Some observations about changes in health insurance products for individuals and families in 2015:

• Four insurance companies offer coverage for individuals and families – Assurant Health, BlueCross BlueShield, CoOportunity Health, and Coventry Health Care.  Policies are available directly from the insurance company or through the Health Insurance Marketplace.

• BlueCross BlueShield and Golden Rule have extended their pre-ACA policies through 2015.  Golden Rule is not selling new policies in Nebraska.

• At the beginning of 2014, some people actually saw their health insurance premiums go down because they were not being rated on pre-existing health conditions.  There were rate increases for 2015.  The second lowest cost silver plan is identified in each state as the “benchmark” plan.  The southeast corner of Nebraska saw a 5% to 10% increase in the benchmark premium.  The remainder of the state experienced an increase greater that 10%. 

http://kff.org/health-reform/issue-brief/analysis-of-2015-premium-changes-in-the-affordable-care-acts-health-insurance-marketplaces/

• Insurance carriers are developing options with provider networks that are designed to lower costs by using a limited group of doctors and/or hospitals.

• Coventry’s health insurance products for Lancaster County are an HMO (Health Maintenance Organization) that requires the policyholder to utilize a limited network with Saint Elizabeth Regional Medical Center

• Coventry has similar products in Douglas and Sarpy County, but offers traditional networks in the rest of the state

• BlueCross BlueShield offers the SelectBlue network in the Omaha metro that offers a higher level of benefits at a lower cost if you utilize the SelectBlue providers.  This includes physicians and hospitals associated with the Methodist, Nebraska Medical Center, and Children’s Hospital systems.

• BlueCross BlueShield and CHI do not yet have a contract; meaning that the CHI hospitals are not an “in-network” provider for BCBS.  Some agreements have been reached to provide “in-network” benefits in the absence of a contract.

• The Affordable Care Act requires us to have health insurance that complies with the law or pay a penalty.  The penalty in 2015 is the greater of 2% of your household income or $325 per person / $975 per family.

• Those who received an Advance Premium Tax Credit in 2014 will be issued a form 1099-H to report the amount of APTC benefit received.  This will be reconciled on your personal tax return. http://www.irs.gov/pub/irs-pdf/f1099h.pdf

• Open Enrollment continues through February 15, 2015.  After that date, health insurance may only be purchased when a Qualifying Event has occurred that creates a Special Enrollment Period.


by Chris McPike, Vice President

402-488-5100

www.comproins.com