Can Family Members Have Seperate Plans

[Blaize]

I have some questions and unable to get a clear answer from the Agent Help Desk at the WHPF. I hoped someone here might know about this and reply.

I have a family of three who have been determined eligible to receive a tax credit. Can they apply for separate plans or do they all have to be on the same plan? If they are able to choose separate plans would this affect their subsidy amount? I tried to make this change directly in the WHPF site but I could not find an option for this.

 

[tins]

I have some questions and unable to get a clear answer from the Agent Help Desk at the WHPF. I hoped someone here might know about this and reply.

I have a family of three who have been determined eligible to receive a tax credit. Can they apply for separate plans or do they all have to be on the same plan? If they are able to choose separate plans would this affect their subsidy amount? I tried to make this change directly in the WHPF site but I could not find an option for this.

It would screw them over all having separate deductibles rather than a family deductible.

 

[Blaize]

Let me add a bit more info, they are looking at the $2500 ded HSA plan, by having the plans separated they can keep the lower $2500 deductible on themselves instead of a combined $5000 family deductible. It doesn't change the price of the plan but would it change their subsidy amount?

 

[LGilmore]

Don't know if you've checked or not, I haven't but HSA plans before in WA had both individual and family deductibles in HSA Plan choices. If an individual hit their personal max, they were covered, the remaining family members had to hit their numbers. The other plan allowed for any combination to hit the family max. You might want to review to see if that's still the case.

 

[NWBenefitProvider]

Don't know if you've checked or not, I haven't but HSA plans before in WA had both individual and family deductibles in HSA Plan choices. If an individual hit their personal max, they were covered, the remaining family members had to hit their numbers. The other plan allowed for any combination to hit the family max. You might want to review to see if that's still the case.

My understanding is that Group Health is the only carrier in WA with an HSA that an individual deductible can trigger benefits even if more than one person is on the plan. All others list the deductible as aggregate, meaning the family deductible must be met before any one person gets the better coverage going.

Also, on the exchange, the GH Bronze plan is not HSA compliant, so you are out of luck there. There is a way to put families on different plans without it impacting the subsidy, but I haven't been able to figure it out. You will need to play around a bit or try waiting on hold another hour to get through to exchange help. LOL!

 

[Blaize]

NWB, that's right, my clients are looking at the Premera Silver HSA which does not have the embedded deductible so yes, with only three on the plan it makes sense for them to have separate deductibles. After 113 minutes of waiting on hold I was finally able to speak with a WHPF rep, she was a bit vague but did say I would have to create 3 new seperate accounts/applications but - before I do this I will need to go into the original joint account/application and change the application to show they do not want to apply for coverage and then in the new accounts I created do not add their social security numbers until I get to the household info page. If all goes well and the system doens't sieze up I can then find out what the new subsidies will be. Apparently the amounts can change and no one knows for sure until you set the whole thing up. The good news is (the rep assured me) I could revert back to the original setup if the client didn't like the end result. I have another call in for an account specialist, I am going to get a second opinion.

 

[NWBenefitProvider]

Yeah, I hope you have better luck than I have had on the exchange. I was hoping to get a few hundred enrolled initially, but it went so wrong so many ways!

I ended up with about 3 dozen and I refuse to take any more, because it is too much of a pain in the butt to deal with the issues and automatic pulling kids to medicaid in many situations. I can make more $$$$ with less hassle just working off exchange only.

 

[Blaize]

I wanted to follow up with this and say that it took me me most of Friday and the following Saturday to make the calls needed to get the insureds set up and policies issued. The people I spoke with at the WHPF are really nice and are helpful but it is so difficult to get someone to the phone. Until they get this website running smoothly and have a real instruction manual with all the little tax rules and details I am not going to pursue this type of business. I want to be helping but I can't spend 6 or 8 hours getting an application through and still stay in business.

 

[NWBenefitProvider]

Thanks for the follow-up. I agree that when you get them on the phone they are helpful, but I don't have the time to wait and try to get through. There are way more important things that need to get done. It is too bad though, because it really is frustrating a lot of people who are trying to get covered.