2016 Open Enrollment – Healthcare Reform

You heard right, premiums are increasing and you have less of a choice in insurance companies effective 01/01/2017.

As of this year’s Annual Enrollment Period (AEP) beginning November 1st, if you do not have Major Medical Insurance and do not qualify for Subsidy (government assistance to pay premium), you will be very limited on the choices you have for a Qualified Health Plan on the open market.  For the counties of Hardin, Jefferson and Orange in Texas, the only option an Individual or Family will have available to them for a Fully Insured Qualified Health Plan will be through BlueCross BlueShield.  All of the plans through BCBS will be HMO plans and have had on average in these areas a 48% price increase.

For individuals and families that qualify for Subsidies (government assistance); the following companies will be available:

  • Hardin County – BCBS, Christus Health Plans
  • Jefferson County – BCBS, Christus Health Plans, Community Health Plan and Molina
  • Orange County – BCBS, Community Health Plan

Should you want to know who is participating in your county, please contact us directly for a quote.

With BCBS being the dominating insurance company for Individuals and Families, they have made modifications to their plans, and are offering a new plan this year. The HMO Network has grown tremendously throughout the state.  There are now 50% of the PPO Doctors contracted in the HMO Network and 60+% of the PPO Hospitals in the HMO Network.  Please keep in mind it is always important to check your physician’s network status regularly to see if he/she is in or out of network.

MD Anderson, as of today’s date, has not changed their position and will remain “Out-of-Network” for anyone on a Individual Health Insurance plan.

For the BCBS 2017 plan year, CVS Pharmacy will not be considered “In-Network”; however, you will have access to pharmacies like Walgreens, Walmart, Sams and HEB.

We try to keep our policy holders up to date with information as we get it.  We do verify all information we receive to make certain it is the most accurate and up to date information available.  Should any of this information changes we will notify our policy holders immediately.

The tax penalty for not having insurance in 2017 will be: 2.5 percent of your annual household income above the tax filing threshold to a cap of the national average bronze plan premium.$695 per adult and $347.50 per child under 18 to a maximum penalty of $2,085 per family.

If you would like to receive a quote for Medical Insurance, please contact our office at (409) 227-4686 or you may complete a form online by visiting our website at http://www.martinandmartininsurance.net.  We look forward to hearing from you all!