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Health insurance signups go briskly with lower rates for many

SoVaNow.com / November 16, 2017
With one month left to sign up for health insurance on the federal government marketplace, enrollment locally is running at a rapid clip — driven in part by the low cost of many individual plans, say local insurance representatives who help navigate the options for their clients.

“Signups are up. We are booked well past Thanksgiving,” said Carolyn Neal of The Neal Agency in South Boston, which caters to individuals in need of coverage outside of employer plans. The deadline to sign up for insurance on the Obamacare exchange is Dec. 15, compared to past years when the cut-off fell at the end of January. “Most people are unaware that the enrollment was shorter,” Neal added.

Kelly Ballance, with Pulliam Insurance in South Boston, also has had her hands full working with clients on coverage options. Along with the shortened timeframe, consumers are having to cope with Anthem’s exit from the individual marketplace.

“Most people know the Anthem name and feel comfortable with it,” said Balance, and “it can be difficult to switch from a company you’ve used for years. I hope we have made people feel better about the change after explaining their current options.”

Two providers remain for Halifax County residents through the federal insurance exchange (heathcare.gov): Piedmont Community Health Care, an incumbent player in the local market, and Optima Health, new in Halifax County after pulling out of the area a few years ago. Optima is a subsidiary of Sentara Health, which also operates Sentara Halifax Regional Hospital.

Optima’s monthly premiums are higher, agree Neal and Ballance, but the network of health care providers is more robust, which can make the difference for some customers. More typically, it does not.

“Optima is much higher in premiums whether you get a subsidy or not. I have not had that many people willing to pay that much more just to be able to go to a larger network,” said Neal.

Ballance said her experience has been largely the same, with one important caveat: “The Piedmont network is smaller and more regional, but their prices are more affordable. Optima is also an HMO so you have to stay in the state of Virginia, but they make the exception of allowing Duke.”

Many enrollees are finding a big surprise when they go to sign up for health insurance in 2018: monthly premiums, especially for Obamacare bronze plans, are sharply lower. In some cases, enrollment is virtually free. “I had a lady that was enrolled into a silver plan at a $525 monthly premium,” recounted Neal. “Once we updated her info, the premium was $2 a month. People are resilient — they are adapting.”

The dramatically lower premiums are showing up mostly with bronze plans, although some gold plans on the Obamacare marketplace also are priced much lower this year.

Covered services provided through gold, silver and bronze plans are identical, but consumers are required to pay greater out-of-pocket costs with each stepdown in tiered plans, with bronze plans featuring the cheapest premiums and highest deductibles before insurance covers the cost of medical care. Bronze plan deductibles can reach into the five figures for family coverage. Tiered plans also can differ in the size of provider networks.

The lower premiums for bronze and gold plans are the result of a Trump Administration decision to cease payments to insurance companies for cost-sharing reductions — a provision that helps to pay for out-of-pocket costs for low- and middle-income enrollees in silver plans. The cut-off in CSR subsidy payments has caused other federal subsidies for the purchase of Obamacare plans to rise — and the biggest differences are showing up with low-cost bronze plans.

For policyholders who stick with silver coverage, there’s also a benefit, said Ballance. In some situations, silver plan holders are being charged very low deductibles.

“If you qualify for cost sharing, you can possibly get a very low deductible ($200-$700) and out of pocket limits ($400-$1400). If you don’t, you can get deductibles from $1,500-$6,650, with out of pocket maximums going up to $7,350. It really depends on your financial situation,” she said.

On Wednesday, the White House released numbers that showed nearly 1.5 million people signed up for Obamacare in the first 11 days of open enrollment, about half a million more than at the same juncture in 2016.

The surge in enrollment comes despite Trump Administration efforts to undermine Obamacare, through such steps as reducing the program’s ad budget. Despite those obstacles for the program, Ballance noted her clients have received ample reminders to sign up now for health coverage in 2018.

“My clients are telling me they are getting a ton of mail letting them know the enrollment period,” she said. Ballance also discounted the impact of the early Dec. 15 cutoff: “The deadline for a Jan. 1 start date [for coverage] has always been Dec. 15, which is when people want their coverage to begin,” she said.

Both local agents urged people to review their options in 2018 rather than sitting back and allowing Healthcare.gov to auto-enroll them in successor plans. “I always advise people to review their applications yearly because of lot of things can change from one year to the next,” said Ballance. “Some people are being enrolled in what I would advise. Some are not.”

Individuals also need to carefully consider what health care services they may need in the coming year, Neal cautioned. “With Anthem, you pretty much could use any hospital in Virginia. With Optima, you would be about the same,” she said. “With Piedmont, you need to stay in central Virginia. Most people say they are satisfied with the network, especially when comparing prices,” but “of course, some people are dead-set in going to Duke and that upsets people when they are restricted.”

Notwithstanding the tumult surrounding Obamacare, signups in Halifax County seem to be going fairly smoothly — and yielding some surprises. “Subsidies have doubled in this area, so lots of people are getting much lower premiums in 2018 than in 2017,” said Neal.



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Comments

I surely would love to know where the cheaper premiums are! I guess it only works if you qualify for a subsidy. I am looking at paying $1600 a month in 2018! And that is the lowest of my few voices. Up $600 from 2017. Not blaming the local agencies, their hands are tied. The Gold Optima is near $2700 a month!!! Just feel these facts should see the light of day.


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