All You Need To Know About Open Enrollment

Open enrollment is here again, and for many Americans this time period – and the entire Healthcare professionals and patienthealth insurance market – spells confusion.

Is Obamacare still in effect? Are premiums really increasing as much as predicted? Do I need to take action now if I’m happy with my insurance plan? What’s the difference between all the plans offered in the marketplace?

So many questions! No worries, though. We’ve got answers. Read on for the complete rundown on open enrollment, the Affordable Care Act (ACA) and today’s health insurance options.

1.) The ACA – still in effect?

Before you go shopping for a cheaper or better insurance plan, bear in mind that the Affordable Healthcare Act is still up and running. Many people are under the mistaken impression that the current administration has overturned the program or will soon do so. While an alternative health care plan has been proposed, there has been no change in the current system thus far, and it is not likely that there will be within the next few months.

What does this mean for the average American?

The ACA has made it mandatory for every American to have sufficient health care coverage. The penalty for failing to comply with this law is the higher of $695 per adult or 2.5% of household income.

The ACA also oversees the government-run health insurance marketplace in which insurance plans can only be purchased during open enrollment. In most states, the open enrollment period for 2017 is about 6 weeks long, running from Nov. 1 to Dec. 15. The following states have extended their enrollment period: California, Connecticut, the District of Columbia, Massachusetts, Minnesota, New York, Rhode Island and Washington.

2.) Rising premiums or cheaper rates?

If you ask the average Jane or John Doe if insurance costs are rising or falling, you’d probably get an earful about ever-climbing premium rates and health care costs. On the flip side, though, is the government, claiming their subsidized plan and the expansion of Medicaid has health care costs steadily declining.

In fact, both arguments are true. The silver plans on the ACA marketplace rose by an average of more than 30% this past year – and 2018 is looking a whole lot worse. Premiums are expected to rise by as much as 34-50% this coming year.

The current administration has claimed it will stop paying for many of the key payments to insurers it’s previously shouldered as part of the ACA. This factor, coupled with the overwhelming uncertainty surrounding the ACA, has led insurers to drastically increase their premiums.

The 80% of customers who receive subsidized insurance through Obamacare will be shielded from these price hikes; it’s the other 20% who will bear the brunt of the unstable marketplace.

The premium increase rates will vary by state and by the individual, but it is quite possible for an Obamacare customer who was paying $593 a month in premiums in 2017 to be saddled with a monthly premium of $1,001 in 2018!

All this uncertainty has led to another significant development: Many providers have left the marketplace plans. This means your doctor may no longer be part of your insurance plan. Be sure to find out about any possible changes before open enrollment is up, even if you aren’t looking to change your plan.

3.) Where to apply

If you do not receive insurance coverage through Medicaid, Medicare or your workplace, you may want to consider changing your insurance plan this year. To find out what your options are, visit healthcare.gov. Most states offer insurance coverage through this site, while others will redirect you to a private state-run site where you can purchase a marketplace plan.

4.) Available marketplace plans

Here’s a quick synopsis of each category of plans available in the ACA marketplace:

  • Bronze: lowest monthly premiums, highest out-of-pocket costs and very high deductibles.
  • Silver: the most popular plans available, silver offers moderate premiums and out-of-pocket costs, with lower deductibles than bronze plans.
  • Gold: high monthly premiums but lower out-of-pocket costs and deductibles.
  • Platinum: the most expensive plans in the marketplace, platinum plans have the highest monthly premiums but the lowest out-of-pocket costs and very low deductibles.

There is also a catastrophic plan available for individuals under age 30 and people who have received an exemption from the marketplace due to extenuating circumstances. These plans include free preventive care, low monthly premiums and very high deductibles.

5.) Choosing your plan

When shopping for a marketplace plan, it’s important not to base your decision on price alone. Many of the cheaper plans come with a heavy price. Your primary care provider or your child’s pediatrician may not be covered under some of the less expensive plans. You may need to pay out-of-pocket for many or all prescription drugs. Lastly, a higher deductible can mean that you’ll end up paying for all of your health care needs in 2018 without “cashing in” on your premiums before the year is over.

