The Present and Future of Health Insurance

SPECIAL TO THE CALDWELL JOURNAL (September 11, 2017 by Laura Sedlacek)…Currently health insurance is the same old same old or so it seems.  Health insurance is still subject to the ACA aka Affordable Care Act.  The Annual Enrollment Period has been shortened to just 45 days.  The AEP for 2018 will be from November 1st through December 15th, 2017.  All effective dates will be January 1, 2018.

There is no anticipation of any extension of the AEP as in years past.  Exceptions to that will only be if you have a Special Enrollment Period aka SEP situation and enroll outside of the AEP time frame.

If an SEP applies to your health insurance situation, there is a new verification process before you can get you policy.  You have to provide documents or proof of your special enrollment situation (permanent move, marriage, loss of coverage, etc.) prior to enrollment taking place.

You are still subject to the Individual Mandate.  Businesses with 50 or more equivalent Full-time and Part-time employees are also still subject to the Group Mandate.  The Cadillac tax is also still on the books and still scheduled to go into effect on January 1, 2020.

For individuals, Form 8962 is required even if you wouldn’t normally have to file taxes.  This form is for the APTC (aka subsidy) Reconciliation.  If you don’t file it, you can lose the APTC.

In the future, you can possibly expect the repeal of the individual and/or group business mandates, more exceptions for not having insurance, and an easement on actuarial requirements for the plans.  Also, more individuals will possibly be able to purchase catastrophic plans.

The main thing to remember right now for an individual is that if you don’t have health insurance and do not have a hardship exemption you will be subject to the “fine” for not having health insurance.  You also will need to enroll and/or make a change during the AEP from November 1st – December 15th. 

–Laura Sedlacek is an insurance agent with Bush and Associates in Lenoir, NC.  Bush and Associates offers ACA Individual Health, Short-term Health, Hospital Indemnity, Accident or Cancer plans, Medicare Supplements, Dental and Group Employee Benefits.