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Actual “affordable care” is coming soon thanks to President Trump

The next likely chance to achieve any kind of legislative change to the ACA (Obamacare) will be on November 6, 2018, which is the midterm election. If Republicans then have enough Senators who are actually willing to cast a yes vote they will then deliberate throughout 2019 until the last date to use the Budget Reconciliation process (requiring only 51 votes). Since it is unlikely that Republicans will achieve a 60 vote majority in the U.S. Senate, they will have to rely once again upon Reconcliation. The final date to pass legislation using Reconcilation is September 30, 2019.  A month later, the next annual ACA open enrollment period begins again. There will be no changes to health care policy until that ACA open enrollment period ends on December 15, 2019. This means the earliest we might see legislative changes to the ACA will be early 2020.

Now for the GOOD news 

The good news is that like his predecessor, President Trump also has a “pen and a phone” and he’s been using them. On October 12, 2017 he signed this executive order which was designed to restore consumer choice in the non-ACA marketplace and to spur competition “across the United States”.  After considerable hand wringing from regulators and opposition groups, H.H.S. finally issued a final rule pertaining to the President’s executive action on August 3, 2018. This final rule makes two important regulatory changes. Both will become law on October 2, 2018. On that date, non-ACA Short Term health insurance plans will once again provide consistent uninterrupted health insurance coverage for up to 364 days. This is a very welcome change since our prior president reduced the amount of time consumers could own non-ACA Short Term health insurance plans to a maximum period of 90 days.

This action by former president Obama exposed consumers to the additional risk of not only facing up to four separate deductibles in one year but also facing the risk of not qualifying for a new 90 day policy due to a preexisting condition. This is true because non-ACA Short Term health insurance policies do not cover preexisting conditions nor do they cover other ACA mandated benefits such as drug rehab therapy and mental health parity. As such, they are much less expensive than ACA qualified health insurance plans and are very popular among the millions of Americans who do not qualify for health insurance subsidies. President Trump’s executive order also requires that these plans be renewable for a period of up to 3 years.

Expanding Association health plans

The  second regulatory change outlined in the final ruling is the expansion of AHPs – “Association Health Plans”. By “expansion”, this order refers to expanding upon the law that has regulated AHPs since 1974. That law is called ERISA – Employee Retirement Income Security Act. Traditionally, ERISA required AHP members to share a professional or other common interest in order to form an association and then offer health insurance benefits to members. Under the new final rule, those who enroll in AHPs after October 2, 2018 can purchase AHPs based on geographic location alone or by the traditional definitions of sharing a common profession or trade. And, new Associations can be formed solely for the purpose of offering health insurance to new Association members. This was heretofore prohibited.

Most importantly, unlike many of the traditional AHPs which offered substandard coverage resulting in multiple lawsuits. The new AHPs must provide many of the same consumer protections that ACA-qualified plans are federally mandated to cover such as keeping your child on your plan until the age of 26, covering preexisting conditions and including the same calendar year maximum out of pocket spending limits which are in place now for ACA-qualified plans. Those limits this year are $7,350 for an individual policy and $14,700 for a family policy.  The new AHPs also cannot impose annual or lifetime maximum coverage amounts which is a welcome improvement to traditional AHPs. AHPs that cover employers with at least 15 employees must also cover Maternity.

Even though all of the aforementioned consumer protections must be included with the new AHPs, they are not required to cover all 10 “Essential Health Benefits” that ACA plans are required to cover. So, if you need coverage for substance abuse disorders, mental health parity or pediatric dental and vision, you may still want to consider an ACA-qualified plan which may be much more expensive for those who do not qualify for federal health insurance subsidies. Either way more options are always better than less.

