Update for those with health insurance policies purchased after 1/1/2014

THIS AFFECTS YOU!!

If you qualify for and want to use a premium tax credit (subsidy) to reduce the monthly cost of your insurance, you have to purchase your policy on the exchange.

The ONLY companies selling health insurance plans on the exchange for 2017 as of 10/7/2016 are:

Maricopa County:    Ambetter from HealthNet HMO – From what we’ve heard, they will use the existing HealthNet Community Care HMO network in addition to the physicians at the CIGNA HMO buildings. The actual plan designs and rates have not been released yet.

Pima County:    Ambetter from HealthNet HMO (no bronze plans)

BCBS referral based Neighborhood Network HMO (One plan only, Simple Health catastrophic plan, for those under age 30)

All other Counties:   BCBS referral based Neighborhood Network HMO.  There will be five plan choices, Everyday Health 1000, Everyday Health 4000, Everyday 6500, Portfolio 6550 H S A and the Simple Health Catastrophic plan, for those under age 30.

I WANT TO PURCHASE MY PLAN DIRECT THROUGH AN INSURANCE COMPANY, NOT HEALTHCARE.GOV.  DOES THIS AFFECT ME?

YES! 

We have been told that Aetna filed for ONE silver plan as a direct purchase (off exchange, no subsidy) in Maricopa County using Aetna Leap Banner HMO.  However, this is being considered a “dormant” plan by Aetna, meaning they do not plan on marketing it and you will not be able to find it or apply on their website.  We do not have any details about the plan, the rates, OR the method of purchase for this product at this time. 

Those of you in all counties EXCEPT (possibly) Maricopa County you will HAVE to purchase your plan on the exchange.  There will be no plans sold direct from an insurance company. 

  

DO I HAVE ANY OTHER OPTIONS?

SHORT TERM medical policies will still be available for purchase to those who can medically qualify.  You can purchase a plan for up to 364 days.  These plans cover you in the case of an illness or injury, but do NOT cover pre-existing conditions, well visits, preventative care, etc.  They do NOT qualify as an ACA approved plan and you may have to pay the penalty for not having compliant insurance.

  1. You have to medically qualify
  2. They do NOT cover pre-existing conditions or preventative or well visits
  3. You may still have to pay the penalty for not having “appropriate” health insurance as mandated by law

Altrua is a health insurance alternative that is exempt from the Affordable Care Act (no tax penalty).  It is a faith-based solution that has been around for 30 years called Health Care Sharing Ministries (HCSM).  It is very affordable but you MUST abide by a strict Statement of Standards.

  1. It is a fully underwritten policy, meaning you have to medically qualify and be accepted.  They can and will charge extra premium, place exclusion riders on existing conditions or decline you all together. 
  2. This option is for healthy people only with no or few pre-existing conditions. 

Self Employed/Small Group Insurance might be an option if you are self-employed with at least 1 (non-spouse) W-2 employee.  Small group is guaranteed issue, usually has cheaper premiums, and has a wide variety of PPO and HMO plans available.  If you think you qualify as a small group, please contact Cindy or Kevin.

Employer sponsored coverage.  If you have group health insurance available through an employer, you may want to consider or revisit this option.

 Stay tuned as we will keep you updated as information becomes available.

We will also send out an email when it’s time to start scheduling the phone appointments for open enrollment, November 1st – December 15th.