Washington State Healthcare Solutions

Open Enrollment is November 1st through December 15th. Outside of that time frame, it requires a special documented reason. Awarded for first year's production. 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 Healthcare.com (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 HealthCare.gov can find a basic "bronze" plan at no cost to them , factoring...

Brokers have always been an important part of the Washington Healthplan Finder . We have education requirements from the state for our license. We receive regular training from the Exchange on how it functions. We receive training from Insurance Companies on how plans functions. It was no surprise that one of the first customer satisfaction survey's rated brokers extremely helpful to 80%  from people enrolling in qualified health plans. Suzie Health Solutions is a no cost broker. The Washington State Auditor's office published it's Performance Audit in 2016 confirming the importance of selecting brokers. Right off the bat on page four, they mention shifting calls to brokers as being a possibility to reduce cost.  Brokers reduce cost by how they are paid. Brokers are paid by commission or charging fees receiving no payment for Medicaid. The exchange on the other hand pays for Navigators and the Call Center which drives up costs (page 28). Certain States improved th...

Maximum Service for Minimum Price There are a few of us no charge brokers out there for the Washington Healthplanfinder. We don't charge fees. That means our only source of income is from a person selecting us. We are not talking a lot of money and we are down to 1544 brokers last count. That is about 1000 less than when we started 6 years ago. Some have started charging fees. No we don't get paid for Apple Health Policies. (The exchange is not allowed to pay us despite being paid by DSHS to manage these accounts). No we don't get paid for some plans for a Special Enrollment. No we don't get paid for companies that don't affiliate with us. This means that we do a lot of charity work. We receive payment for about 1 in 4 policies. It is very rewarding on a spiritual level. Most people couldn't imagine getting paid for 15 minutes of every hour work. The first year that I estimated commissions for everyone that didn't select a broker, it amounted to $1 mil...

What if you could walk into an office and get your questions answered about Healthcare at no cost? It's not complex most companies has someone that does Human Resources. They enroll you in healthcare, have the occasional survey to fill out and remind you to turn in documents. If this personal HR office was not connected to a workplace then it would have to be in a safe place, hold regular hours, easy access and not charge extra fees. In 2016 the Washington Health Plan Finder launched nine store fronts with that idea. The majority were located on the Westside. Suzie Health Solutions jumped at the opportunity. We started this entire thing because a client asked us how healthcare would effect them. We thought we would be a good fit and the Washington Health Plan Finder selected us to run Suzie Health Solutions in Wenatchee.  In 2018 the Washington Health Plan Finder expanded the model into Full Service Enrollment Centers . There are only 10 locations with ours located in ...

What were you doing August 08, 2013? I was driving a couple of hundred miles to Olympia to test the Washington Healthplan Finder . There were four brokers in the room. As we walked through it, we built a list of questions/problems to help the exchange get better. The biggest shocker was what we were expected to do for free. Before the ACA brokers received payment for helping people enroll in Medicaid. Most people can't imagine getting paid for 1/4 of their work but it is how we keep our doors open.  I think I am the only one left writing individual healthcare. The only other one that is in the business in Tacoma does mostly large business solutions.  Pre ACA Problems The early days were wild. I had to create flyers from next to nothing. We did our best to go out and educate the public from radio interviews at KPQ in Wenatchee to Front page in the Wenatchee World. We did classes at the local YMCA , libraries and Rotary Clubs. Honestly, the worst experience was at my ...

I see more value to using the established systems than trying to recreate the wheel. Most of us insurance professionals are using exchanges so we just have to work on making it consumer friendly. I know that the brokers are a dwindling resource because most get torn up between customer needs and insurance company’s demands. Some companies have failed to pay brokers as they rely on the exchanges for their sales force, while others that have reduced their support to the point that some brokers have had to resort to charging additional fees to keep the lights on. If you ever need any help or want me in the room then let me know and we will be happy to be a resource for you. Here are a few talking points to improve the current system. –Matt McColm at www. Wahbroker.org A. The high risk pools proven to be unsuccessful in providing affordable service to the small population that they served. We recommend reinstating the reinsurance corridors to the companies participating in the Health ...

