This is a cautionary tale for people on COBRA.
I keep talking to people whose COBRA is going to run out at the end of the current month. It turns out that this is basically too late to apply for a new plan. It often takes a month or two to get a new plan, and sometimes COBRA members won’t be accepted. It’s a good idea to look for an individual plan several months before your COBRA runs out.
If you end up not being accepted, you have to take a guaranteed issue HIPAA plan, which are always much more expensive than you expect.
People assume they’ll get another job soon, which unfortunately isn’t always the case, and then they find themselves relying on their COBRA coverage until the absolute end. Sometimes, an individual is healthy when their coverage kicks in, but something happens along the road that makes it difficult for them to qualify for coverage when the COBRA runs out. It’s a good idea to apply for insurance when you have a good health history, even if it’s at the beginning of your COBRA coverage.
In addition, COBRA is more expensive than most individual plans, even though the coverage will undoubtedly be better.
Bottom line: it’s better to apply for individual coverage right away. Contact our office and talk to us about a quote to get you on a permanent plan.
There’s been some surprising news relating to health care reform legislation. On Monday, January 31, a Florida federal judge ruled the entire law unconstitutional. This ruling was in response to a lawsuit by 26 states. It remains to be seen what the fallout of this ruling will be. 
“The decision by U.S. District Judge Roger Vinson represents a more sweeping repudiation of the law than the December ruling in a suit brought by Virginia that found the requirement that most Americans purchase health insurance to be unconstitutional.
As the judge ruled in the Virginia case, Vinson held that Congress overstepped its authority by compelling nearly all Americans to be insured or pay a fine. But Vinson went further: Likening the law to “a finely crafted watch” in which “one essential piece is defective and must be removed,” he ruled that the insurance mandate cannot be separated from the rest of the statute and therefore the entire law must be voided.”
For the rest of the original article, please click here.
More information about the lawsuit and the various implications can be found here.
Your voice is being heard by the health insurance industry. Blue Shield in particular, and other carriers including Anthem Blue Cross, Aetna, and PacifiCare, have agreed to delay implementation of their rate increases by at least 60 days from their initial March 1 date. This is in direct response to the hugely unpopular rate increases and the public outcry.
California Insurance Commissioner Dave Jones is steamed about these rate increases as well, and wants to make absolutely sure that they are necessary. Unfortunately, Blue Shield and other providers claim that they do need these increases to cover the cost of claims, so you may see your premiums rise this year anyway.
It is always our desire to bring you the best available plans for the best value. It’s worth it to look at your plans every two or three years, as carriers are always trying to find innovative ways to keep costs down.
Q. I just found out our insurance company doesn’t want to renew us because we only have 1 person on the plan. What can we do?
A. Make quick application for an individual plan.
B. Hire someone — now.
C. Try to buy coverage at Costco.
D. Convert to Cobra.
None of the above are necessary and at least 2 of them won’t even work. You can’t convert to Cobra if there is no policy and Costco doesn’t have a group medical plan. You can be turned down for individual medical and a new employee would have to satisfy a waiting period.
Here’s what I would do: You can have a group with one person as long as you have at least two that are eligible. The other person or persons can waive coverage if they are covered by another group plan, such as a spouse plan or Medicare. You only have to prove the situation, which is not difficult to do.
Blue Shield is getting a lot of bad press right now. They’re raising premiums on some individual and family health insurance policies by as much as 59%, despite a call by the state’s new insurance commissioner for a delay in the increase. And they eliminated the initial rate guarantee for new members. They did say they would subject the rates to an independent actuarial review as required by law and refund policyholders if an actuary finds its rates aren’t sound. Let’s hope the rates come down.
That said, when I compare their costs for my clients against other carriers, they STILL look pretty good. Which is a pretty sad state of affairs. Premiums are quickly becoming unaffordable for a great number of us. What happens next?
This is a forum for information-sharing. If you have a story from which others
might benefit, please forward along with your questions.
If your employer tells you that you can’t join the company health plan until open enrollment, he or she may be wrong.
There are other times you can join. One of them is upon loss of other coverage, such as coverage through a spouse who lost employment. Another is upon the end of Cobra. A third is upon change in status, such as marriage, childbirth or divorce.
All enrollments need to be made within 31 days and are effective the next first of the month after the event leading to lost coverage. Childbirth is an exception where coverage comes at birth.
For loss of coverage, you will be sent a Certificate of Creditable Coverage which you will need to present to the new carrier. Don’t wait for it to make application; it won’t come in for a few weeks after your coverage ends.
One of the most rewarding things about my job is being able to help people find affordable solutions for their families.
People have difficulty getting coverage at all ages. Recently a 64-year old woman contacted me. She had been terminated and was on Cobra. Normally her Cobra would have taken her to her 65th birthday when she would have been eligible for Medicare. She scheduled some elective surgery for January 7. On January 15 she learned her former company had cancelled the plan completely on December 31 and closed its doors. Of course no one would take her and she was faced with a $75,000 + hospital, surgical, and anesthesia bill.
Using my knowledge of HIPAA laws, I was able to find her retroactive coverage to cover the bills.
This is a forum for information-sharing. If you have a story from which others might benefit, please forward it to me along with your questions.
As the new healthcare legislation rolls out, I know you will have questions, and I will answer them as best I can as information becomes available. Note that some of my answers will be superseded by specific insurance contracts.
With more than 30 years in the benefits industry, I am, first and foremost, a client advocate. The new laws will have no effect on my commitment to securing the best possible coverage for my clients.
East Bay Express, July 2010
Lynn was recently voted Best Health Insurance Broker in the East Bay Express!
“Out of work and out of health insurance? COBRA run dry? Need to toss your company’s current insurer? Don’t struggle with some labyrinthine corporate web site. Think local and hie thee to Lynn Caffrey, an extremely dedicated full-service health insurance broker.
[She] finds individuals and small businesses medical, dental, life, vision, disability, and long-term insurance. (She also helps retirees pick the right Medi-gap policy.) Caffrey apparently never sleeps, answering client questions at all hours, chasing down good deals, helping you fill out the crazy multipage forms, and more.
In short, she’s there for you — a rarity among brokers. If you need health insurance now, she’s the first place to turn. And, like any good broker, her services are free.
This applies to small businesses that have fewer than 25 full-time employees with an average annual wage below $50,000.
If this is true and you pay at least 50% of the cost of the employees’ healthcare, you may be eligible to claim a tax credit of 35% of the premium!
