September 2013

Your Partners in Understanding Healthcare Reform
Providing Clear and Creative Health Insurance Solutions

URGENT SEPTEMBER EDITION. CONTAINS CRITICAL INFORMATION REGARDING THE AFFORDABLE CARE ACT AND HOW IT WILL AFFECT YOUR CURRENT POLICIES.
 

 

Lynn Caffrey, Principal, CA License 0557451

Gabriel Caffrey, Broker, CA License 0H66348

About Caffrey Insurance Solutions
Caffrey Insurance Solutions
Phone: 510-444-5447
Fax: 866.530.7365 
Impact of the ACA on Individual and Family Plan Clients

All current individual plans will change to Affordable Care Act compliant plans. You will be transitioned automatically but you will have the option to go to any available plan with your current carrier or with a new one. 

We are planning on having conversations or short meetings with all of our clients over the next few months. Our interest is in helping you determine whether you are eligible for subsidies through the Covered California Health Insurance Exchange or whether you may be covered better through options in the private marketplace. 

In any event, there is a LIMITED open enrollment period of October 1, 2013 through March 31, 2014 in which you can get guaranteed coverage regardless of health conditions. 

If you miss the window and are not covered at the close of open enrollment you'll need to wait until the next opportunity from October 15th, 2014 through December 7th, 2014.

That Procedure Costs How Much?

A massive federal database of national health care costs was made public a little while back, according to an article in the Huffington Post.  

Are You Eligible for a Subsidy Through Covered California? Find Out!

The Covered California website is up and running at:

www.coveredca.com 

You can go online and see if you're eligible for a subsidy, and what you might expect to pay for one of the available plans. 

This will help us aid you in deciding the best way to go. If you are not eligible for a subsidy, you might as well buy off the exchange as the application process will be much easier than it is now, the networks may be stronger and the rates for mirrored (same as the exchange) plans will be identical. Also, not all carriers are represented in the exchange. 

At any rate, remember to use us before signing up for the plan you have for this next year. We are participating in all mandated certification training for Covered California.

We will also be working in our customary capacity moving forward, assisting our clients with the whole process whether in Covered California or the private marketplace.

We take our responsibilities in servicing your policies very seriously and hope to continue to assist you with these new options as well. As usual, our services are entirely free to you.

 

Best Broker in the  

East Bay

Lynn had the honor of being named Best Health Insurance Broker in the East Bay Express Best of the Bay awards. 

 

The review said that she was "an extremely dedicated full service health-insurance broker".  We work hard for our clients.

Review us on Yelp!

Yelp Page

 

Thanks to your great reviews, we have a five star rating on Yelp. If you have received good service from Caffrey Insurance Solutions over the years, please drop by and let prospective customers know about your experience. We really appreciate your time! Thank you.

How Long Will You Live?

This easy and fun calculator estimates your life expectancy.  It was developed by Northwestern Mutual Life, and it tries to predict how long you're likely to live. 

The predictions aren't going to be close if you do have a long-term health issue, but generally it works well. Barring long-term health problems, we are going to live a long time, most was into our late 80s or 90s.

As You Grow, We Grow With You

Please ask about additional services and value-added products such as HR administration and online policy management tools. 

Testimonials

"Lynn really helped me in dealing with a declined insurance claim by guiding me through the appeal process and communicating with the insurance provider. She offered continued support until the claim was reviewed and finally resolved. I truly believe that Caffrey Insurance Solutions' dedication in providing insurance as well as exceptional care and support to clients is invaluable."  --Current Individual Client

"Your expert advice is always appreciated. I literally don't know what I would do without you. You give me the most valuable gift of all: time."    --Scott Gordon 

 

"I'm glad there are individuals like Gabriel who can break it down so the average joe can understand the ins and outs of each plan, and make better-informed decisions."
     --Kerwin K.

