The California Marketplace

by John Hansen

Obamacare rates are going up in 2017. Most states will have rate increases in the double digits. According to leading General Agency / FMO, Health Family Insurance, they have seen nothing in the single digits across the country with regard to average rate increases by state.

Some carriers are raising rates much more than 20%. Blue cross in Texas will have an almost 55% rate increase across the state in 2017 for Obamacare plans. Humana in Michigan will have a price increase of over 50% next year.

For more information on the ACA plan options and rate levels, see Obamacare Plans and Prices.

The 3 R’s, Risk Adjustment, Reinsurance and Risk Corridors, were put in place to reduce risk for health insurance carriers. However, some changes are happening to Obamacare in 2017; 2 of the 3 R’s are going away. This alone is causing medical plans to file for rate increases.

Also, carriers are just now beginning to get a clearer picture of the risk associated with the pool of Health Care...

by Esmeralda Mercado

Did you know that if you were uninsured in 2015 but you buy insurance now, you could still owe a penalty when you file your income tax return this April? That is because income tax filings are based on the activity for the previous year. Although it may be too late to avoid the tax penalty for being uninsured in 2015, it’s not too late to avoid it for 2016. Getting insurance now will protect you from having to be penalized when you file your tax return in 2017. For free quotes or to enroll, go to www.healthforca.com.

If you did not have health insurance for three months or more in 2015, and you did not qualify for an exemption, the penalty when you file taxes will be the greater of:

If you do not get insurance now, you will not have a valid exemption. The penalty when you file taxes for 2016 will be the greater of:

Note that if you had coverage for part of the year, the penalty will be pro-rated. Also, if you were without health insurance for two months or less, then...

by John Hansen

The outcry in the marketplace is: “It costs too much!” For those now getting subsidies, many are finding California health insurance more affordable than ever, but for everyone else the price went up. Tax payer dollars will now be collected to pay for these subsidies. Many question, how long will America be able to foot the bill? The healthcare industry including hospitals, doctors, other medical providers and health insurance companies are now having to deal with greater bureaucracy than ever. More paperwork. More government regulations. Reporting regulations. Budgeting regulations. Delivery of care regulations.  And on and on! So, the industry is screaming for solutions. How can we make healthcare more affordable in this new marketplace that has been radically transformed due to the Affordable Care Act? Like it or not, here are four trends in the industry that are aimed at reducing cost:

Some health insurance carriers have chosen to offer “narrow networks” in or...

By Esmeralda Mercado, John Hansen, and Stephen Saucier

Recently, President Barack Obama issued an executive order to postpone the individual mandate penalty so that individuals and families may begin coverage as late as May 1, 2014 without having to pay a penalty. It’s a Win-Lose scenario. It’s probably a win for consumers at least in the short run and a loss for insurance companies. Consumers could save some money, but health insurance companies might take a hit.

Buggy application systems. That’s why! Lots of people are trying to enroll but are finding it very difficult. One of the reasons that it’s so hard right now is because the online systems that allow everyone to apply for Obamacare aren’t working very well. And so, as a result of all the bugs and glitches, countless people are finding it almost impossible to submit an application.

Others might want to wait just to save some money. For some people, Obamacare is going to cost them more than what they’re currently paying....

By Esmeralda Mercado, Stephen Saucier, and John Hansen

Last week a proposed change to the Affordable Care Act was brought to the table by House Representative Daniel Lipinski, Democrat from Illinois, and approved by executive order by President Barack Obama. This proposal recommended that consumers would not have to pay a penalty as long as they submitted an application by March 31, 2014, which would result in coverage beginning on May 1st. What this means is that you will not have to pay a penalty even if you are uninsured for the first four months of 2014.

Prior to the mandate change, the Affordable Care Act required that you be insured no less than 9 months during 2014 in order to avoid the penalty. So anyone who was uninsured for more than three months was going to have to pay a hefty penalty. A penalty would not have been applicable so long as your coverage began by March 1st. You just couldn’t be without the “minimum essential benefits” for more than three months. However, no...

By Esmeralda Mercado, Stephen Saucier, and John Hansen

If you’re currently insured in California, it’s probably a good idea to know how your insurance company is going to deal with your current coverage going into 2014. If you’re with Health Net, you must act soon or your coverage may get cancelled. The other carriers will automatically switch you to the plan of their choice if you don’t notify them of what plan you want.

Beware, that none of the carriers will transfer you to a Covered California exchange plan, which you’ll need to be on if you want to qualify for government subsidies. You can get one of the exchange plans from any of the top health insurance carriers, but you will have to enroll on that plan and cancel your current coverage.

Here’s a rundown on how the top health insurance companies in California will be dealing with their existing members going into 2014.

If you’re enrolled on an Anthem Blue Cross, Blue Shield or Kaiser Permanente plan that’s not carrying...