Joe Covell and Robyn Barto trust that your Thanksgiving Weekend is going well! With the December 15th deadline for 2019 Health Insurance fast approaching there really isn’t too much time for relaxing (that’s on December 16th). We are working non-stop now until December 15th to get each and every one of our clients squared away for the new year. Let’s celebrate this #SmallBusinessSaturday with some lasting peace of mind when it comes to all of your insurance needs. Shop our website now for all your insurances, not just health!

We do our best to get to every single person during this time of year (open enrollment for Medicare and Obamacare), but if you are completing your Healthcare.gov application on your own (remember we are experts and do it for free), please make sure to do these three things under the “is someone helping you” section, because this is how Brokers are paid by carriers (we work with them all and our prices are the exact same):

1. Select Agent/Broker
2. Type in Joseph Covell under ‘Name’
3. Enter NPN: 16623825

This is greatly appreciated and makes is so we can continue to assist our clients all year round!

The repeal of the Individual Mandate (tax/fine for not having Obamacare complaint health insurance) has made for one interesting year at #DoitForME Insurance, and colleagues from all over the country report similar findings. Other than in New Jersey (and other states who will continue the fine on a state level) there seems to be no real urgency to sign up for health insurance. Despite what you hear on the news, Obamacare/The Affordable Care Act (ACA) is still working and in-tact, with no signs of things changing anytime soon after this most recent election. Regardless of the political climate, everyone should always be protected, even if it’s simply a catastrophic plan to protect your income and assets.  Add an HSA, and your medical expenses are tax free up to the 2019 IRS limit. A $695 fine (or 2.5% of income) should not be the only reason for buying health insurance. For many people $695 is less than one month’s health insurance premium (mainly those not receiving a tax credit/subsidy or participating in an employer sponsored health plan). Don’t miss this December 15th deadline or you will not have Obamacare in 2019 (still the most comprehensive health insurance and guaranteed-issue regardless of pre-existing conditions).

Let’s now focus on all of our Pennsylvania clients, because after all that is where we were born (actually, Robyn was born in NJ…shhhhhhhhhh!), raised, and doing business!

Things in Pennsylvania have become hectic this year, but mainly in Montgomery, Bucks, and Philadelphia counties. The reason is that Pennsylvania Health and Wellness is offering On-Exchange (Healthcare.gov) plans through Ambetter (Centene). Since Independence Blue Cross is no longer the only carrier in these counties, those with a 2019 subsidy (tax credit) have become substantially effected. The subsidy is based on the “second-lowest-cost Silver plan” in a particular market. When there is only one carrier, the carrier can adjust the pricing in order to give everyone in that area the highest subsidy possible (which makes you pay less). When there is more than once carrier, this is not easy to do. This is seen all over the country, and the majority of Pennsylvania has always had more than one carrier for On-Exchange (Healthcare.gov) health insurance. In Delaware and Chester counties, Independence Blue Cross remains the only carrier, so those consumers are not effected (unless their income or family composition has changed). Here is a great article by the marketplace regarding the “second lowest cost silver plan.” 
What exactly should you be buying for 2019 health insurance in Pennsylvania? That depends on where you live, which providers you use, what your health and financial situations are, and how long you need it!

Let’s start by saying that in most cases whenever a consumer is eligible for the subsidy/tax credit than “The Health Insurance Marketplace” options make the most sense. The value of insurance that someone receiving a subsidy gets is hard to find elsewhere. It’s true that with these “marketplace” plans often the biggest challenge is access to healthcare providers. Most of Pennsylvania is fortunate to have their insurance companies accepted at the majority of providers – this really is not case across the country – and many take it for granted.  PA is lucky!  Here’s a quick run-down of the various carriers:

Independence Blue Cross – Available in Philadelphia, Bucks, Montgomery, Chester, and Delaware counties. By far the strongest network with nearly every provider “in-network”. Those who want more need look no further than Personal Choice PPO (utilizes the full National Blue PPO Network).

Ambetter (Pennsylvania Health and Wellness) – New to our block for 2019. A nationwide company that specializes in options targeted for the On-Exchange consumer. Their network is growing, so call us to discuss and find out if your providers are included.

Highmark Blue Shield and Highmark Blue Cross Blue Shield– By far the biggest “Blue” company in Pennsylvania (includes Delaware and West Virginia too) – however – their individual under-65 options networks might be limited. They work best at certain providers, call or email us to discuss their entire portfolio.