The information for Native American Services is spread pretty out. (The ACA is probably one of the worst marketed programs ever). Here are the basics for individuals that have their tribal affiliation. 1. At 300% or less of poverty level (400% in Alaska) you get the no cost sharing (the zero co-pays). This year that is $35,640 per year with a modified adjusted gross income. Which is fancy talk for you can write off some income and qualify for better rates. 2. You can enroll throughout the year. 3. You can apply for an exception for the tax penalty. 4. Improvements to existing Indian Health Services. I always recommend using a no-cost broker. (Ask up front if they charge because some are needing to charge). We don't charge fees, are licensed by the state, trained how plans work, and can help with situations like this. If you have any questions then let me know I am always glad to help out. Websites for more information: https://www.ihs.gov/aca/thingstoknow/ http://www.hh...

Suzie has been working hard. THese last couple of months adding new policies for Medicare Advantage plans all over the state. I made her sit down and do a county by county search to see if we could offer more plans as we are getting questions from all over. When you can cover under 65 with Healthcare and Prescription Plans (Part D) for the entire state then we knew that we could do more. For us it has always been about families helping families and this year we are prepared to help even more. Check out the coverage area for 2017.

Starting January 15, 2016, the Washington State Health Care Authority (HCA) will be mailing Washington Apple Health (Medicaid) clients a new tax form named the 1095-B. The 1095-B form provides of each month the client had minimum essential health coverage in 2015 through Washington Apple Health. The Health Care Authority transmits this information electronically to the IRS. Apple Health clients should keep the form for their records, since it contains important information they will need to complete their 2015 tax return. In some cases, people may get more than one tax form – such as 1095-A, 1095-, or 1095-C – depending on their employer and the kind of health coverage they had during 2015: · The 1095-A is furnished by the state’s Health Insurance Marketplace (Health Benefit Exchange) · The 1095-B can also be furnished by other government-sponsored programs, employer-sponsored group health plans, and more. · State employees and retirees enrolled in the Un...

‘My job offered me a plan for $60 a month but it has a huge deductible, do I have to take it? Last year it was $400 when I visited my doctor.’ We get these questions on a regular basis. I don't expect people to spend money on things that don't work or pay a penality when they don't have to . The employer offers a health plan that covers the employer for the Affordable Health Care Penalty but does very little to help the employee or their family. In Washington State, we have our own state exchange with a lot of plans. So many plans that brokers spend months learning plans so that we can help our clients get the most out of their money. There are Health Insurance companies that will only offer their plans using the state exchange. There are also some that are priced down to the point where a 28 year old was able to get health insurance for $209 a month with a $20 co pay to see his doctor without tax credits! There are times when it is best if a job does not offer health i...

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 reporte...

The Director for the Wenatchee Senior Center dopped in and gave Suzie McColm her plaque. It was the first one that she achieved. She has been helping for years people fill their prescriptions at the local pharmacies struggle. The struggle could have been from not having insurance to having a bad plan. When she had enough, she rolled up her sleeves, got her insurance license and started helping with the affordable care act. After her first year helping, she wanted to help more with Seniors so Medicare was a natural for her. She still helps as a pharmacy tech these days but her passion is helping people on the front in with insurance. Stop in and say hi to a proud member of our team .

The first week of open enrollment has been exciting. We have had some new customers and some old. When we first started and I looked at the system, I let everyone know; the first rule is always use a broker. This year is truer than ever before. Here are the challenges: 1. There are 143 plans for individuals. 30 plans for Small business and 8 dental for kid s. These are plans that myself and many brokers have been training for months. This is a monstrous variety to choose from. 2. There are some plans that are only available on the exchange that are great even if you don’t have subsidy. The first year, we only had one company and now we have three that are going this route. 3. There are still some errors with the system. I was able to catch one early that no tax subsidy was being applied. It was $30 a month that the gentleman could use for other expenses. 4. I am still seeing businesses offering group plans that are either unaffordable or more expensive than some of the plans on ...

