Report on 2018-2019 Open Enrollment

Good news! Rates stable or going down in 2019

ACA, Obamacare, or Healthcare.gov

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 www.dublinhealth.net 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 www.dublinhealth.net

Unlike last year we are in a fairly stable environment with ACA, Obamacare, or Healthcare.gov… 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 jennifer@dublinhealth.net. All of our agents are properly licensed and appointed to handle Medicare Products and look forward to working with you.

Employer Guideline: Implementing a New Group Health Benefit

We all know that health insurance and other health-related benefits are highly sought out by individuals in the job search market. The benefits can support a group’s employee attraction and retention efforts, creating a culture in the workplace of security both in the health and financial arenas.

Dublin Health & Benefit Group LLC has brought group benefits to New Hampshire companies since 2005. We offer health benefits, dental, vision, life, accidental death and dismemberment, short term and long term disability insurance, accident insurance, and other enhancements. We support groups in their long-term goals by bringing them the tools to maintain stability in their organization through employee health benefit programs.

Below please find some common topics employers often want to ask us about. If you find you have further questions or would like to speak with one of our small group brokers about implementing a group benefits plan, we welcome you to contact us directly at 603-563-8820. We look forward to working with you and your employees!

Group benefits are more stable than the Obamacare insurance on the individual marketplace

The individually insured middle class will most understand this. Those earning just above the tax credit threshold (established annually by the federal government) are paying 100% of the cost of their health plan on Obamacare’s individual marketplace. While Dublin Health & Benefit Group enrolls individuals in the individual marketplace, advises them on strategies for capturing a tax credit, not everyone can qualify. There is great stress experienced each year by individuals insured on the marketplace. Having access to their company group plan can relieve these individuals greatly, taking the burden and hassles these individuals face each year on the individual marketplace.

Group health plans are richer, often offering access to out of state providers, and are offered at a more reasonable premium often partially or fully funded by their employer.

Funding a group plan can be a tax-deductible expense for employer and employee

Employer-funded group plans become a tax-deductible expense to the employer by reducing the gross annual income. Employee contributions toward their group health plan may be set up as a pre-tax payroll deduction (we can assist with completing a Section 125 Premium only plan).

Offering benefits to a subgroup of employees

Some small group carriers will ensure small groups who wish to “class out” a subgroup of their company to offer benefits. We have put this in place for groups with a large number of part-time employees who we did not offer benefits to. Another way to “class out” is to offer benefits to those paid on a salary versus hourly basis. It is possible, still, to offer benefits to the executive/management division though we must assess each group on a case by case basis to determine the most viable and sensible way of “classing out” a subgroup of the company.

How much should an employer fund?

Some employers fund 100% the employee and their dependent rate. Others fund 75%. Yet still, others fund just the employee rate. Depending on your organizational culture, employee need and salaries, the employer contribution level we recommend for a group will always be customized to take into consideration just what is necessary to meet the 75% (of eligible employees) participation rate.

We also want to recommend that you don’t fund so much so as to “buy” spouses off of their own company plan. We strive to capture and ensure only those who most need health insurance.

We’ve found that underfunding a plan ensures the plans imminent death with just a few staffing changes within a short amount of time and is not our recommendation for a growing and thriving business who values their employees.

A benefit is easier to give than to take away

Employer-funded contributions should be enough to encourage a consistent participate rate, as required by the carrier for a new plan, and each consecutive year at time of renewal. In New Hampshire, the small group carriers require 75% of all eligible employees to enrolled in the group health plan if there is a plan being offered. The formula for calculating eligible employees depends on several factors, and a qualified Broker from our company can discern this with the company owner, HR staff, or person in charge of implementing the plan.

What type of Brokerage agency will best serve a group’s needs?

Dublin Health & Benefit Group, LLC specializes in providing small group, individual, and Medicare health benefits. As our niche, we work with our clients to bring them the best-aligned product for their needs, as the lowest cost.

As independent brokers (we are not “captive agents”) we are able to shop all of the small group benefit carriers available to the New Hampshire small group market.

One agent, many products, multiple carriers = best value!

How are brokers compensated?

There are few exceptions, though in most circumstances our services are compensated by the carriers at the time of enrollment and monthly for the duration of the plan. Any group enrolling in a group plan, at any time of the year, through Dublin Health & Benefit Group can anticipate that we will be paid by the carrier. We continue to serve you, your employees, and the plan throughout the year even after enrollment.