Highmark Stops Commissions on PA

[YouGotMyMoney]

i been in this for almost a quarter century, i know what these stupid insurance companies do

If you had said you had been in the business for quarter century, with it all being GI business like in NY/NJ, then mb we would of been reassured

 

[AllenChicago]

losing money the last few years. looking forward to there 2015 statement.
I'm guessing 300 -400 million loss.

https://www.highmarkhealth.org/annualreport/financials/index.shtml

You're right on target HamBen. $318 Million.
Story: Highmark loses $318 million on Obamacare plans | PennLive.com

Their premiums are going up 25-30% for 2016 and Medical Networks are being narrowed. If your clients want another carrier, and prospects don't buy HighMark, the commission issue will be irrelevant.

 

[somarco]

If you had said you had been in the business for quarter century, with it all being GI business like in NY/NJ, then mb we would of been reassured

Mark, are you suggesting the commissions have not reset in those states after operating in a GI environment for 20+ years?

Two decades ago, New York passed a law requiring insurers to accept all applicants, even those with preexisting conditions. Now, premiums in the state are the highest in the nation by some estimates.

A cautionary tale in healthcare reform - latimes

 

[CHUMPS FROM OXFORD]

In Western Pa, they were high last year and UPMC killed them. They'll be incredibly high now.

 

[hamben]

You're right on target HamBen. $318 Million.
Story: Highmark loses $318 million on Obamacare plans | PennLive.com

Their premiums are going up 25-30% for 2016 and Medical Networks are being narrowed. If your clients want another carrier, and prospects don't buy HighMark, the commission issue will be irrelevant.

Sometimes it sucks to be right.

Don't know if this is the place but I found another glitch this week.. I wonder if you are all seeing the problems I've been seeing.

One of my clients called in this week and said, his CPA said he owed $248 in shared responsibility tax for not having an ACA compliant plan..I said that's impossible you don't make enough money.

Here is the background. He is 35 wife is 30 with 2 kids. Household income is $47,000
He has insurance through work.. To add wife and kids on plan is $800 a month.
Cheapest marketplace plan is $675.

If we use the 8.05% affordability test he would have to make almost $90,000 a year based on the cheapest ACA plan available to him. I talked to the account and he said his software said he owes the $248. I asked how can software know how much the lowest cost ACA plan could be in every zip code in America.


Bottom line after talking to the accountant he was not able to determine an accurate tax on any of the clients he said owed a tax because there was no way for him to know what the cheapest marketplace plan was and if it was affordable or not. His software just said if you don't have an ACA compliant plan here's your tax..


Has anyone else been seeing anything like this?

 

[Yagents]

If above 8%, the person needs to apply for exemption to avoid penalty.

 

[hamben]

If above 8%, the person needs to apply for exemption to avoid penalty.

Not true.
They can clam exemption when they file taxes.
https://www.healthcare.gov/exemptions-tool/#/results/2015/details/marketplace-affordability

However my point is the tax prepares I have talked to are not taking this rule into account because the software they are using has no way of knowing what the cheapest bronze plan in there area was. This is causing many people to pay a tax they are exempt from..the tax prepare I talked to today found 10 clients in the hour we were on the phone. I wonder how many H&R Block screwed up.

 

[Yagents]

Don't know. Don't deal with clients without insurance

 

[Ann H]

Not true.
They can clam exemption when they file taxes.
https://www.healthcare.gov/exemptions-tool/#/results/2015/details/marketplace-affordability

However my point is the tax prepares I have talked to are not taking this rule into account because the software they are using has no way of knowing what the cheapest bronze plan in there area was. This is causing many people to pay a tax they are exempt from..the tax prepare I talked to today found 10 clients in the hour we were on the phone. I wonder how many H&R Block screwed up.

The tax software says he owes $248. He can then show his tax-preparer the premium for the lowest-cost Bronze plan in his area, plus proof of the "unaffordable" exemption. The Accountant can override the tax-preparation software. However, this guy will be audited. So, it's best to fill out the Marketplace Exemption form that you find here https://www.healthcare.gov/exemptions-tool/#/results/2015/details/marketplace-affordability. Once you get the Marketplace's letter approving the exemption, use that to file (or amend) your tax return and the IRS will accept it. Usually.