State & Federal Exchanges

[somarco]

Thx for the link, Bill.

So let's see how this may play out.

1/1/2014 Obamainsurance kicks in with GI, community rating, etc.

7/1/2014 subsidies kick in.

Yeah, this is going to work really well.

The good news in this is that states who elect not to create an exchange will default to the Federal exchange where we get paid.

Well, OK. But subsidies, if they materialize, are not offered if you buy through the federal exchange.

 

[FLM]

According to this article, subsidies will be available whether purchased through the Federal Exchange (as noted by the IRS):
Feds Hire PPACA Exchange Vendors, Push Ahead with Construction | LifeHealthPro

The reference is near the bottom of the article:

But conservatives are raising yet another argument in hopes of shutting down federal exchanges.

Led by Cato Institute economist Michael Cannon, several opponents say the letter of the complex law precludes the government from subsidizing coverage through the federal exchange. They say the law allows only tax credits to help consumers pay premiums in state exchanges, not the federal exchange, and that's the way Congress intended it. If states don't set up exchanges, that would starve the health care overhaul of money and cause it to unravel, they contend.

The IRS and two nonpartisan congressional units — the Congressional Budget Office and the Joint Committee on Taxation — conducted their own analyses and concluded that subsidies are available in both types of exchanges, federal and state-run. Senate Finance Committee Chairman Max Baucus, D-Mont., one of the law's principal authors, says that's exactly how Congress intended it.

At the National Association of Insurance Commissioners, spokesman Scott Holeman says, "At this time, we don't have any reason to question the federal government's interpretation of the statute."

Obviously this is a point of contention but realistically, with half the states opting out of creating their own exchanges, the Feds are going to tweak this or the whole new system will fall apart.

 

[somarco]

The law as originally written states subsidies only available through state run exchanges.

That doesn't mean HHS won't rewrite the rules many times over.

Of course if Congress doesn't have the money to fund the subsidies . . .

The House controls the purse strings, and the House is controlled by Republicans, at least through 2014. So . . .

 

[FLM]

The law as originally written states subsidies only available through state run exchanges.

That doesn't mean HHS won't rewrite the rules many times over.

Of course if Congress doesn't have the money to fund the subsidies . . .

The House controls the purse strings, and the House is controlled by Republicans, at least through 2014. So . . .

We'll find out soon enough.

My plans for 2013 are to focus on Medicare T65 enrollments locally and Med Supplements in states that have an annual open enrollment period (like California) plus some cross selling of life and annuities.

No marketing money will be spent on U65 health until (and unless) agents have a role in the Exchange totally defined. Once it's defined and it makes sense, I'll start educating my current clients about their options and how I can help them as well as approaching small businesses about converting their groups to HRA's with employees using their subsidies and employer contribution (small groups will go away in 2014, that is a given, and create a very large opportunity for agents to convert them to individual plans within the exchange).

At the same time, it's unlikely a U65 book of business will change much in 2013 so renewals will continue with few, if any, lapses.

The next 10 months will be very interesting, the agents that survive (and potentially thrive) will be those who keep their eyes open and learn how to use the new system effectively.

Most agents don't read these types of forums, they will most likely be led the wrong way by their agencies (who will take advantage of them in order to survive).

 

[taterpeeler]

We'll find out soon enough.

My plans for 2013 are to focus on Medicare T65 enrollments locally and Med Supplements in states that have an annual open enrollment period (like California) plus some cross selling of life and annuities.

No marketing money will be spent on U65 health until (and unless) agents have a roll in the Exchange totally defined. Once it's defined and it makes sense, I'll start educating my current clients about their options and how I can help them as well as approaching small businesses about converting their groups to HRA's with employees using their subsidies and employer contribution (small groups will go away in 2014, that is a given, and create a very large opportunity for agents to convert them to individual plans within the exchange).

At the same time, it's unlikely a U65 book of business will change much in 2013 so renewals will continue with few, if any, lapses.

The next 10 months will be very interesting, the agents that survive (and potentially thrive) will be those who keep their eyes open and learn how to use the new system effectively.

Most agents don't read these types of forums, they will most likely be led the wrong way by their agencies (who will take advantage of them in order to survive).

agree... little if any marketing bucks for u65. all for medicare... once I am handed the official roadmap i will flip the switch on u65....

 

[ABC]

I think you are right on here.

Small groups will drop and so will groups in the 50-150 range.

You are spot on with the HRA approach for these cases.

There is going to be a huge transfer of coverage to the individual market. If the Fed exchange pays a comp we are golden!
I am also hearing rumors that private exchange could qualify for subsidies.

I figure there is a 50% chance of getting really large after 2014.
It is going to be a lot of work but we will no longer have to worry about health conditions. We will have to worry about house hold income.

I plan on continuing to write group plan through 2013.

We'll find out soon enough.

My plans for 2013 are to focus on Medicare T65 enrollments locally and Med Supplements in states that have an annual open enrollment period (like California) plus some cross selling of life and annuities.

No marketing money will be spent on U65 health until (and unless) agents have a roll in the Exchange totally defined. Once it's defined and it makes sense, I'll start educating my current clients about their options and how I can help them as well as approaching small businesses about converting their groups to HRA's with employees using their subsidies and employer contribution (small groups will go away in 2014, that is a given, and create a very large opportunity for agents to convert them to individual plans within the exchange).

At the same time, it's unlikely a U65 book of business will change much in 2013 so renewals will continue with few, if any, lapses.

The next 10 months will be very interesting, the agents that survive (and potentially thrive) will be those who keep their eyes open and learn how to use the new system effectively.

Most agents don't read these types of forums, they will most likely be led the wrong way by their agencies (who will take advantage of them in order to survive).

 

[FL P&C Broker]

Seems like there is 2 different outlooks on what will happen on this board. 1. People who are in health are screwed and there is no place for agents. or 2. Lower margins, higher premiums, easier product to sell. Looks like health is almost going to become a P&C product.

 

[CHUMPS FROM OXFORD]

INDY HEALTH SALES may not be dead but it's on life support. The good news is there are some good doctors that may be able to help.

Meanwhile, diversify and prepare.

WebNanny was not used in this post
WebExpert was used in this post

 

[Ann H]

Seems like there is 2 different outlooks on what will happen on this board. 1. People who are in health are screwed and there is no place for agents. or 2. Lower margins, higher premiums, easier product to sell. Looks like health is almost going to become a P&C product.

Both of those outlooks are valid. The 3rd outlook is that this is a one-time opportunity. If you don't sell a volume of enrollees by 1/1/2014 (or at least 3/31/2014), you lose the big prize.

 

[FLM]

Both of those outlooks are valid. The 3rd outlook is that this is a one-time opportunity. If you don't sell a volume of enrollees by 1/1/2014 (or at least 3/31/2014), you lose the big prize.

Ann, I agree completely with you-this is a one time opportunity to potentially make big bucks.

On the other hand, unless the system becomes single payor, renewals will be around for awhile-my goal is 500 people into exchange plans ($100-150K in commissions) and renewals for a few years at $40-75K per year.

The other good thing is that once you get a book of this size the cross selling opportunities are enormous, it can easily take an agent into the next decade before drying up.
- - - - - - - - - - - - - - - - - -

INDY HEALTH SALES may not be dead but it's on life support. The good news is there are some good doctors that may be able to help.

Meanwhile, diversify and prepare.

WebNanny was not used in this post
WebExpert was used in this post

Chumps, I think you've become repetitive, don't you agree?