Tag Archives: North Carolina

For North Carolina residents in the Charlotte metro area, and surrounding counties, it is very important to pay close attention to networks when searching for an individual health insurance plan for 2016. Carolina HealthCare Network marketplace plans for 2016 information was recently published on the CHC website, which we found to be valuable for North Carolina residents. Of course, you can search ALL North Carolina marketplace plans on our plan finder by CLICKING HERE.

For purposes of this entry, we consider metro Charlotte (NC and SC) to include the following counties: Anson, Cabarrus, Cleveland, Gaston, Lincoln, Mecklenburg, Stanly and Union in North Carolina; Lancaster and York in South Carolina.

For those in the Charlotte Metro area, be aware of some important changes when selecting an individual health insurance plan for 2016:

CoventryOne-Carolinas HealthCare System individual health insurance plans are no longer sold in North or South Carolina. If you have one of these plans currently, you will automatically be enrolled in a similar Aetna Leap-Carolinas HealthCare System plan.
Blue Advantage, Blue Select and Multi-State individual health insurance plans from Blue Cross and Blue Shield of North Carolina are no longer sold in most of the Charlotte area. You may be automatically enrolled in a different plan, but there’s a chance your out-of-pocket costs could go up.

Need help deciding on a 2016 plan? Call or email us: 843-882-7062 or Josh@NChealthconnector.org

Carolinas HealthCare – Network marketplace plans 2016

As noted in the table above, North Carolina Blue Value plans, United Healthcare Compass plans, and Humana plans WILL NOT have Carolinas HealthCare System in network.

Stay tuned to www.NChealthconnector.org for updates!

As reported in the news late last week, Blue Cross Blue Shield of North Carolina recently requested an adjustment to their 2016 rate increase for North Carolina health plans sold on the health insurance marketplace. As we reported in June, Blue Cross Blue Shield of North Carolina (BCBS-NC) originally proposed a 25.7% rate hike for marketplace plans in 2016. However, BCBS-NC recently announced on their website, that the requested rate increase would be revised based on two main factors:

“Early on, industry and government officials counted on two assumptions: A healthier mix of customers in the second year (2015), and a leveling-out of medical spending this year following a surge in demand for the initial year. We now have enough data to know that both of these assumptions have not proven true.”

Blue Cross Blue Shield NC rate increase: 34.6%

In addition, BCBS-NC also announced that they would discontinue the wider network PPO plans in 16 North Carolina counties for 2016: “In keeping with this approach, we will no longer offer Blue Advantage and Blue Select plans in the counties in the Charlotte, Raleigh and Durham markets.”

It is important to note, that in the Charlotte, Raleigh and Durham markets, BCBS-NC has experienced increased competition from United Healthcare and Coventry/Aetna – and Humana is expected to begin offering marketplace plans in these metro areas for 2016 as we previously reported. Click here to see all available marketplace plans in your area of North Carolina.

Of course, the Blue Cross Blue Shield NC rate increase request of 36.4% is still subject to regulatory review, and may not be approved by the North Carolina Department of Insurance. Stay tuned to NChealthconnector.org for breaking North Carolina health insurance news!

Click here to read the entire BCBS-NC blog release concerning the new 34.6% rate increase.

Quick Tuesday Humana North Carolina update:

According to our sources, Humana will be offering 2016 North Carolina health insurance plans thru the health insurance marketplace in 2 metro areas: Charlotte and Winston Salem.

We believe Humana may provide a viable alternative for Charlotte area residents who may have experienced network issues in 2015. Humana may also provide a viable alternative for North Carolina residents experiencing big rate hikes in 2016.

Stay tuned for more info – NChealthconnector.org is your #1 North Carolina Obamacare agent!

2016 Humana North Carolina rates will be available on November 1, 2015 by clicking here.

Bluecross Blueshield North Carolina 2015 ACA rates.

According to various sources around the web, Bluecross Blue Shield North Carolina on Wednesday released some limited rate information or 2015 marketplace health insurance plans.