Be sure to shop around for a plan and do lots of research before making your decision.

Be an educated consumer this open enrollment season so that you make the best decision possible. Your health is too important for anything less!

Your Turn: The nationwide health insurance challenge has been hotly contested for years. If you had the power and means, how would you change the current system? Share your thoughts with us in the comments!

SOURCES:
http://www.medicareadvocacy.org/the-affordable-care-act-in-2017-myths-and-facts/
https://www.google.com/amp/s/www.cnbc.com/amp/2017/10/31/time-to-shop-for-obamacare-what-you-need-to-know-this-enrollment-season.html 

https://www.aarp.org/health/health-insurance/info-2017/open-enrollment-aca-fd.html 
https://www.google.com/amp/amp.timeinc.net/time/money/4826591/aca-premiums-cost-2018

Is 2015 The Year Of The Health Care Hack?

Brought to you by Destinations Credit Union

If 2014 was the year of major retailers being involved in security breaches, 2015 has thus far been the year for insurance companies. Anthem led the way earlier this year with a hack that compromised the personal information of hundreds of thousands of victims. Now, Premera Blue Cross, one of the largest health insurance providers in the Pacific Northwest, has been the target of a security breach.

Security experts are still attempting to discover the full extent of the breach. Hackers evidently accessed housing data from as far back as 2002. It is believed that at least 11 million people were affected by the breach.

Premera also has dozens of subsidiary organizations, clients, and contractors each with its own set of records. Technology experts from the health care provider are working tirelessly to determine the extent of their information that was compromised. Vivacity, a workplace wellness provider, and Connexion Insurance Solutions, which focuses on small- to medium- sized businesses, were both affected, too.

The vulnerability has been in use for some time. Company officials say the first breach occurred in May of 2014 and was only discovered in January of 2015. The FBI, in coordination with private cyber security firm Mandiant, is working to uncover the size and severity of this attack as well as to find the perpetrators.

Criminals have stolen a wide variety of personal information from the provider. Names, addresses, and Social Security numbers are the obvious targets, and these are frequently used to commit identity theft or cloning. A surprising amount of health information is also used to illegally obtain prescription medication or commit insurance fraud. This form of medical identity theft is growing as a black market solution to higher medical costs. In 2014, 2.3 million people were victims of this kind of fraud and each victim had to pay an average of $13,500 to resolve the problem.

There appears to be a strong connection between the attacks made on Premera and those made on Anthem. In both cases, hackers registered domains with common misspellings of the company’s name and used those sites to collect login information. These usernames and passwords were then used to breach the company at higher and higher levels. These tactics, and several others, point to Chinese hacking group Deep Panda.

As these groups grow bolder, it’s more important than ever to keep up with your own best practices in medical identity theft prevention. The FTC recommends following these three steps to keep yourself safe:

1.) Watch your medical records

Medical identity theft results in bills to you for procedures done to someone else. Unscrupulous doctors bill insurance companies for procedures they never did or for more costly versions of operations than what they performed. They count on instant reimbursement, knowing the insurance company will try to collect the fraudulent charge from the policyholder. Medical identity theft confounds this process. In other instances, criminals use your identity to get medical treatment and bill it to your insurance, leaving you on the hook for the charges.

These charges will show up in a few places. For instance, you may get a call from a collection agency over a medical bill. You may also have a medical bill arrive in the mail for a procedure you didn’t have. Your insurance company may also notify you of a change in your premium or coverage based on a new medical condition. Each of these is a red flag that you’ve been the victim of medical identity theft.

2.) Review your records

The Health Insurance Privacy Protection Act (HIPPA) requires that healthcare companies keep and maintain detailed records about patient services. You have the right to obtain a copy of those records. In most cases, your best bet will be to contact a major provider of medical services, like a national pharmacy.

