Citizenship and Income Validation Sept. 5 Deadline


In July 2014, the U.S. Department of Health and Human Services (HHS) begun notifying people who enrolled for health insurance coverage on “The Marketplace” that they needed additional information to verify their coverage and/or subsidies and cost sharing amounts. This letter gave them 30 days to provide the information and validate their citizenship or income.

This week, about 310,000 people nationwide will get another letter with additional citizenship documentation requirements who have not responded. Approximately 52,700 are in Texas.

With this letter, you will have until Sept. 5, 2014, to provide the required documents or they will lose their coverage on Sept. 30.

The Marketplace has tried multiple efforts to contact them. The letters are in English and Spanish. They will try another three times to contact these people before the deadline, after that, you will get a letter saying coverage will be cancelled on Sept 30.

If you have received a letter, act now to avoid cancellation. If your policy is cancelled, this may or may not qualify as a special enrollment privilege, therefore you may not be able to get coverage again until Jan 2015.


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Open Enrollment is closed, what is a special enrollment period (SEP)

Most people don’t realize what it means when you hear that the open enrollment for health insurance has ended for 2014.  Because of the new Affordable Care Act (ACA), basically if you are without insurance … in order to get insurance after the open enrollment has ended you will have to have lost coverage “through no fault of your own” and you have to have experienced a Qualifying or “triggering” event.   If one of these events has happened to you, you have 60 days from the date of that event, (including the date of the actual event) to apply for coverage or make a change to an existing plan. Valid documentation will be required to be submitted for all Special Enrollment events.  Depending on which company you go with, your effective date may be the first of the next month after you submit your application, or it may go retro-active back to when your coverage ended.  If it goes retro-active back, you will have to pay the premiums for those months of coverage as well.

See list of events below and select those that apply.

  • An individual and any dependents involuntarily lost minimum essential coverage
  • An individual gained or became a dependent through marriage, civil union, birth, adoption, or placement for adoption, or placement in foster care
  • An individual experienced an error in enrollment
  • An individual adequately demonstrated that the plan or issuer substantially violated a material provision of the contract in which s/he is enrolled
  • An individual became newly eligible or ineligible for advance payments of the premium tax credit or is experiencing a change in eligibility for cost-sharing reductions
  • An individual or enrollee made a permanent move and new coverage is available
  • An individual, who was not previously a citizen, a national, or a lawfully present individual, gains such status
  • An individual released from incarceration
  • An eligible individual and his or her dependent(s) lose employer-sponsored health plan coverage due to voluntary or involuntary termination of employment for reasons other than misconduct, or due to a reduction in work hours
  • An eligible dependent spouse or child loses coverage under an employer-sponsored health plan due to divorce, legal separation or his or her spouse or parent becoming entitled to Medicare or death of his or her spouse or parent
  • An eligible individual loses his or her dependent child status under a parent’s employer-sponsored health plan
  • An American Indian/Alaskan Native, as defined by section 4 of the Indian Health Care Improvement Act

Call to see if you have  a qualifying event and can enroll or if you need help determining which company may be your best option 877-740-8683.  We will be happy to help.

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July 15, 2014 · 10:00 pm

Open Enrollment Ends March 31 for ALL 2014 Plans

Open Enrollment Ends

Open Enrollment Ends
March 31, 2014

Did you know that after March 31st 2014 you will not be able to purchase Health Insurance for 2014 … AT ALL?   That’s right, after the 31st, the Open Enrollment will be closed for the rest of the year!!!   A lot of people are under the impression that the deadline only applies to Marteplace plans or Exchange Plans, but the deadline will apply to ALL Individual Health Insurance.  The only plans available from any carrier will be Short Term Plans or Limited Medical Plans.   These plans DO NOT COVER pre-existing conditions, they are not all  Guaranteed Issue, and DO NOT qualify as Minimum Essential Coverage.  So what that means to you is if you are covered by a Short Term Plan or a limited medical plan, you probably will still be subject to the Tax Penalty when you file your 2014 taxes.

If you or someone you know needs Health Insurance, please call 877-740-8683 as soon as possible, to explore your options.  Furthermore, if you have a current plan, you will not be able to change to a new plan after the deadline unless you have a qualifying event and even then it may not allow you to “change” your plan, only add or take away dependents.  If you think you think you may want to change plans before 2015, the TIME TO DECIDE is NOW.  Visit , to compare plans, see if you qualify for a subsidy or enroll.

Don’t get caught without Health Insurance, or get stuck in a plan you aren’t happy with.

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How To Report Changes on – Income, Dependents, Etc

So you enrolled in an ACA plan for 2014 AND you got a discounted rate (or a subsidy) from the government.  One thing you have to make sure you do is keep all of your information current so that you continue to get the subsidy and/or you are not be charged back when you file your taxes.

