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Open Enrollment Healthcare Washington State: Week 3

1. Well, I found a first trap because of excessive exchange funding. This effects all clients that have had apple health. Clients are now able to get extensions automatically on their apple health up to a year at a time. I have a family that is now at 200%+ of the poverty level that was granted this extension. Their healthcare is paid by tax dollars and as their broker I receive zero commission. Would you like to make $60,000+ a year and have medicaid for the entire family? Previous to the ACA brokers were paid $100 per enrollment with an average of 10% of people a year coming off medicaid during any given year.

2. If you have been following this was an excerpt from a Health Care Authority recent audit sent Oct 23rd.

HCA regularly conducts audits of Washington Apple Health eligibility. Recent audits by HCA found numerous cases of inaccurate income reported on Washington Apple Health (Medicaid) applications in Healthplanfinder. Clients found to have discrepancies in their reported income are identified through a post-eligibility review and are required to provide verification of their actual gross income to maintain coverage.

Navigators and other assisters are expected to assist clients in reporting their correct gross monthly income on Healthplanfinder applications. Gross monthly income is the income earned before any taxes or deductions are taken out.

Intentionally under-reporting income to qualify for insurance coverage is insurance fraud and my result in severe penalties for the assister, the provider, and the client. The penalties can include but are not limited to loss of coverage, provider referral to the Office of Program Integrity, termination of pri9vileged user access in Healthplanfinder, and criminal prosecution under Washington State Law.

So with the two policies in place there will be a fair population that are receiving health insurance on the tax payers roll that qualified for expanded medicaid in the first place. If the audit was bad enough to send out a reminder, how bad it is only the HCA knows for certain.

3. Premera recently took the unpleasant step to transition to a manual process for applications because we're experiencing issues with people acting as brokers without proper credentials and training, purposefully circumventing our third party payer requirements, and enrolling individuals who don't meet state residency requirements. As a result, we are taking additional steps with five pieces of proof of residency along with wet signatures for business written outside of the exchange. This impacts primarily non-residents with very limited options in purchasing insurance in Washington State.

It is pretty clear that the licensed and regulated brokers are receiving less compensation for their work while unregulated are breaking the law, costing policy holders and tax payers money. Insurance is based upon laws and regulation. Tax payers are consumers of this program and they are being exploited by not policing navigator groups. The downfall of these poor practices will be the increased tax burden and decrease in regulated brokers assisting the consumers. If the ACA fails, then the next generation program will fail again because the 'experienced' people will perpetuate the wasteful spending and poor services.


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Enrollment Centers in Washington State are unique as people are able to get help with out extra charges.

We provide Statewide help for the Washington Health Benefits Exchange. Consumers get no cost help in selecting and enrolling in health and dental plans through the Washington Healthplanfinder. There is wi-fi available. 

As a bonus, the broker partners may provide additional assistance with additional insurance products such as Medicare, Supplemental and Life Insurance products so ask. At Wenatchee, we upload documents, notarize and do our best to assist our clients in effectively using healthcare.

Broker Affiliated Enrollment Centers

Suzie Health Insurance
1630 N. Wenatchee Avenue, Ste. 18, Wenatchee, WA 98801
Schedule an appointment

Rice Insurance
1400 Broadway Street, Bellingham, WA 98225

The Advisor Benefits Group
5101 W. Clearwater Avenue, Ste. 100, Kennewick, WA 99336

2020 Healthcare Open Enrollment and Low cost plans.

Open Enrollment is November 1st through December 15th. Outside of that time frame, it requires a special documented reason.

We have been helping people enroll into plans on the Washington Healthplanfinder with out charging fees since the first Open Enrollment. Insurance is expensive and complicated. Not everyone has been trained by the Insurance Companies how their plans function nor went through the education and licensing for a Insurance Producer in Washington State.

Just as last year, there are a lot of little or no cost plans available. When I say a lot I mean that the people in charge of (Centers for Medicare and Medicaid Services) put out a report stating 2/3 will be able to purchase a plan for $10 or less. An analysis Thursday from the consulting firm Avalere Health found that low-income residents in 96% of counties served by can find a basic "bronze" plan at no cost to them, factoring in subsidies. Bronze plans are skimpy, but experts sa…

1095 Forms, Do I need to file my taxes?

Hey, this is the 3rd year that we have been the Full Services Enrollment Center for the Washington Healthplanfinder. We don't charge a bunch of fees and you get access to extra services. Since it is tax season then you should know we help with 1095 Forms! Yes, we will print one out for you at our office if we are connected to your account.

Tax season is officially from January 27th to April 15, 2020. If you receive tax credits or Washington Apple Health then you need to file your taxes with the IRS. If it is not filed or filed incorrectly then the Healthcare Authority can revoke the tax credits. Yes, I have heard from more than one person that thought that they were saving money by not filing which created massive problems. The worst problems that I heard was they went the next year without healthcare!

If you are a tax professional then let me know and I will add you to this list. A person can be a paid tax return preparer as long as they have an IRS Preparer Tax Identification N…