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EVERYONE is eligible to look at different plans in the individual health market from November 15, 2014 – February 15, 2015. Some people will want to keep their plans if they were written before January 1, 2014. Those with ACA (Affordable Care Act) plans may keep your current plan or make a change. To start your thought process, I’ve got three points I’d like you to be aware of and then call me, because I’m sure you’ll have questions:

If your plan has not changed since September 2010, you have what’s called a “grandfathered plan”. If you have a plan that was written between September 2010 and December 2013, you have a “grandmothered plan”. Nick Gearhardt, Iowa Insurance Commissioner, has allowed these plans to stay in force until 2016. A good share of these plans are Wellmark Blue Cross Blue Shield of Iowa plans. There has been a request for a premium increase, however, the good news is, it should be a single digit increase. Hopefully, this will mean that the plan still fits your needs and you may not find it necessary to make any change at all.

If you have an ACA (Affordable Care Act), you can keep it and not make any changes if you still find it affordable. But, you can look at all plans. The expected premium increase on these plans will be much higher. The reason for that is pretty self-explanatory. These plans were written as a first-time-ever, meeting the guidelines of ACA, with no underwriting and consequently, there was no actuarial history to determine how these plans should be priced. The experience so far has been that an adverse selection (older, not necessarily insurable people) purchased a plan, has a procedure done, and did not renew, driving up the rates on the remainder of the policy holders. Until these have had a few years of history, the rates will undoubtedly experience a substantial increase. I recommend holding on to your traditional plans as long as possible.

Marketplace products. If you purchased your plan through www.healthcare.gov, you like your plan, your income has not changed from 2014 – 2015, perhaps it’s in your best interest to stay put. However, if your income is different in 2015, then 2014, I would encourage you to have a review before you incur a tax liability for 2016.

In summary of those three points, there are quality companies and products for us to choose from. I feel that our market has become more fragmented than ever before. What I mean is we have very low cost plans (you get what you pay for). We have some median coverage and price plans and of course, we have very quality products that would be priced possibly higher. The important thing is to have your agent review all of your options and by understanding your needs and your budget, assist you in making the right choice for you and your family. Call me, I’m sure you will have questions.

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Debbie SearsOctober 20, 2014

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