Archive for the ‘Affordable Care Act (ACA)’ Category

2021 Changes to NC Health Insurance Premiums and Marketplace Subsidies

Thursday, April 8th, 2021

Major changes have been implemented to lower health insurance costs for people purchasing their coverage through the Health Insurance Marketplace.  Under the American Rescue Plan of 2021, many Americans will become newly eligible for federal government subsidies applied toward monthly Insurance premiums.  This will trigger plans to be much less expensive for many people that have shopped for health insurance through the Marketplace in years past. 

Who is Eligible?

  1. People with Higher Income:

Since the introduction of the ACA, individuals and families making over 400% of the Federal Poverty Level (FPL) did not qualify for a subsidy.  After April 1st, 2021, many people making a higher income or over 400% of the FPL will be eligible for a subsidy.  This federal subsidy will help reduce the cost of the health insurance.  Many Americans will pay significantly lower monthly premiums for Individual market health plans.

2. People currently eligible for a Subsidy:

Many people who are already eligible and already receiving a subsidy will qualify for more subsidy.  Estimates indicate that most people will see health insurance costs decrease and some will pay as little as $0 per month with the new subsidies applied.  This group should see a significant change in the cost of plans.

When Can I Apply or Change My Plan?

The Federal Government has created a Special Enrollment Period which will allow health insurance shoppers to enroll in a plan now.  This Enrollment Period is currently set to end on Aug 15th, 2021.  Once you apply, coverage can become effective as early as the 1st of the month following when you apply.

You can View Plans and Apply Online here for a plan through the Health Insurance Marketplace.

Blue Cross Blue Shield of North Carolina Announces Rate Decrease for 2020

Tuesday, August 6th, 2019

Blue Cross Blue Shield of North Carolina is excited to announce filing for a 2020 rate decrease with the North Carolina Department of Insurance.  This is a big step in Blue Cross of NC’s movement toward making healthcare more affordable to North Carolinian’s.

Blue Cross NC Rate Decrease for 2020

For the second year in a row, Blue Cross Blue Shield of North Carolina has filed to decrease rates for coverage starting in the new year. This rate decrease is an overall average of 5.2 percent for Affordable Care Act plans offered to individuals and families in year 2020. There is also an average 3.3 percent decrease for those plans offered to small businesses with one to 50 employees. These rate decreases show a total reduction of $238 million to health care costs in 2020.

“We want to be a national model for health care transformation, where insurers and providers are jointly responsibly for delivering better, simpler, more affordable care,” said Patrick Conway, President and CEO of Blue Cross NC. “The hard work is not done, and we must continue building on these successes if we are going to truly make health care affordable for everyone in North Carolina. What these rate reductions show is that the move to value is working – when the focus is on quality and accountability, costs go down and the customer wins.”

Does this mean your premium will decrease?

Health Insurance premiums will always vary based on your location, age, and federal tax credit/subsidy applied to your premium. It is important to know that the overall rate decrease is an average for all counties in North Carolina. Therefore, not every Blue Cross NC member in North Carolina will experience the same amount in rate changes for 2020.

As of now, the Federal Tax Credits or Subsidies will still be available in 2020 to enrollees with a household income between 100 and 400 percent of the Federal Poverty Level. Nearly 90 percent of existing Blue Cross NC enrollees are subsidy eligible. To determine if you may be subsidy eligible, CLICK HERE to generate a quote online and discover how subsidies can greatly reduce the cost of your monthly Health Insurance premium.

When is the 2020 Open Enrollment Period?

The Open Enrollment Period will begin on November 1st, 2019 and ends December 15th, 2019. This is the time of year where anyone can enroll in a Blue Cross Blue Shield of NC plan without needing a Qualifying Life Event. We know the importance of understanding your health coverage and understand that the Health Insurance market can be confusing. If you are an existing member or considering enrolling in a Blue Cross Blue Shield of NC plan during the Open Enrollment Period, we are happy to help you through the process. Rate quotes for 2020 plans as well as renewal information for existing members will be available in October.

For more information on North Carolina Health Insurance coverage, please visit our website at or call our toll free number 888-765-5400 and speak with one of our experienced and professional agents.

