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Cover Oregon – Oregons Health Insurance Exchange

May 26, 2013 in Affordable Health Insurance, Dependants, Employee Benefits, Employer Sponsored Plans, Group Health Plans, Health Care Costs, Health Insurance Agent, Health Insurance Exchange, Health Insurance Quotes, Health Insurance Reform, Individual Health Insurance

You will likely be impacted by Obamacare, which forces most individuals, families and many groups to change their health insurance benefits soon. According to Obamacare, over 50% of health plans on the market today which consumers often choose, don’t provide enough benefits. As a result, many will be forced onto new plans that meet Obamacare requirements and their old plans will be terminated. Most existing plans on the market today will go away and most of you will be forced to choose a new plan for 2014. If you do not choose a new plan in Oregon, your insurance provider will automatically enroll you into their least expensive health reform compliant plan.

One of the largest changes to the industry will be the health insurance exchanges. Coverage Point agents are in the process of becoming certified in multiple states, which will allow our agents to offer plans on the health insurance exchanges. We anticipate being able to assist you apply for plans both on and off the exchanges. Here is what to expect. All detail are not yet available, but this is our general understanding as of now.

Health Insurance Exchanges & New Health Care Reform Compliant Plans

Enrollment begins October 1, 2013. With these changes, there are many who will benefit from the services offered by Coverage Point. We are here to guide you, and those you know, through this new insurance market. It is estimated that there are nearly 30,000,000 people in the US, who have no health insurance. By 2014, these uninsured individuals, will be required to obtain health insurance, or face a penalty when they file their tax return. For many who can’t afford health insurance, there will be subsidies to make it more affordable for them. Unless prohibited by law, at this time we will give you a $50 Gift Certificate or $50 Gift Visa from us when you refer someone to us and they are issued a new, individual, family or group, health insurance policy, or elect to make us their agent of record on an existing health policy. Please keep your eyes and ears open for anyone who may benefit from our assistance and services. Those who will most likely benefit from our services are:

  • Those who think they can’t afford insurance
  • Those who think their group options are too expensive
  • Those who think their group plan costs too much to add their spouse and/or children to their plan
  • Employers of all sizes
  • Individuals and families of all sizes
  • Those who currently don’t have health insurance
  • Individuals and businesses who think they will qualify for a subsidy, or have questions about them
  • Those who are required to purchase health insurance on their own
  • The self employed

Changes to take place on or before January 1, 2013. Oregon has come up with some of its own ideas while implementing some of Massachusetts current health exchange, Health Connector. Massachusetts implemented many of their own health care reform rules and mandates back in 2006.

  • Similar to group insurance now, there will be open enrollment periods for individual health plans. Like group, there will only be certain times of the year, or certain life instances that you will be eligible to apply for, or switch plans. These enrollment periods will apply to plans both in and outside of the exchange.
  • You must enroll into a health plan or there will be a penalty when you file your taxes. There will be a special “Catastrophic” plan available only for those who are considered as exempt from the penalty, or under the age of 30. The following will expected to be exempt from the penalty:
    o Certain religious groups
    o Certain Native American Indian Tribes
    o Undocumented immigrants
    o Prisoners
    o Those whose premium after federal subsidies and employer contributions exceed 8% of family income
    o Those whose income is so low they are not required to file a tax return
  • New required benefits
    o A health plans max out of pocket cannot exceed around $6,000 per person and $12,000 per family. Small group deductibles cannot exceed $2,000 per person and $4,000 per family
    o Plans must cover clinical trials
    o Plans must cover essential benefits. Lifetime and annual limits for essential benefits will be eliminated. Essential benefits are:
     Outpatient services
     Emergency
     Hospitalization
     Maternity & Newborn Care
     Mental Health & Substance Abuse
     Prescription Drugs
     Rehabilitative and habilitative services and devices
     Laboratory Services
     Preventive, wellness and chronic disease management services
  • Cover Oregon, Oregon’s health exchange is available to every individual and small group beginning October 1, 2013. Health exchange plan effective dates will begin January 1, 2014.
    o Insurance companies will no longer be allowed to deny someone for a preexisting condition. Rates are based on where you live, age and tobacco use. New premium ratios based on age for the January 1, 2014 rate adjustment, will result in a higher rate for children, and less significant for those nearing age 65.
    o Tax subsidy will be available to individuals and families who make up to 400% of poverty level. That means a family of 4 can make around $92,000 a year and still be eligible for a subsidy. A single person can make around $45,000 a year and still be eligible for a subsidy. The amount of the subsidy will be based on family income. The lower the family income, the higher the subsidy. Subsidies will only be available through the exchange. Here is an individual and family health insurance Subsidy Calculator.
    o Employers with 50 employees or fewer will have access to the exchange beginning 2014. Employers with up to 25 employees and an average wage less than $50,000, can receive a tax credit up to 50% the premium paid by the employer. These subsidies will be only available to plans purchased through the exchange. Here is the small group employer Subsidy Calculator.
    o The application process will be much simpler than it has been. Questions pertaining to health history will no longer be asked on the application. If you choose, the exchanges will give you the option to apply on your own and it will also allow you to choose us as your agent, or another agent. You will be able to give credit to the agent who assisted you, if you choose to apply on your own. The advice of an experienced agent is important to seek, prior to applying for any of these new plans that you are most likely unfamiliar with. There are important changes, details, knowledge and feedback about the exchanges, each plan and each company, which us agents have the knowledge or experience to guide you. Input that you will not get from an exchange or a brochure. Our agents are also brokers…we are not loyal to any one plan, one company, or the exchanges. Our assistance is still at no addition cost to you, like it always has been.
  • There will be 5 plan designs. Each insurance company will have comparable plans for each category below. Plans in the same category can somewhat differ from each other. There will be standardized Bronze, Silver and Gold plans, which will have identical benefits, no matter the insurer who offers them. Insurers are required to offer at least the standardized Bronze and Silver plan. Insurer who participate within the exchange are also required to offer a Gold option, though they are not required to offer the standardized Gold Plan. The most noticeable differences in the standardize plans are expected to be the premium you pay, provider networks and customer service received from the company.
    o Platinum – Covers on average 90%
    o Gold – Coverage on average 80%.
    o Silver – Covers on average 70%
    o Bronze – Covers on average 60%
    o Catastrophic – Covers on average 60%. This plan is for those who will be classified as exempt. Those who will be eligible for this plan are those who are under the age of 30, or those mentioned above.
  •  Employers with more than 50 employees will be required to offer insurance to their employees or face a penalty.

