Get Obamacare North Carolina

Get Obamacare North Carolina: We can help!

If you need to get Obamacare in North Carolina during the 2013-2014 open enrollment season, we can help! Our new video series will help you complete the initial steps needed to get Obamacare North Carolina and get enrolled in a 2014 health insurance plan on healthcare.gov. Our team at NChealthconnector.org can help you with your Obamacare enrollment from start to finish via our remote meeting service! As a certified South Carolina Obamacare agent and North Carolina Obamacare agent, we can help you in ways that Navigators cannot. As a marketplace certified agent, we can make recommendations and comparisons regarding your health plan options. Having been licensed in the health insurance agency for over 10 years, we have the experience to help you make the right choice when you decide to get Obamacare in 2014.

Get Obamacare North Carolina: Subsidy eligibility

When you log in to healthcare.gov, the first step to complete your enrollment is to complete the subsidy application process. This process will determine if you are eligible for either of 2 types of health insurance subsidies. The first subsidy, known as Advanced Premium Tax Credits (APTC for short) is a subsidy that may reduce the monthly cost of your insurance. The second type of subsidy is known as a cost sharing reduction subsidy (or CSR for short). The CSR comes in 3 different “flavors” and may reduce your out of pocket costs on health care services such as doctor and hospital visits, as well as prescription drug costs. It is IMPORTANT to note, that if you qualify for a CSR, YOU MUST ENROLL IN A CSR ELIGIBLE PLAN to receive your CSR subsidy! If you need help determining which North Carolina Obamacare plans are CSR eligible, please feel free to contact us for help!

Get Obamacare North Carolina: Choosing a Plan

Once you have completed the subsidy eligibility process, it is time to choose a plan! At this point we recommend you contact us directly for assistance.

Get Obamacare North Carolina

As many people are well aware, the cheapest health insurance plan may not be the best plan for your specific health care needs. We can help you determine which plan best suits your individual needs, whether you need a higher deductible with lower costs, more comprehensive coverage, or coverage that includes specific doctor and hospital systems as in network providers. Need access to the Duke Medical Center in Raleigh/Durham or Carolinas Medical Center in the Charlotte area? We can help you select a plan with Duke and/or CMC in network! Worried about the hospital in your neighborhood being covered by your plan? Let us help you do a network provider search! Need a plan with out of network benefits? We can help!

Get Obamacare: Video Tutorial Series

Do you need help with www.healthcare.gov. We can show you how to get Obamacare NOW! Today we begin the first in a series of videos designed to help you get started with the enrollment process at www.healthcare.gov. Today’s video will show you the process used to create your account at healthcare.gov and verify your identity at www.healthcare.gov.

 

As your #1 North Carolina Obamacare Agent we are committed to helping North Carolina residents find the best, most affordable coverage for your unique situation. As a licensed health insurance agent/broker for over 10 years, we have the experience needed to help you make the right decision. Many North Carolina residents will qualify for lower costs on their health insurance premiums through healthcare.gov. The first step to finding your health insurance coverage for 2014 is to create an account at create an account at healthcare.govcreate an account at healthcare.govhealthcare.gov. Not sure which plan to choose? Contact us today, and we can help you determine if you may qualify for a health insurance tax credit to lower your costs!

Why create your account at healthcare.gov?

By creating your account at healthcare.gov, you are just minutes away from determining if you qualify for a premium tax credit to help get Obamacare. Many North Carolina residents who apply through healthcare.gov may also qualify for cost sharing subsidies. These tax credits and cost sharing reductions are only available for health insurance plans purchased through healthcare.gov. We can help you with the process! Get started today by watching our video and create your healthcare.gov account!

 Is it safe to get Obamacare at healthcare.gov?

After the SC Department of Revenue breach to our south in 2012, it is understandable that many NC residents are wary of their online privacy. While many people are worried about the security of their information at healthcare.gov, we would like to point out that identity theft happens all over the internet. If you use popular services such as Facebook, Google, or online banking, chances are your information is already readily available on the internet. We recommend everyone who uses the internet on a daily basis be wary of their personal information safeguards, use strong passwords, clear your browser cache regularly and use 2-step authentication where possible. As an online health insurance agent, I use a variety of security methods such as encryption, 2 step authentication, virus protection and strong passwords to ensure HIPPA compliance and my own personal data security.

