Jonathan Edewards

Could Consumers Actually Benefit from the Silver Surcharge?

Silver 70 plans through Covered California are being surcharged.

How to avoid the surcharge.

There are several methods.

First, do you even need to avoid it? Covered California plans that are being substantially subsidized with an Advance Premium Tax Credit (APTC) don’t need to avoid the surcharge. If fact, these people could actually benefit from the surcharge.

The reason is due to the complicated formula for calculating the tax credit, which sets the Silver plans as the basis.  By surcharging just the Silver plans, everyone who qualifies for a tax credit (based on income) will receive a larger, more generous tax credit (APTC).

The tax credit (APTC) can be applied to Bronze, Gold, and Platinum plans, as well as Silver plans.

Bronze, Gold, and Platinum plans are not being surcharged.  Just the Silver plans that were purchased through Covered California are being surcharged.

Therefore, some people who have incomes low enough to qualify for a substantial tax credit (APTC), but high enough to be ineligible for the Silver 94 or the Silver 87, will find the Gold, Bronze, and Platinum plans to be a relatively better deal as a result of the more generous ax credit (APTC).

But, do you have enough coverage?

Be careful about purchasing less or more coverage than you actually need merely for the purpose of avoiding the surcharge.

The Bronze plans are much less coverage.  Be careful about the Bronze plans!  The Bronze plans have a very high deductible, and you could wind up with lots of medical bills that you didn’t anticipate.  In general, the Bronze plans are for risk-tolerant, healthy folks who don’t actually plan to fill prescription drugs, have labs, x-rays, MRIs, surgeries, etc and won’t be pregnant, and they have cash reserves of several thousand dollars to pay for unexpected medical bills that arise.

The Gold and Platinum plans have more coverage than Silver 70 and Silver 73 plans.

Thinking about your coverage needs:

How have you used your healthcare in the past year? Did you find that you were paying more out-of-pocket than you expected when you visited the doctors, had lab tests, bought pills, or had surgery? In 2018, do you expect any surgical procedures, hospital visits, or illness?

Email or call me at  (626) 765-4495  we can discuss which plan is right for you.

 

What needs to be done now?

Call me at (626) 765-4495 to review your renewal options.

If you need to apply for new coverage altogether, or switch from an On-Exchange Covered California plan (the “Marketplace”), November 1st is the start of Open Enrollment, that’s when we’ll be able to submit new applications that take effect starting January 2018.

If you need assistance, please plan to call me in November to enroll in a new plan.

 

 


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Rates and Doctor Networks are changing.  Give me a call for assistance!  As a Covered California Certified Insurance Agent (CIA), I can help you:

  • Renew or Change your plan.
  • Make sure you’re getting the best value.
  • Help you qualify for the correct Tax Credit / Subsidy. (And avoid mistakes that might haunt you at tax time!).
  • Know which plans have your doctors & hospitals “in-network,” and which plans do not.
  • Figure out billing issues and answer other questions.
  • Provide an alternative to waiting on hold with Customer Service hotlines.
  • Troubleshoot.

No Cost to You – No Extra Fees.

www.citrust-insurance.com

 CALL:
626-765-4495

626-765-4495

www.citrust-insurance.com

 

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Anthem Blue Cross discontinues Individual Health Insurance plans in Southern California, as Trump administration destabilizes markets

Anthem-ID-card-Sample-non-renewalSome California consumers received an email in August from Anthem Blue Cross, announcing that Anthem will discontinue their health insurance plans starting in January .

Persons living in Southern California with individual coverage* through Anthem Blue Cross will have their coverage terminated on December 31st, and will need to switch to a different health plan.

It’s my opinion that Anthem made this decision due to the uncertainties created by the Trump administration and the Republican party in Congress, among other things. Anthem is also discontinuing plans in the entire states of Ohio, Indiana and Wisconsin, but they will continue to cover the rural areas of Northern California, and they will continue to provide dental & vision coverage, Group medical plans to businesses/employers, and Medicare products.

