covered california

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

Horter Investment Management LLC portfolios focus on preservation of capital during market downtrends; reduced volatility; and daily liquidity. The managers aim to generate positive returns year after year, regardless of any other benchmark index. This style of investing attempts to profit, regardless of market direction and preservation of capital is a key component of this strategy. By following a disciplined defensive strategy in declining markets, Horter’s managers seek to preserve your capital and reduce losses. .

Horter Investment Management LLC’s managers do not focus on the long term “buy and hold” approach; otherwise known as a “hope and a prayer” portfolio. Instead, the managers utilize sophisticated research in determining which assets to use and when to use them for the purpose of capital preservation and growth. The low-risk, low- volatility managers analyze their portfolios on a daily basis and take action if necessary.

To learn more regarding the above, please click the following link: www.him-ria.com .

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, www.CoveredCA.com , 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 (www.CoveredCA.com) 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:

www.CoveredCA.com/fieldcalc/#incomeGuidelines

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.

Important Healthcare Update

The Country is embarking on the biggest change in Healthcare since adding Medicare. Unfortunately, it is a messy process, but we are here to help you get through it. Here is the latest that we know about the upcoming Open Enrollment period.

Covered California is slowly getting everything together. We most likely won’t have the ability to enroll people with them until October 10. We are frustrated by this delay, but it is out of our control.

Anthem Blue Cross has not yet had their rates approved by the California Department of Insurance.  They have told us that they will release the rates and plans as soon as possible, but they have not given us a date.

Blue Shield has released their rates and plans.  If you are our Blue Shield client we can talk to you about your new rates if you were to stay on a similar plan with them, but we will not have the opportunity to shop new plans for you until all the other carriers are active. Some people’s rates have doubled (including ours), some have gone up 5-7% and others have gone down.

CIGNA will not release their new rates until November 1.  If you are a CIGNA client you will be offered the opportunity to renew your plan through December 2014; however, we will not know your new rates until November.

HealthNet has released their rates and plans.  If you are a HealthNet client you will be receiving a letter from them next week about your options.  We will be able to speak with you then as well.

If you are with another carrier like AetnaKaiser, or Pacific Care, we will be in touch with you soon once the quoting engines open!

That’s all the news for now!  We wish it was more positive but the dust is starting to settle. We will keep sending out newsletters as we know more.

As always, we send you our best wishes and have a good weekend.

Open Enrollment Start October 1st

We hope this newsletter finds you well and enjoying the gorgeous Fall weather!

As we stand now, October 1 will be open enrollment for individuals and small groups to get quotes and enroll in new plans that will start January 1, 2014.  This applies to both the new Covered California Exchange as well as private insurance.

The new plans are called Metallic plans:  Platinum, Gold, Silver, and Bronze.  There will also be a Catastrophic plan for people under 30 years of age.

Income Guidelines

To see if you qualify for a premium subsidy look at your IRS Form 1040 on your 2012 tax return. (If you have not done your 2012 taxes, you will not qualify for a subsidy. File them as soon as possible.)  If line 38 on your IRS form 1040 is under the amounts shown on the chart, then you will qualify for a subsidy on the California Exchange.  The subsidy amounts and premiums have not yet been published.

http://www.coveredca.com/fieldcalc/#incomeGuidelines

We are Certified on the Exchange

We will be able to talk to you about the exchange when they are open for business on October 1.  In the meantime, you can rest assured that we are doing everything possible to make this big change as easeful and affordable as we can for you.  Looking forward to speaking with you soon.

Here Comes Healthcare Reform

ing January 1, 2014, most Americans will be required to have health insurance or risk paying a hefty fine. It's part of President Obama's Affordable Care Act. Whether you love it, hate it or are just plain confused, come January, the ACA will be the law of the land.

Don't Panic!

We're here for you. We can guide you through this process, no matter your situation. If you have private insurance you may be able to keep that insurance. If you would like to look at the California Exchange, called Covered California, we will be certified to help you with that. If you own a small business, we will be certified to help you choose between private insurance and Covered California.

Starting January 1, 2014, all health insurance will be guaranteed issue, whether through the private marketplace or through Covered California. No carrier can deny you due to preexisting conditions.

All health plans must cover a range of services called Essential Health Benefits. These include services like doctor visits, hospitalization, emergency care, maternity care, pediatrics, prescriptions, medical tests, mental health care and more.

Plans must cover preventive care services like mammograms and colonoscopies with no out-of-pocket cost to consumers. All newly sold health plans, whether offered by Covered California or in the private marketplace, will be required to meet these basic requirements.

We will keep you updated as we get closer to open enrollment, which starts October. We want to help you make this transition as easeful as possible! In the meantime, please call us at 323.848.7795 with any questions.

TWP Insurance is now TWP Financial

When TWP Insurance was founded seven years ago, we specialized in health insurance.  We have helped well over a thousand clients acquire health insurance and will continue to specialize in providing this service.

Over time, to meet the needs of our clients and to stay competitive in the changing world of health insurance, we have added another passion of ours, financial wellness, based on safe money principles.

Circle of Wealth

As financial planners we operate under the fiduciary standard to always put your needs first.

To do that, we take all clients and prospective clients through the Circle of Wealth™ process to help you better understand your current situation and how to be more efficient with your money.  It is imperative to prepare for life events like your children’s college, weddings, retirement and leaving a legacy. Only after clearly understanding your financial situation do we recommend a strategy.

Horter Investment Management, LLC

We are also constantly combing the world for the best financial products that can give you peace of mind. There are a lot of financial products on the market. Each financial product is like a tool in a tool belt.  Life insurance is good for several things; annuities are good for others. To offer a more complete financial planning package,  Tim is now a Registered Investment Advisor representative with Horter Investment Management, LLC.

Horter Investment Management, LLC was founded in 1991by Drew Horter.   Horter Investments manages assets on a fee basis. Early in his career Mr. Horter recognized the need for high quality private wealth managers for his clients. Since becoming a Registered Investment Advisor, Mr. Horter has worked with many equity and fixed income managers.

More recently Mr. Horter has focused on low risk, low volatility asset managers for the 70 investment advisor representatives affiliated with Horter Investment Management (located in 33 States). These private wealth managers can attain equity like rates of return without the risk generally associated with the stock market.

To compliment the low risk and low volatility private wealth managers, Horter Investment Management also works with high quality, low beta equity managers that present excellent opportunities for clients.

To learn more please click the following link: www.him-ria.com

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