"You are different from any image I have had of an insurance broker. I simply enjoy being with you. I experience a combination of efficiency, care, honesty, commitment and flexibility. I couldn't ask for better.               --Miki Kashtan


Lynn and Gabe profile picture
We are being pushy this month in the hope you will take the time to read this newsletter special edition carefully. The material is very important and timely. 
 
In the next three months, all individuals should be reviewing their current plans in anticipation of losing their current coverage. Individual plans will be automatically transitioned to Affordable Care Act compliant plans. Your benefits will change, as may access to your providers. Your carrier will notify you of these changes shortly.
 
Much of the information in this dispatch will not apply to clients who participate in grandfathered individual or group medical plan.
 
The open enrollment period for new ACA compliant individual and family plans runs from October 1st, 2013 through March 31, 2014. If you don't enroll in a plan during this time frame you will not be able to enroll until the next open enrollment session running October 15th, 2014 to December 7th, 2014 unless you have a qualifying event.
 
All groups will be either renewing early to avoid changes in 2014, or at the bare minimum learning how their plans will change in 2014. Even if you keep your old plan you will be paying new taxes in January to support the ACA changes. Part of what we do for you as brokers is assist you in sorting through the choices and finding what's best for you.

Do You Want To Touch Base?

Lynn Caffrey We're asking all of our clients to schedule meetings (telephone, in person or via email) through our online appointment booking tool. 

This is our first time using this software so there may be some bugs but rest assured that when you request an appointment we get the request and will schedule you as soon as we can.  

Model Notice Requirement

Doctor Earth Stethoscope IMage If you are an owner or manager of a business in California and are providing health insurance benefits to your employees, you will be required (before October 1, 2013) to notify your staff of the availability of the Covered California health insurance exchange. We will assist all of our group clients with the forms and specific wording moving forward.

 

The official Department of Labor Model Notice can be found at HealthCare.Gov or by linking directly here. Please let us know if you have questions regarding this form or how to customize it based on your business.

Alert! 

If You Are Currently Without Coverage, A Temporary Policy May Be The Answer

We are close enough now to January 2014 that a temporary policy may provide a good solution for your insurance needs. Although temporary plans are not guaranteed issue, the underwriting process comparatively simple and may meet your needs well until a plan can be issued through Covered California or the private individual and family market for January 1. 

 

In most cases temporary medical coverage can be effective the day after you apply! (Important caveat: they do not cover presciption medications.) 

 

Ask us if you want some options if this scenario applies to you. Or if you prefer, you can try the direct application linked here, which will assign us as your broker of record and save you some time. We will service any policies applied for this way.

New Census Form For Group Plan Quoting

Upon request, we will be re-marketing all of our small group clients to see if new ACA compliant group plans are the best option available to you. In order for us to calculate your rates prior to the deadline for your particular carrier, please send this in at least two weeks before that. You should have received notice of this deadline already but if you have not let us know.

 

In general, we and the carriers are recommending that you take advantage of a December 1st anniversary to maintain your plans and networks for another year.

 

Please fill out the linked census form and return to us at your earliest convenience so we can quote options that will continue to serve you well next year. 

For Those Groups Considering Dropping Group Coverage

Even if you are giving some thought to dropping group coverage altogether when the Affordable Care Act takes full effect in January, we do want you to provide us an up to date formatted census, detailed in the census section above. We will do a comparison for you as soon as we have all of the rates and plan designs that will affect you.

 

It's important for you to remember that you are not permitted to pay for private individual policies either through Covered California or on the standard individual and family marketplace as a company benefit.

 

Please do bear in mind that everyone in the insurance industry, from your broker to the carriers to the underwriters to the practitioners, is taking a hit on their income. We expect to need to write about twice as much individual and group business to stay on an even keel, and we appreciate your continued trust and faith in our services during this transitional time.

Aetna of California Group Clients

If you are interested in taking advantage of the early renewal opportunity and protecting yourself for most of 2014, please let us know. The deadline for an early renewal date of 12/1/2013 is October 15, 2013 although you need to have already submitted an early renewal intention request as of September 1, 2013 to take advantage of that date.

