Summer is over, the kids are back at school and open enrollment is nearly upon us! Almost instantly, we have a new tradition in America – the fall open enrollment.
Here are all the open enrollment periods for this year:
Medicare: October 15 – December 7
Individual health insurance: November 15 - February 15, 2015
Group: Every company has a unique open enrollment period depending on the month when they began the plan.
What are some of the individual health insurance changes?
It has been a relief for everyone to be able to enroll into a health plan and not worry about pre-existing conditions. Gone are the days where a psychiatry visit, an abnormal lab result or the use of marijuana five years ago gets one declined from getting health insurance.
Many people have also appreciated getting a subsidy on the Covered California Exchange. A single person making $17,000 a year (adjusted gross income) has been able to qualify for an amazing plan at a very low price.
The biggest problem has been the network of doctors. Many of you like to go to UCLA or Cedars Sinai for medical related issues. Peter Lee, executive director of Covered California, said “More isn't always better. The days of every doctor in every network are over”. We do not agree with Mr. Lee. We feel that the more doctors in a plan’s network, the better the plan serves our client.
Assurant and Healthnet have offered our clients the ability to see the widest range of doctors. For 2015, Healthnet is reducing their network of doctors by 54% and only offering an EPO (rather than a PPO). If you are on a Healthnet PPO, we need to make sure that your doctor is the new smaller network. With an EPO plan you do not get any benefits if you go out of network.
Anthem is supposed to keep the same network of doctors. They have also added 7,000 doctors since January so their network is filling out. More doctors at Cedars are also taking Anthem so that has been a positive change.
Blue Shield used to be our favorite carrier. We love the fact that they are a non-profit and agree to only keep a 2% profit. Unfortunately, they reduced their individual plan network by 33% and it has gotten so small in Los Angeles that we now recommend them with caution. For 2015, Blue Shield has proposed two health plans with up to 4% fewer physicians. They have also been riddled with customer service problems. Hopefully they will rise to the occasion for the 2015 open enrollment. We would like to see them get back to their old efficient ways.
In addition to the network of doctors, another issue for open enrollment is that this is the only time of the year carriers can raise their premiums. Assurant reported that they lost over $300 million dollars this year by not charging enough. Rates overall are expected to go up 4.2% but unfortunately, Assurant’s rates are expected to go up more than that to cover their loss.
We do not have the new prices or plans at this time. We expect to get them on November 15, the day of open enrollment! Let’s schedule a time to talk after November 15th.
Now that it is October 1, we can talk about the Medicare changes. The biggest news is that Anthem is getting rid of their Medicare Advantage PPO plan in Los Angeles County. This is a sad day for us since a lot of people really enjoyed that plan.
Some good news is that the Blue Shield HMO plan is now contracted with Cedars Sinai! Some of the people that were on the Anthem plan might want to move over to Blue Shield.
Aetna HMO has been a great plan for people wanting access to UCLA doctors. That plan is now going to be $28/month and they have now lost their contract with UCLA starting January 1, 2015. A solution is to move over to SCAN or AARP. We are now contracted to sell SCAN and AARP. SCAN is ranked by Medicare with 4.5 stars out of a 5 star rating! And it is free.
Aetna is now offering a Medicare Advantage PPO plan in San Diego for $74/month and $108/month in Orange County. Unfortunately, it is not offered in Los Angeles.
Please call us to set up your appointment to revaluate your Part D plan and your Medicare Advantage plan. We can talk after October 15th. If you are on a Medicare Supplement plan, your open enrollment period is your birthday month to change that plan.
We just signed a lease at a new office. We will be moving in November 1. The benefit is that it is bigger, which will allow us to add new staff for the open enrollment period.
Our new address is:
8665 Wilshire Blvd (at Willaman)
Beverly Hills, CA 90211
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