 New and Improved NC Health Insurance Marketplace Application

Thursday, February 21st, 2019

The Health Insurance Marketplace has recently approved a brand new, quick and simplified application process that will benefit all Marketplace customers, old and new. As we are in the Special Enrollment Period, existing Marketplace members often find themselves needing to make updates or changes within their application. On the other hand, new members who qualify for a Special Enrollment Period need to apply on the Marketplace within 60 days of their Qualifying Life Event. This new and improved application process was designed to help simplify the process and make your marketplace application easier to navigate. If you are in the market for an affordable Health Insurance plan, or are currently enrolled through the Health Insurance Marketplace, look no further to make your editing or enrollment process much easier during the Special Enrollment Period.  The process can be started by generating a quote and clicking “Enroll.”

Do you need to get enrolled in an affordable health plan?

If you qualify for Special Enrollment Period and have experienced a qualifying life event within 60 days, you may be eligible to enroll in an Affordable Care Act health plan. In order to apply for savings on the cost of these health insurance plans, one must apply for a federal tax credit or subsidy through the Health Insurance Marketplace. Subsidies can greatly reduce the cost of your monthly premiums, allowing you to save money on the cost of health insurance.  In the past, the application has been lengthy and repetitive.  However, the new and improved application process can simplify this experience, making it easier to navigate your application. This more user-friendly application helps guide you through the questions and makes them easy to understand. Generate a quote to discover if you are eligible for savings during the Special Enrollment Period and get started on your application!

Already enrolled through the Health Insurance Marketplace?

If you are already enrolled through the Health Insurance Marketplace and receive savings on your Health Insurance premium, there are several topics to consider during the Special Enrollment Period. These topics may trigger you to make changes to your application throughout the year. If you experience income changes, you must submit these changes to the marketplace. It is very important to keep your income up to date to ensure you are receiving the correct amount of federal tax credit, or savings on your premium. Other updates may include adding or removing household members from your application or reporting a move from your primary place of living. Utilizing this updated application platform will allow you to make these changes quickly and easily when needed. If you are enrolled through the Marketplace and need to make updates or changes, CLICK HERE to access your application or give us a call. We are happy to discuss these changes with you and ensure that you are taking the correct steps to update your application during the Special Enrollment Period.

For more information on North Carolina Health Insurance coverage, please visit our website at or call our toll free number 888-765-5400 and speak with one of our experienced and professional agents.

Learning about North Carolina Health Insurance

Thursday, August 16th, 2018

North Carolinians already know that we live in a wonderful and special place. It is not often that you can make a trip from the most beautiful mountain tops to the crystal clear waters of our coast in just a day. With North Carolina having so much to offer, it is not surprising that our population is growing, and more and more people are choosing North Carolina to call home.

Because the health Insurance industry is regulated partially at the state level, living in North Carolina can directly affect the health insurance that is available to you, and how and when you can apply. Whether you have deep roots or have just become a resident of “The Old North State”, these are some things that all North Carolinians should know about North Carolina Health Insurance:

What Types of Coverage are available to me in NC?
Residents of North Carolina have two major types of individual/family insurance available to them, Affordable Care Act (ACA) compliant, also referred to as “Obamacare”, and other alternatives like Short Term coverage. ACA-compliant plans are required to cover the same set of essential health benefits under the Affordable Care Act laws. Blue Cross Blue Shield of North Carolina offers the broad majority of these plans across the entire state. Short Term plans are not ACA compliant, but allow individuals and families to enroll outside of Open Enrollment Periods without a Qualifying Event. These plans do not cover pre-existing conditions, but are often more affordable than ACA compliant plans.

When Can I Apply?
The Open Enrollment Period is a yearly period when individuals and families can enroll in health insurance. Open enrollment for 2018 will begin on November 1st and last until December 15th. Open Enrollment is a very important time period because all individuals are eligible to enroll. If you miss Open Enrollment, you must qualify for a Special Enrollment Period. To qualify for Special Enrollment, you have to experience a Qualifying Life Event. Qualifiers such as getting married, having a baby or losing coverage provided by an employer could make you eligible to enroll during Special Enrollment, as long as you enroll within 60 days of the life altering event.

Is it Affordable?
One of the amenities of the Affordable Care Act is federal tax credits, also known as subsidies. Subsidies are designed to lower the cost of health insurance for low and middle income individuals or families. If you are eligible for a subsidy, it could greatly reduce the cost of your monthly premium. Generate a Blue Cross Blue Shield of NC health insurance quote to find out more about whether you are eligible for a subsidy.

At NC Health Plans/Jerry Ballard & Associates Inc., we love living in North Carolina and take pride in serving North Carolinians statewide. Our website allows you to generate quotes, shop for plans, and apply online at your convenience. If we can assist you in selecting a health insurance plan, please call us at 888-765-5400. We are North Carolinians serving North Carolinians!