Don’t worry–there are other options

The good news for those consumers is that there will be some solid, stable options for you to switch to in 2018. At least two other companies have announced that they will offer a PPO health insurance policy (and there are also lots of HMO options). I’ll be working with my clients to make sure we choose a plan that covers their doctors and hospitals.

“Blue Shield” plans are not affected and will continue in 2018

Many people hear the word “Blue” and confuse the insurance company “Blue Shield of California” with “Anthem Blue Cross.” In the state of California, “Blue Shield” and “Anthem Blue Cross” are two entirely separate insurance companies. This confusion is understandable because others states typically have some version of a “Blue Cross Blue Shield” insurance company (they are all related by a common association, but that’s it—just an association). The insurance company “Blue Shield of California” is a San Francisco-based nonprofit health plan founded in 1939 by the California Medical Association, and it operates only in the state of California. Blue Shield has announced that it is strongly committed to continuing in 2018 and beyond, and most people with Blue Shield plans will receive an offer to renew their coverage.

What needs to be done now?

For now, nothing. Active Anthem plans will continue with no changes for the remainder of 2017. We can begin to look for replacement coverage starting in November. November 1st is the start of Open Enrollment, that’s when we’ll be able to submit new applications and changes that take effect starting January 2018.

If you need assistance, please plan to call me in November to enroll in a new plan.

If you’re itching to take action now, you can:

  • Take a deep dive into the details here – Page 62 shows the rate changes for Western portion of Los Angeles county.
  • Review your other insurance policies… I also help people with auto & home insurance. A similar situation is occurring with auto insurance, due to the fact that claims have risen as people have been driving more miles, cellphones/texting has increased the number of crashes, and medical costs are increasing. Many auto insurance companies are raising rates and a few are exiting the market. You can get an instant online auto insurance quote on my website: http://www.citrust-insurance.com or call me call / text me at 626-765-4495

I’m planning to do a Facebook Live broadcast next week to answer questions… stay tuned!

Although the nightly news may seem dire, we’re fortunate to be living in California, where we have it much better than the rest of the country. Be well!

 

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*Exception: Persons who purchased their individual plans prior to 2010 and did not convert them into new ACA plans (“Grandfathered” plans) may be able to keep those grandfathered plans in 2018. This is relatively rare.

Also, parts of Northern California will be offered renewal. According to Anthem’s blog post,

…. we’ll offer plans in three regions of Northern California only, which will include Region 1 (Redding/Far North), Region 7 (Santa Clara County), and Region 10 (Stockton/Modesto). The coverage will include an Exclusive Provider Organization (EPO) plan and will be available both on-exchange and off-exchange, and at all metal levels. Q: Which counties are included in the regions you’ll offer plans for 2018? A: Region 1 includes Alpine, Amador, Butte, Calaveras, Colusa, Del Norte, Glenn, Humboldt, Lake, Lassen, Mendocino, Modoc, Nevada, Plumas, Shasta, Sierra, Siskiyou, Sutter, Tehama, Trinity, Tuolumne, and Yuba counties. Region 7 includes Santa Clara County. Region 10 includes Mariposa, Merced, San Joaquin, Stanislaus, and Tulare counties.

 


Jonathan-Edewards-Citrust-Insurance-2017-500

 

Rates and Doctor Networks are changing.  Give me a call for assistance!  As a Covered California Certified Insurance Agent (CIA), I can help you:

  • Renew or Change your plan.
  • Make sure you’re getting the best value.
  • Help you qualify for the correct Tax Credit / Subsidy. (And avoid mistakes that might haunt you at tax time!).
  • Know which plans have your doctors & hospitals “in-network,” and which plans do not.
  • Figure out billing issues and answer other questions.
  • Provide an alternative to waiting on hold with Customer Service hotlines.
  • Troubleshoot.

