HMO Medicare Advantage

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.

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.

Good News: Healthcare Reform & Medicare

We are ready to sell plans for Covered California.

The main reason a person would get a plan on Covered California is if their income is below the guidelines on this chart.

If you qualify for a subsidy or are unsure if you qualify, please let us know, and we will help you make that determination and ultimately enroll you in a plan. Covered California cannot yet accept applications online, which means that everything needs to be done via paper applications. We can get the application to you by email, snail mail or you can come to our office to fill it out.

If you clearly make more that the income guidelines, we are recommending you wait until after November 1, 2013 to sign up for a new plan. The rates for the "off the exchange" plans are currently only available with two of the five carriers in California (Kaiser and Blue Shield). In November all the carriers should have their rates available and then we can look at the all the options to determine the best value for you.

As always, there is never an extra fee for our insurance services – the carriers pay us on their end.

Medicare Annual Election Period Begins!

October 15, 2013 was the beginning of the annual Medicare enrollment season. If you have a Medicare Advantage Plan this is the time where we can review your coverage and possibly change you to a new plan.

One big change is that Anthem unfortunately raised their PPO plan rates from $28 to $80 in Los Angeles County. If you have this plan, we can look at other options for you like a Medicare Supplement plan or an HMO Medicare Advantage plan.

If you have a Medicare Supplement plan and Part D (drug) plan, we can also change your Part D at this time. Humana has a new plan for $12.60 a month which could be a good choice if you do not take a lot of medications.

Keep In Touch

If you want to have us address your situation right now, please contact us. Otherwise our goal is to contact you before December 15 if you are under 65 and prior to December 7 if you are over 65 and on Medicare!

Investment advice is offered by Horter Investment Management, LLC, a Registered Investment Adviser. Insurance and annuity products are sold separately through TWP Financial. Securities transactions for Horter Investment Management clients are placed through Pershing Advisor Solutions, Trust Company of America, Jefferson National Monument Advisor, Fidelity, Security Benefit Life and FC Stone.

A Lesson In Patience: Healthcare Update

Thank you for being so patient with the Affordable Care roll out. We have been preparing for this for six years (mostly emotionally and mentally) and it is finally here! The grand entrance is less than we had hoped, but we have faith that it will all come together so that we can get you on a new plan as of January 1, 2014.

At this point, you can go onto the California exchange, , to see what plans are available and if you qualify for a subsidy. If you are eager to enroll on the exchange, you will need to fill out a 25 page paper application, which we can supply to you.

The online enrollment process should be much simpler. We expect this to be up and running soon – ideally well before November 1, 2013! We, as well as all other agents, are waiting for our ID numbers with the exchange. We cannot officially sell a policy on the exchange until we have those IDs.

What to do in the meantime? Let us help you figure out a preliminary plan!  We are currently talking to people and having a basic consultation on whether they will be qualified for a tax subsidy on the exchange or if they should buy their policy off the exchange. We then review the current plans that are available to see which one they will most likely obtain.

One source of confusion is whether you should get a plan on the exchange or off the exchange. The only reason you would get a policy on the exchange ( is if you qualify for a subsidy.

The subsidy is based on your income on line 38 of your Form 1040 tax return from 2012.  See the income guidelines at:

If you clearly do not qualify for a subsidy, then we recommend getting a plan off the exchange. Currently, we can only quote Blue Shield and Kaiser. We expect Anthem’s plans and rates to be available by October 15. Cigna’s rates will not be available until November 1.

Another big issue will be each plan’s network of doctors and hospitals and determining if your doctors are in the network.

For example, many of you like PPO plans and appreciate seeing doctors at Cedars-Sinai and UCLA. At this point, Blue Shield has the least expensive PPO plans in Los Angeles, but on their individual plans both of these hospitals are outside of the network. This is quite frustrating.

In Los Angeles, Anthem is only offering an EPO – Exclusive Provider Organization – which is a modified PPO plan that will not allow you to go out of the network. Cedars-Sinai and UCLA are currently in this network.

Making sure your doctors are in the network is one of the most time-consuming parts about picking the right plan. It would be ideal if you talked to your doctor’s billing department to find out which plans they will be contracted with in the new era of health insurance, starting in 2014. The main carriers are:

Blue Shield PPO
Healthnet PPO and HMO
Cigna PPO
Anthem EPO and PPO

Please call us if you would like the initial consultation. Hopefully we will be able to start enrolling you soon!

Investment advice is offered by Horter Investment Management, LLC, a Registered Investment Adviser. Insurance and annuity products are sold separately through TWP Financial. Securities transactions for Horter Investment Management clients are placed through Pershing Advisor Solutions, Trust Company of America, Jefferson National Monument Advisor, Fidelity, Security Benefit Life and FC Stone.