You’ve worked a lot of years and are ready to retire, but you’re not yet 65 and eligible for Medicare. What 
can you do to avoid a gap in health coverage? A Blue Cross Blue Shield of North Carolina individual under 65 health plan can keep you covered until Medicare is available. (more…)
If you are currently in the market for health insurance, you know all too well how stressful it can be. Whether you lost coverage unexpectedly or are losing coverage in the near future, it can be overwhelming to consider how you will keep your family covered. (more…)
Under the Affordable Care Act, young adults are now eligible to remain on their parents’ Blue Cross Blue Shield of NC health insurance policies up to age 26, even if they are not full time students. (more…)
By now, most Americans are aware of the changes instituted by the Affordable Care Act and the impact this law has had on health insurance. Terms like “premium tax credit,” “federal subsidy,” “Health Insurance Marketplace,” and “individual mandate,” however, are still often unfamiliar to consumers now navigating a system reorganized under completely different criteria and governed by federal law. Understanding the new terminology is paramount in understanding much of what constitutes the Affordable Care Act and is a key part of being able to successfully choose, enroll and manage a health insurance policy.
That being said, perhaps one of the most confusing aspects of the Affordable Care Act is the Special Enrollment Period and why you must have a Qualifying Life Event in order to enroll in health coverage. Prior to the Affordable Care Act, consumers had the benefit of enrolling in individual health insurance or making changes to their existing policies at any time during the year. On the flip side, insurers had the right to practice medical underwriting and charge more for, or deny coverage to, consumers who had serious or preexisting health conditions. Under the new law, these conditions have changed. Insurers may no longer ask consumers any health questions (with the exception of whether or not you are a smoker) and no consumer can be denied health insurance based on a preexisting condition; however, consumers may not enroll or make changes to their health policies whenever they choose, but are now subject to the rules of Open Enrollment, Special Enrollment and Qualifying Life Events (QLE’s).
For 2015, Open Enrollment will begin November 1st and end January 31st. During Open Enrollment, you may purchase health insurance or make changes to your current policy for any reason. Currently, however, we are in the Special Enrollment period, which means consumers are required by law to have a Qualifying Life Event in order to purchase insurance. A Qualifying Life Event is some special circumstance, such as a recent move or the loss of access to minimum essential coverage, that allows the consumer to purchase insurance outside of Open Enrollment. Although this does limit your ability to enroll in health coverage, the good news for 2015 is that the list of Qualifying Life Events has been expanded and the Healthcare Marketplace is offering more opportunities for consumers to get insured during Special Enrollment.
In order to determine whether or not you may have a Qualifying Life Event, it is important for you to take a look at the list provided on your Blue Cross Blue Shield of North Carolina health quote. Reading the list of QLE’s will help you to determine if one of these special circumstances applies to you. Although the process of obtaining health insurance has changed under the ACA, the expansion of these QLE’s allows you greater freedom outside of Open Enrollment to manage your current health plan or enroll a new health plan according to your life circumstances.
For more information on Blue Cross Blue Shield of North Carolina health insurance coverage, the Marketplace and healthcare gov to apply for your subsidy, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our experienced and professional agents. Let us help you navigate through the Health Care Reform changes in accordance with the new regulations of The Affordable Care Act, also known as Obama care.
Between web generated quotes, online applications, automatic bill pay and the healthcare Marketplace, you may be wondering why in the world you would even need an insurance agent. When so much can be accomplished right over the phone or online, is there really any benefit to contacting a BCBSNC health insurance agency and what can we possibly do to make purchasing insurance a simpler and more satisfying experience? Although it may seem counter intuitive, the truth is that despite all of the technology and all the companies and agencies involved now in purchasing health insurance, the process is actually more complicated than ever.
The Affordable Care Act alone has added so many pieces to the insurance puzzle that it can leave your head spinning just trying to determine who is eligible to purchase health insurance and when, let alone who qualifies for a federal subsidy and what determines eligibility. Open Enrollment, Special Enrollment, Qualifying Life Events, Premium Tax Credits, Subsidies, Tax Penalties, Cost Share Reduction Benefits and so on are only some of the new terms that now have a profound impact on your health insurance policy and how you go about applying for and purchasing it.