For more information on North Carolina insurance coverage, please visit our website at or call our toll free number 888-765-5400 and speak with one of our experienced and professional agents.

2019 Blue Cross Blue Shield of NC Rates and Changes

Friday, August 3rd, 2018

Blue Cross Blue Shield of North Carolina announced on July 31st the company has filed for an average rate decrease of 4.1% on Affordable Care Act individual health plans for 2019.  This will mark the first year North Carolina’s largest health insurance company has filed for a rate decrease on individual plans after several years of double digit increases since the implementation of the Affordable Care Act in 2014.

“We’re moving in the right direction, but even with a lower rate, premiums are still too high — particularly for those who don’t get a subsidy,” said Dr. Patrick Conway, Blue Cross Blue Shield of NC’s President and CEO.  “With more certainty from Washington, rates would be 15 percent or more lower. We must address both market instability and the rising price of health care.”

A number of factors contributed to this rate filing.  Brian Tajlili is BCBSNC’s Director of Actuarial and Pricing Services.  He references: the cost of providing medical services and prescription drugs for members, new provider arrangements that will reduce costs, the suspension of the federal Health Insurer Tax, and the elimination of the individual mandate penalty; as a few of these contributing factors.

Although the overall average rate will decrease on plans across the state of North Carolina, some counties will still see rate increases.  The counties that do see a rate increase will not incur increases over 10%.  Blue Cross will not release the exact rates for plans until closer to the start of Open Enrollment on November 1st.

Other Changes to Blue Plans

Another of the most significant Blue Cross NC plans will take place in the Triangle and surrounding regions.  The Blue Local with Duke Health and Wake Med will be discontinued in 2019.  This plan currently covers approximately 50,000 members in 12 counties.  These members will be receiving notices in the coming months to help prepare for the transition to new plans.  Alternatives to the Blue Local with Duke and Wake Med will depend on which county the member resides in.

Transitional Plans will continue to be offered in 2019.  Transitional plans are plans purchased between March 2010 and October 2013.  These plans do not meet the ACA requirements and are only offered to existing customers.

More details on these changes and others will likely continue in the months ahead.  Blue Cross Blue Shield NC has filed for plans in all 100 counties of North Carolina for 2019 and continues to be the only insurer in North Carolina that offers Individual ACA health plans in all counties.

For more information on North Carolina insurance coverage, please visit our website at or call our toll free number 888-765-5400 and speak with one of our experienced and professional agents.

6 Topics to Consider Outside Open Enrollment

Friday, March 16th, 2018

Whether you are enrolled in Medicare, Health Insurance, or are uninsured, there are some concepts, rules and requirements to consider outside the Annual Enrollment Periods.  Here is a list of a few basics to consider about insurance despite currently being outside the heavily publicized Open Enrollment Periods.

  1. 1095 Tax Forms– As most are filing taxes this time of year, don’t forget the IRS may require you to show proof of health insurance. The 1095 tax forms serve as proof of health insurance coverage.  These 1095 forms can be provided by the Health Insurance Marketplace or by a private insurance carrier, depending on how you are enrolled.  We recommend consulting a Certified Public Accountant for more information on about the need for these forms.
  2. Short Term Health Insurance– If you are currently uninsured and have not recently experienced a Qualifying Event that would allow you to enroll in a qualified health insurance plan, a short term health plan may be an option. Short term plans do not comply with the Affordable Care Act regulations which allows shoppers to enroll in these plan outside the Open Enrollment Period.  You could qualify for coverage to begin as early as the next day.
  3. Medicare Supplements “Blue to Blue”– If you are an existing Blue Cross of NC Medicare Supplement member, you are currently able to make a change to your Medicare Supplement plan during the month of May to take effect on June 1st. See rates for alternative Medicare Supplement plans here.  The capability to change plans during this time frame is through the Blue to Blue program.
  4. Dental Insurance– Don’t forget your smile! Dental insurance plans can be enrolled in anytime throughout the course of the year.  These plans are not regulated like health insurance plans by separate enrollment periods.  Learn More about BCBSNC Dental Insurance
  5. Qualifying Life Events– If you have experienced a Qualifying Life Event, this could allow you to make a change to your health plan or enroll in a new plan. Get a Blue Cross Quote to see whether any of the Qualifying Events apply to you.
  6. Report Income Changes to the Marketplace– If you are enrolled in a health insurance plan through the Health Insurance Marketplace and you have experienced an income change, it’s important to report this change to the Marketplace. Income changes can impact health insurance plan rates and coverage.