LifeWise Health Plan of Oregon SPECIAL Producer Bulletin – Products and Rates Filed for 2014

May 8, 2013 in Affordable Health Insurance, Grandfathered Health Plans, Health Care, Health Care Costs, Health Care Reform, Health Insurance Agent, Health Insurance Exchange, Health Insurance Quotes, Health Insurance Reform, Individual Health Insurance

LifeWise Health Plan of Oregon SPECIAL Producer Bulletin – Products and Rates Filed for 2014 (05-08-13)

Oregon May Have the Answer for Child Only Health Policies

March 3, 2011 in Affordable Health Insurance, Child(ren) Only Health Plans, Dependants, Employer Sponsored Plans, Grandfathered Health Plans, Group Health Plans, Health Care, Health Care Costs, Health Care Reform, Health Insurance Agent, Health Insurance Reform, Individual Health Insurance

Oregon May Have the Answer for Child Only Health Policies

By John Rueschenberg & Ashley Ahle of Coverage Point Insurance in Happy Valley, OR

The state of Oregon, a few months ago, restructured child only individual enrollments by switching to open enrollment periods, similar to that of a group open enrollment period. Child only applications are only accepted during the months of February and August of every year with effective dates of either March 1st or September 1st.

Congress Passed a law earlier this week allowing states to create similar laws that will close the loopholes in child only policies applications, which prevent insurance abuse of benefits. In order to keep insurance companies on board, regulation is needed to keep premiums from skyrocketing due people only obtaining coverage after they become sick and with no no consequences.

To simplify the process and reduce risk, annual enrollment periods across the industry, including enrollment for Medicare Advantage plans, should be changed to the month the eldest applicant was born. If this were to happen consumers, insurance companies, agents and the Federal Government would experience more ease when dealing with coverage.

Remembering the month you were born is far easier than researching the dates for the next enrollment period. Making this change would eliminate confusion that comes with purchasing an insurance policy. Enrollment periods that are lumped into a small time frame, like what currently happens for Medicare, group coverage and now child only policies in Oregon, increases the chances for error and reduces the quality of service, by creating an increased workload for the government, insurance companies and agents involved with enrollment.

Not only would changing the open enrollment period to the month of birth lessen the workload, it would also reduce the amount of SPAM email consumers receive year round. Instead of soliciting year round, agents and companies would only focus on the weeks leading up to the insureds birthday, making it easier for all parties involved.

Under health care reform, insurance companies are prohibited from denying any child with pre-existing conditions. Due to this change, many companies have either adopted the open enrollment periods or have stopped offering child only policies all together. Although companies are allowed to offer them outside enrollment periods, they are still prohibited from denying any child thus allowing people the opportunity to only gain coverage when an illness occurs, therefore driving up costs for everyone.

Not only would the birth month enrollment periods ease workloads across the industry, many more consumers would find it easier to obtain coverage and in turn, more people would be covered. Which is the goal of health care overhaul all together.