You may also need to contact your insurance provider for copies of their records. They have the same record-keeping and disclosure requirements that providers do, but they may charge for the service of providing records. If you can narrow down a window of time during which you suspect your account was compromised, you can save yourself both time and money.

Providers may refuse to comply with your request for disclosure because they fear violating the privacy of the identity thief. Fortunately, an appeals process exists for this decision. You need to contact the person named in the privacy policy as the patient representative or ombudsman. If you are still unsuccessful, you can contact the US Department of Health and Human Services’ Office for Civil Rights.

3.) Get corrections to your records

You can submit requests for corrections to each provider that has charged you for services. Such a request should explain the reason for the error and include documentation that the charge is, in fact, an error. Examples would be proof that you were nowhere near the provider at the time of the charge or a letter from your doctor stating that you have never experienced the condition that was treated.

If your provider refuses to change or reverse the charge, ask them to place a notice of dispute on your account. This notice will show credit agencies that the charge may not reflect your borrowing habits and will help you mitigate the impact of a poor credit score. Such a notice should also stop the collection calls.

This pattern of security leaks means everyone is potentially at risk. You can’t avoid digitizing your health care information. But you can take steps to keep your identity safe. Credit monitoring services can provide you with peace of mind. Knowing you’ve got a team of dedicated professionals watching your back around the clock can help you sleep soundly at night.

SOURCES:

Affordable Care Act Tax Forms


The Affordable Care Act (ACA), also called Obamacare, made a lot of changes to the tax system. This last year, people saw the healthcare side of the bill, including the healthcare exchange marketplace, pricing rules and simplified plans. This year, the funding side of the act goes into effect.

This change in regulation might seem like it’s happening somewhere far away from daily life. Most of the time, that’s true. When it comes to tax time, though, the ACA will get up close and personal.

There are a variety of new tax forms people must use to comply with the regulations of the act. They might seem confusing, but they’re no worse than any other tax form. Let’s take a look at three steps you might need to take under the new rules.

1.) Check a box on your 1040

The “master sheet” of your return, where you list your gross income and deductions, is called the 1040. This year, there’s a new line that asks you to certify you have health insurance. If you do, check that box. If you have insurance through your employer, or you’ve purchased private insurance, that’s all you need to do. Keep a copy of a statement from the company just in case the IRS needs proof and move on to the rest of your taxes.

The IRS estimates that 75% of taxpayers will have to do no more than this. “For the vast majority of Americans, tax filing under the Affordable Care Act will be as simple as checking a box to show they had coverage all year,” said Treasury Secretary Jacob Lew in a press statement. Line 61, where the check box is located, will be the only noticeable change to your tax form.


2.) Deal with new forms

Like many new government regulations, the ACA created several new forms to fill out. The most common of these is the 1095a, which provides proof of your coverage and how much of a credit you were advanced to cover the costs of your premiums.

People interested in claiming that credit will not be able to file a 1040-EZ, the simplified 1040 form used by people in straightforward tax situations. To claim the credit, they will have to fill out their return on the standard 1040 form, which is slightly longer. They will also need to fill out form 8962. This is also the form to use for reconciling the amount of tax credit advanced versus the amount due.

If you got a new job, got a raise or had another significant life event, you may have to pay back part of the subsidy on your insurance. If you had a child, lost your job or had your hours cut, you might be eligible for an additional credit. That same form, 8692, will help you figure out what your life changes mean for your taxes.

3.) Pay a penalty (or request an exemption)

The reason for the check box on the 1040 is to ensure compliance with the so-called individual mandate that requires everyone have health insurance. If a person didn’t have health insurance in 2014, they can expect to pay a penalty this year. The penalty is calculated based upon how much their family earns above a certain level. Most tax experts predict the average penalty will be $301 this year and could go as high as $600 next year.  If you need to obtain insurance, Destinations Credit Union has partnered with TruStage to offer health insurance to our members.

