Must You Enroll In A HIX?


Photo by Jessica Rinaldi of REUTERS
Photo by Jessica Rinaldi of REUTERS

President Obama and Secretary Sebelius plan to launch an educational campaign about the new health insurance exchanges (HIX).

Unfortunately, I am a bit of a skeptic.  I have worked with health insurance for over 25 years.  I recognized the lies, incomplete information and half-truths that the president and his cronies told the American people in 2009-2010 to get the Patients Protection and Affordable Care Act passed.

In my opinion, the law that has become known as, “Obamacare,” is the worst federal legislation since “Prohibition.”  It is my opinion that the Affordable Care Act will be repealed and replaced with a health care law that actually works for all Americans and not just for the President’s constituency.

However, I do not expect that to happen until after America elects a new president in 2016.   Until then, Obamacare is the law of the land.  Law abiding Americans must abide by the terms of the Affordable Care Act.

As the National Open Enrollment approaches, I am afraid that many Americans will be confused by the propaganda that is about to come from the Department of Health and Human Services.

CONCERNS

One of the things that bother me is that the “educational campaign” is scheduled to start before Navigators and Insurance Agents are given final details about the new health insurance exchanges.  The only source that you will be able to consult if you have questions will be the Department of Health and Human Services until the very last minute before you have to make a final decision.

In my weekly emails I want to point out all of the options that will be available to middle-class Americans and not just what will benefit the federal government.

Below you will find the text of my email for next week.  You will also be able to subscribe to automatically receive my email in your computer or phone each week.

When the National Open Enrollment starts, on October 1, 2013, it is my intention to be certified to offer health insurance both inside and outside of the new health insurance exchanges.

There is no financial incentive for me to guide you to purchase your health insurance either inside or outside of the exchanges.  From what I know, at this moment, my compensation will be the same, regardless of which option you choose.

My goal, with this email and blog post, is to let you know that unless you qualify for a tax-subsidy, the only differences you will find is what insurance companies you want to use.

Many insurance companies have elected to offer plans through the new health insurance exchanges.  Others have elected not to deal with federal “red-tape.”  They will offer Obamacare compliant policies outside of the exchanges.

I am afraid that federal “education” advertisements will not mention that you have the option to get a compliant health insurance plan without having to register with the federal government.

EMAIL TEXT

“In a couple of weeks the Department of Health and Human Services will flood the airwaves with advertisements designed to encourage Americans to enroll in one of the Essential Benefit Plans through the new Health Insurance Exchanges during the National Open Enrollment that starts in October.

If the advertisements are like many of the other communications that have come out of D.C., I anticipate there to be much confusion.  In this week’s email I want to try to anticipate much of the confusion that is about to happen in America.
While it is true that Obamacare mandates that all Americans must by a government approved “Essential Benefit Plan” or pay a penalty, there are several exceptions.

  1. If you are enrolled in Medicare you are not required to do anything during the National Open Enrollment.
  2. If you get your health insurance at work, you do not need to do anything during the National Open Enrollment.  Your employer will work with your insurance company to adjust your plan to one of the Essential Benefit Plans.  You will make your decisions when your group plan renews after January 1, 2014.
  3. If you already have a qualifying, “permanent” type of individual health insurance you can wait until your current policy renews in 2014 to elect an Essential Benefit Plan.  Many, but not all, insurance companies have adjusted policy renewal dates until December 31.  If your has, you will not be required to change your health insurance until the annual election period in October, 2014 for the plan year to cover 2015.

However, there are two groups of people who are required to enroll in an Essential Benefit Plan during the National Open Enrollment.

  1. If you have elected to go without health insurance in the past, you must elect one of the Essential Benefit Plans during the last quarter of this year or pay a “penalty” for each month you remain uninsured in 2014.
  2. If you have been using Short Term policies or any other “Limited Benefit” plans in order to keep premiums affordable for the past few years, the time for paying full premiums for full coverage has arrived.  You also will be required to enroll in an Essential Benefit Plan during the last quarter of 2013 or pay a penalty for each month you remain uninsured in 2014.

The good news is that “subsidies” may be available to you under specific conditions.  If you qualify for them, I will be able to help you with your application.

If you are still not certain if you need to do anything during the National Open Enrollment or pay the “penalty,” contact me.”

If you share my distrust of “educational” materials that come from D.C., click the banner below to subscribe to my weekly email.  I will try to keep you informed on all your options, both in and out, of the exchanges.

Weekly Email 1

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