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2 months ago · by

Open Enrollment Changes for 2019: What You Need to Know

On a chilly Washington D.C. evening in December 2017, legislators met to decide the fate of millions of Americans. The mantra “repeal and replace” reverberated across the country since the earliest days of the Trump presidency. And now, folks from both sides of the aisle still had no idea what was about to happen…

Fast forward to present day and the outcome of the lawmaker’s decision that day in December didn’t actually “repeal” or “replace” much of anything. And while the total number of insurers in Texas fell from 10 to 8, not much has drastically changed for Lubbock and neighboring counties versus last year.

Here’s what you need to know for 2019 open enrollment:

Penalties Removed (Mostly)

While the individual mandate technically remains firmly in place for 2018 and 2019, the penalty associated with it has changed.

What does this mean to you?

Under current law, if you don’t have minimum insurance coverage (and aren’t exempt) you could owe a tax penalty for the time you’ve been uninsured. The 2019 changes however, remove the tax penalty if you didn’t enroll in minimum essential coverage.

So for 2019 depending on your healthcare needs and the amount you can afford, you can choose an insurance plan or enroll in alternative coverage like short-term health insurance (e.g., a hospital plan) and avoid owing a tax penalty. Depending on your age you can also still apply for “catastrophic” coverage to potentially reduce your monthly premiums.

Remember, without any health insurance you’re playing Russian roulette with your future and could end up paying medical bills for the rest of your life. Additionally, if you choose to go without health insurance in order to save money, realize you will still lose out on a tax credit applied to federal income tax.

Speaking of tax credits, you may qualify for a premium tax credit that lowers your monthly insurance bill, and creates extra savings on any out-of-pocket expenses like deductibles and copayments. These plans are offered by private insurance companies with a range of prices and features. Get in touch with an insurance agent to learn about your options before deciding if you can’t afford health insurance.

Be aware business penalties for group health insurance still apply. If you’re a business owner with 50 or more full-time employees (fte) and you do not offer coverage to at least 95% of your workforce, you still face penalties in 2019. For example, if you have 65 FTE employees, don’t offer coverage, and at least one employee gets coverage in the exchange with a premium subsidy, you may owe a $74,240 penalty for 2018. The calculation is: (65-30) x $2,320 = $74,240. Therefore, it’s essential you have a group health insurance plan in place.

Premium Changes

After years of continuous rate increases, one Lubbock county insurer has decided to change course and cut rates by about 6% for two of their ACA individual plans. Blue Cross and Blue Shield of Texas executives believe both market stability and knowing more about policyholders should decrease rates in 2019.

Across the rest of the state, other insurance providers have significantly reduced their rate hikes for 2019. The proposed average increase statewide in Texas is 3.8%, down from a 41% average increase last year among benchmark plans on the exchange.

What’s Next

Mark your calendar: the 2019 Open Enrollment Period runs from Thursday, November 1, 2018, to Saturday, December 15, 2018.

In Lubbock county, Blue Cross Blue Shield of Texas and First Care will continue offering plans in 2019. Nearby counties Cochran and Bailey will continue with just one option, however, through Blue Cross Blue Shield of Texas.

If it’s been awhile since you’ve been to the doctor, schedule a wellness exam to see if your healthcare needs might need to change for 2019. Also think about why you may dislike or like your existing coverage (if you have any) and what is important to you going into next year.

Remember, if you don’t act by December 15, you can’t get 2019 health insurance coverage unless you qualify for a Special Enrollment Period. If you have any questions about your health insurance and want to learn about all of your available options, contact a licensed agent today.

Company Information

Hettler Insurance Agency
Ron Hettler

4432 S Loop 289
Lubbock, TX 79414

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