The FINAL Deadlines to Enroll or Change 2024 Health Insurance are Here!

The FINAL Deadlines to Enroll or Change 2024 Health Insurance are Here!

The FINAL Deadlines to Enroll or Change 2024 Health Insurance Are Here!

The deadlines for the 2024 Open Enrollment Period for Individual and Family Health Insurance Plans are here. As the Health Insurance Marketplaces, including Healthcare.gov and State Based marketplaces/exchanges like Pennie, GetCoveredNJ, Maryland Health Connection, and Virginia’s Insurance Marketplace, reach their final days, it’s time to take action. Don’t miss out on this opportunity to enroll in or change the coverage you need. Act now!

Here are the important deadlines for the markets we currently serve:

  • MarylandHealthConnection.gov: Monday, January 15th (as per their website at the time of writing)
  • Healthcare.gov and Select State Based Exchanges like Marketplace.Virginia.gov: Tuesday, January 16th
  • Pennie.com in Pennsylvania: Friday, January 19th
  • GetCovered.NJ.gov and Select State Based Exchanges: Wednesday, January 31st

Diving Deeper into Specific Markets We Serve:

As is the case with all Open Enrollment Periods, there are not only unique but also recurring challenges. Plan Year 2024 was no exception. Plan offerings can change drastically from year to year, including the renewal of current plans, the introduction of new plans by existing carriers, the entry of new carriers into the market, and the exit of specific plans and the companies offering them from markets entirely.

Open Enrollment 2024 seemed to be extra challenging this year in the Philadelphia 5 County Region, as Jefferson Health Plans and Highmark Blue Shield entered the Under 65/Affordable Care Act market for the first time and along with Ambetter (more competitively positioned) gained substantial membership. This proved to be significant competition to Independence Blue Cross, which has dominated the market with over 90% share and had not faced a formidable competitor since 2016 when Aetna and United Healthcare last offered plans in the area (neither has returned to this market yet for ACA compliant Individual and Family Health Insurance Plans). Pennie.com is the State-Based marketplace for the Pennsylvania, with most carriers offering “off-exchange” plans directly (Do It For Me Insurance assists with both with no fees for service).

Having a Blue Cross and now a Blue Shield in the market continues to cause a great deal of confusion. The average consumer is still unaware that Blue Cross and Blue Shield companies can be completely different entities and are merely independent franchises of the Blue Cross and Blue Shield Association. Highmark, for example, not only insures the entire state of Pennsylvania, except until 2024 the 5-County Region of Philadelphia (Bucks, Montgomery, Chester, Delaware, and Philadelphia counties), but also all of Delaware, West Virginia, and parts of New York. Up until recently, it was understood that no two Blue Cross or Blue Shield entities could exist within a single market. If a company such as Horizon Blue Cross Blue Shield in New Jersey happened to be both a Blue Cross and a Blue Shield, then no other Blue Cross or Blue Shield could enter that particular market. That restriction has been lifted recently, and big changes are inevitable in the future for markets nationwide. More information can be found at: https://www.bcbssettlement.com.

Aside from the new carrier options, there were several technical issues with billing and confusing notices sent out in error. Existing policy holders received new member identification and policy numbers without making any plan changes, leading to confusion among doctor offices in the region. This lead to providers telling members that their coverage was not valid or canceled when it wasn’t. Some billing errors were unbelievably excessive, but fortunately, most of them are being resolved. Do It For Me Insurance has extensive experience in handling this nature of issues, providing assistance to consumers since 2012. Just when we believe we have seen it all, new challenges arise, keeping us on our toes. We continue to learn while addressing the recurring legacy issues. Some members received letters stating they were no longer in the service area, even though they hadn’t moved and the carrier hadn’t left the region. These letters turned out to be technical errors and didn’t affect coverage in the majority of cases. Additionally, letters were sent out without subsidy amounts applied to the overall bill, and the list goes on.

