The American Rescue Plan

President Biden signed the American Rescue Plan Act of 2021(ARP) into law on March 11, 2021. ARP makes improvements in access to and affordability of health insurance through the Marketplace by increasing eligibility for financial assistance to pay for Marketplace coverage.
and more good news…..

ARP Overview

  • The new law will lower premiums for most people who currently have a Marketplace health plan and expand access to financial assistance for more consumers.
  • The enhanced tax credit is available beginning on April 1. Financial assistance is retroactive to January 1 via 2021 tax filing reconciliation for individuals and families that received their health insurance through the Marketplace. 
  • Premiums after these new savings will decrease on average by $50 per person per month, or by $85 per policy per month. 

Current Marketplace Enrollees

  • If a current enrollee chooses not to update their Marketplace account, the increased tax credit will be reconciled with the 2021 income tax return filing in 2022.  You need do nothing and you will receive your additional tax credit in a lump sum after filing.
  • Current enrollees may also change their 2021 plan but must do so by August 15, the 2021 Special Enrollment Period end date. IMPORTANT: current enrollees can choose a new plan, but it is not always the best course of action. When you change plans, the amount you paid towards meeting your prior plan’s deductible can be reset to zero and you would need to start paying out of pocket expenses to reach the deductible on the new plan. 
  • To take advantage of new tax credits, existing enrollees must opt to apply the new subsidy. If you prefer to do it yourself, you can log in to your “healthsherpa” account and see if you have a message indicating you qualify for additional subsidy. If you do, simply select the big green button: “Apply the new subsidy”. If you do not have a message indicating you qualify for a new subsidy, run through your application anyway; not everyone who was eligible received a message.
  • If you would like us to apply your new subsidy to your existing policy, simply reply to Include the name of the primary insured and a request to “Apply the new subsidy to my existing policy”. We will update your tax credit and you will be notified via email of the savings. You can also contact our office at 603-563-8820 and we will let you know if you are eligible for additional savings.
  • If you would like to review the option to change coverage, reply to Include the name of the primary insured and a request to “apply new subsidy and review changing plans”. Our office will contact you to schedule a time to review your options.

Enrollees Outside of the Marketplace or Otherwise Not Tax Credit Eligible

  • Prior to the American Rescue Plan, households had to contribute up to 9.83% of their income, based on a benchmark health plan, to pay for health insurance premium to be eligible for tax credits. Households with income greater than 400% of the Federal Poverty Level weren’t eligible for any assistance to reduce the cost of purchasing a health insurance plan. 
  • Under the American Rescue Plan, individuals and families with income greater than 400% of the Federal Poverty Level may be eligible for a temporary increase in premium tax credits for this year, with no one paying more than 8.5% of their household income towards the cost of the benchmark plan or a less expensive plan. 

Contact our office at 603-563-8820 prior to August 15, with your projected Modified Adjusted Gross Income for 2021 and we can help evaluate if you are now eligible for a tax credit to reduce the cost of your health plan and if it makes sense to change to a Marketplace plan.

Report on 2018-2019 Open Enrollment

Good news! Rates stable or going down in 2019

ACA, Obamacare, or

No matter what you call it continues to be controversial, continues to have divided support and is hotly debated no doubt. This program jumps into the fray with an open enrollment season running from November 1st through December 15th. The tax penalty is still open to interpretation but at this writing appears to go away for 2019.

One problem with the penalty, however, is that it takes the focus off having health coverage at all. Penalty or not you still retain the risk of a large health claim. Dublin Health’s Colleen Gutwein and Michelle O’Sullivan regularly work with people in this market and are quick to point out “remember the real penalty is lost peace of mind and a large risk left uninsured is a recipe for financial disaster”. No matter your path or challenge with navigating healthcare in the region the team at Dublin Health & Benefit may be able to help. “It’s a little bit crazy around here right now but all here are willing to help,” says Managing Director Ken Woods. 603-563-8820 or for more info.

The above is reprinted from the Shopper News front page article on October 3rd, 2018 beginning next Thursday open enrollment begins and as usual there are 20 ways to hang yourself if you navigate the programs yourself but there is much good news to report!