Here are the life changes you need to report:

If you:
Get married or divorced
Have a child, adopt a child, or place a child for adoption
Have a change in income
Get health coverage through a job or a program like Medicare or Medicaid
Change your place of residence
Have a change in disability status
Gain or lose a dependent
Become pregnant
Experience other changes that may affect your income and household size

Other changes to report: change in tax filing status; change of citizenship or immigration status; incarceration or release from incarceration; change in status as an American Indian/Alaska Native or tribal status; correction to name, date of birth, or Social Security number.

When and how to report changes

You should report these changes to the Marketplace as soon as possible.

If these changes qualify you for a special enrollment period to change plans, in most cases you have 60 days from the life event to enroll in new coverage. If the changes qualify you for more or less savings, it’s important to make adjustments as soon as possible.

You can report these changes 2 ways:

Online. Log in to your account (or create an account if you don’t have one). Select your application, then select “Report a life change” from the menu on the left.

By phone. Contact the Marketplace Call Center at 1-800-318-2596 (TTY: 1-855-889-4325)

After you report changes to the Marketplace, you’ll get a new eligibility notice that will explain:

Whether you qualify for a special enrollment period that allows you to change plans

Whether you’re eligible for lower costs based on your new income, household size, or other changed information. You may become eligible for the first time, for a different amount of savings, or for coverage through Medicaid or the Children’s Health Insurance Program (CHIP). You also could become ineligible for savings–if your income has gone up, for example.

If you’re eligible for a special enrollment period

You’ll be able to shop for a different plan in the Marketplace. You usually have up to 60 days from the date of the qualifying event to enroll in a new plan.

If you have a special enrollment period, you can change plans 2 ways:

Online. Log in to your account and select your application. Then select “Eligibility and Appeals” from the menu on the left. Next, scroll down and click the green “Continue to enrollment” button. You can then shop for plans and change your selection.

By phone. Contact the Marketplace Call Center at 1-800-318-2596 (TTY: 1-855-889-4325).

If you’re not eligible for a special enrollment period but the tax credit you qualify for has changed

You can’t change plans. But you can choose to adjust the amount of the tax credit to apply to your monthly premiums.

To change your home address, email address, or phone number, update the information on your Marketplace Profile page.  This will only update it with, you will still need to report address, email, and phone changes to your insurance company too. 


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Are you too Poor for Obamacare?

Yes, you can be too poor or not make enough to qualify for a subsidy and apply for “Obamacare”.  If you are in a state that didn’t expand Medicaid, such as Texas, and you make less than $11,490 annual income you make less than 100% of of the poverty level.  In this case, you will not be eligible for a subsidy or credit towards your insurance.  In addition, you may not qualify for Medicaid – income alone doesn’t make you eligible.  Check your local state Medicaid office for qualifications if your income is less than 100% of the poverty level.

If you fall into this category, there are some options out there:

1.  Short term medical – It won’t cover pre-existing conditions, doctor visits and will probably only give a discount for prescriptions, however there are generally only 5 health questions to answer so most people qualify.  You can purchase this plan after March 31, 2014 (the annual enrollment cut-off date) and you can purchase a plan for 1-12 months.  They run anywhere from $100-$300/ individual depending on age, smoking, and location.  There is normally a $20-$35 application fee to apply.

2.  Limited medical insurance – These plans generally don’t have any qualifying questions to ask, so everyone can qualify.  They normally pay so much per doctor visit, or per day in the hospital.  If you use the network tied to them you get a deep discount on your service, or you can go out of network and pay more out of pocket.  These plans run anywhere from $250-$350 / individual depending on your location.  The is normally a $50-$99 application fee to apply which is non-refundable.

3. Discount Plan – You will be able to get a large discount on doctor visits, surgeries and certain procedures, prescriptions, even dental and vision with these plans.  They are not insurance, so they do not pay anything.  You must go to a participating doctor to receive the discount at the time of visit.  There is no claim filing.  These plans cost anywhere from $12-$90/ individual depending on the plan.  There may be an application fee of $20-$30.

Read more stories on people not qualifying for Obamacare here.

“Obamacare” is not an insurance plan.  Obama is the President who set forth the laws of the Affordable Care Act in which all insurance companies had to abide by.  Each company had to make an ACA compliant policy to sell on or off the marketplace.  The plans did not have to be the same.  So if you go to you may not be seeing all the plans that are available in your area.   You can use a licensed agent to assist in the process who can give you more details than what you see online at the marketplace and  also can make the process  a lot easier to choose just by asking some simple questions.

