed and the gates are locked.

The deadline is two weeks away and the procrastinators are about to be closed out. And they aren’t alone. The insurers aren’t advertising. The State of Ohio is uncharacteristically silent. A surprising number of people are still trying to determine whether any of this, this Obamacare, has anything to do with them. Others won’t start looking for insurance until their current policy renews in June or July and their premium goes through the roof. Boy are they going to be surprised.

Since we are no longer asking health questions and since preexisting conditions must be covered, there has to be an open enrollment period each year to purchase coverage. Otherwise, people would wait until after an illness or an injury to apply for insurance. We can’t have ambulance drivers selling insurance on the drive to the hospital.

These are the qualifying events for a Special Enrollment:

• Loss of Minimum Essential Coverage (Loss of Minimum Essential Coverage does not include termination due to non-payment of premium, including COBRA premium, or in the event of rescission)
• Becoming a dependent through Birth
• Becoming a dependent through Adoption or placement for adoption
• Becoming a dependent through Marriage
• Error in enrollment
• The plan or insurer substantially violated a material provision of the contract under which you are enrolled
• Newly eligible or newly ineligible for advance payments of the premium tax credit or experience a change in eligibility for cost-sharing reductions through the Exchange Marketplace
• New coverage becoming available as a result of a permanent move

In simple terms, you must have an insurable event, a major change in your life. And if you don’t, you will have to wait till the next open enrollment at the end of 2014 for a January 1, 2015 effective date. Your only other choice will be short term coverage.

I know, I know. You are going to get around to this. No problem. You’ve still got two weeks.

DAVE

www.bcandb.com

Month Six

(The Last Month of Open Enrollment)

The first open enrollment of the Patient Protection and Affordable Care (PPACA or Obamacare) is coming to an end. Six months. Much anticipated. Terribly disappointing. We began in October with a system of crashing computer sites and missing forms. We end way too close to where we began.

Even with all of the television, newspaper, and magazine stories, an incredible number of people are still surprised when I tell them that there are no longer any health questions on the application. So, let’s do a quick reminder:

Date of Birth?

Where Do You Live?

Do You Smoke?

Those are the questions, the only questions, used to determine the price of health insurance under the PPACA. It doesn’t matter whether you purchase a policy through the government website or through an agent, the rules are the same. Preexisting conditions are covered. Maternity is covered. And if your income is low enough and you would like some help in paying the premium, we’ve got that covered, too.

Healthcare.gov is still a mess. There are days where it works well. There are days when it doesn’t work at all. What many of us have discovered is that success on Healthcare.gov is purely random. No luck at 10 AM and Jackpot two hours later. We still have clients misdirected to Ohio Medicaid. We can still spend an hour and a half, get to the last screen, and watch it crash. But two weeks ago I zipped through an entire application, start to finish, in less than an hour with a single woman who has had the same job for years.

Avoid Healthcare.gov unless you are getting a subsidy. You don’t need the extra steps. You don’t need the aggravation.

These posts have detailed the successes and failures of both the government and the insurance companies as we attempt to process the changes our new system has wrought. And there have been successes, huge victories for the previously difficult to insure. And there have been moments of terrible frustration, anger, and tears.

New stuff since the last update:

Billing – It appears that the insurance companies have forgotten how to generate timely paper bills. I have clients still looking for their January statements. Electronic Transfers from checking accounts seem to favor the insurer. Cancel a policy with certain insurers and the next payment may still disappear from your account. My suggestion? If given the option, choose automatic payment from a credit card. It is much easier to reverse an erroneous charge. No bounced check charges. Less hassle.

Individual Mandate – The House Republicans are set to vote on their 50^th attempt to dismember the PPACA. Oddly enough, if they had packaged this request, the postponement of the requirement to purchase coverage till next year, with less vitriol, I suspect that it would pass easily. Too many Americans have given up on Healthcare.gov or have simply chosen to sit out this year for the government to enforce this part of the law. Postponing the Individual Mandate till 2015 would actually help the Democrats much the same way as skipping the Employer Mandate made the fall of 2013 more pleasant.

Kicking ‘em When They’re Down – An insurer, who will remain nameless, is still digging out from a problem created by a President who was only trying to help. Call it the law of unintended consequences. On November 22, 2013, the administration changed the deadline for January 1, 2014 coverage from December 15^th to the 23^rd. This caused any number of problems for the insurers. At least one major insurer failed to change the computer programs. The applications received after the 15^th were coded with a February effective date. Those people were not in the insurer’s system for January. No coverage (technically, no coverage without a fight), no billing, no insurance cards. Worse, when the insurers backed them out of their systems, the new applications were not necessarily reentered in a timely fashion. Again, this blog will not gloat over this system failure. I have talked to the employees of at least one of the affected companies. They are aggravated and embarrassed.

New taxes – insurers must now collect the following Federally Mandated Fees (Taxes) each month:

PCORI - $0.18

Reinsurance - $5.32

Market Share – 2.4% of the total premium

This money goes directly to the government and the fees are subject to change (UP).

Short Term Policies – UnitedHealth One is having a banner year in Ohio. They aren’t on the Exchange and their individual policies aren’t competitive in our area. Their Short Term Major Medical Policies, plans perfect for those people who choose to sit out 2014 and avoid the PPACA, are very popular. Cheap and easy wins out again.

Kicking ‘em When They’re Down II – A woman (not a client) felt compelled to share with me the problems she is having with her current insurer. The insurer has a well-known name, but does not have much of a market share in Greater Cleveland. Their reputation was that they were paperwork challenged. This insurer also undercharged on certain conditions which, of course, was reflected in their over-all rates. Anyway, she took the time to detail improper charges, months without coverage, and excessive withdrawals from her checking account. I offered a simple solution, change insurers. We still have two weeks to get her covered for April 1^st. She declined. After all, her current policy is less! I quoted David Ackles. “They suffer least who suffer what they choose.”

Anthem Blue Cross – The senior division, the area that sells Medicare Supplements, Medicare Advantage, and Medicare Part D, has been providing great service to my clients and me. Of course, the PPACA hardly touched this division. We are holding out hope that the rest of the company regains solid footing.

Medical Mutual of Ohio – Sure there have been challenges, but I must report that the last six months have given me a greater appreciation of the employees on East 9^th Street and out in the Strongsville outpost. Maybe it is the local aspect. Maybe it is the corporate culture. Regardless, nobody returns phone calls faster or trying harder to get through this changeover. G-d knows we’ve given them the opportunity to shine.

The open enrollment ends in 30 days. Are you where you want to be?

Six months and we are still in this together.

DAVE

www.bcandb.com