Changes from 2015 to 2016... Rules, Premiums, Plans, Exchanges, Etc.

[AllenChicago]

AC, you are being way too logical. Do you think the folks in DC really care about acquisition costs?

No Somarco. I understand that they don't care about any costs, if the voters/taxpayers are funding the project. I was merely stating that Government would have much better success with reducing the number of uninsured Americans, if they paid us to acquire these customers.

Example: They spent $2 million on a freaky Paul BunYun enrollment video that scared uninsured women away in Minnesota. If HHS had made the $2 million available for rewarding producers in Minnesota, that campaign would have generated a ton of new Obamacare sales.

 

[Yagents]

Damming report on HC.gov rollout ............who woulda thunk that?

But the inquiry unearthed vivid details that have not been public. And it concludes that the central reason for the problems rested not with the shoddy work of vital IT contractors but with mismanagement by federal health officials carrying out this part of the law.

http://oig.hhs.gov/oei/reports/oei-06-14-00350.pdf

https://www.washingtonpost.com/nati...344e7c-d67e-11e5-9823-02b905009f99_story.html

Oh, and can't forget this nugget.

only six people nationwide managed to select health plans through HealthCare.gov on its first day

 

[Yagents]

Here is your joke of the day:

Healthcare.gov Could Establish A Dedicated Broker Line – Insurance News Net

The head of Healthcare.gov said his agency plans to establish a dedicated telephone line to answer questions from brokers, but it may not be running in time for the next open enrollment season in November.

Counihan said one of his goals is to create complete records of every conversation customers have with the call center so when they call again, they don't have to reinvent the wheel.

"It is not rocket science. It is something we should have had years ago," he said.

Counihan said he would like to release plans and rates in advance of open enrollment season, but there may be technical issues that would prevent that. He said he feared the early release of that information potentially could have negative consequences on the rest of the ACA system.

 

[RayNY]

Wait, they don't have records of conversations?

We have detailed records going back to 1988 of every call received...

Maybe we should license them our CRM software?

 

[Yagents]

This is rich............Last I checked, they lost a lot of tax payer money, and now want more, even though they are already closed. Wasn't the missing money from the carriers who all lost money and didn't contribute?

http://www.modernhealthcare.com/art...0225-NEWS-160229940&utm_campaign=financedaily

Oregon co-op files class-action suit over risk corridor payments
By Lisa Schencker | February 25, 2016
A shuttered Oregon co-op health plan filed a class-action lawsuit against the federal government Wednesday, saying it and other insurers are owed as much as $5 billion in risk corridor payments.

Health Republic Insurance Company of Oregon alleges that the government had no right to reduce risk corridor payments to qualified health plans operating on the federal exchange. The money could have helped it and others stay open, said Stephen Swedlow, an attorney representing the insurer and a partner at Quinn Emanuel Urquhart & Sullivan.

 

[AllenChicago]

This is rich............Last I checked, they lost a lot of tax payer money, and now want more, even though they are already closed. Wasn't the missing money from the carriers who all lost money and didn't contribute?

Oregon co-op files class-action suit over risk corridor payments
By Lisa Schencker | February 25, 2016
A shuttered Oregon co-op health plan filed a class-action lawsuit against the federal government Wednesday, saying it and other insurers are owed as much as $5 billion in risk corridor payments.

The failed co-ops want that money so they can set things right with the agents and brokers. They are owed several months of commissions, ya know.

 

[Yagents]

With employers required to report affordable group coverage access on 1099C's for the FIRST time this year (due by Mar 31st), Get ready for the uproar when people who incorrectly took APTC and subject to the family glitch, get walloped.
Didn't realize the harshness of the clawback. 3 yrs into this, and they finally start policing the family glitch problem.

The next PR problem for Obamacare | Broker Innovation Lab

Now let's look at the legal nature of the subsidy. It is technically an advanced tax credit, meaning it is a dollar for dollar reduction in your tax liability which gets paid to the carrier in advance, on your behalf. If it is determined you were not eligible for that tax credit, it becomes a liability in a prior tax year, and is widely believed that the IRS will have the right to garnish wages, freeze assets and place liens on property. Some have confused this with the lenient enforcement announced for the penalty for not carrying insurance that was publicized as only a reduction in a tax refund. This is NOT that.