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No lying Leftists, Trump is NOT trying to “end coverage for preexisting conditions”

No lying Leftists, Trump is not trying to “end coverage for preexisting conditions“. His D.O.J. however has chosen not to defend Obamacare against the latest legal challenge to it led by Texas and 19 other states. That case argues (legitimately) that since the SCOTUS found the “Individual Mandate” constitutional in 2012 by defining it as a “tax” and later Republicans passed tax reform which included repeal of the Individual Mandate. The Individual Mandate can no longer be constitutional because there will be no more penalties assessed for not buying health insurance as of January 1, 2019. The D.O.J. is also arguing that two other Obamacare provisions should be struck down — one requiring insurers to cover those with preexisting conditions AT THE SAME PRICE AS THOSE WITHOUT PREEXISTING CONDITIONS.

I put that last part in caps because the lying Leftist propagandists at Politico, WAPO and every other Left wing rag have left that important part OUT. The truth is, if this legal challenge prevails (and that’s a BIG if) those who have preexisting conditions would simply pay more than those without preexisting conditions and coverage for preexisting conditions would still exist as it did for decades before Obamacare. For responsible reporting on this issue read the following article from the Washington Examiner.

https://www.washingtonexaminer.com/opinion/trump-doj-asks-court-to-invalidate-obamacare-regulations

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Cheaper non-Obamacare Short Term health plans lasting 365 days returning.

By May 1st of 2018 United Healthcare, Aetna, Cigna, Humana, Blue Cross and other carriers will once again be able to legally offer non-ACA (Obamacare) Short Term health insurance plans that will cover you for an entire year. This is thanks only to President Trump who reversed Barack Obama’s previous order restricting these much less expensive health insurance plans to 90 days of maximum policy ownership.

This is very good news for millions of healthy Americans who do not qualify for federal health subsidies and as such cannot afford to pay for individual health insurance that now costs more than their mortgage payment. THANK YOU President Trump!

Please note: Non ACA-qualified Short Term health insurance plans are not required to cover preexisting conditions or certain ACA (Obamacare) mandate “Essential Health Benefits” that are covered with ACA-qualified plans. These benefits are:

1.) Maternity and newborn care.
2.) Mental health and substance use disorder services.
3.) Certain Preventive care benefits such as routine mammograms and cancer screenings are covered with Consecutive Short Term health insurance plans.
4.) Pediatric services (including both oral care and vision care).

 

 

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Group health insurance for couples ensures access to Chicago Teaching hospitals for small businesses owners.

In November of 2015, Chicagoland residents were shocked to learn that Northwestern Memorial hospital, University of Chicago medical center, Rush University medical center and the Ann & Robert H. Lurie Children’s hospital would no longer accept patients who have ACA (Obamacare) qualified individual health insurance plans.

This action led to a significant increase in the purchase of small group health insurance policies which still provide national PPO networks and still ensure access to the aforementioned teaching hospitals in Chicago.

For small corporations who could afford to insure themselves and 70% of their eligible full time employees (the minimum participation requirement), purchasing small group health insurance was a costly fix to the new narrow networks in the individual health insurance marketplace.

The ability to purchase group health insurance for you and your full-time employees is well known. What is not well known is the fact that you can purchase a small group health insurance policy without insuring your employees during a small window each year. This year that window begins on November 1st and ends on December 15th. The same time period that 2018 ACA Open Enrollment for individual plans begins and ends.

During this little known ‘relaxed underwriting’ period, an owner of a small corporation (less than 50 full-time employees) can purchase small group health insurance while employees ‘waive’ coverage without producing an eligible waiver. Normally, 70% of all full-time employees must participate in a group health insurance plan unless they have an eligible waiver such as an offer of group health insurance from a spouse’s employer or Medicare and Medicaid coverage. If you do decide to offer coverage to your full-time W2 employees during this Special Enrollment period, you do not have to pay any portion of your employee’s premium. Normally, you must pay 25% of your employee’s premium.