Another Lawsuit Against ObamaCare Survives a Preliminary Challenge

January 20, 2011 in Affordable Health Insurance, Child(ren) Only Health Plans, Doctors, eHealthInsurance.com, Group Health Plans, Health Care, Health Care Costs, Health Care Reform, Health Insurance Agent, Health Insurance Exchange, Health Insurance Quotes, Health Insurance Reform, Individual Health Insurance, Life Insurance, Permanent Life Insurance, Primary Care Physician, Specialists, Term Life Insurance, Uncategorized, Whole Life Insurance

Another Lawsuit Against ObamaCare Survives a Preliminary Challenge
October 14, 2010 6:32 pm

The rulings keep rolling in on the constitutionality of the federal reform law. On Thursday, a federal judge in Florida refused to dismiss the lawsuit brought by a group of state attorneys general( led by Florida’s Bill McCollum), although he threw out several of the suit’s lesser claims. (Here’s the ruling, courtesy of the Wall Street Journal.) That’s the second such decision; a federal judge in Virginia held in August that the Commonwealth’s attorney general could proceed with a similar lawsuit. On the flip side, a federal judge in Michigan ruled earlier this month against a lawsuit that had been brought by the Thomas More Law Center, declaring that the law’s requirement to buy was constitutional….

— Jon Healey

Administration: Health Repeal Could Cost Millions Coverage

January 18, 2011 in Affordable Health Insurance, Child(ren) Only Health Plans, Dependants, Employer Sponsored Plans, Grandfathered Health Plans, Group Health Plans, Health Care, Health Care Costs, Health Care Reform, Health Insurance Agent, Health Insurance Exchange, Health Insurance Quotes, Health Insurance Reform, Individual Health Insurance, Specialists

Administration: Health Repeal Could Cost Millions Coverage

By the CNN Wire Staff
January 18, 2011 1:19 p.m. EST

Washington (CNN) — Nearly half of all Americans under the age of 65 have health conditions that could prevent them from getting insurance if the Republican effort to repeal health care reform is successful, U.S. Health and Human Services Secretary Kathleen Sebelius said Tuesday.

Sebelius said 129 million people — nearly half of all Americans under the age of 65 — have some form of pre-existing condition that could make them ineligible for coverage should they lose or change jobs, get divorced or face other changes that force them to seek new insurance….

Health Insurance Exchanges Should Not Be Like eHealthInsurance

September 20, 2010 in Affordable Health Insurance, eHealthInsurance.com, Health Care, Health Care Costs, Health Care Reform, Health Insurance Agent, Health Insurance Exchange, Health Insurance Quotes, Health Insurance Reform, Individual Health Insurance

Health Insurance Exchanges Should Not Be Like eHealthInsurance
By John Rueschenberg
CoveragePoint.com

Two months ago, I had a meeting with Mary, a director at a reputable health insurance company. Mary’s name has been changed and her company’s name will not be disclosed to protect her identity. Mary and I were talking about the different insurance agencies and the amount of production that they bring to her company each year. Not at all to my surprise, her number one producer of individual health plans was and has been eHealthInsurance. eHealthInsurance is the largest online insurance agency, owned by publicly traded company eHealth Inc. We have all seen their TV commercials for affordable health insurance. The truth is that the rates are no different if you apply using eHealthInsurance, another agency or if you apply directly to the company by yourself. It will be the same rate no matter what, but keep in mind that an agent can help you and keep you from making a costly mistake, so that is why you should always use an agent.

Most will agree, the ongoing history of publicly traded companies is to make a huge profit and achieve excellent numbers so that they can keep their stock holders happy. While some publicly traded companies do care about customer service, many others don’t. I have never been to the eHealthInsurance’s headquarters before nor have I spoken to someone who works for, or previously worked for the company, therefore I don’t know exactly how they operate. What I do know and can share with you are the experiences of others who have dealt with the company at one time or another.

In my meeting with Mary, she described eHealthInsurance as her double edged sword. They continually have brought Mary’s company the most new individual health business, but eHealthInsurance has had an ongoing history of not providing adequate service to their clientele after the policy is issued. Mary also said of the people who applied for one of her companies health plans using eHealthInsurance.com, that ongoing for years now, eHealthInsurance has had the highest percentage of policies not taken after an application was submitted. “Not taken” is an insurance term meaning someone applied, but for one reason or another the policy was never issued. Similar stories are out there on websites such as Epinions.com and other product or service review websites. Interestingly enough, one of the automatically generated search terms that Google gives is “eHealthInsurance scam.” The Better Business Business Bureau of North Eastern California alone has received 22 complaints in the past 36 months for eHealthInsurance.

