Network Issue BC TN

[vic120]

Hey anyone knows if there is a way to change plans now

Here is the problem, I purchase Ins on the exchange every year, Last couple of years I have been doing HSA with BC

I did check other plans, But ultimately decided to stay BC HSA

However, I did not realize BC had a new and additional Identical HSA

Went to doc today and got told I can't use Ins there because its a network L, not Network S

OK so I call BC they told me I can call exchange and they would let me switch to a BC Network S HSA same company same exact plan only a dif network think its like $100 or so more a month but OK She said I just need to call exchange

When I called though the woman told me I cannot make any changes under any circumstances, So why would BC say I could


OK if that is not an option what If I say made a few hundred more a month income change would that help?

or is that In done nothing can be done?

 

[goillini52]

Hey anyone knows if there is a way to change plans now

Here is the problem, I purchase Ins on the exchange every year, Last couple of years I have been doing HSA with BC

I did check other plans, But ultimately decided to stay BC HSA

However, I did not realize BC had a new and additional Identical HSA

Went to doc today and got told I can't use Ins there because its a network L, not Network S

OK so I call BC they told me I can call exchange and they would let me switch to a BC Network S HSA same company same exact plan only a dif network think its like $100 or so more a month but OK She said I just need to call exchange

When I called though the woman told me I cannot make any changes under any circumstances, So why would BC say I could


OK if that is not an option what If I say made a few hundred more a month income change would that help?

or is that In done nothing can be done?

Are there any SEP's available?

 

[LostDollar]

These are probably stretches, but with goillini's comment about seps

Enrollment or plan information display errors

• Misinformation, misrepresentation, misconduct, or inaction of someone working in an official capacity to help you enroll (like an insurance company, navigator, certified application counselor, or agent or broker) kept you from:
  • Enrolling in a plan
  • Enrolling in the right plan
  • Getting the premium tax credit or cost-sharing reduction you were eligible for
• A technical error occurred when you applied on HealthCare.gov -- you probably saw an error message when completing your application – that prevented:
  • You from enrolling in a plan, or
  • Your health insurance company from receiving your enrollment information
• The wrong plan data was displayed on HealthCare.gov at the time that you selected your health plan, such as benefit or cost-sharing information.

(The part I particularly wanted you to see is hidden at the bottom under the click to expand button)

From:
Special Enrollment Periods for Complex Health Care Issues

And a FEMA wind disaster declaration:
Designated Areas | FEMA.gov

 

[vic120]

These are probably stretches, but with goillini's comment about seps



(The part I particularly wanted you to see is hidden at the bottom under the click to expand button)

From:
Special Enrollment Periods for Complex Health Care Issues

And a FEMA wind disaster declaration:
Designated Areas | FEMA.gov

I don't know or probably it does not apply

I was a mistake an honest mistake but not wrong info on site it is just that The plan I enrolled in did not exist the year before there were not 2 Identical plans ther was only 1 HSA

So when I went through other plans and decided they were no good I just went to BC HSA with the deductable I had and signed without checking Network

I did not realize they opened a 2nd HSA identical with a lesser network

The reason I am not sure BC person is 100% correct is she also said there is a chance I can get it effective before the 1st of next month if I told exchange I have autistic child so I am pretty sure that is not accurate

But according to her, I Would be able to change

Because the New plan was Identical to the other plan (which is still offered and on On-exchange)

Its the same carrier both HSA both $5950 deductible 2 per family 50% coinsurance max out of pocket $13800

The only dif between the 2 is one is a smaller network L I needed the network S which I had on the last plan

The other difference is the correct plan was like $100 more

However, the reason I don't trust the exchange person she right away was and angry person kind of like going to an unemployment benefits person in NY years ago

She right away with attitude told me probably the insurance company changed the network and the plan I had no longer existed ( I already knew it was there)

There were several other angry statement she made before telling well there is no SEP for me and forget it

I was confused and said well why did you go through all these different excuses before telling me no sep she said I was just letting you speak I am trying not to be rude totally left me confused

 

[vic120]

These are probably stretches, but with goillini's comment about seps



(The part I particularly wanted you to see is hidden at the bottom under the click to expand button)

From:
Special Enrollment Periods for Complex Health Care Issues

And a FEMA wind disaster declaration:
Designated Areas | FEMA.gov

the 2nd option I thought of was a change of income I thought I remember something with a change of income I can change plans

The question is is there a specific minimum of change necessary to make a change

Last year I did not get a subsidy

This year I got small subsidy with same income as last year

would like a $300 a month increase open this opportunity or does it have to me much more

 

[LostDollar]

If the plan you want is offered both on and off exchange AND you are willing to give up the option of a possible subsidy refund when you do your income taxes, you may be able to drop your exchange plan and just purchase the other from BCBSTN off exchange.

