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ESSENTIALS: презентация
Содержание
- 1. ESSENTIALS:
- 2. With the onset of healthcare reform,
- 3. We’ll describe what you need to know
- 4. Let’s share a very short background
- 5. You’ll know that individual versus employer health
- 6. As an individual or BUSINESS OWNER
- 7. BECAUSE FOR CERTAIN BUSINESS OWNERS: THE INDIVIDUAL SEGMENT WILL BE MOST IMPORTANT NOW ANYWAYS.
- 8. HERE ARE THE “ESSENTIALS”
- 9. THIS IS PROBABLY THE BIGGEST GAME-CHANGER OF
- 10. For years-upon-years, if you were going to
- 11. You heard that right: OUTA’ HERE. It’s
- 12. ALL GUARANTEED ISSUE MEANS, IS THAT IF
- 13. Q: How does this change the ballgame?
- 14. It can’t be emphasized enough how much
- 15. And to boot: if you’re eligible for
- 16. This all sounds fine and dandy, right?
- 17. In the past (before 2014), you could
- 18. BECAUSE TODAY (in 2014 and Beyond): There’s
- 19. THIS is that exact same concept. Except
- 20. Need an appendectomy in the middle of
- 21. BUT. WHAT IF I LOSE MY COVERAGE
- 22. ESSENTIAL #3: Special Enrollment Period Q: What
- 23. WHAT ARE THESE SPECIAL ENROLLMENT CIRCUMSTANCES?
- 24. In the KNOW. Most events
- 25. Rolling. CONGRATULATIONS: MOVING RIGHT ALONG.
- 26. ESSENTIAL #4: “Shared Responsibility” “Shared responsibility” is
- 27. ESSENTIAL #5: Minimum Essential Coverage “Minimum essential
- 28. Effectively: “Minimum Essential Coverage” has standardized
- 29. Roger that. IN ORDER TO
- 30. THIS is where the bar was raised.
- 31. NO “ifs, ands, or buts.”
- 32. AND THAT’S IT. THOSE
- 33. TYSON J LESTER, RHU, REBC
- 34. We help individuals and businesses
- 35. Nearly 10,000 Followers at Twitter: www.twitter.com/policyadvantage
Слайд 2
With the onset of healthcare reform, the landscape in the individual
There are LOTS
of questions.
Слайд 3We’ll describe what you need to know in order to navigate
Get. Ready.
Слайд 4
Let’s share a very short background about the differences between individual
They’re not
Differences?
the same.
Слайд 5You’ll know that individual versus employer health insurance are two completely
There are different rules. There are different tax incentives. There are different eligibility criteria. The list goes on.
And THAT’S a whole different article.
IF YOU KNOW MUCH ABOUT THE HEALTH INSURANCE INDUSTRY AT ALL…
Слайд 6
As an individual or BUSINESS OWNER you’ll want to know the
Слайд 7
BECAUSE FOR CERTAIN BUSINESS OWNERS:
THE INDIVIDUAL SEGMENT WILL BE MOST IMPORTANT
Слайд 8
HERE ARE THE “ESSENTIALS” OF THE NEW INDIVIDUAL HEALTH INSURANCE MARKETPLACE.
Слайд 9THIS IS PROBABLY THE BIGGEST GAME-CHANGER OF THEM ALL:
“Guaranteed Issue.” One
ESSENTIAL #1: “GUARANTEED ISSUE” MANDATE
Слайд 10For years-upon-years, if you were going to apply for an individual
You had to go through a series of health-related questions in order to apply for coverage. There were 50, 60, and sometimes even 70 or more questions. If you’ve applied for coverage before 2014, you know what this is all about.
YES. MISERY.
Слайд 11You heard that right: OUTA’ HERE. It’s still difficult for many
THIS is what is called “Guaranteed Issue” in the insurance world.
LOVE. That.
Starting in 2014: these health related questions are all GONE.
Слайд 12ALL GUARANTEED ISSUE MEANS, IS THAT IF YOU APPLY FOR COVERAGE,
You’re in.
Слайд 13Q: How does this change the ballgame?
Game changer.
A: You
This is huge. Especially for those with preexisting conditions.
Слайд 14It can’t be emphasized enough how much this has freed up
We like options.
You can literally pick any plan from any company, and apply for coverage now.
Слайд 15And to boot: if you’re eligible for subsides at the new
Game changing. Again.
You could end up receiving quite a bit of money in the form of subsidies that will help you pay for your premiums.
Слайд 16This all sounds fine and dandy, right? It is. But there
Movin’ on.
Слайд 17In the past (before 2014), you could apply for an individual
You could go out, pick a plan, and apply for coverage… but you might be denied.
ESSENTIAL #2: OPEN ENROLLMENT PERIODS
WELL THAT’S ALL HISTORY NOW.