North Carolina Marketplace Update – December 10, 2013

This is simply a quick update, as we are BUSY helping people get enrolled! The health insurance exchange has been functioning fairly reliably over the past couple of weeks. Noticeable improvements to healthcare.gov occurred in the December 1st, 2013 update. These improvements included many new features that allow us, acting as your North Carolina Obamacare Agent, to resolve many of the glitches previously experienced on www.healthcare.gov. If you have tried to complete an application and received errors, CALL US TODAY at 843-367-8372 – we can help!

Last Friday, I was able to enroll a single person, with premium subsidies and cost sharing subsidies in UNDER 25 minutes! Health Insurance APPROVEDToday, I helped a Wake county resident save over almost $400 a month with a new 2014 plan. However, TIME IS RUNNING OUT if you need new insurance effective January 1st, 2014. Please call or email us ASAP if you need January 1st coverage. As we get closer to the December 23rd and December 15th deadlines, the Exchange Marketplace website is getting busier. This morning was very busy, with wait times up to 15 minutes just to get in. Thankfully, we also have the issuer-based pathway, AKA the “backdoor” access to the Federal Exchange Marketplace. Thankfully, the “backdoor” has not been subject to the long wait times experienced on the front end of healthcare.gov.

Carrier direct policy subsidies?

We recently receive news of another possible workaround for the problem plagued healthcare.gov website. Last week I learned that the National Association of Health Underwriters (NAHU) has requested clarification from the IRS on the subject of subsidy eligibility for consumers who purchase a Qualified Health Plan (QHP) directly from an insurer. Specifically, it was asked if subsidy determination could be made at a later date, for example, at the time of 2014 tax filing. Currently, as the law stands, coverage must be purchased through the Federal Marketplace to be subsidy eligible. However, a change in this interpretation of the law could open the door for many more consumers to get enrolled, without the burden of applying through healthcare.gov. The downside, however, is that consumers would have to finance the entire unsubsidized cost of the premium up front. Considering the median household income in North Carolina is roughly $45,000 per year, this could present a financial challenge for many residents who are already struggling with high premiums. However, we view any additional enrollment options as a move in the right direction! See below for the full NAHU update on the subject of carrier direct policy subsidies:

Finally, NAHU is seeking clarification from the IRS on a subsidy issue, which if resolved could also facilitate enrollment more directly. We have requested immediate clarification if individuals who can afford to advance the premium on their own monthly but might also be subsidy eligible could by an exchange offered QHP directly from a carrier “off the marketplace” and with out getting a marketplace subsidy determination. We have asked if it would be permissible for those individuals to obtain a subsidy determination and advance premium credits later, when the marketplace is working better, or simply claim the credit on their 2014 taxes with an exchange-based determination. As soon as we get resolution to this issue, we will let the membership know.

Stay tuned to NChealthconnector.org your North Carolina Obamacare Agent for the latest breaking news regarding healthplan subsidies for NC residents

North Carolina Platinum Plans

Have you seen the new 2014 North Carolina Platinum Plans? It has been repeated numerous times in the news and in print, that only two North Carolina Platinum plans are offered by BlueCross BlueShield North Carolina. However, other Platinum plans are available in North Carolina at competitive rates, with some of the lowest out-of-pocket costs of any plans available!

North Carolina Platinum Plans

NC Platinum Plan Quote

Of course, there is a catch – these North Carolina Platinum plans are only offered off of the exchange/marketplace.

What does “off marketplace” mean? Keep reading to find out!

 

What is a North Carolina Platinum Plan?

Platinum plans, as defined by the Affordable Care Act (ACA, or as some say, “Obamacare”) are health insurance plans that have an actuarial value of 90%.  In general, Platinum plans have higher monthly premiums, but lower out of pocket costs. For this reason, North Carolina Platinum plans are more suited to people who expect to go to the doctor often, have regular monthly prescriptions, or expect to have other substantial medical expenditures throughout the year.

Off-Exchange/Marketplace Health Plans

We really enjoyed this article from the New York Times, especially as it relates to North Carolina Platinum plans :

WITH so much attention being paid to the troubled debut of the Obama administration’s health insurance exchanges, another alternative has largely gone unnoticed: unless you live in Washington, D.C., or Vermont, you can also buy insurance outside the exchanges — by going directly to insurance brokers, agents or company Web sites. Read More Here