No Cost to You – No Extra Fees.

www.citrust-insurance.com

 CALL:
626-765-4495

626-765-4495

www.citrust-insurance.com

 

How long does a traffic violation, accident, or suspension stay on my Motor Vehicle Record (MVR) and drive up my insurance rates?

Answer: at least 3 years (36 months).  This is standard across all insurance companies in California.

DUIs: 10 years.

License Suspension (including for “Failure to Appear”): 5 years, depending on the insurance company.  Insurance companies have some flexibility on what they can decide to charge for, so some insurance companies may be more lenient than others on suspended licenses, if the suspension is due to a technicality.

At-Fault Accidents: 3 years, if the damage caused by the accident exceeds $750 (some companies $1,000) or if the accident resulted in bodily injury or death.

Exceptions:  Non-Chargeable Violations include:

  • Most parking violations.
  • Bicycle or Moped violations
  • Emission Control (Smog) Violations.

 

 

 

Type of Violations, by the severity of the surcharge:

MINOR

  • Failure to yield
  • Driving on the shoulder
  • Defective equipment

MINOR PLUS

  • Red light / stoplight violation / stopsign

SPEEDING

MAJOR

  • Reckless driving
  • Refusal to test
  • Drag racing

 

Need Help?

Call me at 626-765-4495

or

Get an instant online quote on my website: www.citrust-insurance.com

Southern California Earthquake Risk Increases; Most Homeowners Uninsured

A sudden flurry of minor earthquakes at the tip of the San Andreas Fault has seismologists worried that the “Big One” could be triggered, the Los Angeles Times reports. In any given week, the normal risk of a major quake that would cause homeowners and commercial property owners in Greater Los Angeles to lose their properties is about 1 in 6,000, scientists estimate. This week’s swarm of quakes dramatically increases the risk of a major (7.0+) quake occurring within 7 days to as low as 1 chance in 100. Read the Los Angeles Times article here.

 

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Despite the annual warning notices that insurance companies mail to homeowners, most property owners have let their earthquake insurance policies lapse or have never purchased coverage, and would lose their home or business if an earthquake levels it. For the past decade, there have been few options to purchase earthquake insurance, and policies came with such high deductibles (15%) that homeowners were discouraged and opted to forgo coverage and take the risk.

In recent months, new earthquake insurance policies have become available with improved coverage.

Under the previous offerings, a 15% deductible meant that a home insured for $500,000 had to sustain at least $75,000 in damage for the policy to pay a claim; faced with the thought of having to pay the first 15% of their home’s insured value, many homeowner preferred to ignore the risk altogether.

(Notice that fine point: the earthquake deductible applies to a % of the insured value, not a % of the damage.) For example, if an earthquake hits a home insured for $500,000, and the earthquake causes minor cracking of the foundation and walls, and also results in water damage from a burst pipe, and that damage costs $100,000 to repair, the claim would be settled like this:

$100,000 repair cost – (15% x $500,000 insured value) = $25,000 claim payout.

New Earthquake Insurance Policies are closing the gaps in coverage that older policies contain.

The new earthquake insurance policies now offer lower deductible options: 5% or 10%. That means that homeowners can sleep better at night! It’s much more comforting to know that your earthquake insurance policy will pay the cost to rebuild or repair your house in the event of an earthquake without having to take a out a loan to cover the policy’s deductible.

In addition, some of the new earthquake policies now include substantial coverage for swimming pools, walkways, driveways, patios, and retaining walls. Most earthquake policies limit coverage on those items to just $3,000 or so. Clearly, $3,000 would not be sufficient to replace a swimming pool or a lot of paving/decking. The new policy options can take care of those items, too, if you are careful to purchase a policy that specifically provides that coverage.

For advice and help obtaining earthquake coverage for yourself or your business, contact Jonathan Edewards at Citrust Insurance at 626-765-4495 or GetHelp@Edewards.com.