In addition, even though these terms can be researched online and applications completed through various websites and phone lines, the process of purchasing health insurance can be overwhelming even for the most well-versed among us. We all know what a huge difference there is between knowing a fact and understanding how that fact impacts our lives on a personal and financial level. That is the very reason we hire attorneys, accountants, doctors and contractors. We rely on the expertise of those whose job it is to understand their various industry and guide us in making the best decisions based on their professional experience and understanding. Health insurance is no different! In fact, more than ever before it is important, if not imperative, to consult a health insurance professional before purchasing a health plan.
And that’s where Jerry Ballard and Associates can help. The good news is that unlike hiring an attorney, accountant, doctor or contractor there is no fee associated with contacting our office. In fact, having an insurance agent does not impact the cost of your health plan in any way. All it does is allow you the opportunity to have a personal contact person at your disposal to help explain the process, discuss the plans and determine subsidy eligibility and how obtaining a federal tax credit can impact the cost of your health insurance premium.
At Jerry Ballard and Associates, it is our pleasure to provide the professional guidance you need when purchasing health insurance either on or off the federal Marketplace. It is our desire to make the application process as painless as possible and help you determine whether a subsidized or unsubsidized plan is the best choice for you and your family. We will discuss your options in detail, making sure you are 100% comfortable with the BCBSNC health plan you choose prior to enrollment and we will then follow up to make sure your plan is properly processed and that you know how and when to make your payment.
Having an insurance agent is important and Blue Cross Blue Shield of North Carolina understands that personalized service is always in your best interest. In truth, having an agent is one of the great benefits that is available to you when you purchase a BCBSNC health plan. Don’t let health insurance overwhelm you and don’t make important decisions about your health coverage without fully understanding your choices and the implications of your choices. At Jerry Ballard and Associates, we are determined to help you through the process from start to finish!
For more information on Blue Cross Blue Shield of North Carolina health insurance coverage, the Marketplace and healthcare gov to apply for your subsidy, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our experienced and professional agents. Let us help you navigate through the Health Care Reform changes in accordance with the new regulations of The Affordable Care Act, also known as Obama care.
With all of the changes in the health insurance industry under the Affordable Care Act and an overall increase in the cost of health insurance for consumers, you may be wondering exactly what your monthly premium pays for and where all of that money goes. Blue Cross Blue Shield of North Carolina is happy to answer that question. As most people already know, your health insurance premium is part of a large pool of money collected by the insurance company, which is then distributed in the form of health care claims to those in need of medical care. A portion of that pool of money pays for health care and a portion goes toward operating the insurance company itself and creating a profit. The question most people have is how much of that money actually goes toward claims and how much is simply profit for the company.
Recently, BCBSNC announced that they spend almost 86 cents of every premium dollar to pay for customers’ health care needs, including visits to the doctor’s office, surgeries, diagnostic tests, prescriptions, contact lenses, etc. In fact, Blue Cross Blue Shield of NC paid $5 billion dollars in claims in 2013 alone, making that $5 billion dollars worth of coverage directly benefiting BCBSNC customers. In addition, there is non-medical spending that still directly affects BCBSNC members in a positive way. Non-medical expenditures include things like customer service and technology improvements, which provide customers with the most up-to-date, user friendly website and an exceptional customer service experience.
Even further, under the Affordable Care Act there now exists what is called the Medical Loss Ratio Requirement. This requirement prevents insurance companies from engaging in excessive spending on administration, salaries and other business costs. Insurance companies are now required to use 80 cents of every premium dollar collected from individual and small group customers to pay customer claims and support quality of care. Even before the law, however, BCBSNC exceeded that standard, and in 2012 they paid $260 million dollars more toward health care expenses than was required under the law. This requirement also means that insurance companies cannot increase rates simply as a way to increase profits, but must maintain a minimum percentage of dollars spent on health care or refund that money to customers.
Let’s face it, the cost of health insurance is on the rise and it can be a strain on any income. Understanding where your insurance premium goes is an important part of understanding your health insurance plan and what makes it valuable. Although it may be tough to pay out a few hundred dollars a month, when the need for medical care arises, Blue Cross Blue Shield of North Carolina is there to make sure you and your family are covered.
