Options Limited for Health Insurance in 2017

If you buy individual health insurance (especially via healthcare.gov), your options WILL be limited this upcoming year.

Right now DuPage County (IL) has 4 options. Aetna, BCBS of IL, Coventry, and United Healthcare. BCBS and Coventry have PPO networks. In 2017, you will have BCBS and Cigna only as Aetna, Coventry, and United Healthcare pull out. Cigna will be an HMO. This means the ONLY PPO network available will be the Blue Choice PPO network via BCBS of IL (assuming they continue this plan, which I think they will). If you need a variety of specialists who are not in the same medical group, you will either have to pay out of pocket or change doctors.

Cook County won't be much better. You have 7 options, but 3 will be going away (see above). Harken Health (who currently has the best PPO network) will be changing the network to either a smaller PPO network or HMO (they haven't told me yet). In 2017, you will probably have Ambetter, BCBS of IL, Harken Health, Humana, and newcomer Cigna. The only two that would possibly have a PPO is BCBS of IL and Harken Health (see above).

Downstate will at least have Health Alliance (as of my writing this article) who offers a POS plan (less restrictive than an HMO, but not quite as flexible as a PPO) in addition to BCBS of IL.

BTW, I didn’t mention the premiums. Go to https://ratereview.healthcare.gov/ if you want to see how bad it is going to be.

To help people who can’t afford the cost, I have a new plan that is NOT insurance but is a cost sharing ministry that will be available to those who just can’t afford the new premiums. It avoids the penalty and has some holes, but something is better than going with nothing. If you want more information on this, contact me. The good news is that you can sign up at any time, but it does NOT cover any pre-existing conditions or medications other than generics. View this as a “last resort” plan.

http://www.bloomberg.com/news/articles/2016-08-19/choices-may-be-limited-for-obamacare-shoppers-avalere-says

IRS Issues Draft Instructions for Forms 1094-C and 1095-C for 2016   

August 4, 2016

By Larry Grudzien, larrygrudzien.com, 708-717-9683

On August 1, 2016, IRS released draft instructions for Forms 1094-C and 1095-C for 2016. The following is an overview of important changes to the forms:

Form 1094-C

On line 22, box B is designated "Reserved." The Qualifying Offer Method Transition Relief is not applicable for 2016.

In Part III, column (b), "Section 4980H" was inserted before "Full-Time Employee Count for ALE Member" to remind filers that the Code Section 4980H definition of "full-time employee" applies for purposes of this column, not any other definition that an ALE Member may use for other purposes.

Form 1095-C:

The language "Do not attach to your tax return. Keep for your records." was inserted under the title of the form to inform the recipient that Form 1095-C should not be submitted with the return.

Changes to codes. Code 1I for line 14, and Code 2I for line 16, are no longer applicable and have been reserved.

New codes 1J and 1K have been added for line 14. These codes are used to reflect conditional offers of coverage to an employee's spouse. A conditional offer is an offer of coverage that is subject to one or more reasonable, objective conditions (for example, an offer to cover an employee's spouse only if the spouse is not eligible for coverage under a group health plan sponsored by another employer.

Multiemployer Plan  Interim Rule Relief:  The use Code 2E for line 14 has been extended to 2016.

Form 1094-C and Form 1095-C:

Transition relief. Several forms of transition relief were available to employers for 2015 under Code Sections 4980H and 6056, but only limited transition relief continues to apply in 2016. References to transition relief that applied only in calendar year 2015 have been removed. Descriptions of the remaining forms of transition relief have been amended to clarify for which months in 2016 the transition relief applies.

New Definition: The term "Employee Required Contribution" has been added.  This  term refers to the employee's share of the monthly cost for the lowest cost self-only minimum essential coverage providing minimum value that is offered to the employee by the ALE Member.

For a copy of the instructions, please click on the link below:

https://www.irs.gov/pub/irs-dft/i109495c--dft.pdf