25 Oct 2013

Pre-Weekend Update: California Individual Health Market

25 Oct 2013

As promised, I have been putting together updates on the individual market, and want to share some information with you before the weekend. I’ll answer a few common questions, and also provide links to more information about what’s happening with specific carriers as well as the Covered California marketplace.

A Handful of FAQ’s

  • I got a notice from my carrier that my rates are going up and I am being moved to a plan with a higher out of pocket maximum. What can I do?

Most people will not have the option to keep their current plan, and some are seeing 2014 rate increases as high as 70%. I recommend that everyone in this situation consider switching to a Cigna PPO plan before the end of 2013, as a cost-mitigation strategy. Read more about this here, and then contact us to discuss whether this is the right strategy for you.

  • Why would someone who knows their 2014 income will be over 400% of the Federal Poverty Level apply through the Covered CA marketplace?

The only reason is if you have income uncertainty for 2014. If you might fall below the threshold, you can preserve your right to a possible tax credit by choosing a plan through the marketplace. However, for those who are certain they will not qualify, the application process directly with the carriers will be surprisingly quick and easy. No health or income questions required; just who is enrolling, and what plan do you want.

  • How do I estimate my Modified Adjusted Gross Income (MAGI) for 2014?

The default information from UC Berkeley Labor Center has confused quite a few people. Please consult with your tax professional, but in general, for most people, MAGI will be the same as AGI (line 37 of your 1040 tax return).

Quick calculation: 1040 Line 37 (Adjusted Gross Income) + Non-taxable income (Muni bonds, etc) + Non-taxable part of Social Security + Sec 911 deductions (overseas domicile, etc) = MAGI

  • How many people are in my “household?” Does my roommate / boyfriend / girlfriend count?

Generally, the number of people in the household means the number of people who will file a tax return together in 2014 (primary taxpayer, spouse if applicable, dependents if applicable).

  • I really don’t want to wait for the Covered California online application to work properly. Can I just complete a paper application and submit it through you?

Absolutely. You can download the .pdf version here, and submit it to our office via US Mail, secure fax or scan/email. Please be sure to alert us that you have sent the application so that we know to look for it.

Carrier Updates
I put together a series of blog posts to help you understand what is happening with your coverage and the different carriers for the remainder of 2013 and in 2014.

Covered California
Aetna
Anthem Blue Cross
Blue Shield of California
Cigna
Health Net
Kaiser Permanente

Next Steps

  • If you need guidance, or just want to talk through your options, please contact my Account Manager, Carla Arriola, at (888) 992-2244 x5 or carla@allpointe-is.com to schedule a call with me. I continue to recommend that people wait until early- to mid-November before applying for a January 1, 2014 plan.
  • If you know that you will not qualify for a tax credit or subsidy, and are ready to move forward, you can get quotes and apply now to all carriers (except Cigna), using the Quick Apply option.
  • If you want to move to a Cigna plan on 11/15 or 12/1 in order to lock in a lower-cost, ACA-compliant option for all of 2014, use this link.
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