For more information on Blue Cross Blue Shield of North Carolina health insurance coverage, the Marketplace and healthcare gov to apply for your subsidy, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our experienced and professional agents. Let us help you navigate through the Health Care Reform changes in accordance with the new regulations of The Affordable Care Act, also known as Obama care.
The Special Enrollment Period the federal Marketplace granted for those individuals who did not meet the February 15th deadline for Open Enrollment is ending April 30th. This could be your last chance to enroll in a health insurance policy until January, 2016. This Special Enrollment Period is not for everyone, but if it applies to you, you could have one last opportunity to get insured.
In an effort to enroll as many Americans as possible, the federal government installed this Special Enrollment Period for people who meet the following three criteria: 1) you were not insured in 2014; 2) you had to pay a tax penalty when you filed your 2014 taxes; 3) you will attest to the fact that you were unaware of the tax penalty or did not fully understand the implications of that penalty. If these criteria apply to you, you have 6 more days to complete an application for health insurance with the federal Marketplace. Keep in mind, your application must be completed and submitted by midnight April 30th, meaning you have selected a health plan and your application has been sent to Blue Cross Blue Shield of NC. Depending on your effective date, however, you may still have a period of time before you will need to make your first premium payment.
Once this Special Enrollment Period ends, your opportunity to enroll in health insurance becomes much more limited. Under the rules of the Affordable Care Act, for the remainder of 2015 you will need to have a Qualifying Life Event in order to purchase health insurance. If you do not have a Qualifying Life Event, you will have to wait until Open Enrollment 2016 begins in November and you will not have health coverage until January 2016. Also, don’t forget that the tax penalty, sometimes called the “individual mandate,” for being uninsured is increasing in 2015 and instead of paying $95 per person or 1% of your household income (whichever is greater), next year you will pay $325 per person or 2% of your household income (whichever is greater). The tax penalty will increase again for 2016.
The bottom line is it doesn’t pay to be uninsured. Not only are you running the risk of incurring potentially devastating health care bills, you are also not able to maintain your health and wellness through regular preventive care physicals and health maintenance. If you are one of the many Americans who are still able to enroll in health coverage under the Special Enrollment Period ending April 30th, take advantage of this opportunity to get insured! Instead of throwing money away on tax penalties, make an investment in your wellness and peace of mind. Blue Cross Blue Shield of North Carolina is pleased to provide the residents of NC with quality health coverage at a competitive price. Don’t wait another minute!
For more information on Blue Cross Blue Shield of North Carolina health insurance coverage, the Marketplace and healthcare gov to apply for your subsidy, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our experienced and professional agents. Let us help you navigate through the Health Care Reform changes in accordance with the new regulations of The Affordable Care Act, also known as Obama care.
Despite the current Administration’s push to make health insurance a top priority, according to a recent Gallup Poll study, North Carolina ranks among the states that still have the greatest population of uninsured residents. In fact, NC had an uninsured rate of 16.1 percent in 2014, ranking it among the top five states in the nation with the greatest amount of residents who still have no health insurance. Although many residents in 2014 did take advantage of the Affordable Care Act, purchasing subsidized health plans through the federal Marketplace, a large portion of the population did not.
Changes in the law regarding health insurance as well as changes in state programs such as Medicaid have created quite a stir in the last few months and left many North Carolina residents scratching their heads wondering what to do. Blue Cross Blue Shield of North Carolina is committed to helping residents of NC obtain quality, cost efficient health coverage both on and off the federal Marketplace. In fact, every Blue Cross Blue Shield of North Carolina health plan is ACA (Affordable Care Act) approved and offers the 10 essential benefits required under the law. In addition, BCBSNC has a wide variety of health plans available on the Exchange for members who qualify for a federal subsidy. Blue Cross Blue Shield of North Carolina has an uncontested presence in the state, providing accessible networks in all 100 counties in NC. Furthermore, unlike other insurance companies offering subsidized plans on the Marketplace, BCBSNC plans are not HMO’s, meaning you will still have coverage even if you happen to go out of network.
With or without the law and the tax penalties associated with being uninsured under the Affordable Care Act, living without health insurance is never a good idea. Life happens and even the healthiest and most cautious among us can’t control the unexpected. BCBSNC wants to make sure the residents of North Carolina are covered for routine preventive care and also in case of medical emergency. Experience the benefits of being a Blue Cross Blue Shield of NC member and help make North Carolina among the nation’s leaders in insured residents.
