The Health Exchange Time Table for California health insurance

We\’re now wrapping up 2012 (as of this writing) and bravely heading into 2013. There are all sorts of activity related to Health Reform in California behind the scenes (10000 rules were just released…yes..10000) but what can the California health insurance consumer whether individual or group expect in terms of important milestones and a timetable? Great question and one we need to start actually considering. Let\’s walk through the big items coming up on our schedule.

Summer of 2013 – Release of health plan benefits and rates

There won\’t be too much for California individuals and companies to actually do right away but that doesn\’t mean there Health Reform impacts are lacking. They\’ll mainly be occuring on the backend in terms of fees ($63/employee), taxes (payroll tax changes), and other requirements (SBS – Standardized Benefits Summary delivery for companies). The real changes will become apparent in the summer of 2013 when the carriers will start to roll out their new Health Exchange compliant plans (the Metallic plans) and rates. Health Reform mandated certain levels of benefits which California based on the Kaiser $30 copay plan with no deductible. We really need to see what the four levels (platinum, gold, silver, and bronze) really look like and more importantly, what the rates will be. We\’ve been warned that the new rates will likely be 30-50% higher than current, comparable coverage but it will be nice to put some hard figures in front of people to compare. This will apply to both individual and group California health insurance and it\’s the first step toward full implementation of Health Reform.

October 1st, 2013 – Can apply for qualified Health Exchange Plans

The carriers are required to be ready to accept applications starting October 1st, 2013 for a Jan 1st, 2014 health plan which conforms to the new requirements. October 1st will also begin the initial 6 month open enrollment window (October 1st through March 31st, 2014) for health Exchange plans. Any application submitted during 2013 will have a Jan 1st effective date while any application submitted after Jan 1st, 2014 will have the 1st of the month following the app submittal as the effective date. For example, if you submit an application Jan 15th, 2014, you\’ll likely receive a Feb 1st, 2014 effective date. The key point is that you can submit an application as of October 1st, 2013 for a Jan 1st 2014 effective date although we expect most people will wait till later as they try to assimilate all the information involved.

Jan 1st, 2014 – Health Reform plan change over for new and most existing members

Jan 1st, 2014 is the official kick off. If you are on a Grandfathered California health plan (effective date prior to 10/23/2010 with no changes), you will likely be able to continue on that plan although the number of these members continues to shrink. All other currently members will likely be rolled on to an equivalent plan and given the option to choose from any of the plans available. We feel that most people will choose the Silver in the Exchange (if they meet below 400% of poverty) or the Bronze plan outside the exchange (if they make more than 400% of poverty) which we\’ve discussed in other articles with more detail. New enrollees will also be able to choose from one of the four metallic plans (with a catastrophic option for younger people). Subsidies and Penalties will also go into effect Jan 1st, 2014 so this really is the big roll out of health reform.

Out years bring incremental changes to California health market

Beyond 2014, the end consumer will likely not see significant changes but there will be impacts. Penalties for not buying health insurance are scheduled to go up with each year. Some of the Federal dollars to subsidize Health Exchanges will go away over the next few years which will force the State Exchanges to be self-sustaining. We expect some adjustments to account for the increased costs that is expected by everyone. At this point, we\’re just trying to get through 2013 but we\’ll update calhealth.net with new changes.

Dennis Jarvis is a licensed California health insurance agent with extensive knowledge of the Individual California health market. California health insurance Exchange Time Table

Dennis Jarvis is a licensed California health insurance agent with extensive knowledge of the Individual and Small Group California health insurance market. http://www.calhealth.net

Author Bio: Dennis Jarvis is a licensed California health insurance agent with extensive knowledge of the Individual California health market. California health insurance Exchange Time Table

Category: Finances
Keywords: california health insurance,california health reform,california health exchange,california health