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For advice and help obtaining earthquake coverage for yourself or your business, contact Jonathan Edewards at Citrust Insurance at 626-765-4495 or GetHelp@Edewards.com.

 

How President Abraham Lincoln obtained a last-minute insurance policy the night before leaving for Washington D.C. to be inaugurated.

 

Like any American homeowner, Abraham Lincoln was rightfully proud of his home in Springfield, Illinois, the only home he ever owned. All of his children had been born there, and he made many improvements, even adding a second floor to accommodate his growing family.

On February 10th, 1861, on the eve of Lincoln’s departure for Washington DC for his first inauguration, his home in Springfield was buzzing with friends and well-wishers.  But there was work to be done that night, and Lincoln had asked his old friend, Hartford insurance agent James J. Hill to help, because he was planning to rent out his home while he was living in the White House.
Lincoln sought the protection and security of a fire policy from The Hartford.  Carefully measuring the rooms, and even providing a discounted premium for Lincoln’s new wood stoves, Agent Hill worked long into the night to diligently write the $3,200 insurance policy that Lincoln would sign the next morning before departing for Washington DC.
Jonathan Edewards is an independent insurance agent in Pasadena, California who is proud to continue the work of insuring homeowners and business owners, and represents quality insurance companies such as The Hartford, Safeco Insurance, QBE, and others.
[UPDATE SEPT 2017:  Unfortunately, due to poor loss experience (higher than anticipated claims) The Hartford has discontinued issuing new Homeowners & Auto policies in the state of California. They will continue to offer Business Insurance and other types of insurance and financial products.]

“Small Group” Health Insurance – why rates are increasing, and the difference between “Grandmothered” or “Grandfathered” plans vs the new “ACA” plans

January 2016: No more “grandmothered” health insurance plans, and now any employer with 1 to 100 employees is considered a “small group.”

Employers who have more than 50 employees* are now required to provide health insurance, or face a large tax penalty.

 

This infographic, published by Anthem Blue Cross is very helpful for explaining:

“Why are small group health insurance rates increasing?”

and

“What is the difference between the way that the new “Obamacare” /  Affordable Care Act (“ACA”) plans are rated vs the way they were rated previously?”

 

Why are small group health insurance rates increasing, and what is the difference between the way that the new "Obamacare"/ACA/Affordable Care Act plans are rated vs the way they were rated previously. The explanation is: 1. No more "discounts" (previously known as a "RAF"). 2. In many cases, the new ACA plans have better or increased benefits that are mandated by law. The new plans cover more. 3. New regulations regarding how plans charge consumers, designed to spread the cost more equally among the population, so that there are fewer instances of some people paying very little and some people paying extraordinarily high rates. This benefits people who are sicker and older, or who live in areas where hospitals and doctors charge more, and it hurts people who are young, healthy, or live in areas where healthcare costs are very competitive.

Essentially, there are three fundamental trends:

  1. No more “discounts” (previously known as a “RAF”).
  2. In many cases, the new ACA plans have better or increased benefits that are mandated by law.  The new plans cover more.
  3. New regulations regarding how plans charge consumers are designed to spread the cost more equally among the population, so that there are fewer instances of some people paying very little and some people paying extraordinarily high rates.  These new regulations on rates benefit people who are sicker and older, or who live in areas where hospitals and doctors charge more, and the regulations hurt people who are young, healthy, or live in areas where healthcare costs are already very competitive.

* 50 employees = the sum of all your full time employees plus “full-time equivalents.”  Call us at 626-765-4495 for a full explanation.


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Rates and Doctor Networks are changing.  Give me a call for assistance!  As a Covered California Certified Insurance Agent (CIA), I can help you:

  • Renew or Change your plan.
  • Make sure you’re getting the best value.
  • Help you qualify for the correct Tax Credit / Subsidy. (And avoid mistakes that might haunt you at tax time!).
  • Know which plans have your doctors & hospitals “in-network,” and which plans do not.
  • Figure out billing issues and answer other questions.
  • Provide an alternative to waiting on hold with Customer Service hotlines.
  • Troubleshoot.