If you need help enrolling in Obamacare, or to see if you qualify for a subsidy click here

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Health Reform Poll Numbers

In Health Reform Weekly an article published by Aetna … we read about some startling facts.

Health Reform Weekly – Aetna – Week of February 3, 2014
Despite the publicity surrounding the problem-plagued launch of new health insurance exchanges and the January 1 implementation date for many important provisions, the American public still seems largely unaware of what has changed under the Affordable Care Act (ACA). The latest Kaiser Family Foundation tracking poll found that a significant majority (62 percent) of the public continue to believe that only some of the law’s provisions are in effect. Just 19 percent say most or all of the law has been implemented. Awareness of the individual mandate has climbed to 81 percent, but awareness of other provisions remains low – only four in 10 adults are aware of potential subsidies for coverage purchased through the new exchanges. Americans continue to have a largely negative view of the ACA overall – 50 percent have an unfavorable view of the law while 34 percent have a favorable view. But 55 percent say the focus should be on trying to improve the law rather than repeal, while 38 percent support repeal.

To see if you qualify for a subsidy go to Calculate My Subsidy


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BCBS of Texas now accepts MoneyGram Payments

If you  are a new members with Blue Cross and Blue Shield of Texas you can now pay your premiums with cash through MoneyGram at no cost!!!!   This will make things so much more convenient.  We were told that there are more than 38,000 MoneyGram locations across the U.S.    You can also pay premiums with cash or a bank debit card at WalMart.

If you want to make a payment through MoneyGram, you will need a code which will be printed on your invoice.  This identifies the company account to send the payment to.

When you make the MoneyGram payment, you will need the code and the following:

Member Account Number or ID Number
The company name, Blue Cross and Blue Shield of Texas
Personal identification such as a driver’s license or government issued identification

This is just another way BCBS of Texas is making it easier to do business with them.

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BCBS of Texas FAQ – New Applications

Due to the fact that BCBS of Texas is experiencing unusual call volume, they have posted some Frequently Asked Questions to help during this time.

Whether you are choosing a new health plan or have questions about an existing plan – we want you to know that we’re here to help you.

You may have noticed that your wait time for customer support is longer than normal. This is due to high call volumes. We are working very hard to return to the level of customer service you have come to expect from us. This week we’ve added 500 additional Customer Advocates to take calls in our Call Center to reduce your hold time.

In the meantime, here are some answers to our most frequently asked questions.

Has my coverage started? Can I use my health plan?

If you have a plan that started Dec. 1 and you paid your first premium, your coverage is active. If you have a plan that started the first of the month, but you haven’t paid your first premium payment yet, you won’t be able to use your health plan when you see a doctor or get a prescription filled. Once you’ve activated your coverage by making your first payment, you can have health care expenses during that coverage gap applied to your deductible, or even get paid back for some services.

If you have coverage that starts Jan. 1, 2014, you will need to make your first payment by Dec. 31, 2013, to have active coverage on January 1.

I applied on the Health Insurance Marketplace, but haven’t heard if my application has been received and accepted. Will I have coverage Jan. 1?

We receive new applications from the Marketplace every day. The applications take a few days for processing through the Marketplace. It then takes us a few days to process the application in our system. If you have not heard from us by phone, mail or email by Dec. 20, please try to call us again. We can let you know if we’ve received your application and how we can help if we haven’t.

I need help enrolling in a plan before the Dec. 23 deadline.

We encourage you to work with a local insurance agent, who can look at all your options and advise you on the best plan for your needs and budget. There is no additional cost to you when working with an agent.

You can also get information on all your options and apply on our website. In addition to our direct purchase plans, our site includes the plans we offer on the Health Insurance Marketplace, and a calculator to help you find out if you might qualify for financial assistance through the Marketplace.

When will I get my bill to pay my premium?

You should have received your bill for your first payment. If you haven’t and you have your group and member ID numbers, you can log in to your Blue Access for MembersSM, account to review your invoice online, and even submit a payment electronically.

If you set up your premium payments through automatic bank draft, you will not receive a paper bill. Your account will be drafted on the date you chose when you set it up.

When will I get my member ID cards, and how many will I get?

You will receive your member ID cards within 10 days of your application being approved. If you applied online through our Shopping Cart, you can print a temporary ID card and request additional cards through your Blue Access for Members account within 48 hours of enrolling online.

Individual plans will get 1 card and family plans will get 2 cards. You can request additional cards through your Blue Access for Members account. Please note that all member ID cards you receive will have the subscriber name on it and can be used by all of the dependents enrolled under the policy.

When will I get benefit coverage information and the contract on the plan I selected?

Soon after your application is accepted, you will receive a “Welcome Kit” from BCBSTX that includes your member ID and group number, your policy booklet and other information.

This information is also available in Blue Access for Members once your plan is in effect.

