Healthcare Reform School Lesson #14 - Who is providing insurance during open enrollment

Good day to you and happy Friday.  I got a day behind because I was busy helping people with their health insurance yesterday.  That is a good day, though.

Courtesy of basketman at freedigitalphotos.net

Today I wanted to explain a bit about open enrollment and who will be providing health insurance in 2014.  As with many about the Affordable Care Act, it has a mufti-faceted answer.  Nothing is really that easy to explain when discussing its implementation and the ramifications in the long term.  Hopefully in the short term and in the execution of the act it will be much simpler.  My answer to "who will be providing insurance" will focus on Illinois, since that is where I reside and where many of my clients reside.  I also have many clients in Indiana, Iowa, Wisconsin, Michigan, Minnesota, Texas, Colorado & Oregon, so if any of you are reading my blog and would like to get detailed information on what companies will be providing insurance in your state please respond and let me know.

Open enrollment will start run from October 1, 2013 and end on March 31, 2014.  This is six full months and this is a very long open enrollment period due to the number of people expected to enroll and due to the newness of th experience. Each subsequent year, the open enrollment period will be only about 8 weeks.  There will be three options open for business during open enrollment from October 1, 2013 to March 1, 2014.  The insurance can not be effective (or start) until January 1, 2014 on the public exchanges, but on the private exchanges that is not a stipulation, it can start whenever an applicant gets qualified.. 

No about how to buy insurance during open enrollment.   Illinois is setting up their own exchange, or Marketplace, as they are to become known, and all of the exchanges are scheduled to be open for business on October 1, 2014.  Just a few short weeks away.  There are three types of exchanges that will be open for business come October.  I will explain these briefly and then after that will tell what we know now about which insurance companies will be offering products on which exchange.

• The Marketplace for individuals
• Individuals can go here and purchase insurance
• If they are eligible for a tax credit/subsidy, this is where that will be arranged
• I will be certified to help clients sign up on the marketplace and get their tax credit /subsidy

• SHOP for small businesses
• This will be a place for small businesses to shop for options for small group plans
• I will be certified to help businesses sign up on the SHOP

• Private Exchanges
• This will be an options for individuals that do not qualify for a tax credit/subsidy because their income is more than the cut-off of 400% over poverty level.  It will also be an option for those who want to get insurance from a provider that is not on the Marketplace and utilize a wider doctors network.
• I am currently, and will continue to be, qualified to help people find insurance in the private exchanges.  This exchange will be the same as it is now, which means all of the insurance companies that currently sell insurance in Illinois will sell on private exchanges.

These are the three options and they will be open for business during open enrollment from October 1, 2013 to March 1 2014.  The insurance can not be effective (or start) until January 1, 2014 on the public exchanges, but on the private exchanges that is not a stipulation, it can start whenever an applicant gets qualified..  This first open enrollment period is 6 months, but each subsequent year after that it will be only around 6 weeks.

The following list of insurance companies just submitted their plans to the Department of Insurance (DOI)  August 8, 2013.  They submitted a combined 165 plans that will be offered on the Marketplace for Individuals and SHOP for Small Businesses. 

1. Blue Cross & Blue Shield of Illinois
   
2. Humana
   
3. Aetna
   
4. Carle Foundation
   
5. Coventry Health Care
   
6. Land of Lincoln Health Inc Co-op
   
    The exchange plans will be reviewed by the Illinois DOI to determine whether the plans meet required Essential Health Benefits, were underwritten under acceptable actuarial standards, and meet network sufficiency standards. Once the review is completed, the DOI will make recommendations to the federal Health and Human Services (HHS). HHS will make the final determinations by August 31, 2013. 
   
    While still a work in progress, the exchanges are coming together.  I did speak with a gentleman last night that is working extensively with dental insurance companies and they are working on a an exchange for dental insurance as well, but that is a deifferent subjext for a different blog.
   
   I hope this cleared up some questions about open enrollment.  Next week I will be talking about SHOP for Small Businesses.  If you would like to review any of my previous blog or learn more in depth about a particualr topic, they are all listed below.
   
   Lesson #1 - Introduction
   Lesson #2 - Basic Reason for creating the Patient Protection and Affordable Care Act
   Lesson #3 - Public exchanges for Purchasing Insurance
   Lesson #4 - Essential Health Benefits that will be added to all Health Insurance policies in 2014
   Lesson #5 - Tax Credits to Help Pay for Health Insurance
   Lesson #6 - Enforcement and Penalties in the Affordable Care Act
   Lesson #7 - Preparing for the Affordable Care Act
   Lesson #8 -  Options for Small Businesses
   Lesson # 9 - Will my Insurance Premiums change in 2014?
   Lesson #10 - What Will Happen to Small Groups in 2014?
   Lesson # 11 - Why Should I Buy Insurance Before the Deadline?
   Lesson #12 - What does the Delay in the Employer Mandate Really Mean? 
   Lessone #13 - Can I keep my Current Health Insurance Plan?