Health Insurance

January 31st Is the Deadline For Open Enrollment 2017

Dear Clients,

The final deadline for Open Enrollment (individual plans under age 65) 2017 is January 31st for a March 1st start date. No matter what the media says the Affordable Care Act is still alive and well through 2017.

Please contact us if you would like to get health insurance for 2017. Here is our scheduling link: www.twpfinancial.com/schedule 

Wishing You All the Best in 2017, 

TWP Financial

Oscar Comes To California

OSCAR comes to CA: If you have been noticing all the health insurance advertisements in the last few weeks then you have surely noticed the new player in California named OSCAR. Oscar is marketing themselves as very tech oriented, particularly with a phone app that gives you access to 24/7 doctor visits over the phone, and a fit bit tracker that rewards you with Amazon gift cards for achieving your fitness goals.  For people who do not go to the doctor very much and just want coverage, Oscar may be worth checking out. 

However, here is TWP’s analysis of Oscar for 2016 in LA County:

1.       Oscar in new in California and that means their network is very small. How small? Pretty darn small. You can search their network here: https://www.hioscar.com/search/CA/doctors

2.       Oscar is new which means they are an unknown. An unknown is an unknown. For people who enjoyed the new to California health insurance company Assurant can attest, two years later after the Affordable Care Act began we are having to move every client to a new plan because they are now not offering Major Medical Coverage in the United States.

3.       Oscar is only offering an EPO, which means “exclusive provider network”. In human speak this means that only the doctors in Oscar’s network will accept this coverage. This is not a big deal if you never go to the doctor or if you want to use this network. This is a very big deal if you have specific doctors that you see often and they are not in the network.

4.       We recommend Oscar to those who rarely go to the doctor, enjoy tech and how it is working to make our lives easier, and want to experiment being on the cutting edge of a new health insurance company in California.

If you would like, you can sign up directly with Oscar on their nifty and clean website through our broker link here, and/ or pass this on to your friends and family: https://www.hioscar.com/brokers/referral/715 The benefit of having us as your broker rather than being on your own is that there is no cost to you and we can call the health companies for you be your advocate to help with any situations that tend to arise regarding billing, payment, processing, etc.  


Oscar's List of 2016 Participating Hospitals in LA County: 

● Providence St. Joseph Medical Center ● Providence Holy Cross Medical Center ● Providence Little Company of Mary Medical Center - Torrance ● Providence Little Company of Mary Medical Center - San Pedro ● Providence Tarzana Medical Center ● Providence St. John’s Health Center ● Good Samaritan Hospital ● St. Joseph Hospital of Orange ● St. Jude Medical Center ● Hoag Memorial Hospital Presbyterian ● Mission Hospital Regional Medical Center - Main ● Mission Hospital Regional Medical Center - Laguna Beach ● Huntington Memorial Hospital ● Henry Mayo Newhall Memorial Hospital ● UCLA Medical Center - Santa Monica ● UCLA Medical Center - Ronald Reagan

Medicare Open Enrollment Starts October 15th. Please Schedule Your Appointment.

Medicare open enrollment begins October 15th and ends December 7thPlease book an appointment between those two dates. By law, we can't talk to you about your options before October 15th.  This is our annual review of your Medicare coverage to ensure that you have the best coverage possible.
 
Please schedule your appointment on our new website here or give us a call at 424-288-4254. 
 
Regular Open Enrollment under the ACA Affordable Care Act starts November 1 –January 31, 2016. 
 
You should be receiving your renewal packet in the mail shortly. Whether you are on Covered California or directly covered with the carrier please speak to us prior to submitting your renewal so we can make sure you’re on the best carrier for your needs. Click here to schedule or call us 424-288-4254. Please schedule your appointment after November 1st. We will not have the new rates until then. 
 
Assurant is ending so if you are covered by Assurant please schedule an appointment here or call us so we can move you to another carrier.
 
Anthem is changing from EPO to PPO for Los Angeles, San Francisco, San Diego and Orange Counties.  This is a very positive change because you will now have out of network benefits with Anthem.
 
Blue Shield will also only offer a PPO throughout the entire state of California for all of 2016. They will no longer be offering their EPO policies in Northern California. 

United Health Care is coming to California in a few counties in Northern California but will not include Los Angeles, San Diego or Orange Counties.

Anthem and Blue Shield Now Have Mobile Apps

With Anthem's New app you can:

  • Access an exact copy of your ID card
  • Find doctors in your network
  • Gain quick access to your health record
  • Use tools to refill and manage your prescriptions

And the latest update now includes touch authentication* — using just your fingerprint.  No new passwords to remember, so, it's secure, but also convenient. Download the Anthem Blue Cross mobile app today from Google Play or iTunes! Or, Learn More Here

Blue Shield's New App: 

Blue Shield members can now get more health plan and healthcare services information anytime, anywhere. We designed the Blue Shield mobile website and mobile apps for easier access to more helpful online features and functions. Download Here

Good News: Blue Shield Individual (Under-65) Plans are Now Accepted at UCLA and Cedars-Sinai

Blue Shield of California has reached a long-awaited agreement with University of California Health System (Hospitals and IPA/Medical Groups), including UC Davis Medical Group, UC Davis Medical Center, UCLA Medical Group, Ronald Reagan UCLA Medical Center, UCLA Medical Center Santa Monica, UC Irvine, UCSD Medical Center, UCSD La Jolla, UCSF Medical Center, UCSF Mt. Zion, Langley Porter Neuro Psychiatric Institute, and UCSF Medical Center at Mission Bay.

Effective July 1, 2015 the University of California Health System providers will be participating in Blue Shield's Individual and Family Plan (IFP) Exclusive PPO Network and IFP EPO Network with Covered California on-Exchange and off-Exchange directly through Blue Shield.

This is great news! Blue Shield’s network is finally growing and now has a similar size network to Anthem’s. Blue Shield is also a PPO plan so it will also pay for out of network services. This can be very important especially if you see a therapist since most therapists do not take insurance. In this situation, we recommend a gold or platinum plan so you do not need to meet a deductible before getting a reimbursement.

Get Ready for Open Another Open Enrollment!

The Fall Open Enrollment will be here before we know it. This is our busy season and our goal is that each one of you feels you are given white-glove service. We will be contacting you to set up an appointment to talk about your health plan during the open enrollment periods.

Here is the schedule:

Medicare Open Enrollment for Medicare Advantage and Part D Plans: October 15 – December 7

Individual Plans: November 1 – January 31, 2016

Update on Assurant:

Unfortunately, Assurant is closing their doors for health insurance business so we will be contacting all of our Assurant clients to make sure they are successfully moved to a new plan by December 15, 2015.  Let us know if you know someone that could also use our help in moving from Assurant to a new plan. As always, there is never any extra fee for our services when we help with insurance related products.

Please give us a call at 424-288-4254 if you have any questions.

Tis the Season for Open Enrollment!

Greetings!

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.

Medicare

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.

New Office

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)
Suite 206
Beverly Hills, CA 90211

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