The general climate

Rates are slated to stay about the same or go down depending on whether you are receiving a tax credit or not. Our expectations are projected to be a reduction ranging 11% – 20%. Those receiving tax credits with all other things being equal will likely be stable. Plans are about the same in 2018 as they were in 2019. Tax credits are still available to those who qualify and will roll over in a passive re-enrollment scenario. Once again no one carrier is coming in with “fire sale” pricing and the pecking order is the same as it was in 2018.

Passive re-enrollment, which requires you do nothing, is available from Anthem, Harvard Pilgrim and Ambetter. What this means is that you need to do nothing if you are happy with your current plan and benefits. Everything will simply map to the 2019 plan most closely aligned with your current plan. Just be sure to confirm that any auto draft is continued as 1st payment for 2019 is due by the 10th of January and we recommend paying and checking sooner to avoid lapse. Keep an eye on your statements to confirm the auto pay transaction has taken place by January 10th.

Passive re-enroll is good for most, but specific situations call for a consult with our brokers. Some examples are:

  • You have a complex income and tax situation and need to strategize to achieve a tax credit
  • You have significant changes in care needs
  • You have significant changes in medications particularly involving brand name drugs
  • You are unhappy with your current plan
  • You have significant or drastic changes in projected income for 2019 (up or down)
    • Remember small adjustments can be made at any time throughout the year by calling the office.
  • You need to add or drop dependents
  • You are aging into Medicare in 2019

Contact information for the entire team can be found at

Unlike last year we are in a fairly stable environment with ACA, Obamacare, or… some might even call it boring! Then again in health insurance boring and stable is good.

Happy Holidays to all.

Important 2019 Medicare AEP Open enrollment period 10/15 – 12/7/2018

To the many hundreds of clients and friends who depend on our guidance for their Medicare Supplements, Advantage Plans and/or Part D Prescription plans and to those you refer to our office: I want to offer a simple snapshot of the options before you for 2019. I address each of the possible scenarios in hopes that you can identify your current situation and determine what additional steps you wish to take so that you can proactively work with us, to maximize your program value during this open enrollment season as we move into 2019.

Medicare Supplement policyholders

If you like what you have and it is meeting your expectations for coverage and budget, you are probably in the right place as rates adjust for cost of living only and are fairly stable with nominal increases. Your age is locked in at entry age so moving to a different carrier does not typically yield savings. Exception: You wish to learn more about Advantage plans like an HMO or PPO or PFFS or SNP.

Medicare Advantage policyholders

If you like what you have and it is meeting your expectations for coverage and budget you are probably in the right place, but you should review the renewal information from your current carrier to make sure the premium is still affordable and the formulary for the drug component is still covering all medications. If so, than we should stay the course. We will also monitor these programs and if a significantly better value emerges, we will reach out to you via phone call and/or email. Note: A zero cost plan will be offered by Harvard Pilgrim Stride this year. Exception: You are unhappy with your plan or wish to explore a supplement.

Prescription Drug Plans (PDP)

This is an area we encourage all of our supplement clients and anyone with a stand-alone PDP to evaluate yearly as premiums change, formularies change, plan designs change, carriers change, your medications change and carriers come and go each year.  It is the most volatile component in your program. If you do nothing you will be automatically re-enrolled if the carrier is remaining in the marketplace but alternatives are worth a look. Exception: You have evaluated the renewal communications from your current carrier, are satisfied your drugs are on the formulary, the carrier has performed to your satisfaction and new premium is acceptable to you.

What Dublin Health will do for you

  • Current clients: We will reach out to you by phone and/or email over the next two weeks to invite and answer questions about plan changes either in person at the office or over the phone.
  • We will serve you and/or someone you know who desires guidance as an AEP (existing Medicare beneficiary) or IEP (New to Medicare friends you are referring) and SEP (Special election period) beneficiaries going through a life change needing guidance.
  • After receiving a signed  Scope of Appointment (click the link to complete and sign) we will assist you in learning about and enrolling in any plan changes or new plans you wish to pursue.
We will always relentlessly pursue the best values existing in the current marketplace and be a resource to you in your effort to understand and select the best options based on your needs and financial resources. Contact our office at 603-563-8820 or email All of our agents are properly licensed and appointed to handle Medicare Products and look forward to working with you.