There are a few available exceptions to the individual mandate. Individuals who make less than the income filing threshold, for example, are not required to purchase insurance. You may also claim an exemption if the cost of the premium would exceed 8% of your household income, or if the gap in your coverage was less than 3 consecutive months. These exceptions are all certified through form 8965.

If you can’t claim an exemption, it might be time to buckle down and get health insurance. The cost will continue to rise, and the longer you wait, the more you’ll pay. You’re also gambling that your health will hold. Insuring younger people without health problems is cheaper than insuring older people with health problems.

The IRS has devoted considerable resources to public outreach about the new changes. It is encouraging anyone who has questions about the new policy to visit its website, IRS.gov, and follow the link to the ACA help page. It’s also included video tutorials showing how the new forms work and providing walk-throughs of the trickier parts.

Tax time can be confusing! If you’re absolutely flummoxed by the new forms, it might be time to find an expert. You can also used a guided system like TurboTax Online to make it a lot easier.  Destinations Credit Union has partnered with TurboTax to provide a discount to our members!  Check it out for free.  Then make sure you directly deposit your refund check into your Destinations account!

SOURCES:

Early Retirement Costs You Might Have Missed and How to Save for Them

Retiring early is the dream. You get to spend more time with your family and enjoy your hobbies while you’re healthy enough to do so. You can say goodbye to the workaday world and begin your permanent vacation. 

Maybe it’s less of a dream and more of a necessity. Maybe health problems like chronic pain or arthritis, are forcing you to consider giving up your career before age 65. Perhaps your children need you to help with caring for your grandchildren. 

Whatever your reason for retiring early, a new study released on 6/12/14 by Fidelity Investments warns it will cost you in ways you might not expect. According to the study, early retirees can expect to pay an extra $17,000 per year in medical expenses. The reason? Medicare coverage gaps. You give up your employer-provided health insurance when you retire, and Medicare doesn’t kick in until age 65. This means you’re on your own at a time when your health care costs are near their peak. 

Insurance companies charge older policyholders higher premiums, which means a they’ll claim a bigger chunk of your retirement money. As a savvy credit union member, you know the advantages of planning ahead for your golden years. Let’s look at a few ways you can avoid sticker shock at your retirement party: 

  1. Short-term insurance One popular option is to look for an emergency-only or high-deductible insurance plan (HDHP). These plans feature inexpensive monthly premiums, but offer little in the way of coverage. These budget-friendly insurance options are great if private health insurance is too expensive. You can expect to pay for a variety of costs out-of-pocket. Routine, preventative, and non-emergency medical procedures will be your responsibility. A regular checkup will cost at least $75 and the costs can escalate if your doctor orders tests or other procedures. You may also pay full price for prescription drugs. This option is best if you’re retiring just before age 65. You can afford a few months of risk before Medicare coverage starts. However, you’ll still want another savings option to help with massive medical bills. 
  2. Open a savings certificate for major medical expenses You likely use savings certificates (similar to CDs at a bank) to keep an emergency fund on hand. These savings instruments are ideal for building up money in case of a rainy day. You may want to create one specifically for your health care costs. You’ll want to keep this money separate since you’ll have different needs for it. A sudden, unexpected medical bill is different than needing a new car. You’ll likely have a little more time to pay your medical bill. Many hospitals are willing to work around your financial situation. A 6- or 12-month certificate provides the perfect combination of accessibility and growth. Once you turn 65, you can add your remaining funds to your other retirement savings or even use it to finance a vacation! 
  3. Open (and use) a Health Savings Account A Health Savings Account (HSA) is a special tax-advantaged account for your savings that allows you to defer taxation on the money. The idea is that the money you spend on health care costs shouldn’t be taxed. So, you can save money to pay premiums, deductibles, and other healthcare-related expenses. These accounts have been growing in popularity this year. If your family insurance plan has a deductible of $2,500 or more, you can open an HSA. You can contribute up to $6,450 to your HSA per year, tax-free. Many employers also provide matching contributions to HSAs as part of their benefits package. While withdrawals from your HSA are allowed only for medical expenses, this rule is waived for people 65 or older. While non-medical withdrawals are taxed, the money still grows tax-free. Many financial planners are advocating the use of HSAs as a kind of “shadow IRA.” With them, you reduce your current tax burden while saving for retirement. 


