happy family on couch browsing health insurance options on tablet

Getting the Most out of Open Enrollment

With 2020 Open Enrollment period in full swing, families across the country are reviewing their current insurance coverages and seeing what other options may be available to them. Below are a few tips to help you navigate the process.

  1. Learn the Language

Insurance jargon may be enough to make some people’s heads spin but learning just a few key terms could help you pick the best health coverage for you and your family. To make it easy, here are a few words we feel you should know:

  • ACA-compliant” refers to plans that follow all the guidelines and regulations in the Affordable Care Act. These plans are only available during the annual Open Enrollment period or through a Special enrollment period, if you have a qualifying event.
  • Non-ACA plans” also known as short term health plans do not adhere to all of the Affordable Care Act’s guidelines and regulations.
  • Deductible” the amount of money you must pay out of pocket before your insurance kicks in
  • Premium” the amount you pay to your insurance company every month
  • In-network” refers to a provider that has a contract with your insurance provider
  • Out-of-network” refers to a provider that does not have a contract with your insurance provider
  1. Think of the Future

No one can predict the future, but you may be able to take an educated guess as to what the next 12 months could hold. Thinking about the coming year could help you determine how much coverage is right for you and your family. Have you had any health issues in the past year? Are you taking any medications? By examining your current health status and concerns you may be able to narrow down your health insurance plan options.

  1. Utilize Your Resources

Did you know you have access to our team of licensed Benefits Counselors? Our Benefits Counselors are experts in their field and are standing by to help you navigate the Open Enrollment process and find the best health insurance for you and your family’s needs.

We’ve been providing health insurance answers and guidance for over 30 years. Be sure to visit our Individuals page for access to appointment scheduling services, webinar replays, and other informational resources designed to help make the Open Enrollment process as quick and easy as possible.

  1. Know Your Deadlines

Like last year, the annual individual health insurance Open Enrollment period began on November 1 and will run until December 15. For those who enroll in one of these ACA-compliant plans, you can expect an effective date of January 1.

Non-ACA plans typically do not follow the ACA open enrollment period dates and are available in most states year-round.

Ready to make your decision? Visit https://memberbenefits.com/individuals/ today to secure ACA-compliant coverage for you and your family in 2020.

Upcoming 2020 Individual Health Insurance Open Enrollment Webinar

Join us for a free webinar on Tuesday, October 29 from 12:00pm-12:30pm EDT, where we’ll review the upcoming 2020 Individual Health Insurance Open Enrollment period and cover topics such as important dates, preparation tips, industry updates, and more! Reserve your spot by registering today. Can’t make it to the webinar? Register anyway and we’ll send you a link to the video replay later that day.

young happy doctor high fiving little girl after open enrollment

Knowing Your Open Enrollment Options In 2018

Here are some important reminders to help guide you through the 2018 Open Enrollment process.

You may have recently received a letter from your health insurance carrier about the 2018 year. If the letter was confusing, don’t worry—a licensed Benefits Counselor will help you navigate your health insurance elections for the 2018 coverage year.

Need To Know For Open Enrollment 2018

Unlike years past, this year the Open Enrollment period lasts from a start date of November 1, 2017, and ends on December 15, 2017.

In order to obtain coverage on January 1, 2018, you must apply by the December 15, 2017, Open Enrollment deadline.

Plans and pricing will be available for review on November 1, 2017. We recommend that you evaluate your health insurance options every year in order to ensure that you are still receiving the benefits you need.

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young female asian doctor treating mother and daughter

What You Need for Open Enrollment 2018

Open Enrollment 2018 is just around the corner and for many, this is the only time to secure health insurance coverage for you and your dependents.

Since the beginning of the Affordable Care Act, the term Open Enrollment refers to the specific period of time each year when an individual can enroll in, or switch, their health insurance plan without the need to qualify for a special enrollment period. This is also when additional eligible members can be added to an existing plan.

Open enrollment only occurs once per year, so keeping an eye on the Open Enrollment deadlines is important in order to avoid losing coverage. This year the Open Enrollment window has been shortened and begins November 1st with a December 15th deadline.

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Health Insurance Terms

Understanding Health Insurance Terms

Coinsurance:

Coinsurance is your share of the costs of a covered healthcare service calculated as a percent (for example, 20 percent) of the allowed amount for the service. You pay coinsurance plus any deductibles you still owe for a covered health service.

Premium:

A premium is the amount of money charged by an insurance company for coverage. The cost of premiums may be determined by several factors, including age, geographic area, tobacco use, and number of dependents.

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Letter From Member Benefits’ CEO Regarding Health Insurance Delays During Open Enrollment

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Dear Client,

I want to assure you that all of us at Member Benefits completely understand your concern regarding the complications and delays that are occurring in regards to your application for health insurance. I feel privileged that you have chosen Member Benefits to help you with such an important decision to choose and apply for your health coverage.

These are unprecedented times for health insurance carriers. The following will help you understand why all of the carriers are overwhelmed to various degrees:

  • Over 27,000,000 people have newly applied or changed their plans for insurance since 11/01/15.
  • One of our leading carriers informed us that they received more than 10,000 applications on 12/15/15, the deadline date to apply for a 1/1/16 effective date.
  • Several carriers dropped some of their most popular plans for 2016, causing a panic amongst insureds to secure similar coverage with other carriers.
  • Regardless of the reasons, insurance companies underwriting, billing, and issuance systems are overwhelmed with the volume and are not able to deliver approvals, policy documents, and identification cards in a reasonable manner.
  • One carrier is predicting that policies may take as long as March to be issued with a 1/1/16 effective date.
  • Some carriers are asking us to inform insureds that they might need to pay their claims “out of pocket” and request reimbursement once the policy is issued.
  • Although the carriers greatly increased their staff to handle the volume, some carriers stated that they were expecting a 40% increase in customer service needs and actually received an increase of up to 500%.

It is important to me that you know our staff is working tirelessly and is in constant contact with the carriers to expedite the processing of our clients’ applications.

Again, we are all empathetic with your very justifiable concerns. In addition, we are certain that we will be able to satisfy your needs and ultimately deliver to you the product you applied for.

Earl C. “Chip” Trefry, Jr. CLU
President/CEO

 

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