I don't know this for a fact, but I don't think it makes any differences for the HSA account whether the HDHP plan is purchased on or off exchange as long as it meets the HSA HDHP requirements.

 

[vic120]

If the plan you want is offered both on and off exchange AND you are willing to give up the option of a possible subsidy refund when you do your income taxes, you may be able to drop your exchange plan and just purchase the other from BCBSTN off exchange.

I don't know this for a fact, but I don't think it makes any differences for the HSA account whether the HDHP plan is purchased on or off exchange as long as it meets the HSA HDHP requirements.

BC cross aid I cannot buy off exchange if I have exchange plan now Plus pre ex is a concern

I think my option would be change of income I would like to know more on how much is necessary to make a change

 

[scagnt83]

Yes. Change your income. Speaking from experience.

You cant change plans while enrolled on exchange, but if you cancel the on exchange plan you can enroll off exchange. But pre-ex is at play then.

Being self employed, you can manage to have an "income change" over 1 month and a new SEP will open up. You will need to provide documentation showing the income change.

If you are set up as a business entity you could possibly look at forming a group and do a group plan. Some states require 2, others require 3. If its 2 for TN just add on the wife. It might be cheaper with BCBS, might not. If you look at a Level Self Funded Plan from National General it will likely be cheaper, but not in the long run if you have a lot of claims.

 

[vic120]

Yes. Change your income. Speaking from experience.

You cant change plans while enrolled on exchange, but if you cancel the on exchange plan you can enroll off exchange. But pre-ex is at play then.

Being self employed, you can manage to have an "income change" over 1 month and a new SEP will open up. You will need to provide documentation showing the income change.

If you are set up as a business entity you could possibly look at forming a group and do a group plan. Some states require 2, others require 3. If its 2 for TN just add on the wife. It might be cheaper with BCBS, might not. If you look at a Level Self Funded Plan from National General it will likely be cheaper, but not in the long run if you have a lot of claims.

Thank You

I have a question What proof would they need?

Probably difficult to show over the short term I mean there is always ups and down more money spent on buis and less

I will make more this year But until the year is done and the accountant draws up papers I don't know what to show,, Yes I get quarterlies But I have spent more on buis over the last few months too However I pay annually for a lot of things

The problem with nay off-exchange plans is Pre Ex I have afib my youngest son is severely autistic Also I have paid his end of the deductible and most of the rest of your deductible

I have HSA and the only dif between the plan I am on and the one I was supposed to choose was network and about $100 dif a month Everything else is exact

Unfortunately, even though My son's stuff is all in-network I found out my and my wife's doctors are not, I didn't even realize till last month

 

[scagnt83]

Thank You

I have a question What proof would they need?

Probably difficult to show over the short term I mean there is always ups and down more money spent on buis and less

I will make more this year But until the year is done and the accountant draws up papers I don't know what to show,, Yes I get quarterlies But I have spent more on buis over the last few months too However I pay annually for a lot of things

The problem with nay off-exchange plans is Pre Ex I have afib my youngest son is severely autistic Also I have paid his end of the deductible and most of the rest of your deductible

I have HSA and the only dif between the plan I am on and the one I was supposed to choose was network and about $100 dif a month Everything else is exact

Unfortunately, even though My son's stuff is all in-network I found out my and my wife's doctors are not, I didn't even realize till last month

NP.

Fortunately, in the past at least, they were pretty lax on the requirements for proof. You could show a P&L statement, monthly "Pay Summaries", even bank records. Some type of documentation from the business showing that your income decreased by the amount needed to trigger SEP. (I think it was a 10% or 20% reduction if I remember off the top of my head)

I have not looked at it in a few years. But in the past it was based on monthly income. So if your income drops by the % needed for just 1 month, you can get a new SEP if you show proof.

If you normally dont keep a running P&L statement, or dont normally generate monthly Pay Summaries ... you are the boss... so start this year! lol. The Pay Stubs (summaries) are easy to create on word or powerpoint. Keep in mind that this is HHS reviewing the docs, not the IRS, so it doesnt have to be perfect or even look exactly a certain way.

Even if you are co-mingling funds and not moving funds to a personal account each month. You can still generate a pay summary or "income summary" for each month.


A potential issue you brought up though, if you switch plans, any money paid toward the deductible might not transfer over to the new plan. I honestly dont know the answer here (I only do group health professionally) ... but Id bet that it will not. BCBS should be able to tell you for sure. So depending on the amount paid already, you might want to bite the bullet and find a different provider this year for you and the wife who is in-network.

Keep in mind in the future, that providers within a network can change from year to year. So always be sure to run a provider check each year even if you are enrolling in the exact same plan and exact same network. ( I get that was not the case this time, just a possibility to keep in mind for the future)