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January 2014 Group Insurance Analysts Newsletter


In this issue we will discuss more on health reform (The ACA), and Home/Auto insurance.

Haystack Help Radio and The Source, 560 KLZ

Tune in every other Thursday from 4-5 pm on 56 KLZ on the AM dial as GIA will join Scott Whatley, the host of Haystack Help radio, for insurance related issues and updates. GIA has been a regular guest on the show for the past 18 months and now will be on for an hour every other Thursday. The next show is 1/23/14, then again on 2/6/14 and 2/20/14, and every other Thursday thereafter.  This is also a great way to call in with insurance related questions.


Health Reform (The Affordable Care Act) Updates

Applications for new health insurance policies will be accepted up to March 31, 2014 at which time the initial open enrollment period will end. The lock in period will be from April 1 until December 31, 2014 in which new enrollments will not be accepted unless there is a qualifying event, such as the involuntary loss of coverage.

On November 15, 2014 the 2015 open enrollment will begin for policies with a 1/1/2015 effective date. That enrollment period will be open until 1/15/2015. Due to the new enrollment period guidelines, it is important to understand that people cannot go out and buy a policy just when they need it. All policies must be purchased during an open enrollment period, or if there is a qualifying event.


What About Your Insurance?

The following is what you can expect based on your individual situation:

  1. Grandfathered health policies will not be cancelled due to the requirements of the ACA. However, a consumer with a grandfathered plan may drop that plan in favor of a new, ACA compliant plan up until 3/31/2014, or they will need to wait until the next open enrollment period.
  2. Non grandfathered policies are set to cancel at their 2014 renewal date. Many of these policies early renewed late last year and will be good until the end of 2014. If an existing policy cancels during the lock in period, it is considered a qualifying event to purchase a new policy.
  3. It is possible that an existing non grandfathered policy could be modified to become ACA compliant if that policy is close enough in structure to allow the change by amendment. Most existing policies are too lean to be allowed to be modified by amendment to meet the ACA requirements and won’t be given that option.

A grandfathered plan is one that became effective prior to 3/23/2010.

Updates on Individual and Family (non group) Health Plans

As we had anticipated, the huge last minute rush to sign up for a policy effective 1/1/14 has caused a severe logjam with the insurance companies. Many people are still waiting for ID cards, policies, and premiums statements. Please be patient as many of us are working overtime to get these issues resolved.

Help With Premiums

Households with income less than 400 percent of the Federal Poverty Level (FPL) may qualify for premium assistance through an advanced premium tax credit when purchasing health insurance through the State Insurance Exchange, called Connect for Health Colorado. However, to qualify for assistance you cannot have access to other affordable health coverage such as Medicare, Medicaid, CHIP, or affordable employer based group coverage.
Under the Affordable Care Act (ACA), states must expand Medicaid eligibility to include non-disabled childless adults.  (Prior to the passage of ACA, states could only cover this population through a Medicaid waiver or through a program that was completely state-funded.)  There is, however, confusion about the income threshold at which this new population is Medicaid-eligible, with some sources citing 133 percent of the federal poverty level (FPL) and others citing 138 percent.

Going forward, states should be sure to include childless adults up to 138 percent FPL when planning and modeling Medicaid expansions.  SHADAC’s Data Center allows the calculation of insurance coverage by characteristics related to health reform, including the 138 percent FPL income category

2013 Poverty Guidelines for the 48 Contiguous States and the District of Columbia

For families/households with more than 8 persons, add $4,020 for each additional person.



Newest ACA Figures Show Enrollment Surge, Low Youth Sign-Up

On Monday (1/13/2014), the Department of Health and Human Services released an Affordable Care Act enrollment update, news which received heavy print and online coverage, though just one nightly news broadcast mentioned the announcement. Demonstrating the Administration’s take on the news, HHS Secretary Kathleen Sebelius touted a total enrollment so far of six million Americans in an upbeat blog post, before highlighting several people who have benefited from the law. However, despite the Administration’s optimism, most of the outlets characterized the release differently, noting just 2.2 million sign-ups so far have been for private insurance and pointing out–many on their front pages–that far fewer young people have applied than is thought necessary for the law’s success.