For more information on North Carolina insurance coverage, please visit our website at or call our toll free number 888-765-5400 and speak with one of our experienced and professional agents.

Will Presidential Election Results Affect Obamacare?

Thursday, November 10th, 2016

Election Results 2016 ConceptThe Presidential election is officially over and Donald Trump has won, which may leave many Americans wondering what, if anything, will happen to the Affordable Care Act/Obamacare.  Although Mr. Trump suggested during his presidential campaign that he would push for changes in the ACA, those changes will likely not be immediate and will certainly take time to implement.

Open Enrollment 2017 is now in full swing and it’s important to remember that as of today, nothing has changed in regards to health insurance.  ACA/Obamacare plans are still available through BCBSNC in all 100 counties in North Carolina and now is the time to enroll!

For now and in the near future, the Affordable Care Act is the law of the land and Americans are still required to maintain health coverage or face a federal tax penalty.  Keep in mind that the tax penalty for 2017 is $695 per person or 2.5% of your income, whichever is higher, so there is a high cost to being uninsured.  Despite substantial losses, Blue Cross Blue Shield of North Carolina has chosen this year to continue participation in the ACA within North Carolina and is working diligently to provide ACA-compliant, quality health plans to the residents of NC.

Whether you need to make a change to your existing coverage or enroll in a health plan for the first time, at NC Health Plans we are here to help.  We can assist you in estimating subsidy eligibility and offer an online or over-the-phone application process for individuals enrolling through the health insurance Marketplace.  Don’t let another year pass without enrolling the health coverage you need for you and your family.

At NC Health Plans, we understand that your time is as valuable as your health and we work hard to help our customers enjoy the best possible enrollment experience.  For your free rate quote visit, call 888-765-5400, or click the button below.

How will the Presidential Election Affect NC Health Insurance?

Monday, November 7th, 2016

Election In United States Of America. Voter Holds Envelope In HaThe current presidential campaign is big news, but how might the upcoming election affect the NC health insurance market?  As might be expected, the two presidential candidates, Donald Trump and Hillary Clinton, have very different ideas when it comes to healthcare policies, leaving many North Carolinians as well as other Americans wondering what might happen to their health insurance in the months to come.

Presidential hopeful Hillary Clinton has promised that should she win, she will work to improve the ACA markets by offering additional subsidies to offset the cost of health insurance as well as increase enrollment through aggressive marketing.  She has also suggested that she intends to pursue a public option on the federal Exchange, but many argue this would be a tough sell to Congress, even if the Democratic party takes control.

Donald Trump, on the other hand, has made it clear that he intends to shrink, though likely not completely abolish, the Affordable Care Act considerably.  Ending the individual mandate, eliminating ACA reforms such as minimal essential benefits and restructuring federal subsidies are a few of the ways he would likely begin.  Most experts agree that abolishing the Affordable Care Act would be a near impossibility now that millions of Americans are insured under ACA plans; however, under a Trump administration Americans would probably see a substantial overhaul of the current law.

With the presidential campaign in full-swing, one thing is for certain.  The Affordable Care Act, or “Obamacare,” is a hot topic and one that many Americans say is at the top of their list in terms of policy concerns for 2017.  At NC Health Plans, our goal is to help the residents of North Carolina navigate the ever-changing health insurance market and we will continue to do so whatever changes may come in 2017.  We make it our business to stay up-to-date on market changes as well as federal laws affecting health insurance, and strive to give our customers the information and tools needed to choose and enroll a health insurance plan with confidence and ease.

For more information on North Carolina insurance coverage, please visit our website at or call our toll free number 888-765-5400 and speak with one of our experienced and professional agents.


Blue Cross Blue Shield of NC Announces Participation in ACA for 2017!

Thursday, September 22nd, 2016

bigstock-141086612Blue Cross Blue Shield of North Carolina announced today that they will be offering individual health insurance plans on the federal Marketplace for 2017!  This is good news for North Carolina residents and comes as a sigh of relief for consumers in the wake of Aetna’s announcement earlier this summer that they would no longer be participating in the ACA in NC.  Aetna was the second major health insurance company to pull out of the Market, following United Healthcare’s similar announcement in April.

Blue Cross Blue Shield of NC’s decision to participate in the Marketplace reaffirms the North Carolina-based company’s commitment to providing quality, sustainable health insurance to the residents of North Carolina.