For more information on Blue Cross Blue Shield of North Carolina health insurance coverage, the Marketplace and healthcare gov to apply for your subsidy, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our experienced and professional agents. Let us help you navigate through the Health Care Reform changes in accordance with the new regulations of The Affordable Care Act, also known as Obama care.
For individuals and families who did not have health coverage in 2014 and are subject to the tax penalty when they file 2014 taxes, a special enrollment period (SEP) has been announced. This SEP has been created for those individuals who were unaware of the tax penalty or failed to fully understand the implications of the penalty for not enrolling in coverage during 2014. From March 15th to April 30th, CMS is providing consumers with another opportunity to purchase health insurance; however, if consumers do not purchase during this enrollment period, they may have to pay the penalty when they file their 2015 income taxes.
The special enrollment period will begin on March 15, 2015 and will end at midnight Eastern Standard Time on April 30, 2015. If a consumer enrolls in coverage before the 15th of April, coverage will begin on May 1st and if a consumer enrolls between April 16th and April 30th, coverage will begin on June 1st.
Because this year’s tax season is the first time individuals and families are required to provide information about their health coverage on their tax returns, CMS recognizes that there may be an adjustment period. Administrator Marilyn Tavenner stated regarding this special enrollment period, “Our priority is to… provide those who were not aware or did not understand the requirement with an opportunity to enroll in affordable health coverage this year.” Further, those who could not afford coverage or met other certain conditions may be eligible to receive an exemption from the tax penalty.
The majority of taxpayers will only be required to indicate on their tax return that they had health coverage in 2014, either through an employer, Medicare, Medicaid, or other health coverage that meets the requirements of minimal essential coverage. Other taxpayers will be granted an exemption from the tax penalty and still other taxpayers will pay a penalty for choosing to remain uninsured. Americans who do not qualify for an exemption and who are required to pay the penalty will be paying a fine of $95 per adult or 1% of their income, whichever is greater. This special enrollment period is designed to allow such individuals one final opportunity to get coverage and avoid having to pay other penalties in 2015.
Those eligible for this special enrollment period must meet ALL of the following requirements:
For more information on Blue Cross Blue Shield of North Carolina health insurance coverage, the Marketplace and healthcare gov to apply for your subsidy, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our experienced and professional agents. Let us help you navigate through the Health Care Reform changes in accordance with the new regulations of The Affordable Care Act, also known as Obama care.
All information contained herein is subject to change, from time to time, if the Federal Government or Blue Cross Blue Shield of North Carolina implement any new updates and/or changes that can impact information provided in this blog.
As most Americans know, under the Affordable Care Act you are now required by law to carry qualifying health coverage or pay a tax penalty. This penalty is sometimes referred to as the “individual shared responsibility payment,” or the “individual mandate.” In some cases, however, you may qualify for what is called a “health coverage exemption.”
First and foremost, if you are covered by any plan that meets the ACA guidelines of minimum essential coverage , you will not have to pay a tax penalty. Take a moment and learn what qualifies as minimum essential coverage under the Affordable Care Act Law. Being properly insured is the safest way to avoid any penalties.
If you did not have ACA approved coverage for all or part of 2014, however, you may still qualify for an exemption from the tax penalty.
Below are some examples of potential exemptions that might apply to you:
You can learn how to apply for any of the above exemptions and find the forms you need by visiting the federal Marketplace.
Once again, the easiest and smartest way to ensure you do not incur a tax penalty is to obtain an ACA approved health plan.
For more information on Blue Cross Blue Shield of North Carolina health insurance coverage, the Marketplace and healthcare gov to apply for your subsidy, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our experienced and professional agents. Let us help you navigate through the Health Care Reform changes in accordance with the new regulations of The Affordable Care Act, also known as Obama care.
All information contained herein is subject to change, from time to time, if the Federal Government or Blue Cross Blue Shield of North Carolina implement any new updates and/or changes that can impact information provided in this blog.