If you are a small business owner who is seeking to purchase small group health insurance and cannot afford to insure your employees or, your employees simply do not want to participate in a group health insurance plan. Now is the time to learn more about “relaxed underwriting”. The cost for group health insurance is now commensurate with individual health insurance but the PPO network is much larger and far more inclusive than any of the narrow networks now available in the individual marketplace. Want to learn more? Click on “contact” at HealthInsuranceMentors.com

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Consistent Short Term health insurance returns as ACA Open Enrollment begins

On October 12, 2017 President Donald Trump signed this Executive Order designed to restore consumer choice in the Short Term health insurance marketplace. Short Term health insurance is the only kind of non-ACA (Obamacare) qualified health insurance available in the individual marketplace. While both ACA-qualified health insurance and non-ACA qualified Short Term health insurance policies are considered major medical health insurance, or comprehensive health insurance and both cover major health events in your life, there are important differences between the two. ACA-qualified health plans are guaranteed issue, meaning you cannot be denied coverage based on preexisting conditions. ACA-qualified health insurance plans are also required to cover certain “Essential Health Benefits” that are not covered with non-ACA qualified Short Term health insurance plans. “Essential Health Benefits” that are not covered with Short Term health insurance policies are as follows:

1.) Maternity and newborn care
2.) Mental health and substance use disorder services
3.) ACA mandated Preventive care benefits, routine mammograms and cancer screens ARE COVERED with Consecutive Short Term health insurance policies.
4.) Pediatric Services (including both oral care and vision care).

On March 31, 2017 a preexisting Obama era regulation limited Short Term health insurance coverage to 91 days of policy ownership. This regulation exposed millions of Americans to new and unique risk factors. Prior to March 31, 2017, consumers could purchase Short Term health insurance policies that would last for the entire year without interruption. So, there was no risk of your policy ending in the middle of the year outside of the annual ACA open enrollment period. Those who developed new medical conditions during the first 91 days of Short Term policy ownership, faced the new risk of not being able to qualify for another Short Term policy when their first Short Term policy ended at the end of 91 days. Consumers placed into this difficult position would then be left uninsured and uninsurable in the individual marketplace until the next annual ACA open enrollment period began again when they could once again obtain coverage for preexisting conditions. President Trump’s executive order plans to rectify that situation as soon as the 60 day comment period expires. So, we should be able to once again purchase Short Term health insurance that provides consistent coverage for 365 days as early as January or February of 2018.

Until then, the health insurance industry has responded by creating “Consecutive” Short Term health insurance coverage that will be available for purchase as of 12/01/2017. With these new Short Term health insurance policies from National General Accident and Health you are guaranteed to be issued up to four Consecutive Short Term health insurance policies, each lasting 90 days. You answer health questions only for the first policy which lasts 91 days, then on day 92, National General guarantee issues you a second policy, 90 days later they gaurantee issue you a third policy and finally a fourth policy 90 days later all without evidence of further underwriting and without any new preexisting condition clause. So, you can now remain consistently insured for up to 360 days without answering any new health questions and without the fear of conditions developed during the first, second, third or fourth policies being excluded.

Click here to download the brochure for National General’s Consecutive Short Term health insurance. National General Consecutive Short Term health insurance policies use the Aetna Open Choice PPO network. This network includes access to Northwestern Memorial hospital, University of Chicago Medical Center, Rush University Medical Center and the Ann & Robert H. Lurie Children’s hospital as well as many other hospitals and medical providers nationwide. Search Aetna’s Open Choice PPO network here. For quotes and to apply online for Consecutive Short Term health insurance policies from National General click their logo. Please note: You can only purchase Consecutive Short Term plans AFTER 12/01/2017.

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Please note: Because U.S. Senate Republicans failed to repeal or even repair the PPACA (Obamacare) the fine for not having ACA-compliant health insurance is still law and still being enforced by the IRS. This being the case, you will be fined 2.5% of your AGI – Adjusted Gross Income – by the IRS for purchasing non-ACA compliant Short Term health insurance. 