In the Garden State of New Jersey, across the Delaware River, the most significant change in 2024 was the reentry of United Healthcare into the scene. This marked their return to offering plans through the GetCoveredNJ State-Based Marketplace, a first since 2016 when the state relied on the Federally Facilitated Marketplace (Healthcare.gov). United Healthcare’s plans closely resembled those offered by their competitors, with a comprehensive network covering the entire state. Notably, Aetna has seen a steady increase in membership, as they entered their second year of offering plans through GetCoveredNJ. The Silver 2 plan continues to be a popular option, delivering excellent value and leveraging a robust state-based Aetna Whole Health NJ Network.

Horizon Blue Cross Blue Shield has decided to restrict network access on the Omnia Gold EPO, which, up until Plan Year 2024, had been the only plan they offered with National Blue Card access. This now means that none of Horizon’s Individual ACA plans will allow for out-of-state use, except for emergencies. As far as we know, Ambetter/Wellcare is the sole carrier that permits access to multiple states with all their plans, as long as Ambetter providers are available in the area. It’s important to note that there are no plans that offer out-of-network benefits. Aetna is unique in that customers can visit any CVS Minute Clinic in the country to receive treatment.

Currently, there are no ACA-compliant plans with PPO networks available throughout the entire state of New Jersey. This applies to both options offered by GetcoveredNJ and plans obtained directly from Insurance Carriers “Off-Exchange”. New Jersey presents unique challenges as it does not permit certain options that are available in other states, such as Short Term Medical plans or most Indemnity plans like Aflac. In New Jersey, the sale of association products, including those offered by Christian Ministry/Healthshares, is permitted. Consumers are advised to give careful consideration to these options.. It is crucial to understand that these Healthshares are NOT HEALTH INSURANCE and are exempt from Affordable Care Act regulation. Therefore, they have the discretion to approve or deny claims. Make sure to thoroughly review all the details in the fine print. For instance, if a car accident happens while someone is under the influence of alcohol and the Healthshare denies the claim due to conflicting values, they have the full right to reject the claim, and there is little recourse available.

For many years, Delaware had only one insurance carrier, Highmark Blue Cross Blue Shield, offering compliant Individual Affordable Care Act Health Insurance. However, in 2023, the options expanded with the return of Aetna/CVS Health and the expansion of Amerihealth Caritas NEXT. Amerihealth, a long-time ACA carrier in New Jersey, is owned by the same parent company as Independence Blue Cross in the Philadelphia region. Amerihealth Caritas, another sister company, has traditionally focused on Medicare and Medicaid coverage in Pennsylvania but has in recent years expanded into other states. Along the way, they also ventured into the ACA market, offering Marketplace options in select states, including Delaware. In 2024, Ambetter joined the state of Delaware, following their established presence in Pennsylvania and New Jersey. Ambetter, along with WellCare (mainly offering Medicare products), is owned by Centene, a highly successful national company experiencing exponential growth. While Delaware has been recognized as an emerging Medicare market due to the number of senior citizens choosing to retire here, it is now also becoming an emerging market for Affordable Care Act/Marketplace plans.

Do It For Me Insurance is certified to assist consumers in the state of Maryland through their State-Based Marketplace known as Maryland Health Connection. In 2023, United Healthcare emerged as a strong competitor in Maryland, and in 2024, Aetna/CVS Health expanded its offerings into Maryland including both On and Off-Exchange options. Maryland consumers now have the freedom to choose from four insurance companies (depending on their zip code): Carefirst Blue Cross Blue Shield, Kaiser, United Healthcare, and Aetna/CVS Health.

Two more states, Virginia and Georgia, have chosen to develop their own State-Based Insurance Marketplace, joining the ranks of those who already have such systems in place. Virginia’s newly launched “Virginia’s Insurance Marketplace” bears a striking resemblance to Pennie, GetCoveredNJ, and Nevada Health Link, as they all opted to utilize the same vendor, GetInsured. This shared vendor arrangement is particularly advantageous for brokers like us who operate in multiple states, as it streamlines the process of adapting to a new system. Initially, there were concerns in 2020 when Pennsylvania and New Jersey announced their decision to work with this vendor, given previous issues with the rollout of Nevada Health Link. However, the vendor has surpassed expectations and now operates seamlessly. On the other hand, Georgia encountered some challenges during the launch of their new exchange, known as “Georgia Access.” For the year 2024, Georgia Access functions as a “state-based exchange using a federal platform” (SBE-FP), meaning that while the state manages the exchange, enrollment still takes place through Healthcare.gov. This arrangement is expected to change in 2025, transitioning into a fully State-Based Exchange. For more information, please visit: https://georgiaaccess.gov/about-georgia-access/#:~:text=During%20Open%20Enrollment%202024%2C%20Georgia,also%20known%20as%20HealthCare.gov.

