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A lot of emphasis has been placed on the Affordable Care Act’s premium tax credits over the past couple years—and rightly so. The Advanced Premium Tax Credit (APTC) makes it possible for millions of Americans to purchase health insurance; without the financial assistance, many would likely remain uninsured.

There is another type of financial assistance, though, that gets a lot less fanfare than the APTC: cost-sharing subsidies. While you may have learned about the subsidies when the law was first passed and are likely guiding your lower-income clients to subsidized plans, we thought you might benefit from a quick review of how the subsidies work, in turn enabling you to better explain them to your clients.

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In what seems like a strange move to most brokers, some carriers have stopped paying commissions on their most desirable plans, those with larger provider networks and out-of-network options. Why in the world would they do this? Do they not value the agent anymore?

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It’s funny to think that, just a few years ago, many of us were worried that the government was creating a do-it-yourself, Travelocity©-like website that might eliminate the need for health insurance agents altogether. Boy, were we wrong.

It is true that Healthcare.gov and the state-based exchanges are significantly better than they were during the first open enrollment period. The sites aren’t crashing anymore, and they do allow individuals to compare their options and apply online without any outside assistance, but how many consumers actually understand what they’re looking at? The reality is that health insurance is becoming more—not less—complicated, and it can be very difficult for the average person to find the right plan without consulting with a professional.

Here are just a few of the reasons why health insurance agents are more important than ever.

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Are you striking out when trying to sell supplemental and ancillary insurance? Maybe it’s because you’re trying to cram all of your sales efforts into a single call or appointment. There are three big reasons why this may not be a good idea.

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It’s that time of the year again—open enrollment. The 2016 individual open enrollment period begins November 1 and ends January 31, which means that brokers who specialize in individual coverage will be very busy for the next three months. To help make sure this is a successful selling season for you, we thought we’d share a few quick thoughts.

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One of this fall’s “hot topics” highlighted in this month’s AHCP newsletter (link to newsletter), was the definition of small group for purposes of the plan design and rating rules and how it varies and may change. One such change is that brought about by the Affordable Care Act. Starting in 2016, companies with 100 or fewer employees will be considered small employers and be subject to the essential benefits requirement and the modified adjusted community rating rules. Currently, every state sets the cutoff at 50 employees, rather than 100.

 

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A lot of the brokers who work with AHCP focus on both group and individual health insurance. Sure, most of you also market a full range of voluntary and supplemental products to your clients and prospects, but there’s no denying that health insurance is at the top of everyone’s priority list.

For that reason, we thought it would be helpful to highlight some of the biggest concerns your clients are likely to have this fall. While you may not offer detailed advice on their tax or legal questions, this tutorial should help you avoid the “deer in the headlights” look if they touch on a topic you don’t feel familiar.

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Special enrollment periods (SEPs) are nothing new. For health insurance agents working with groups, HIPAA regulations have meant that employees and family members who originally waive coverage on a group plan have special enrollment rights if they lose other qualified coverage or have a life event such as marriage, birth or adoption. During these special enrollment periods, employees and their family members usually have 30 days to sign up for the group health plan.

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The Affordable Care Act’s advance premium tax credit (APTC) has been wildly successful. It’s helping millions of Americans pay for health insurance purchased through the individual Marketplace. However, one thing that’s still confusing for a lot of people is the fact that it is an advance. The tax credit is based on the amount that people think they’re going to earn when they’re applying for the credit. Their actual income, of course, could be higher or lower than the projected amount.

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To be successful during this feeding frenzy, preparation is the key. It’s not too soon to start pre-paring for AEP/OEP so that you can capitalize on the opportunity when it arrives. Brokers who delay may find their options limited or possibly locked out altogether.

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