We believe that healthcare should be affordable and usable. There are 136+ plans on the Washington Health Benefits Exchange and it can be a little confusing to who covers what, for how much. For 2014 we helped so many people in Eastern Washington that Matt McColm was named a Top Producer by the Washington Health Benefits Exchange . Open Enrollment is just around the corner. It doesn’t matter if you are a new or a repeat customer as we take the time to explain how plans work so that our clients can make informed decisions. This is a tremendous time for Health Insurance because it allows customers to shop and select new plans that start in 2016. Some important things to consider: 1. Open Enrollment runs from November 1st to Jan 31st. This is when Health Insurance is the most Flexible. 2. There are Special Enrollments outside for a variety of reasons including moving careers to one that does not provide Health Insurance. 3. Households of 2 qualify for reduced prices for Health Insur...

Who likes paying something for nothing? When the ACA went into effect almost three years ago, the maximum a household would pay was $285. This is on top of any fees or expenses if you got sick or injured. Most people wouldn’t ever see the penalty because it was taken when they filed their taxes. We started helping people that year because we saw where the penalty was going to lead. The average client under 30 paid less than $150 a month for insurance or nothing at all if they qualified for Washington Apple Health. For 2016 the tax penalty will be up to $2085 per household. This is significantly more than more people enrolling would pay for insurance. 80% enrolled were either free or qualified for a subsidy. There are 136 plans on the exchange which can lead to some confusion, which is why we recommend working with a broker. A broker receives training on how different plans function and are licensed and regulated by the Washington Insurance Commissioner. Ask a broker up front if the...

2016 is shaping up to be a big year for health insurance in Washington State. We are now looking at: • 180 approved plans on the Washington Health Benefits Exchange . • A 4.2 percent Increase approved by the Office of the Insurance Commissioner. • Regence Blue Shield’s Innova plan is the state’s essential health benefit (EHB) benchmark plan so the tax credits are changing. Our office has been training a few months on the different plans. There are some big differences with new carriers entering the exchange market such as Health Alliance Northwest Plan Inc, Regence BlueShield and United Healthcare of Washington. There have been significant changes in plan structures of Lifewise, Moda and Coordinated Care. We regularly reach out to carriers to find out how they function from customer feedback and with utilizing the products ourselves. Our brokers do the best to distill the information down to a usable format so that our clients can make the best possible choice in carriers. Y...

Washington Association of Health Underwriters held their 2015 Spring Symposium in Spokane. I was able to carve out the time and be able to attend as it was amazing. There were at least 30 vendors organized around the room. We had speakers that had serious content about Healthcare in the State of Washington. The Affordable Care Act and how it is interacting was a major topic. I wish that more of my agency was available to go. I wish a big thanks to Premera , Asuris and the other Sponsors of this event. Events are not cheap. I got signed in early and ran around talking with every one that I could to see who was doing what with Insurance. There were familiar faces such as Group Health, Connext , Moda, etc. I also encountered new Venders, ones that were able to provide multiple group quotes, private health exchanges or inexpensive plans for large groups that are 100% ACA compliant. This was an excellent way to start collecting information and put together some dynamic solutions for...

Health Insurance doesn’t have to be intimidating. I got involved because I saw for the first time; it could be affordable to normal people. That they didn’t have to go bankrupt. A lot has changed during the last couple of years to make it better for people. There is a simple principal that I started early with to help people who do not want to dedicate their lives to get better health insurance. I got involved in 2012 when a client walked into my office in Wenatchee and asked me, ‘how does Obamacare affect me?’ If you do nothing then you will have a fine and let’s take a look at it next year. When the summer of 2013 came around, we priced it and found that she could get insurance for around $50 a month. For the first time in her life Health Insurance was affordable. I priced more of my friends to discover that it would have a large impact in the Wenatchee Valley. I talked with my primary insurance company and they were not participating. I was left to find companies become affiliat...