Scott Pelley, on the CBS Evening News reported that on Monday, the Administration “put out new numbers about who is signing up for health insurance under the Affordable Care Act.” Pelley noted that “young adults, 18 to 34 years old, make up only 24 percent of the total so far” although, for the ACA to work properly, their share needs to be “closer to 40 percent, to subsidize older, sicker Americans.” In Colorado, the share of young enrollees was even less, coming in at 22 percent.

Individual Mandate

2014 begins the first individual mandate requirement for health insurance where those without a qualified health plan for more than three months in 2014 will pay a tax penalty. In 2014, the penalty is 1% of income or $95 whichever is greater. The penalty rises in 2015 to 2% of income and in 2015 it is 2.5% of income. People covered under Medicare, Medicaid, and employer group health or retirement plan, or under a qualified individual health plan are exempt from the penalty.

Small Group Health Plans

Small employer health plans will be required to comply with the requirements of the ACA effective 1/1/2014 or their first renewal thereafter.  If your health plan renews May 1, 2014 then you can retain that plan until then, unless you want to switch to an ACA compliant plan for 1/1/2014. Some of the insurance companies will offer early renewal options for December 1, 2013 to allow employers to keep that plan until 12/1/2014.

To determine whether you should keep your plan until renewal, early renew, or switch to a new, ACA compliant plan for 1/1/2014, we will need to consider several factors. First, are you getting the small employer tax credit. If you are and want to continue to get that tax credit, you will need to buy your plan through the new SHOP Exchange effective 1/1/2014. Enrollments for the SHOP Exchange will be ongoing throughout the year and we will be able to assist you with that process. Other considerations will be what are your current premiums, your plan design(s), employer contribution, employee participation, and how busy you might be in the fourth quarter.

Medicare Annual Election Period

The Medicare Annual Election Period (AEP) is now over for 2014. However, there is still an SEP available until February 28, 2014 for anyone that was involuntarily cancelled off a plan for 1/1/2014. Also, the Medicare Annual Disenrollment period (ADP) from 1/1/4 through 2/14/2014 allows anyone on a Medicare Advantage plan to disenroll and go back to original Medicare and a stand alone Rx plan. It does not guarantee acceptance into a Medicare supplement.

Winterize Tips for Your Home

If you are at the Home:

  • Wrap insulation around water heater & pipes
  • Add a small amount of anti-freeze in both tank & bowl of each toilet
  • Consider purchasing a low temperature sensor & heat /freeze alarm monitor
  • Clean gutters to avoid clogging & prevent ice dams where water backs up, freezes & causes water to seep into your house

If you are Not at the Home:

  • Shut off water systems by turning off the pump or shutting the valve if on city water
  • Drain the pressure tank
  • Open all faucets
  • Break a union close to the valve so water will drain out clear to the shut-off valve
  • Drain pump & run a second or two to be sure all water is out of lines from the pump
  • Flush toilets & dip all water out of the flush tank or put in some anti-freeze
  • Be sure to drain flexible spray hoses in showers & sinks
  • Drain water heaters & softeners

Updates on Auto and Home Insurance

GIA Risk Management, LLC is considered to be one of the fastest growing, locally owned, independent P & C insurance agencies in Colorado. We do this by contracting with many different insurance companies so that we can offer our clients the choices and options they seek. Because we are not employed by one insurance company, we can truly represent the needs of our customers.

Insurance companies use many different criteria to determine rates, which is why rates can vary dramatically from one insurer to another. Some insurers have very low rates for those with exceptional credit, while other insurers might be better for teenage drivers. This is why it is so important to review and shop insurance coverage’s.

As you are probably aware already, the recent weather related events in Colorado and the rest of the United States is causing significant increases in property insurance for the first time in several years. Some large insurers are now refusing to write property insurance on a stand alone basis, but only as part of a package with an auto insurance policy. Other insurers are offering larger discounts for bundled policies, or putting restrictions on roof damage from wind and hail.

As weather related claims hit, most homeowners need to be aware that standard homeowner’s policies do not cover damage from flooding. Earthquakes are another standard exclusion. Flood insurance is a separate policy that can be purchased in addition to your homeowners insurance even if you are not in a flood plain. If you don’t have flood insurance and a severe rains storm floods your basement, that damage will not be covered. If you are interested in a quote for flood insurance, please let us know.

As independent brokers, we shop the market to help our customers find the right coverage at the best price. This is a value proposition that is difficult for a captive agent to match.

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