The headline number for this story is that rates will rise “more than 13 percent on average”. Of course, that does not tell the entire story. As we recently saw in South Carolina , rate increases for ACA plans offered on the exchange will fluctuate quite a bit between different regions. We do not expect every Bluecross Blueshield customer to receive a 13% increase. Rates will vary across regions, as North Carolina has 16 distinct rating regions, each with differing rate increases. In addition, different types of plans will receive different increases:

Rate increase got you down? Click here to shop for a lower price!

Bluecross yesterday provided only one scenario of how rates would increase next year. For a 45-year old nonsmoker, the monthly premium rate would increase 15.6 percent – from $364.39 to $421.32 – on one of the most popular individual plans Blue Cross sold in Raleigh through the federal marketplace – a Silver plan.

Keep in mind, however, rate increases for Bronze and Gold plans will change by different amounts. We have also been told certain plans in specific areas may actually decrease a bit – stay tuned for more!

Of course, most North Carolina residents will also be able to choose a marketplace plan from Unitedhealthcare for 2015, as well as Coventry Healthcare in certain areas!

Our takeaway? If you need the most robust network options for North Carolina in 2015, Bluecross Blueshield of North Carolina may be your best bet. However, if you are willing to change doctors to accept an HMO or Tiered network structure, you may be able to save some money.

Beginning November 15, North Carolina residents can view 2015 rates and apply online from our frontpage (click the Blue button!).

North Carolina newborn insurance coverage

We can help get your child covered!

Over the course of the year, we have received many inquiries from people wanting to know when a North Carolina newborn can get insurance coverage through the health insurance marketplace. As many people may be aware, most marketplace enrollments are effective the 1st day of the month following the date of enrollment.

However, for newborn children in North Carolina who need insurance coverage, a Special Enrollment Period or SEP is available that will provide coverage effective on the date of birth! This is great news for new parents worried about the hassle of getting a newly born child insured.

What is a a Special Enrollment Period? A special enrollment period is when you have a qualifying life event that allows you to enroll in coverage on or off of the marketplace, outside of open enrollment. Of course, giving birth to a child is one of the many life events that would qualify you for a Special Enrollment Period.

Below is the specific guidance, directly from CMS, that details how Special Enrollment Periods for Nouth Carolina newborn insurance coverage work:

Per 45 CFR §155.420, Special Enrollment Periods (SEPs) constitute periods outside the initial or annual
open enrollment when a QI may enroll in a QHP and QDP or a QI can elect to change a current QHP and
QDP selection as a result of a triggering event, such as birth/adoption, relocation, death, or loss of MEC.
It is the responsibility of the FFMs to determine whether a QI meets eligibility requirements for a SEP.
The FFMs determine eligibility for SEPs, which are described by regulation at 45 CFR §155.420(d). In the
individual market FFMs, Special Enrollment Periods generally last 60 days from the triggering event, per
45 CFR §155.420(c). In SHOPs, including FF-SHOPs, Special Enrollment Periods generally last 30 days
from the triggering event, although there are two exceptions, when an enrollee loses Medicaid or CHIP
coverage and when an enrollee becomes eligible for Medicaid or CHIP coverage For the Medicaid and
CHIP exceptions the SEP is 60 days. The start date of an SEP is based on the date of the triggering event.
Although certain SEPs adhere to the standard effective dates described earlier in section 1.2, there are
exceptions to this rule. For example, for birth, adoption, placement for adoption, or placement in foster
care, coverage is retroactive to the date of birth, adoption, placement for adoption, or placement in
foster care.

North Carolina Newborn Health Insurance Coverage enrollment example:

Example : An enrollee contacts the Marketplace on 09/25/2014 to inform the Marketplace of the birth of
twins on 09/01/2014. The Marketplace does a redetermination of the enrollment group. The Marketplace sends
an 834 change transaction to the selected Qualified Health Plan adding the newborn children with a coverage
effective date 09/01/2014.

Do you need help with North Carolina newborn insurance coverage?

Of course, if all of this sounds complicated, please call (843.882.7062) or email us directly. or leave a comment. We can HELP!

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 healthcare.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.

