We Help Clients Understand the Changing Healthcare Landscape
The Affordable Care Act (ACA) as originally passed continues to be the law of the land. However, important changes took place throughout 2017 that may change elections moving forward.
- 2018 Open Enrollments dates shortened: Insureds can make changes to their individual health plan, including Covered California™ plans, from Nov. 1, 2017 – Dec. 15, 2017, for a Jan. 1, 2018 effective date. After this period, you may not be able to enroll again until the 2019 Open Enrollment period without a qualifying life event.
- Anthem: One of the largest carriers in California, Anthem made changes for their 2018 Individual health plan offerings. Coverage will be discontinued in much of the state, except the Modesto and Stockton areas, as well as Redding and Santa Clara County. For networks, Anthem will offer only an Exclusive Provider Organization (EPO) plan, which will likely change the specific, in-network doctors and practices.
- Forms 1094-C and 1095-C: The IRS released final versions of 2017 Forms 1094-C and 1095-C with instructions. Remember, the Form 1095-C for CY 2017 is due January 31, 2018 to ACA FTEs. Filings to the IRS are expected electronically by April 2, 2018.
If you are eligible, Open Enrollment dates for Medicare are the same as prior years: October 15, 2017 to December 7, 2017. Any changes to Medicare plans will need to be done during this time.
Cost-Sharing Reductions Halted
In October 2017, President Trump signed an Executive Order ending the Affordable Care Act’s cost-sharing reduction payments to insurance companies effective immediately.
- For employers and group plans
The direct impact of this decision was minimal.
- For individual health policies (including Covered California™)
Be aware that lower co-pay and deducible plans, such as the Silver 73, 87 and 94 Plans, could be eliminated or changed. Insurance companies may ask you to choose a different plan and will contact you directly if there are any changes.
Premium Subsidies Left Unchanged
If your household income is 100% -- 400% of the Federal Poverty Level, you may be eligible for subsidies that reduce premium costs. Please be sure to review the 2017/18 Federal Poverty Guidelines to see how you may be affected. For example, a family of four may be eligible for some type of assistance with income up to $98,400.
The IRS has issued their 2018 Guidelines for Health Savings Accounts (HSAs). This information may be useful for those considering a Plan that includes this savings feature.