Anthem Blue Cross of California Group Clients

If you are interested in taking advantage of the early renewal opportunity and protecting yourself for most of 2014, please let us know. The Anthem Blue Cross of CA Early Renewal Request Form must be submitted to the carrier by November 15th, 2013.

Blue Shield of California Group Clients

If you are interested in taking advantage of the early renewal opportunity and protecting yourself for most of 2014, please let us know. The deadline to get these in to Blue Shield is October 7, 2013, so please get the Early Renewal Option Form back to us within the next two weeks to ensure these are processed promptly.

California Choice Group Clients

California Choice may prove less competitive in the new marketplace and we will definitely wish to market your options to improve your return on investment and get maximum value for your premiums. The Early Renewal Form must be completed and submitted to California Choice by October 1. If you want to take advantage of this, please let us know immediately and we'll help out. Please forward us the completed form directly and we'll make sure it's submitted properly to California Choice.

Health Net Group Clients

For our few clients with medical policies through Health Net, we will be contacting you directly. Groups that are eligible for early renewal will receive an early renewal packet in the mail indicating early renewal will take place automatically. If you do not wish to adjust your renewal date automatically, you will need to contact Health Net to opt out.For non-qualifying groups we may need to request Early Renewal options for you.

HSA California Group Clients

HSA California may prove less competitive in the new marketplace and we will definitely wish to market your options to improve your return on investment and get maximum value for your premiums. Unfortunately the early renewal deadline for HSA California groups has already passed.

Kaiser Permanente of California Group Clients

You have indicated your intention to consider early renewal already. We will have rates available to calculate on your half before the deadline in October, but we will need an updated census to run the quotes because rates are soon to be calculated on a per-member basis and may vary considerably. 

 

The sooner you get this to us, the sooner we can analyze the options and see if it makes most sense for you to renew early or shop for new plans with us in October. The Confirmation to Renew Early Form must be received by October 4, 2013, so please get that to us as quickly as you can.

SeeChange Group Clients

If you are interested in taking advantage of the early renewal opportunity and protecting yourself for most of 2014, please let us know. Groups not pre-approved should have received paperwork directly from SeeChange in early September to request an underwriting review.

Insurance Carriers Announced for Covered California 

and 

Small Business Health Options Program (SHOP)

Small Business Health Options Program (SHOP) Carriers

  • Blue Shield of CA
  • Chinese Community Health Plan
  • Health Net
  • Kaiser Permanente
  • Sharp Health Plan
  • Western Health Advantage

 

Covered California Individual and Family Plan Carriers

  • Alameda Alliance for Health
  • L.A. Care Plan
  • Anthem Blue Cross of California
  • Molina Healthcare
  • Blue Shield of California
  • Sharp Health Plan
  • Chinese Community Health Plan
  • Valley Health Plan
  • Contra Costa Health Care Plan
  • Ventura County Health Care Plan
  • Health Net of California
  • Western Health Advantage

For more information please visit www.coveredca.com. We will be participating in all agent trainings and should be certified to work with Covered California for individuals, families and companies on your behalf in the near future. We will assist our clients with more details on these programs as they become available.

About Caffrey Insurance Solutions 

Caffrey Insurance Solutions is a family business employee benefits brokerage firm that provides insurance expertise for small companies (fewer than 50 employees) and individuals seeking individual or family coverage. We also provide Medicare assistance.  

Caffrey Insurance works with you to find the best insurance benefits that provide the best value, tailored to the unique needs of your company.
 

California License Information
Lynn Caffrey: 0557451
Gabriel Caffrey: 0H66348
Caffrey Insurance Solutions, Inc.: 0G80281

Caffrey Insurance Solutions, Inc.
405 14th Street, Suite 711
Oakland, CA 94612
Phone: 510-444-5447
Email: [email protected]