Perhaps you are among the many Americans who received a federal subsidy to help reduce the cost of your Blue Cross Blue Shield of North Carolina health insurance in 2014. If so, there are some things you may need to know. Although as insurance agents we don’t have all the answers, we can offer some helpful information as you enter into tax season. For more specific details about how your subsidy will affect your personal taxes for 2014, we recommend speaking with your tax adviser or the federal Marketplace.
What we can tell those of you who received a federal subsidy for health insurance is that the Obama administration stated earlier this month that it will begin sending out tax reporting forms that you will need in order to fill out your 2014 tax return. These forms are specifically for individuals who got tax credits under the Affordable Care Act. This form is important, so make sure you are looking for it in the mail and take it with you when you file taxes. The form is called 1095-A and according to the administration, the form comes filled out with all the pertinent information from the federal healthcare Marketplace. The form lists the members of each household that received a subsidy and how much the government paid each month toward the health insurance premium.
Secretary Sylvia M. Burwell said in a statement, “In the coming weeks, HHS will work with other agencies, tax preparers and community organizations to arm… consumers with the information they need to know as they prepare to file their taxes.”
As most people getting a federal subsidy already know, the amount of tax credit you receive is based on a formula that takes into account your income and the number of people you claim on your tax form. According to the IRS, those individuals who received too much of a subsidy will see a reduction in their tax refund and those who received less of a subsidy than they were entitled to will receive a refund.
Some important things to keep in mind:
If you did not receive a subsidy for 2014, but are interested in seeing whether or not you may qualify for a premium tax credit toward your BCBSNC health plan for 2015, you may generate a quote and enter income information to help estimate your potential subsidy.
For more information on Blue Cross Blue Shield of North Carolina health insurance coverage, the Marketplace and healthcare gov to apply for your subsidy, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our experienced and professional agents. Let us help you navigate through the Health Care Reform changes in accordance with the new regulations of The Affordable Care Act, also known as Obama care.
The Open Enrollment period for 2015 and your once-a-year opportunity to enroll a new Blue Cross Blue Shield of North Carolina health plan or make changes to your current plan is coming to a close February 15th. Open Enrollment began November 15th, but if you are one of the many Americans still trying to obtain health insurance for 2015 or if you still need to make changes to your health insurance policy, there is still time.
Here are four different scenarios that may apply to you:
Members with Grandfathered Plans:
A Grandfathered Plan is a health plan that was in place on March 23, 2010 and has had no changes made to it. These plans are exempt from many of the Affordable Care Act requirements; however, you do have the option to change to an ACA plan. Keep in mind, though, that once you give up your Grandfathered plan you will not be able to get it back. Carefully consider the costs and benefits of your current plan and compare it against the available ACA plans before making a decision to change.
Members with Transitional Plans:
A transitional plan is a health plan that was purchased between March 24, 2010 and October 1, 2013. These plans were originally supposed to be canceled on January 1, 2014 because of the new ACA requirements, but the administration decided at the last minute that members could keep these plans for two additional years. Like with Grandfathered Plans, you may decide to switch to an ACA plan but remember, a new plan may cost more than your current plan, even with a subsidy applied. Be sure to weigh your options carefully.
Members with ACA or Subsidized Plans:
ACA plans include many of those purchased on the Health Insurance Marketplace for 2014. If you have one of these plans, there are some important questions you need to ask. You want to consider how much you want to pay out of pocket for premiums and deductibles and also you need to consider the size of your network. If you received a subsidy in 2014, you need to visit the Marketplace and update your subsidy qualifications. If you don’t, you might not receive as much subsidy as you deserve and could wind up paying more than necessary for your health plan.
Members with ACA or Non-Subsidized Plans:
If you did not receive a subsidy in 2014 and you would like to make changes to your plan, you can still see if you qualify for a subsidy. Again, consider the plans carefully, including the size of your network, out of pocket costs and monthly premiums.
FEBRUARY 15, 2015 is the last day you can apply for a 2015 plan or make changes to your current plan before the end of the Annual Enrollment Period. After February 15, you will be subject to the rules of Special Enrollment involving Qualifying Life Events.
For more information on Blue Cross Blue Shield of North Carolina health insurance coverage, the Marketplace and healthcare gov to apply for your subsidy, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our experienced and professional agents. Let us help you navigate through the Health Care Reform changes in accordance with the new regulations of The Affordable Care Act, also known as Obama care.
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