During the first week of open enrollment for the Affordable Care Act, the Federal Health Insurance Marketplace has had a rocky start, to say the least. As your trusted North Carolina Obamacare Agent, we are continuously checking the status of the enrollment portal at www.healthcare.gov, as well as keeping an eye out for any pertinent news regarding open enrollment. Recently, while perusing the news, we found a particularly disturbing article from CNBC.

You can read the original article here. On Friday, CNBC reported that as many as 99% of Obamacare enrollment applications contain enough information for the insurance carrier to process the application! Another insurer reported that approximately half of all applications received did not have enough information to process the enrollment. Don’t let this happen to you!

This is why you need a North Carolina Obamacare Agent!

As your North Carolina Obamacare Agent, our agency tracks every application to ensure that your enrollment is complete! Sure, you could go to healthcare.gov and enroll on your own – but why risk not having insurance on January 1st? As your North Carolina Obamacare Agent, we have the knowledge, resources and experience to help ensure that your health insurance enrollment application is complete!

North Carolina Obamacare Agents must be CMS certified before helping consumers apply for Obamacare plans. North Carolina Obamacare Agents must complete assigned training and pass exams before they may assist individuals with an application, plan selection, and enrollment through a Federally-facilitated Marketplace.

North Carolina Obamacare Agent vs. Navigators

Navigators may help you navigate the Federal Marketplace. By law, the Affordable Care Act forbids navigators from actually recommending what specific health plan or coverage people should purchase. Navigators are only allowed to help people understand their options and they’re banned from receive compensation from insurers, as North Carolina Obamacare Agents can.

North Carolina Obamacare Agents are not only certified by the Federal Government, but also licensed, trained, and appointed with each insurance company they represent. This relationship ensures that your North Carolina Obamacare Agent has a professional working knowledge of the plans they represent.

NC DOI officials have approved 67 on exchange health plans for North Carolina’s Federally Facilitated Marketplace, opening on October 1, 2013.

Health insurance plans will be offered by 3 companies:

Bluecross Blueshield of North Carolina – 26 plans in all 100 counties.

Coventry Healthcare of the Carolinas – 25 plans in various metro areas.

FirstCarolina – 16 plans in six counties: Lee, Moore, Richmond, Hoke, Montgomery and Scotland.

RALEIGH — The North Carolina Department of Insurance today announced that it has completed timely reviews and approvals of health insurance rates for plans that insurers have proposed to sell in the federal Health Insurance Marketplace. This approval allows the insurers to continue the process to become certified by the federal government to participate in the Marketplace.

The Health Insurance Marketplace, also known as a health benefit exchange, will be accessible online through www.healthcare.gov and is a place where individuals, families and small employers will be able to compare health insurance options and shop for coverage. Those eligible will be able to take advantage of federal subsidies and tax credits. Pursuant to N.C. Session Law 2013-5, the federal government will operate the Marketplace in North Carolina.

As of today, rates have been approved for three insurers that have indicated to NCDOI their intent to sell plans on the Marketplace. The insurers include Blue Cross and Blue Shield of North Carolina, Coventry Health Care of the Carolinas, and FirstCarolinaCare. All three have indicated intent to participate in the individual market; BCBSNC has indicated intent to also participate in the small group market. Coverage options will vary by county. As the federal government will be operating the Marketplace in North Carolina, it will make the final decision as to which plans may be sold through the Marketplace in this state.

Rate details for these insurers were filed with NCDOI as trade secret, and under North Carolina law, may not be released by NCDOI without the consent of the insurer.

The Health Insurance Marketplace is scheduled to open for enrollment on Oct. 1. Health insurance plans, from the insurers above as well as others operating in the state, will also be available outside of the Marketplace; however, income-based federal subsidies are only available through the Marketplace. For coverage beginning in 2014, no health insurer may deny coverage to an individual or small group, or charge more for coverage because of health status, claims experience or a pre-existing condition.

For more information about the Health Insurance Marketplace, visit www.healthcare.gov or call the federal Marketplace Consumer Call Center at 800-318-2596.