Off exchange plans are plans that are offered outside of the Federal Health Insurance Marketplace.  These plans, starting January 1, 2014, must comply with all of the laws that apply to health plans offered on the Federal Exchange/Marketplace at www.healthcare.gov. Just like plans on the marketplace, qualified health plans purchased outside of the federal marketplace must cover the 10 essential health benefits as defined by the healthcare reform law. The biggest difference to YOU, the consumer? Anyone who purchases an off-exchange plan cannot qualify for Federal subsidies to offset health insurance premiums. Many North Carolina individuals and families making between 100% and 400% of the Federal Poverty level may be eligible for premium assistance through the Federal Exchange. I personally believe, that in certain situations, many North Carolina residents who are eligible for a subsidy, may be better off forgoing the subsidy and buying an off exchange policy. In addition, many off-marketplace plans use more robust provider networks than those found on the marketplace plans. Recently, many news sources, both national and local have reported on the narrow networks associated with the new Marketplace health plans . This is why we recommend working with a North Carolina Obamacare agent to be sure that you choose the plan that best suits YOUR unique needs.

 Who offers North Carolina Platinum Plans?

Of course, as a full service Health Insurance Agency we recommend North Carolina Platinum plans through through Assurant Health. Assurant Health offers 2 Platinum Plans in North Carolina: CoreMed Platinum 1 and CoreMed Platinum 2. Each of these plans allows the enrollee to select one of 3 robust networks:  Aetna Signature Administrators Network, Medcost or CoventryHealthcare of the Carolinas Point Of Service network . For benefit summaries for each of the two North Carolina Platinum Plans, click the links below:

Assurant Platinum 1                                                                     Assurant Platinum 2

Who is Assurant? Great question. Assurant traces its roots to the founding of the LaCrosse Mutual Aid Association established in LaCrosse, Wisconsin in 1892, formed to provide consumers with disability insurance. Assurant Health now provides quality health care insurance products to customers with an emphasis on individuals who need coverage but are not part of a larger group plan. With a 120-year legacy, the business offers affordable health care products including major medical, supplemental and fixed-benefit plans for individuals, families and small employers. Financial ratings information for Assurant’s various companies can be viewed HERE.

Who should consider a North Carolina Platinum Plan?

Anyone who visits the doctor often, takes many prescriptions, or otherwise has high anticipated medical costs. Our analysis indicates that North Carolina residents under the age of 50 may see the most value in a North Carolina Platinum plan in 2014. In our analysis, many residents with high medical costs were better off paying higher Platinum plan premiums in exchange for much lower out of pocket costs. Please contact us today to help determine if you may be a good candidate for a North Carolina Platinum plan. We can HELP!

 

 

Healthcare.gov Quick Update – Tuesday 11/12/2013

HealthCare.gov

NEW Weekend Alert: The Health Insurance Marketplace online application isn’t available from approximately 1 a.m. to 5 a.m. EST daily while we make improvements. In addition, between Saturday evening, November 9 and early morning on Tuesday, November 12, there will be times when you can fill out your application, but you will need to return and log in Tuesday afternoon to review and submit it. The rest of the site and the Marketplace call center remain available during these hours.

North Carolina Healthcare Reform Quick Update – 11/08/2013

North Carolina Healthcare Reform Quick Update – 11/08/2013

The federal marketplace website has been working somewhat more reliably. However, as of Thursday 11/07/2013 the site indicated the HUB was down. Although we could complete and submit a subsidy application, we could not receive a subsidy determination. Stay tuned for more news! Currently, 11/09/2013, it appears applications are not available for access.

Use it or Lose It: IRS issues new FSA guidance

On November 1, 2013 the Internal Revenue Service issued new guidance affecting Flexible Spending Accounts. How will this guidance affect North Carolina residents?The new guidance allows up to $500 of unused FSA funds at the end of a plan year in a health FSA to be paid or reimbursed to plan participants for qualified medical expenses incurred during the following plan year, provided that the plan does not also incorporate the grace period rule. The new rule does not change the maximum annual contribution limit of $2500 to health FSA’s. In addition, the new guidance does not make the new carryover rules mandatory for employers.

Read more HERE….

IRS guidance HERE..

Individual Mandate Update 10/28/2013

Individual Mandate Update from CMS – 10/28/2013

North Carolina residents will have until March 31 — not Feb. 15 — to sign up for Obamacare marketplace coverage without any penalty under the individual mandate, according to new guidance issued by the CMS.Individual Mandate Shared Responsibility PPACAThis guidance is to clear up confusion about the two dates. The Obamacare open enrollment period runs until March 31st 2014 — but initially people would only have had until Feb. 15 to meet the deadline to avoid a tax penalty under the individual mandate / shared responsibility laws.

