Category Archives: Health Care Reform

Why am I getting a “1411 Certification?”

From Labor Attorney Jason Cogdill:

I have received many reports about employers receiving notices from the Marketplace since the middle of last week.  These are “1411 Certifications” from HHS identifying individuals currently receiving an advanced premium credit (or cost-sharing reduction) and whose application referenced a specific employer.  It is likely that the majority of employers will receive at least one of these notices, so if your clients have not communicated to you about the notices, they soon will. 

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Connecticut CO-OP fails…

Connecticut Co-Op Healthy CT will stop selling plans and wind down enrollment over the next 12 months. 40,000 people will lose their coverage under ObamaCare, for the same reasons as all the others- ObamaCare is underfunded, although for slightly different reasons this time.  They will no longer be able to renew coverage as of August 1.

This makes it the 14th of the 23 CO-OPs formed by ObamaCare to fail (61%)

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SC ObamaCare Exchanges to “implode”?

This is from the Post Courier on July 2.  For the full article, click here.

COLUMBIA — With insurers struggling to make money and access to plans severely limited, top South Carolina health officials warn the Obamacare health insurance marketplace is on the verge of collapse.

Obamacare was supposed to create a competitive platform for customers to shop for coverage. But in most South Carolina counties, HealthCare.gov more closely resembles a monopoly dominated by the largest private health insurance company in the state — BlueCross BlueShield.

Next year, access to Obamacare in South Carolina will likely become even more limited. United Healthcare, which sells Affordable Care Act plans in five counties and in several other states, has announced it will leave most markets in 2017. The company estimates it lost $475 million on Obamacare customers across the country last year.

Republicans propose to limit Corporate Tax Deductibility of health insurance!

Thanks to Keith Zuckerman of PGP for this information:
House Republicans released their healthcare plan last week and it is very misguided in our opinion. It would attempt to repeal the law but keep some main provisions of the law. Dependents would continue to be covered to age 26 and no preexisting conditions would be allowed to be not covered as well as not being allowed to drop enrollees from coverage. But the most controversial aspects are limiting the cap on what employers can deduct for health insurance premiums, which would threaten the current system of employer provided health care and give people tax vouchers to go into the individual marketplace. In most markets that would be a mess as the individual plans are very limited in scope and don’t have many of the high quality facilities that  people come to this area from all over the world to receive world class treatment. The individual marketplace in New York is a mess with carriers losing hundreds of millions of dollars in it and limited choices in provider selection verses the employer provided system that allows you to use the best hospitals in the world in our market and cross state lines many times to receive treatment. The New Jersey and South Carolina individual markets are a little better, but not much. Also they would allow people to cross state lines to find coverage which would result in a very litigious environment as people would not know what they are purchasing.  Currently no individual plans allow you to cross state lines, so we are not sure how that would work, especially since healthcare costs vary widely by region.

It just goes to show, it doesn’t matter what side of the house you are on, it is very tough to create good policy when you do not know what you are voting on or proposing. We spend time lobbying and talking to elected officials and they just don’t truly understand the cost of healthcare and the business of healthcare.

Oxford pulling HMO and POS from NY Market

Beginning with January renewals, Oxford will no longer make the Oxford HMO and POS plans available.  the PPO and EPO plans will continue to be available.  This impacts a lot of groups, as the LIberty HMO was the “affordable” alternative for a company that wanted to keep Oxford.

The company also has indicated it is leaving the individual off-exchange market in NY as well.

 

 

 

Oxford Health Plans (NY), Inc. (OHP) License Withdrawal,
Effective January 1, 2017, Upon Renewal

We have conducted a review of our entire portfolio, which has led us to the decision to exit the commercial market on our Oxford Health Plans (NY), Inc. (OHP) license in 2017. This change will result in withdrawal of our individual and small group OHP New York HMO products and our large group OHP New York POS product. This change will occur on your clients’ 2017 renewal date, beginning January 1, 2017. Please work with your affected clients to ensure they have selected a new OHI group plan before their current coverage ends.

This change does not affect our Oxford Health Insurance, Inc. (OHI) plans. Our OHI portfolio in New York offers a wide range of coverage options for employers of all sizes.

Impacted groups and members will receive a notice from us approximately 180-days prior to their 2017 coverage end date. The notice will outline the actions they need to take and other available coverage options. Samples of the 180-day communications are enclosed. The first mail drop to January 2017 renewing groups, their members, and individual policy holders will be postmarked by July 1, 2016, with subsequent mailings issued monthly thereafter to renewing groups and their members through June 2017.

What this means for your clients

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Reeve Conover is a Registered Representative. Securities offered through Cambridge Investment Research, Inc., a Broker/dealer member FINRA/SPIC. Cambridge and Conover Consulting are not affiliated. Licensed in SC, NC, NY, CT, NJ, and CA.
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