Do Private Plans Still Exist?

[Zoaty]

Hello Pros,

Got a quick question: Do qualified non-exchange plans still exist that count as having major medical in the governments eyes?

Do private qualified health insurance plans exist anymore, or are the qualified health plans provided on the exchanges considered to the only legit ones in terms of having qualified health coverage from the government's perspective?

I recall that in the beginning it was said 'You can keep your existing plan', but I know they later said some couldn't. Is that referring to non-exchange plans are no longer valid?

Thanks!

 

[Ann H]

In addition to plans ON the exchange, here are some other options that qualify as MEC.

*Off-Exchange QHPs (qualified health plans that are ACA-compliant), which are purchased privately between the individual and the insurance company without going through the Exchange

*Employer provided plans that are at least MEC (minimum essential coverage)

*Government plans (such as Medicare, Medicaid, CHIP, VA, etc.)

*Grandfathered pre-ACA policies

*Grandmothered pre-ACA policies that you are now allowed to "keep"

 

[Zoaty]

In addition to plans ON the exchange, here are some other options that qualify as MEC.

*Off-Exchange QHPs (qualified health plans that are ACA-compliant), which are purchased privately between the individual and the insurance company without going through the Exchange

*Employer provided plans that are at least MEC (minimum essential coverage)

*Government plans (such as Medicare, Medicaid, CHIP, VA, etc.)

*Grandfathered pre-ACA policies

*Grandmothered pre-ACA policies that you are now allowed to "keep"

Thanks so much Ann - also thanks for your detailed response to my instant message a little over a week ago - very helpful. I've sense gotten certified to sell ACA for the up-coming enrollment period for 2015 as a result of your response. Took some time but I think it will pay off.

So with regard to off-exchange QHP's - does anybody know are they in the strong minority, with most people signing up through the exchanges?

Thx

 

[Yagents]

So with regard to off-exchange QHP's - does anybody know are they in the strong minority, with most people signing up through the exchanges?

Thx

It all depends on your state, and the make up of your clientele.

Most of my business was OFF exchange, as my clients income or situation did not allow for subsidies.

 

[DS4]

The majority of my business is grandfathered.
The majority of my new business(after 1.01.14) is on the exchange, APTC

 

[Zoaty]

It all depends on your state, and the make up of your clientele.

Most of my business was OFF exchange, as my clients income or situation did not allow for subsidies.

Ahhhh - I see. Possibly the subsidy can be a determining factor. Brings me to the assumption that offline private QHPs don't allow for subsidies.

Thanks for the feedback...

 

[AllenChicago]

Ahhhh - I see. Possibly the subsidy can be a determining factor. Brings me to the assumption that offline private QHPs don't allow for subsidies.

Thanks for the feedback...

When you run quotes at insurers websites, the resulting list of plans usually show you which are subsidy-eligible and which are off-exchange only..not subsidy eligible.
ac

 

[Ann H]

I see that you are in Indiana, Zoaty. From what I hear from other Indiana agents, a lot of folks are getting subsidies. It's state specific, and even county specific. If you are entering this market, selling to the subsidized crowd will probably net you the most sales. It is the easiest market from the standpoint of the most qualified leads, but a hard market in terms of the learning curve. If I was in Indiana, starting out this year, I would prospect young families, blue collar, working families, and others in subsidy eligibility range, (but not near Medicaid eligibility range). Good luck.

Yes, subsidies are only allowed on the exchange.

 

[Zoaty]

Thanks so much everyone - appreciate your responses.

 

[AllenChicago]

October 2, 2014

Not surprising, but it's startling when you see the numbers in print... In just two short years, from 2012 to 2014, 90% of health insurers left the major medical business!

Story: Small insurers devastated by big corporations in Obamacare state exchanges | WashingtonExaminer.com

Where's all the competition that President Obama promised would lower family health insurance premiums by $2,500 a year?
-ac