How much are we talking here? Well I have seen subsides as big as $1,500 per month, although the average is around $2,890 per year per person, according to the Kaiser Family Foundation. So if a family of four owes the entire year back, at the average subsidy, we are talking over $10,000 per year, plus likely penalties and interest from the IRS (since this was an advanced tax credit they would have the full right to do that).

So what is the average working person going to do if they get a $1,000 demand from the IRS? Or $10,000? Or more? And if the IRS exerts the same force they do on normal tax debts, frozen bank accounts, liens, and garnished wages could come pretty quickly.

All in all, this reporting that we are preparing now for employers will likely have significant financial impact on many American workers who should not have received the subsidy to begin with, but many, in all likelihood, didn't fully understand that.

 

[cadylou]

With employers required to report affordable group coverage access on 1099C's for the FIRST time this year (due by Mar 31st), Get ready for the uproar when people who incorrectly took APTC and subject to the family glitch, get walloped.
Didn't realize the harshness of the clawback. 3 yrs into this, and they finally start policing the family glitch problem.

The next PR problem for Obamacare | Broker Innovation Lab

Now let's look at the legal nature of the subsidy. It is technically an advanced tax credit, meaning it is a dollar for dollar reduction in your tax liability which gets paid to the carrier in advance, on your behalf. If it is determined you were not eligible for that tax credit, it becomes a liability in a prior tax year, and is widely believed that the IRS will have the right to garnish wages, freeze assets and place liens on property. Some have confused this with the lenient enforcement announced for the penalty for not carrying insurance that was publicized as only a reduction in a tax refund. This is NOT that.

How much are we talking here? Well I have seen subsides as big as $1,500 per month, although the average is around $2,890 per year per person, according to the Kaiser Family Foundation. So if a family of four owes the entire year back, at the average subsidy, we are talking over $10,000 per year, plus likely penalties and interest from the IRS (since this was an advanced tax credit they would have the full right to do that).

So what is the average working person going to do if they get a $1,000 demand from the IRS? Or $10,000? Or more? And if the IRS exerts the same force they do on normal tax debts, frozen bank accounts, liens, and garnished wages could come pretty quickly.

All in all, this reporting that we are preparing now for employers will likely have significant financial impact on many American workers who should not have received the subsidy to begin with, but many, in all likelihood, didn't fully understand that.

As always - "buyer beware" . . . .the minute you take federal money, you are living by whatever their rules are for the convenience offered. I've had clients get burned in a multitude of unexpected ways since we started the reporting of the subsidies on taxes. I've also had other little "surprises" due to their inability to run a large software system and deal with the client problems created by their failures. In a way, maybe the carriers have done us all a favor by cutting commissions to 0% - this way we just won't have to deal with it at all . . . . .

 

[Yagents]

Sound familiar?

https://aishealth.com/archive/nblu0...Magnet&utm_medium=Email&utm_campaign=91794029

Since the beginning of the year, payment and enrollment problems have plagued Blue Cross Blue Shield of North Carolina (BCBSNC). On Feb. 11, the North Carolina Dept. of Insurance (DOI) said it had launched an examination of the state's largest health insurer after receiving more than 1,000 formal customer complaints and thousands of calls.

The problems are being fixed, but it will take time before everything is resolved. In January, Liz Gallops, president of the North Carolina Association of Health Underwriters, said she typically called the Blues plan every other day with a list of a dozen clients who had been enrolled in the wrong plan, enrolled in two plans or didn't have confirmation of coverage. That has decreased to four or five. With most coverage issues resolved, she is working to fix payment snafus for people who were billed for the wrong plan and for claims that were paid under the wrong plan.

 

[Yagents]

Feds Now Will Demand Verification For All ACA Special Enrollments

https://aishealth.com/archive/nhpw022916-04