2016 Cheat Sheet for Individual Health Insurance

OPEN ENROLLMENT Nov 1st 2015 – Jan 31st 2016

Watch this video for an Overview of 2016 plans

Watch this video for an Overview of 2016 plans

Open Enrollment is here! Watch our video for an overview of 2016 plans. BOOKMARK this page (forward to friends if they have questions as well), or to review mid-year what you have again.

You literally can only change plans during this time period. Once signed up for a plan you are locked in until January 2017. It’s a very important choice to make and our goal is to help you get the BEST policy for your specific needs.

The agents at Achieve Alpha Insurance are Gary Franke, Kerry Aldridge, Colleen Jensen and Lewis McMurran. We are here to help you with Health Insurance questions at 425-802-2783, or health@achieve-alpha.com to go over your options. Below is the Cliff Notes version of the advantages and disadvantages for the carriers, as it’s hard to compare the main nitty gritty details on your own. Often there are certain plans that seem to be custom made for your specific situation.

NOTE: Just letting you know that our commission is already built into the price, so it’s the same cost to do it yourself or work with us.

The blog links will be coming soon…check out the 2016 overview video.

2016 Video Overview of Plans

Exchange Screw Up

Blog Article About How to Renew 2016 Correctly

Okay, we all know the Washington HealthPlanFinder has issues, but they made the same mistake a 2nd year in a row. Essentially if you have an Exchange Plan you most people can’t sign up for a 2016 plan until after Nov 24th, otherwise it will change your December 2015 plan…not your January 2016 plan. They told us last year they would have it fixed (and I actually believed them). So be patient if you have an Exchange plan…

Which Company is Best?

I get this question every single day and we can definitely help you out. If you expect to have more medical expenses then get a GOLD plan (there are zero Platinum plans in 2016). However, for those that intend to use less medical coverage get a BRONZE plan. If you want to take a balanced approach with great benefits yet more cost effective a SILVER plan is probably best. There is no such thing as one best company, it’s which company best fits your needs. Ironically some people love one company and the very next person hates them, however there are ones that generally have the best prices and plan designs.

Exchange or Direct to Carrier Plan? What’s the Difference?

2016 Tax Credit LevelWhile the plans structures of Gold, Silver and Bronze are the same IN & OUT of the Exchange the pricing can be dramatically different. For those with income BELOW the “Full Cost Level”  for the size of family in your 2016 tax household (can be an issue for blended families) you get immediate tax credits up front.

For those that have 2016 income ABOVE the Full Cost Level for the number of family members in 2016 you will not get any tax credits for buying a plan through the WA Exchange (so might as well buy directly from the carrier).

Yes, you will need to estimate your income for 2016 before you sign up (you can always update it as the year progresses). You can ONLY get Tax Credits if you sign up through the HealthPlanFinder in Washington State.

Deadlines for Signing Up

The only time you are normally able to sign up for Individual Health Insurance is from Nov 1st 2015 to Jan 31st 2016. If you want coverage for January 1st, the last day to sign up for coverage on the WA Health Exchange is December 23rd and Direct to the Carrier (if your income is above the Tax Credit chart below) is Dec 31st for most carriers.

Outside the normal Open Enrollment period you can get individual health insurance if you have a Qualifying Event, such as changing jobs, married, divorced, or moving to another state. But only if you had health insurance within 63 days of when you sign up for the new coverage. No exceptions on the 63 day gap in coverage outside of the Open Enrollment period.

Rates are increasing in 2016 (as usual)

Yes, it’s sad but true. Prices are increasing again as usual. However we have tips on how to save money. The one exception is with Group Health Cooperative lowering prices by 8.3%. This year Group Health has a new true PPO plan using the great First Choice Health Network and is about 20% cheaper than Premera. Group Health PPO = -8.3%, Premera = +8.8%, Regence = +9%

Top Health Insurance things to think about:

1. Doctor Network (all networks change slightly from year to year). Ensure your doctor’s are still covered by your plan.

2. Hospital Network. There are new “Narrow PPO” networks which are only slightly cheaper and generally not worth it (Premera has the best “narrow PPO” plans since you can switch any month you want and UnitedHealthCare has good NEW plans as well).

3. Prescription Drugs (some carriers cover them up front and some after the deductible).

4. How to Avoid Exclusions (tips on how to ensure your procedures are covered and how to reduce out-of-network charges).

Give us a call at 425-802-2783 and would be glad to assist you in finding the right 2016 health insurance plan for your needs.

Making payments in 2016

If you are self employed do NOT make premium payments from your business accounts for individual plans. They WILL cancel your coverage. You will need to make the payment from your personal account, then work with your accountant to get the tax deduction moved over to your business (if they allow you to). So make payments from your business account at your own risk. The carriers are simply following the rules they are required to follow…they just want to get paid like everyone else, but they have to play by the rules.

Below are my areas of expertise:

Gary Franke, MBA
Independent Broker
Achieve Alpha Insurance, LLC           
12507 Bel-Red Rd, Ste 103
Bellevue, WA 98005
(425) 802-2783

Achieve Alpha