Capital Blue Cross– Servicing Central PA, Capital Blue is the only “Blue” PPO option available to those in need of Individual health insurance. Their prices are very competitive and they have specific Off -Exchange options too (not on Healthcare.gov, subsidy cannot be applied).

UPMC – This Pittsburgh company continues to expand and has entered new counties such as Lehigh. UPMC has some really rich plans, however, they are new and we really need to examine their networks and find out which of your providers are covered.

Geisinger – This PA company continues to “hang in there” and offer some great choices, however they have gone up in price. Again, watch this network, check your providers.
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This concludes the Obamacare/ACA-complaint Health Insurance carriers for 2019.

Now that we’ve discussed the On and Off-Exchange (Obamacare/ACA) Individual health insurance options, let’s look at all the various alternatives on the market – there seem to be more every day. Aside from the Obamacare options there are really only 3 main types of alternatives: Short Term Medical (PA now allows for 12 month policy maximums), Indemnity Plans (known as fixed-benefit, fixed-indemnity, mini-meds) which pay a scheduled amount per listed service (Aflac being most-known), and association options (Christian Ministries, employer associations, etc.). The sky is the limit when it comes to companies offering these products, but we sell only vetted, reputable companies, and here are our picks:

Short Term Medical – We continue to recommend this to be the only real 2019 Obamacare alternative and we are ecstatic to have the 90-day-maximum-duration lifted by the federal government in October 2018! We stick to 2 major companies for this: United Healthcare (only 90-day-maximum policies in PA) and National General (they purchased Assurant, 364-Days-Maximum in PA). Similar to the major-medical plans of the “old days” these plans: have health underwriting (basic medical questions asked); often do not cover pre-existing conditions; have lifetime maximums; and other nuances-important-to-consider that really should be discussed with a licensed insurance broker prior to purchase.

Indemnity Plans Our favorite is United Healthcare’s Health Protector Guard (Joe Covell personally has this plan coupled with his Independence Blue Cross Silver Proactive HMO). This type of plan pays out a fixed amount per-service. Aflac is the most known, but is designed more as an “accident plan”. United Healthcare and National General offer more comprehensive options designed at being a complete replacement to traditional health insurance. We feel however that this is not enough peace of mind for those big-ticket items (such as open-heart surgery). You win more with this plan if it is in combination with either a high-deductible ACA Bronze Plan or a high-deductible Short Term Medical Plan (depending on your budget, health status, and the state you live in). If price is a major issue, Aflac and National General’s Triomed have some great low-cost options to consider.

Association Health Plans: In 2019 we pick two solid options depending on health status and budget. Aleira Healthcare is the only Christian Ministry worth taking a look at. The company is much more laid back compared to other Ministries, and has been around for some time with a large membership. Aliera does accept pre-existing conditions but excludes these conditions for a period of time. Please call or email us to discuss this more before purchasing.

Our other association of choice is through a New York-based Union/Association. These plans cost: $549 ($1,356 family) with a $6,795 deductible HSA, $660 ($1,644 family) with a $2,500 deductible, and $1,085 ($2,771 family) with a $0 deductible. The union/association requires that interested clients contact us directly and we can e-mail or send via post an enrollment kit complete with plans and pricing and application.

So there you have both Obamacare and Obamacare Alternatives in a nutshell!

We also work with group insurance , as well as dentalvisionaccidentlifedisability, fixed annuities, Medicare supplementsMedicare Advantage and Part D Prescription Planshome, auto,and business insurance. We can handle any situation you throw at us.

Visit our website, contact us on social media, send us a text, an email, or call us anytime. Joe Covell and Robyn Barto work every hour of every day up until the December 15th deadline (Mon-Fri regular business hours after that). We also have a store front in Willow Grove, PA.

We do our best to get to every single person during this time of year (open enrollment for Medicare and Obamacare), but if you are completing your Healthcare.gov application on your own (remember we are experts and do it for free), please make sure to do these three things under the “is someone helping you” section, because this is how Brokers are paid by carriers (we work with them all and our prices are the exact same):

1. Select Agent/Broker
2. Type in Joseph Covell under ‘Name’
3. Enter NPN: 16623825

This is greatly appreciated and makes is so we can continue to assist our clients all year round!

Have a safe and happy holiday season – we are here to help make this process easy! In honor of #SmallBusinessSaturday make it a point to support all small businesses, the backbone of our Great Country!

Best wishes,

Joseph L Covell
Robyn Barto

Independent Insurance Brokers
Custom Benefit Plans, Inc.
616 Easton Rd
Willow Grove, PA 19090
267-374-0975
Doitformeinsurance.com
josephlcovell@gmail.com

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