Ordinarily, I’m not about attacking someone or a company and pointing out their flaws, but this has changed because EhealthInsurance has made the recommendation that the new health insurance exchanges starting up over the next few years should operate similar to how eHealthInsurance.com does now. While lack of service does sound like how most government agencies have long been operating; such as the Department of Motor Vehicle, the Internal Revenue Service and Social Security Administration, the US population as a whole is not looking for health care to operate as another poorly serviced government agency.

There are other sites out there that do provide the same great online experience as eHealthInsurance, but also offer ongoing service for years to come. Websites like CoveragePoint.com give you the same great online service as eHealthInsurance.com does, but they instead have an ongoing reputation of being there for you when sticky situations come along. It is important that the example of the health insurance exchanges follow the examples of agents and agencies who have built a solid reputation of being there after the policy is issued. The agent is the person who is supposed to be there for you at the hardest time, such as when dealing with a difficult claim, especially if you have to deal with multiple insurance companies. An agent helps you during the application process, prevents you from making a simple mistake that would otherwise hold up your application in underwriting for days or weeks longer than necessary, or cause for you to receive a higher premium. An agent can help prevent a decline or a rider. An agents advice and experience are both invaluable and free to the consumer.

Circumstance and claims often do happen where you are dealing with your health insurance company, your auto insurance insurance company and Workman’s Comp; all three at once, or two at the same time for the same injury or claim. More than likely, each company wants the other to pay the claim, so often times none of them pay. Your agent is there to get you through these unfortunate circumstances as your personal representative. Your agent is supposed to be on your side. They should help you figure out the mess and point you in the right direction. The example of health insurance exchanges should not be eHealthInsurance, but instead the example should be that of agents and agencies who have built a solid reputation of being there for their clients when they are needed.

The Centers for Medicare and Medicaid Services(CMS) projects that the expense of health care would be 0.3% less by the year 2019 had the health care reform bill never passed. CMS also predicts health insurance exchanges are expected to cost roughly a total of $220 billion just to start up by 2014. Between 2014 through 2019, the health insurance exchanges are predicted to cost an additional $37.7 billion to operate. Roughly 85% of US health insurance policies are issued with the assistance of an agent. When you consider that about 85% of policies are issued using an agent, the duplicated efforts of exchanges will be a waste of taxpayer dollars. Eliminating the creation of the exchanges all together will save over $250 billion between now and 2019; health care savings would be seen and achieved much sooner. The creation of the health insurance exchanges will simply be a waste of time and taxpayer money, especially if they will be run like any other poorly serviced government agency. There is no reason to reinvent what has already been proven to work.

Health Reform News & Updates – Health Insurance Quotes & Affordable Health Insurance Plans – Compare Health Insurance Rates

June 9, 2010 in Affordable Health Insurance, Child(ren) Only Health Plans, Doctors, eHealthInsurance.com, Group Health Plans, Health Care, Health Care Costs, Health Insurance Agent, Health Insurance Exchange, Health Insurance Quotes, Individual Health Insurance, Life Insurance, Permanent Life Insurance, Primary Care Physician, Specialists, Term Life Insurance, Whole Life Insurance

Health Reform News & Updates – Health Insurance Quotes & Affordable Health Insurance Plans – Compare Health Insurance Rates.

Why Should I Work With An Agent?

June 7, 2008 in Affordable Health Insurance, Group Health Plans, Health Care, Health Insurance Agent, Health Insurance Quotes, Individual Health Insurance

The internet has made shopping for insurance easier. Instead of driving around town to meet with an agent, you can compare rates, benefits, and apply online. Some insurance companies even let you apply right from their website.

Does it still make sense to have an agent help you choose a plan? You bet.

Agents are insurance experts. It’s their job to help you shop plans from leading carriers so you can be confident you’ve found the best rates and benefits for you.

4 Reasons To Work With An Insurance Agent
When you consider all the benefits, working with an agent just makes good sense.

  1. Agents guide you through the process. Buying an insurance policy can be complicated. An agent walks you through each step of the process and helps you make sense of all the “insurance-speak”.
  2. Agents offer you choice. Your agent has a portfolio of plans to choose from, often from multiple companies. Your agent will know which policy will protect you the best. They’ll even know which company is most likely to accept your application.
  3. Agents troubleshoot mistakes. A mistake on your application can cause a company to raise your rates or even reject your application. Your agent will help you fill out your application correctly so you get the rates you deserve.
  4. It’s free. This is the best part about getting insurance through an agent. Agents collect payment from the companies they represent. So you get all the advice you want — absolutely free.

As professional agents, we’re happy to help you find the best plan. You can compare popular plans on our website, too. Get started now with your free online health insurance quotes.

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