National General Holding Corporation
 is a publicly traded company with $2.5 billion in annual revenue. Their new “Consecutive Guaranteed Issue” Short Term health insurance plans are underwritten by Time Insurance Company (est. in 1892), National Health Insurance Company (incorporated in 1965), Integon National Insurance Company (incorporated in 1987) and Integon Indemnity Corporation (incorporated in 1946). These four companies, together, are authorized to provide health insurance in all 50 states and the District of Columbia.

Short Term health insurance for less than 91 days

If you need short term coverage for less than 91 days you can purchase coverage from United Healthcare which includes their Choice PPO network. To get quotes and apply click the link below.

2018 ACA (Obamacare) Open Enrollment begins on 11/1/2017 and ends on 12/15/2017

The 2018 PPACA (Obamacare) Open Enrollment period begins on November 1, 2017 and ends on December 15, 2017.  During this 45 day window, individuals and families can purchase guaranteed issue individual health insurance (with no preexisting condition exclusions). Coverage will not begin until January 1, 2018. Depending on your projected 2018 MAGI – Modified Adjusted Gross Income – you may qualify for one or more federal health insurance subsidies to lower your premium, deductible, coinsurance and copays. To learn the income levels necessary to qualify for health insurance subsidies scroll down this page. If you do not qualify for subsidies please click “Shop for unsubsidized plans OFF the exchange” below to purchase health insurance directly from the carrier of your choice Questions? Call (630) 674-1551. Out of state? Call toll free (866) 724-7123.

Buying on the exchange? If you do qualify for subsidies please click “Shop for subsidized plans ON the exchange” below. You will be able to pick a plan, get your subsidies and finish the entire process much faster than using Healthcare.gov alone. HealthSherpa speeds up the Healthcare.gov process.

unsubsidizedshopping                   subsidizedshopping

Determining your elibility for subsidies

Depending on what you expect your 2018 total household MAGI – Modified Adjusted Gross Income = (after deductions but before taxes) to be, you may qualify for a significant APTC – Advance Premium Tax Credit (federal subsidy) under the new health care law to lower your premiums. You may also qualify for a Cost Sharing subsidy to lower your deductible. If you believe your 2018 total household MAGI will be lower than:

$48,240 for an individual
$64,960 for a couple
$81,680 for a family of three
$98,400 for a family of four
$115,120 for a family of five
$131,840 for a family of six

you will be better off financially by shopping for a plan on the exchange (via Healthcare.gov) in order to receive an Advance Premium Tax Credit and/or a Cost Sharing reduction to reduce the premium and deductibles of either the Bronze, Silver, Gold or Platinum Qualified Health Plans.

Buying on the exchange? If you qualify for a subsidy please click the link below. You will be able to pick a plan, get your subsidy and finish the entire process much faster than working solely with Healthcare.gov

subsidizedshopping

Shopping from another state? Call us toll free at (866) 724 7123 or scroll down to get quotes from carriers in your state. 

Please note: If your income is lower than the 2018 Federal Poverty Level Information – 2018 FPL in your state, which is less than 138% of the FPL – Federal Poverty Level in states that expanded Medicaid and less than 100% of the FPL in states that did not.  You will be offered Medicaid will not be able to qualify for subsidized health insurance. You can purchase health insurance even if you qualify for Medicaid but you must do so without a subsidy. Click the chart below to determine the current Federal Poverty Level and percentages above it. 2018 Federal Poverty Levels will not be released until late January of 2018 so, the 2017 FPL chart must be used to determine 2018 subsidy eligibility.

FPL2017

Please also note: If you qualify for a federal health insurance subsidy and your state has expanded CHIP – Children’s Health Insurance Plan – under Medicaid you may not be able to insure your children on your policy. Healthcare.gov will instead send them to Medicaid. You may wish at that juncture to purchase private health insurance at full price for your children instead.

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2018 Individual health plan rates include higher prices for Illinois consumers thanks to Bruce Rauner’s “side hustle”.