Date: October 28, 2013

Subject: Shared Responsibility Provision Question and Answer

Q: Will any individual who enrolls in coverage through the Marketplace by the end of
the open enrollment period for 2014 have to make a shared responsibility/individual mandate payment in 2015 for the months prior to the effective date of the individual’s coverage?

A: Starting in 2014, the individual shared responsibility provision requires each
individual to maintain health coverage (known as minimum essential coverage), qualify
for an exemption from the requirement to maintain minimum essential coverage, or make a shared responsibility payment when filing a federal income tax return. To help make coverage affordable for millions of individuals and families, the Affordable Care Act provides, among other things, a premium tax credit to eligible individuals and families to help pay for the cost of health insurance coverage purchased through Health Insurance Marketplaces.

The shared responsibility payment generally applies to people who have access to
affordable coverage during a taxable year but who choose to spend a substantial portion of that year uninsured. The Affordable Care Act gives the Secretary of the U.S.
Department of Health and Human Services (HHS) the authority to establish hardship
exemptions from the shared responsibility payment for individuals who “have suffered a hardship with respect to the capability to obtain coverage under a qualified health plan [QHP].”1 Under this authority, HHS has enumerated several situations that constitute such a hardship.2

Furthermore, the Affordable Care Act provides the Secretary of HHS the authority to
determine the initial open enrollment period for individuals to enroll in coverage through the Marketplaces for 2014. 3Pursuant to this authority, the final rule entitled “Patient Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans; Exchange Standards for Employers” and published on March 27, 2012, at 45 CFR 155.410(b) (“Exchange Final Rule”) specifies that the initial open enrollment period for individuals begins on October 1, 2013, and extends into 2014. The Exchange Final Rule also provides the coverage effective dates for individuals enrolling in coverage through the Marketplaces during the initial open enrollment period.4

For plan selections made between the 1st and the 15th of a given month, the coverage effective date is the first day of the immediately following month, and for plan selections made between the 16th and end of a given month, the coverage effective date is the first day of the second following month.

To ensure that the shared responsibility payment generally applies only to the limited
group of people who have access to affordable coverage during a year but who
nonetheless choose to spend a substantial portion of that year uninsured, the Affordable Care Act provides nine statutory exemptions relating to the individual shared
responsibility provision within the Internal Revenue Code.5
The short coverage gap exemption specifies that an individual is exempt for “[any] month the last day of which occurred during a period in which the applicable individual was not covered by minimum essential coverage for a continuous period of less than 3 months.”6

The length of the initial open enrollment period and the coverage effective dates, in
tandem with the terms of the short coverage gap exemption, created the possibility that an individual who enrolled in coverage through a Marketplace during the initial open
enrollment period could nonetheless be liable for a shared responsibility payment for
months prior to the effective date of that coverage, if the individual were not otherwise
exempt. More specifically, under this structure, an individual who enrolls between
February 16, 2014 and the close of the initial open enrollment period will have coverage
effective as of April 1 or later. As a result, such an individual would not be eligible for
the short coverage gap exemption, which applies only when the coverage gap is less than (but not equal to) 3 months.

HHS recognizes that the duration of the initial open enrollment period implies that
individuals have until the end of the initial open enrollment period to enroll in coverage
through the new Marketplaces while avoiding liability for the shared responsibility
payment. Yet, unless a hardship exemption is established, individuals who purchase
insurance through the Marketplaces towards the end of the initial open enrollment period could be required to make a shared responsibility payment when filing their federal income tax returns in 2015. HHS has determined that it would be unfair to require individuals in this situation to make a payment. Accordingly, HHS is exercising its authority to establish an additional hardship exemption in order to provide relief for
individuals in this situation.

 

 

 

1
26 USC § 5000A(e)(5). 2
“Patient Protection and Affordable Care Act; Exchange Functions: Eligibility for Exemptions;
Miscellaneous Minimum Essential Coverage Provisions”, published on June 26, 2013, at 45 CFR
155.605(g). 3
§ 1311(c)(6)(A) of the Affordable Care Act.
4
45 CFR 155.410(c). 5
26 USC 5000A(d) and (e). These categories of exemptions are: individuals who do not have access to
affordable coverage; individuals with household income below the federal income tax filing threshold;
members of federally recognized Indian tribes; individuals who experience a hardship; individuals who
experience a short coverage gap; members of certain religious sects; members of a health care sharing
ministry; incarcerated individuals; and individuals who are not lawfully present. 6
26 USC 5000A(e)(4)(A). This statutory provision is implemented in final Treasury regulations entitled
“Shared Responsibility Payment for Not Maintaining Minimum Essential Coverage” and published on
August 30, 2013, at 26 CFR 1.5000A-3(j)(2)(i).

