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.

 


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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

 

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.]

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

Customer Service Matters – The Hartford

Will you be treated right?

When things go wrong–and even for every day needs like billing and showing proof of coverage–you want an insurance company that responds quickly and efficiently.  An insurance agent can help you when the insurance company is slow to respond, but why not start out with the best?

When it comes to customer service and satisfaction, I think that The Hartford Insurance Company is one of the best available.  I’ve personally seen The Hartford respond time and time again, and they are unfailingly pleasant and eager to help.

If you aren’t receiving the customer service that you’d like, and you are losing money because you are wasting time trying to fix insurance problems, call me and we’ll get you started with The Hartford immediately.

 

[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.]

Santa Ana Winds Topple Pasadena Trees, Insurance Claims Result

How a personal insurance agent can help you recover from a personal or commercial loss.

The fiercest winds in 50 years caused a lot of damage in Pasadena and Los Angeles on Wednesday.

This unlucky Volvo was crushed by a toppled tree

On the street where I live, I saw at least 2 cars that had been crushed by huge tree limbs that fell on them, smashing the roof and windows.  “Comprehensive” auto insurance coverage, also known as “other-than-collision,” is devised to help an insured recover from just such a loss.  It also provides coverage from theft. Home owners and business owners whose awnings blew away, or whose roofs were damaged, or windows broken, or who lost business due to a power outage, should be able to recover the loss from their property insurance. Businessowners’ policies even typically provide some coverage for plants, shrubs, and trees (usually limited to $2,500 or less per plant), and may be able to include the cost to replace the trees that were torn from the ground in their claim. The fastest and easiest way to report a claim is to call the insurance company claims hotline directly.  My Safeco Insurance clients should call 800-332-3226. Insureds who have bypassed an agent by purchasing insurance online, or directly from the insurance company, must call their claims hotline, and have no other alternative. However, an insurance agent provides a second alternative to contacting the insurance company directly and dealing with the claims hotline.  My clients know that they can always call me for assistance with the claim. Having an agent is valuable for (at least) two reasons: an agent has a personal, continual relationship with you and should be familiar with your special situation already.  Less time is spent gathering information and correcting misunderstandings.  Secondly, an agent is familiar with the “inside contacts” within an insurance company, and can help a client “go up the ladder” if a problem arises and the claim is not handled to the client’s satisfaction. For example, I recently assisted a business client who had experienced an costly auto accident.  The dealership, where the Mercedes had been taken for repair, was backed up and not cooperating with the claims department.  After several non-responses, and an estimate that was close to the car’s value, the insurance company moved to declare the vehicle a total loss, rather than proceeding with repair.  The insured preferred to repair the vehicle. I intervened with both the dealership and the claims department, pointing out to the dealership that they were about to lose the repair business unless they offered better terms to the insurance company.  On the claims side, I contacted the manager of the claims department, reviewed the valuation report, noted that the vehicle’s condition was better than the report indicated, and thus a total loss would require a larger settlement than previously thought.  The vehicle was repaired, and my client was pleased. The insurance companies that I represent have excellent, fast, and friendly claim departments, and claims are handled to the customer’s satisfaction the first time around, which is why I recommend that clients make their initial report directly to the insurance company. But if the case goes awry, I’m available to assist. Pasadena will be green again, and the residents and businesses who are properly insured will be able to recover from their loss relatively painlessly.  That’s what insurance–and an insurance agent–is for.