For 2017, BCBSNC will be the only health insurance company offering Affordable Care Act (ACA) plans in all 100 counties of North Carolina, meaning the company will absorb over 250,000 more customers than originally anticipated.  In light of this news, Blue Cross Blue Shield NC announced they will be revising their initial rate filings, with new rates being public sometime in October.

Over the past two years, Blue Cross Blue Shield of North Carolina has weathered Marketplace changes, reporting $405 million in losses on Affordable Care Act plans alone. These losses have played a major role in BCBSNC’s debate over whether to participate this coming year in the ACA and similar losses are what Aetna and United Healthcare cited as their reasons for exiting the market in 2016.  Blue Cross Blue Shield of North Carolina reiterated today that they are “doing everything [they] can to make the ACA work for North Carolina.”  Without Blue Cross Blue Shield NC’s participation in the Marketplace, 600,000 residents of NC would be at risk of losing their coverage, which is not something the company was willing to risk.  “This is our home too,” says Brad Wilson in an article released by BCBSNC earlier today, “and it’s important that our families, friends and neighbors – our customer – have access to the coverage they need.”

For more information on North Carolina insurance coverage, please visit our website at or call our toll free number 888-765-5400 and speak with one of our experienced and professional agents.

Combat the Rising Cost of NC Health Insurance with Short Term Coverage

Monday, April 25th, 2016

Health care concept. Expensive medical insurance or medical budgThe health insurance market has changed dramatically under the Affordable Care Act and it continues to change every year.  2016 brought a greater than anticipated rise in the cost of health insurance premiums across the board and many Americans are now wondering what other options are available.  Although in the past short term health insurance plans were primarily geared toward individuals who needed to fill a gap in health coverage due to a move, a job change, or recent graduation, many people are now taking a closer look at the benefits of temporary health insurance policies.

In terms of affordability, short term health insurance plans are typically much less expensive than regular health insurance policies.  Because they do not have to cover the 10 essential benefits required under the ACA, short term plans have much lower monthly premiums and are an excellent way to make sure you have coverage in case of an unexpected accident or illness.  Many temporary plans also include copayments for doctor visits as well as prescription drug coverage. (more…)

Last Chance to Apply for January 1st Effective Date!

Monday, December 14th, 2015

Clock With Red Seconds Hand Area Deadline 3DIf you are still uninsured and trying to secure health coverage for 2016, your application must be submitted by midnight December 15th in order to qualify for a January 1st effective date (some exceptions apply).  Although Open Enrollment will not officially end until January 31st, 2016, you do not want to miss this important deadline!  In fact, if you fail to submit your application by December 15, 2015, in most cases you will not be eligible for health coverage to begin until February 1st and you will remain without health coverage throughout the month of January. (more…)

Blue Cross Adjusts to ACA Market

Friday, November 27th, 2015

Questions and Answers signpost

Open Enrollment for 2016 is now in full swing and customers are asking a lot of hard questions, fair questions, questions that demand an answer.  Most of the questions and frustrations center around one thing:  rate increases.  On a near daily basis, insurance companies, agents and brokers are having to try to explain why the cost of insurance is soaring and how families and individuals are supposed to step up and meet the rising costs.  Prior to Open Enrollment, Blue Cross Blue Shield of North Carolina made a strenuous effort to try and answer some of these questions in advance, stating that the “goal, as always, is to offer health coverage that our customers can depend on at rates as affordable and sustainable as possible.”  Blue Cross went on to explain why a rate increase was imperative in order to maintain viability.  In fact, the company provided claims data for 2014 and the first half of 2015, reporting a $132 million dollar loss on ACA business alone.  At that time, BCBSNC explained two important trends:  First, there was no slowdown in any residual demand for medical services from new customers entering the health insurance marketplace after the induction of the ACA and second, there was a prevalence of more chronic health conditions needing medical treatment among ACA customers.

In more recent news, United Health Care has announced it may completely pull out of ACA Exchanges in 2017, citing significant losses on ACA business as the reason for this consideration.  The New York Times reported that United Health Group told investors “it was significantly lowering its profit estimates and blamed an expected loss of hundreds of millions of dollars selling individual policies under federal health care law” (11/20, B1, Abelson, Subscription Publication).   The article further stated “the company said it was estimating losses of more than $600 million from its exchange business, before taxes, in 2015 and 2016.”  With this announcement, customers are once again faced with hard questions about what is happening in the health insurance industry. (more…)

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