HSA for America

Your 2015 Health Insurance: How to Navigate This Year’s Open Enrollment

September 1, 2014
Vol. 10, Issue 9

Open Enrollment: November 15, 2014 - February 15, 2015

Annual open enrollment is right around the corner. This is your one time during the year when you have the right to change health insurance plans, or sign up for a new plan. But do you know what your options are and how to get the best plan at the lowest cost?

While some people may be best off keeping their current plan, others will be forced to change plans. By reviewing your options, it’s likely you’ll find a lower-cost option. These are just a few things you’ll want to consider before continuing with your current plan or choosing a new one:

  • Is your current plan grandfathered?
  • Is your current plan grandmothered? If so, when does it terminate?
  • Has your income changed?
  • Do you qualify for premium assistance?
  • Are your rates going up?

Should I Keep My Grandfathered or Grandmothered Health Plan?

Grandmothered plans are plans that were in force after March 23, 2010 and were still in effect on October 1, 2013. These plans were scheduled to terminate last year until a last-minute decision allowed for them to be extended for another year. Many of these plans expire in December, though in some states some carriers are extending up until 2016.

Grandfathered plans are plans that were in effect prior to March 23, 2010. As long as your carrier continues servicing your plan, you can keep it indefinitely. If you’re considering making any changes to your plan such as changing deductible or coinsurance amounts, you should know that this would cause your plan to lose its grandfathered status, so take precaution before doing so.

Grandfathered and grandmothered plans do not meet Affordable Care Act (ACA) requirements and most do not contain all of the “10 Essential Benefits.” They are also not guaranteed-issue, and in most cases will be less expensive than new plans. If you know you don’t qualify for premium assistance, your best option is likely to keep your grandfathered or grandmothered plan to help keep premiums low.

If you make less than 400% of the federal poverty level (FPL) ($46,680 single and $94,400 for a family of 4), you qualify for premium assistance. An ACA plan could significantly reduce your premiums, and in this case, you should seriously consider changing plans during this year’s open enrollment.

Some plans are scheduled to terminate in 2014. If this is the case, you’ll have to make the switch to an ACA plan. You should set up a time with your Personal Advisor as soon as possible to start discussing your options so you don’t experience a lapse in coverage.

How 2015 Rate and Subsidy Changes Could Affect Your Premium

Rates will be changing for 2015. Some will go up, while others will go down. If you have a 2014 health plan, you should receive notification of your 2015 rate sometime in September. If you were planning to auto-renew your health plan, your advance subsidy will remain the same as 2014. This could mean you’ll be getting more or less than you should be! This also means you could end up owing a large amount when income taxes are due.

Here’s why auto-renewing is risky. Plan rates change and new carriers are joining the market. Subsidies are based upon what’s called a “benchmark plan.” This benchmark is the second least expensive Silver plan in a demographic area. If the price of the benchmark plan changes for 2015, so could your subsidy. Here’s an example:

Let’s say you currently have a plan at a cost of $300 per month and receive a subsidy of $250 per month. (You pay $50/month) Your health plan decides to increase rates by 10 percent. That increases your total plan premium to $330, and your subsidized premium to $80.

Assume that the benchmark plan in your area has changed to a cheaper plan. Your subsidy is now based on the cheaper plan and not the cost of your 2014 plan, so your subsidy decreases. Not only will you have to pick up the $30 rate increase, but you’ll also have to pay the difference between the cost of the old benchmark plan and the new one. If your subsidy decrease is $20, your total premium has now doubled - from $50 to $100 per month!

To avoid any surprises, I highly recommend anyone who received a tax credit in 2014 schedule a review with us during this year’s open enrollment. If you decide on keeping your health plan for 2015 and want to ensure you receive the correct advance subsidy, you must request a redetermination of your subsidy. Your Personal Advisor can assist you with this process - but be sure to reserve a time on their calendar now!

Why You Should Schedule Your 2015 Enrollment Now

You can only sign up for or change health insurance plans once per year, unless you qualify for a special  enrollment period. During open enrollment this year we will be extremely busy, and our Advisor schedules are likely to get completely booked.

For that reason, I recommend that you go ahead and schedule your review call well in advance. You can schedule a time directly on your Personal Advisor’s calendar, by simply clicking on their name on the About Us page on our website. If you’re not sure who your Advisor is, just call us at 800-913-0172 for assistance.

During your review call, your Advisor can determine if there are less expensive plans available for 2015 and let you know how your subsidy may be affected. They can also review your grandfathered or grandmothered plan and help determine if it’s to your advantage to keep your plan or switch to an ACA plan.

If you have not yet had your Annual Comprehensive Policy Review, I encourage you to discuss your plan with your Advisor now. But unless you are absolutely keeping your current plan for another year, definitely schedule a time to talk to us in late November, so your new plan will be in force January 1.

To your health and wealth!

"First day in his new school"

Wiley Long
President - HSA for America

P.S. If you do plan to hold on to your current coverage through 2015, please just hit "reply " and let me know, and I'll make sure your record is marked so we know not to bother you during this year's open enrollment.



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