Слайд 18BECAUSE TODAY (in 2014 and Beyond):
There’s now an “individual open enrollment
Save the date.
Q: What’s an open enrollment period?
A: It’s a time-frame at the end of the year when you can enroll for individual health insurance.
OPEN ENROLLMENT PERIOD
Слайд 19THIS is that exact same concept. Except it’s in the new
AND IT’S A BIG ENROLLMENT: IT’S THE ENTIRE USA.
If you’ve ever worked for an employer that has a company health insurance plan, you’ll know that you’ve usually got to apply for coverage during yearly enrollment.
Слайд 20Need an appendectomy in the middle of June? It’s too late.
Get covered.
You’ve now got to enroll during open enrollment each year.
This can be very important, because if you miss open enrollment, you don’t get an opportunity to apply again until the end of the next year.
Слайд 21BUT. WHAT IF I LOSE MY COVERAGE IN THE MIDDLE OF
BECAUSE: You’re special.
IMPORTANT QUESTION.
Which leads us right into our next individual marketplace essential:
SPECIAL ENROLLMENT.
Слайд 22ESSENTIAL #3: Special Enrollment Period
Q: What is a special enrollment period?
A:
THIS IS SPECIAL.
Слайд 23
WHAT ARE THESE SPECIAL ENROLLMENT CIRCUMSTANCES?
They’re events. It’s life.
They’re “life events”
You get married.
You get divorced.
You have a child.
You lose your coverage.
You move. Plus others…
LIFE
EVENTS
Слайд 24
In the KNOW.
Most events give you 60 days to enroll
HOWEVER: A Few of these events only give you 30 days.
Be sure you know which event applies to you, and how much time you have to enroll.
YOU’LL WANT TO MAKE SURE TO UNDERSTAND THESE LIFE EVENTS IF YOU EVER NEED TO UTILIZE THE SPECIAL ENROLLMENT PERIOD.
Слайд 25
Rolling.
CONGRATULATIONS: MOVING RIGHT ALONG.
THERE ARE ONLY A COUPLE OF
We’re going to briefly go over these terms:
ESSENTIAL #4: SHARED RESPONSIBILITY
ESSENTIAL #5: MINIMUM ESSENTIAL COVERAGE
Слайд 26ESSENTIAL #4: “Shared Responsibility”
“Shared responsibility” is a term that has been
It means everybody has got to be “in” in order to make these reforms work:
Individuals.
Employers.
The Government.
EVERYONE has got to have a health insurance plan.
Слайд 27ESSENTIAL #5: Minimum Essential Coverage
“Minimum essential coverage” is the type of
THE BAR HAS BEEN RAISED.
Слайд 28
Effectively: “Minimum Essential Coverage” has standardized health insurance.
There are now
PLATINUM. GOLD. SILVER. BRONZE.
(For those under 30yo, there’s also a “Catastrophic” plan)
It’s minimum. It’s essential.
Слайд 29
Roger that.
IN ORDER TO AVOID PAYING A TAX PENALTY, YOU
There’s no doubt about it.
There are tax penalties that start in 2014 if you don’t have a health insurance plan.
You’ll need to participate in a bronze, silver, gold, or platinum level plan in order to avoid it.
Слайд 30THIS is where the bar was raised.
AND: THAT PLAN WILL
Count ‘Em:
Слайд 31
NO “ifs, ands, or buts.”
#1) Outpatient Care.
#2) Trips to the
#3) Inpatient Hospital Care.
#4) Well Baby Care.
#5) Mental Health Coverage.
#6) Prescription Drug Coverage.
#7) Services if you’re Disabled.
#8) Lab Testing.
#9) Preventive Services.
#10) Pediatric, Including Dental.
EVERY HEALTH PLAN MUST HAVE:
Слайд 32
AND THAT’S IT. THOSE ARE THE ESSENTIALS OF THE NEW INDIVIDUAL
Слайд 33
TYSON J LESTER, RHU, REBC
President, Policy Advantage Insurance Services
Toll Free:
Los Angeles Area: (424) 442-0170
Email: info@policyadvantage.com
www.policyadvantage.com | CA Insurance License #0F22799
ARTICLE WRITTEN BY
Слайд 34
We help individuals and businesses sort out all of the aspects
Please contact us if you have questions. We share high-value information and look forward to working with you. Thanks for stopping by.
Toll Free: (800) 617-0089
Los Angeles Area: (424) 442-0170
Email: info@policyadvantage.com
www.policyadvantage.com | CA Insurance License #0F22799
WE HELP INDIVIDUALS AND BUSINESSES
Слайд 35
Nearly 10,000 Followers at Twitter: www.twitter.com/policyadvantage
Catch up at Facebook: www.facebook.com/policyadvantage
We’re also
www.policyadvantage.com
WE’RE SOCIAL