Planning for your future health care costs can be scary, but it’ll be much scarier to go into retirement unprepared. Sit down with a representative from your credit union today to discuss how you can save for your health care in retirement. You’ll thank yourself later. 

SOURCES: 
http://www.irs.gov/pub/irs-pdf/p969.pdf http://online.wsj.com/articles/health-savings-accounts-can-double-as-shadow-iras-1401481345
http://www.marketwatch.com/story/fidelity-analysis-reveals-extra-health-care-costs-in-retirement-for-couples-retiring-before-age-65-savings-for-those-who-delay-2014-06-12 
http://www.sentinelsource.com/business/financial_news/hidden-cost-of-early-retirement-medical-bills/article_791fce9c-584c-5245-84c2-0c7746b7523e.html

The ACA deadline: What to do now that it’s passed

March 31 was the last day to sign up for health insurance through the Affordable Care Act marketplace, and 7 million Americans enrolled in the health care exchange before the deadline. However, if you’re one of the many who missed your window to sign up, and you don’t have health insurance this year, it looks like you’re going to have to pay a penalty next year come tax time.
But just because it’s too late to sign up in “open enrollment” for 2014 doesn’t mean you’re stuck paying the penalty. There are still some solutions to your health insurance needs. Let’s take a look at a few ways you can get covered post-deadline.

Qualifying life events
The ACA allows for “special enrollment” periods for people whose life circumstances change. These changes are “qualifying life events.” Examples of these are having a child, marriage, divorce, moving out of state, or losing significant income. After one of these events occurs, you get 60 days to apply for coverage on the exchange. Although there are better options than quitting your job or getting divorced to get health care, if you’re expecting one of these events, you could sign up for health care within 60 days of that event.

Applying for an extension
Like most government programs, the ACA includes a sort of human release valve. You can apply for an extension to open enrollment on the marketplace enrollment website. To qualify for an extension, you’ll need to show good reason why you need one. One of the most common reasons for applying for an extension is technical difficulties. If you struggled with the website, you can note that on your application. Describe the attempts you made to enroll and the technical hurdles you encountered.
Remember, lying or intentionally submitting false information in an attestation is a crime. Not only could it put you in legal trouble, it could also be a reason to void your insurance coverage. While there’s no harm in asking for an extension, you should be truthful about your reasons for the request.

Getting private insurance
Though the exchange deadline has past, you can still get insurance through a private company. Companies like Blue Cross Blue Shield are still open for business and they would be happy to sell you a plan. Calling the insurance company and signing up for a plan the old fashioned way is still an option. You won’t get the benefit of seeing all the available plans next to each other, but you can still get health insurance.
The ACA mandates simplified insurance pricing, so you can still get access to all the same benefits at the same price. If you had thought that private insurance was too expensive, it might be time to take another look.

Paying the fine (or not)
The penalty for non-compliance is small. If you don’t have health insurance, you can expect to pay either $95 or 1% of your income. The federal filing threshold for income was $10,000 last year and ought to be about the same next year. If you don’t make more than that, you don’t have to pay the fine. There is also a list of exemptions. If you belong to a recognized religious organization with objections to health insurance, you’re exempt. Also, if the least expensive plan costs more than 8% of your household income, you won’t be penalized.
The penalty is also pro-rated for the number of months you’re uninsured. If you don’t have insurance now, you can reduce the amount you’re fined by starting insurance next month. The March 31 deadline isn’t an all-or-nothing. You can get coverage for most of this year, and then plan to sign up on the exchange next year.
Even if the penalties are low and infrequently applied this year, expect them to become harsher in future years. In 2015, for example, the penalty will be $325 or 2% of your taxable income, and it will probably go up from there. There will be another open enrollment period starting in November, so start planning to get covered then.