With the exception of the specific states mentioned, all the other states we serve utilize the Federally Facilitated Marketplace (FFM) known as Healthcare.gov. For the Plan Year 2024, some carriers decided to expand into new states and areas within existing states, while others scaled back or completely withdrew. In recent years, companies like Friday Health and Bright HealthCare faced significant financial difficulties and had to exit markets altogether. Currently, according to their website, Bright HealthCare is only offering Medicare Advantage Plans in California, and Friday Health does not seem to provide coverage options in any state.

United Healthcare and Aetna/CVS have been expanding to new states and regions, offering competitive choices in numerous markets nationwide. Cigna remains a reputable name in the Health Insurance sector, but consumers should be aware of the limited networks associated with their (Likewise, this applies to the majority of national brands) ACA plans. It’s crucial to remember that Insurance Carriers, especially national ones, do not generate the same profit margins with Affordable Care Act Options as they do with Medicare Advantage Plans and Commercial “Group” plans. Hence, their offerings in this particular line of business may not appear as attractive and may come with significant network limitations. When evaluating a plan or company, always conduct thorough research on the plan and network. If Health Insurance were straightforward, there probably wouldn’t be a need for Brokers to provide assistance.

When it comes to Independent Insurance Brokers, similar to any other business, there are good and bad actors. A trustworthy Broker will always prioritize the best interests of their clients, but unfortunately, others may have different intentions. While fraudulent activities against consumers are unlikely to last long in the heavily regulated world of health insurance, some individuals persistently seek new and innovative ways to deceive. Typically, these bad actors operate out of call centers, not the reputable ones you see on TV, but rather the infamous “Rooms” where compliance and ethical conduct are disregarded. Although call centers of any size offer convenience and availability, reconnecting with the representative who initially assisted you can often prove challenging. The alarming rise in fraudulent practices necessitates extreme caution when sharing personal information with any entity. At Do It For Me Insurance, we adhere to the requirements and regulations set by The Centers for Medicare and Medicaid Services (CMS) and have incorporated their Consent Form on our website. This form ensures that we operate solely within the boundaries of your trust, and you retain the ability to revoke access at any time. Access our Consent Form here!

In closing we want to leave you with our usual words of guidance. Pay attention to any official notices sent via mail or email by your state exchange or carrier, requesting documentation for income, citizenship, or related matters. If you would like us to review and assist in validating a notice before you respond, feel free to ask for our help. The exchanges provide ample time to supply the required documents, but they will terminate once those deadlines pass.

If you’re experiencing any billing issues or haven’t made your initial payment yet for January 1st or February 1st coverage, we suggest contacting your insurance carrier before the deadline. This will help ensure that your coverage hasn’t been cancelled and that you can be reconnected for a start date of 2/1/24 if needed. If you’ve been on autopay and noticed a change in price, we highly recommend reaching out to your insurance carrier to ensure that they are charging the correct amount for 2024.

Our commitment is to provide unwavering support to our clients throughout the year, without any charges. As long as we remain your trusted broker, we are compensated by the insurance carriers. This compensation is secured by listing us as your broker on your healthcare.gov application or by connecting us through your state-based marketplace account. You can find more information about this in the “Fee Free Help” dropdown menu on our website.

If we are not currently serving as your broker, please feel free to contact us! Our purpose is to assist any consumer in need, regardless of whether you enroll in a plan or not. We hope that our assistance will leave a lasting impression. Whether it’s you or someone close to you who requires our help in the future, we will be there to provide support!

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