No Cost to You – No Extra Fees.

 CALL:
626-765-4495

626-765-4495

Breaking News! Cedars-Sinai Joins Blue Shield PPO Network—March 2015

In-Demand Hospital finally becomes accessible to many residents who live on Los Angeles’ West side.

On January 26, Cedars’ website was updated to show Blue Shield’s Individual and Family Plan (IFP) PPO options as “in-network”.

Screenshot of cedars-sinai.edu taken on1/29/15

Screenshot of Cedars’ Insurance Page taken on 1/29/15.

These plans are available both “on-exchange” (through a Covered California Certified Agent) and “off-exchange” (directly through a Blue Shield agent).  There is no difference between “on” and “off” exchange plans; simply a different method of submitting an application for coverage.  (Purchasing an on-exchange plan is the only method to apply for a tax credit/subsidy, however).

Blue Shield’s plans have been the lowest-cost PPO plans available in LA County for the last two years, but the lack of access to Cedars-Sinai was previously a disadvantage that was a deal breaker to many people who live nearby in West Hollywood, Beverly Hills, and Los Angeles, or who value the hospital’s excellent reputation.Print

Now, many people may consider switching plans to take advantage of the premium savings.  However, the opportunity to change plans (or enroll in a new plan) closes with the end of Open Enrollment on February 15, 2015.

Blue Shield also offers excellent Dental and Vision Insurance options, but only when enrolling “Off-exchange”. (Covered California has plans to offer Dental options, but the rollout has been delayed.

If you would like to explore your options with Blue Shield (or any other insurance company) call me at 626-676-3466 and I’ll be happy to provide advice and assistance.

Or, click THIS LINK or the photos below to explore your options online.

 

 

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What do you need Liability coverage for?

The liability coverage on your homeowners or renters insurance policy covers you for your responsibility for property damage or bodily injury. It’s not always easy to think of an example, but here is a news article in which a homeowners insurance policy paid $100,000 to a man who broke his spine in the course of a search and rescue attempt.

http://www.latimes.com/local/orangecounty/la-me-0117-hiker-rescue-20150117-story.html

How much is the penalty for not buying Health Insurance?

Starting January 1, 2014, most consumers must have health insurance. This may be through your employer, coverage you buy for yourself, Medicare, or Medi-Cal.

Consumers who don’t have health insurance may have to pay a penalty called a “shared responsibility fee” that increases each year up to a maximum amount.

2015: The fee is 2% or $325 per adult, plus kids.

In 2015, the fee is 2% of the annual household income, or $325 per adult, whichever is higher.

In 2016, the fee increases to 2.5% or $695 per adult, whichever is higher.

For example, the chart below shows the penalty with the maximum for an uninsured household of four:
Health-Insurance-Penalty-Fee-2015-2016
If you’re uninsured for just part of the year (longer than 3 months), you pay a pro-rated penalty.  That is, 1/12 of the yearly penalty for each month you’re uninsured.

The penalty is due when you file your taxes at tax time.

Remember, if you are uninsured you also pay 100% of your medical costs.

The Good News: Help is Available.

If you can’t afford either the monthly premiums or the penalty, there is help available.  Call me at 626-676-3466 and we can discuss your options.

 

Your friendly insurance professional

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Give me a call for assistance!  As a Covered California Certified Insurance Agent (CIA), I can help you:

  • Renew or Change your plan.
  • Make sure you’re getting the best value.
  • Help you qualify for the correct Tax Credit / Subsidy. (And avoid mistakes that might haunt you at tax time!).
  • Know which plans have your doctors & hospitals “in-netowork,” and which plans do not.
  • Figure out billing issues and answer other questions.
  • Provide an alternative to waiting on hold with Customer Service hotlines.
  • Troubleshoot.

No Cost to You – No Extra Fees.

 CALL:
626-676-3466