Do you have questions about the Individual Mandate and Shared Responsibility Provisions of the Affordable Care Act?

Contact your North Carolina Obamacare Agent today for more information!

For more information, visit:

http://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/Downloads/enrollment-period-faq-10-28-2013.pdf

www.healthcare.gov

 

Marketplace update from HHS – October 26, 2014

Kathleen Sebelius, Secretary of Health and Human Services
Saturday, October 26, 2013

To give Americans a better way to shop for health coverage, the federal government and states recently launched Health Insurance Marketplaces.  Yesterday, we announced a clear path forward so that by the end of November, HealthCare.gov will work smoothly for the vast majority of consumers. But you probably haven’t heard about the Data Services Hub which serves as a critical resource for the Marketplaces, both state and federal.  The Hub is a tool to help you and your family get affordable, quality health care.

What Is the Hub?

The Hub is a routing tool – an information sharing tool. It is an efficient and secure way to rapidly verify the information submitted by consumers seeking a determination of what coverage options and financial assistance are available to them.

You see, one of the great things about the new Marketplaces, which are getting better every day, is that through them, you can apply for health coverage, and check to see if you and your family may qualify for lower premiums, or for Medicaid or the Children’s Health Insurance Program (CHIP).  But that one-stop shopping is possible only if information can be shared quickly, accurately, and securely.

The Hub provides one connection to the common federal data sources needed to verify consumer application information for income, citizenship, immigration status, access to minimum essential coverage, etc.

What the Hub Is Not

It’s important to understand that the Hub is not a database.  It doesn’t retain or store information.  And the Hub queries only those systems necessary to determine your eligibility for what you apply for.  It is a model of efficiency and security because it eliminates the need for each Marketplace, state Medicaid agency, and CHIP agency to set up separate data connections to each of the systems that are in place to help you and your family.

How Many People Has It Helped?

As of yesterday, nearly 700,000 Americans had completed an application through the Marketplaces – more than half of them through the federal Marketplace.  This does not count applications directly to Medicaid and CHIP agencies that also can use the Hub.

A few more stats of note:

  • State-based Marketplaces and the Federal Marketplace are getting real time and accurate eligibility determinations from the Data Services Hub in less than 1.2 seconds.
  • The Social Security Administration has reported 4.2 million transactions involving individuals or households who have elected to establish an account.  The current overall verification rate for Social Security numbers is 96%.  With respect to those we’re unable to verify, consumers are notified online with instructions for resolving their verification issues.  The highest numbers of transactions continues to involve individuals and households in the following states:  Pennsylvania (323,000), New York (310,000), California (290,000), West Virginia (240,000), and Washington (135,000).
  • The Internal Revenue Service (IRS) has received and responded to more than 1.3 million requests for historical household income and family size tax data from the hub.  The number of requests received does not reflect the number of people about whom the requests were made (i.e., a single request can involve everyone in a household).  Thus, the number of individuals about whom the requests were made could be higher than 1.3 million.  The IRS has provided data responses electronically via the hub in “near-real” time (average actual response time is 0.37 seconds).
  • The IRS also offers an advance premium tax credit computation service, which is optional for state Marketplaces.  If a Marketplace chooses to use the IRS service, it sends a few data points, without identifying the applicant, and the IRS provides a math result in response. More than 330,000  requests have been received for the computation service with an average actual response time of 0.21 seconds.

States are reporting that they are satisfied with the hub’s performance.  The technology program manager for Kentucky’s Marketplace said recently that 92% of applicants have been successfully verified through the hub: “We’re overjoyed with that 92 percent.  I don’t know that we thought it would be that high of a success rate.”  Connecticut has also reported few problems with the hub.

Bottom Line

The Hub is a 21st century way to assess eligibility for coverage and premium assistance, and it’s working for residents of all 50 states and DC.  We’ll continue to monitor and optimize its performance.  And we won’t stop working 24/7 until the doors of HealthCare.gov are wide open.  If you need health coverage, it’s our mission to be sure these tools are here for you, running smoothly.  The Hub is on the job, and so are we.

From: http://www.hhs.gov/digitalstrategy/blog/2013/10/marketplace-data-services-hub.html