Back on August 1, 2017 the Chicago Tribune provided a preview of 2018 annual premium increase requests made by Blue Cross Blue Shield of Illinois for their 2018 individual health insurance plans. Then on October 12, 2017 the U.S. Health and Human Services Department issued a statement reconfirming that former president Barack Obama authorized CSR – “Cost Sharing Reduction” subsidies (which artificially reduce deductibles and co pays for those under 250% of FPL) illegally, unilaterally and unconstitutionally. As such, those subsidies were ended after a thorough review by HHS, the U.S. Treasury, the Office of Management and Budget, and an opinion from the U.S. Attorney General.

Since the Surrender party in the U.S. Senate failed again to repeal and replace the PPACA a.k.a. Obamacare (after promising to do so for 7 years), Obamacare remains the law of the land. Because Obamacare is still the law, health insurers are still obligated to artificially reduce deductibles and co pays for those under 250% of Federal Poverty Level. So, someone still has to pay for these CSR “subsidies”. “Someone” is the 17 million Americans who purchase health insurance in the individual marketplace.

The hope was that time would be allotted for congress to legally appropriate the $7 billion needed to continue CSR subsidies so that additional premium increases would not be levied on self employed consumers seeking individual health insurance coverage.  In fact, Patty Murray and Lamar Alexander are working on such a piece of legislation now.

Instead of waiting for congress to legally appropriate money to continue CSR subsidies, “Social Justice Warrior” Bruce Rauner (who recently became the first U.S. governor to initiate publicly funded abortions for all state employees and for all Medicaid recipients) wasted no time in taking swift action to “protect Obamacare” by directing health insurers offering individual health plans to attach a surcharge—on average 15 percent—to Silver health plan premiums. Silver health plans are the most popular health insurance plans available under Obamacare because they are the only health plans that consumers who (qualify) can receive federal subsidies for. So, what are the end results of Governor Rauner’s “side hustle” to protect Obamacare? Below are the new 2018 approved health insurance premium increases released today via Healthcare.gov after they were “fundamentally transformed” by “Social Justice Warrior” Bruce Rauner.

BEFORE Bruce’s “side hustle”: 

38.2% for BlueCare Direct HMO Silver plans
14.5% for Blue Precision HMO Silver plans
9.3% for Blue FocusCare HMO plans

5.4% for Blue Choice Preferred Silver PPO plans.

 

AFTER Bruce’s “side hustle”: 

35% Blue Care Direct HMO Silver plans
28% Blue Precision HMO Silver plan
11% Blue FocusCare HMO Silver plan
13% Blue Choice Preferred PPO Silver plan
 

Since the Blue Choice Preferred Silver PPO plan includes access to the last individual PPO network that Chicagoland consumers have left to purchase (since we only have three carriers left in Chicagoland that offer individual plans). And, the Blue Precision HMO Silver plan is the most popular individual HMO plan. This means that Illinois consumers who do not qualify for subsidies and have already received on average a 99% increase (and in many cases more than a 200% increase in their individual health insurance plan premiums since 2014) will now pay double the annual premium increases for the two most popular individual health plan options. Namely, the Blue Choice Preferred Silver PPO plan and Blue Precision Silver HMO plan.  Obamacare remains anything but “affordable” and our elected “Republicans” are providing no assistance whatsoever.

Source data:

Click here > BCBSIL2017IndividualPlanRates < to see quotes for a 50 year old male in Will county, Illinois run with today’s effective date.

Click here > Healthcare.govBCBSIL2018IndividualPlanRates < to see quotes for a 50 year old male in Will county, Illinois run with a January 1, 2018 effective date.

 

 

 

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Blue Cross Blue Shield of Illinois proposed 2018 premium increases

Blue Cross Blue Shield of Illinois proposed (not APPROVED) 2018 premium increases for Individual policies are as follows:

38.2% for BlueCare Direct HMO plans
14.5% for Blue Precision HMO plans
9.3% for Blue FocusCare HMO plans
5.4% for Blue Choice Preferred PPO plans.

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