California IFP Health Agents HBEX Reminder

[bobson]

The exchange in Utah pays $37.00 per head per month, right? $37.00 for an individual, family.....how does that work?

That seems high. It will be cut if that is the case. On the exchange you will have a platinum, gold, silver, and bronze package. Why do they need help?

 

[somarco]

On the exchange you will have a platinum, gold, silver, and bronze package. Why do they need help?

Because the navigator's are idiots.

Have you ever tried to get help from a govt entity?

 

[Yagents]

That seems high. It will be cut if that is the case. On the exchange you will have a platinum, gold, silver, and bronze package. Why do they need help?

Because they won't be as standardized like med supps. The only thing each metal plan will have in common is their actuarial value, and covering (to varying degrees) the 10 essential health benefits.

Med supps have 5+ different plan letters, is easier than buying an exchange plan, and seniors still prefer an agent's assistance.

 

[Dave020]

Lots of rules in addition to plan differentials (in addition to network, formulary and so on). So far they are not in favor of plan standardization.

No Catastrophic level plan for anyone over 30 and not on a valid waiver.

250% FPL and below are prohibited from buying at the Gold or Platinum levels. Limited to Silver or Bronze only.

Some people are going to be subsidy-eligible and Medicaid eligible as duals and may have to buy in the exchange or may be exempted from the exchange.

And much more.

 

[Yagents]

So, lower income are going to be required to buy a plan that has higher out of pocket costs? If I were getting 80% premium subsidies, I'd want the cadillac plan.

 

[Dave020]

One other concern is the Gold and Platinum plans attracting the most adverse risk. Those between 251% and 400 FPL with subsidy eligibility who have severe medical conditions may rush to the highest level coverage plans creating an adverse selection problem. In CA the carriers are apparently aware of this and there is concern in the HBEX whether carriers might choose not to offer plans in the Platinum and Gold levels.

Lots of details need to be worked out.