I’ve gotten a call from someone asking me questions about my new coverage. Is this person with BCBSTX, and why are they asking these questions?

Since you have new coverage with us, we want to make sure you understand your benefits and that we have the information we need to help you with your health care needs. We are calling to explain how your plan works, to answer questions you may have, and to tell you about some of the services we offer to help manage your care and your coverage. We also check your information, such as the names of everyone on your plan, your address and other details. The call often only takes about 15 to 20 minutes.

I had coverage, then you changed my plan effective date and now I don’t have coverage. What happened?

When the effective date change was made, some Blue Cross and Blue Shield of Texas plan members who had payment due dates after the 14th of the month were not showing as activated in our system, which generated a cancellation in error. We have corrected the problem and are reaching out to members impacted by this error. If you have paid your December premium payment, your coverage should now be active. Once you’ve activated your coverage by making your first payment, you can have health care expenses during that coverage gap applied to your deductible, or even get paid back for some services.

If you have questions about how health care reform affects you or would like to learn more about your health plan options, please call or write to us to learn how the new law might affect you.

Freedom Benefit Solutions – a premier agency with BCBS of Texas
Toll Free 877-740-8683

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BCBS of Illinois Policyholders Can Keep Current Policy

Special Bulletin from your Blue Cross Blue Shield Agency Office

Blue Cross and Blue Shield of Illinois (BCBSIL) previously notified you that your current policy would not be available after Dec. 31, 2013, because it didn’t meet the minimum standards required by the Affordable Care Act (ACA) starting in 2014.

Under federal and state guidance announced in November, you may now keep your current policy and renew it for the upcoming policy year beginning in 2014.

As a BCBSIL policyholder, you now have two options:

Option 1 – Keep Your Current Policy

You may choose to keep your current policy. If you choose this option, your current individual health insurance policy will not be canceled. If you did not choose a new policy for 2014, and would like to keep your current policy, just continue to pay your premiums on or before their due dates. Your current policy will renew for 2014.

If you chose a new policy for 2014, but you would like to keep your current policy, you need to let BCBSIL know that you want to keep your current policy AND cancel your request to change to the new policy you choose for 2014. Please click here to get the   “Request to Withdraw Enrollment in New 2014 Policy.” form. It will need to be returned through email, fax or mail by Dec. 23, 2013.

Your premium will be adjusted to reflect 2014 rates as well as a 4.1% increase to reflect ACA fees and other associated costs that go into effect in 2014. These fees are designed to support programs that will stabilize premiums and provide subsidies to qualified individuals to help them purchase coverage.

Option 2 – Choose a New Policy

You still have the option to choose a new policy for 2014. If you choose a new policy, your current policy will be canceled to coordinate with the effective date of the new policy. You will have a new individual health insurance policy that meets the minimum standards required by ACA in 2014.

If you’ve already selected a new policy for 2014, you do not need to take further action.

If you haven’t selected a new policy for 2014 yet, but would like to do so, please go to

or contact, Bonny Allbright /FREEDOM BENEFIT SOLUTIONS, your BCBSIL agent, at 877-740-8683 to review your options.
If you would like your new policy to begin on Jan. 1, 2014, you will need to make your selection and enroll by Dec. 23, 2013.

This year’s open enrollment is scheduled to continue through Mar. 31, 2014. When you enroll after Dec. 23, 2013, the date your new policy will begin will be based on your enrollment date.

Next week, a letter with full details and a notice required by the federal government will be mailed to you.

Until then, please call our office if you have any questions or view the FAQ.

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What if I need coverage that starts before January 2014?

You can buy individual insurance that starts before January 1, 2014. We can help you find your options. Please note, since the ACA (Affordable Care Act) doesn’t take place until January 1, some rights and benefits won’t apply yet.

You can still shop for an ACA plan for January 1, 2014, however if you don’t have coverage now and need it before then, you have several options. You can buy directly from an insurance company with our assistance or using our online service

You can purchase either a temporary plan for 1-3 months, or a permanent plan. No matter which plan you buy, be aware that some protections and benefits of the health care law are not yet in effect such as the underwriting process. For example:

  • You may be denied coverage, charged more, or have certain kinds of limits or exclusions if you have a pre-existing condition.
  • Women may be charged more than men.
  • Plans may not include or offer essential health benefits, so find out the benefits and exclusions before you apply.
  • You won’t be able to get lower costs based on your income, as you might be able to with a Marketplace plan.

Also before you apply, make sure you can stop your policy–at any time, and find out how to cancel. If you are planning on switching to an ACA plan from the Marketplace later, this will be valuable information.

Health Insurance Marketplace open enrollment starts October 1, 2013 and ends March 31, 2014. Coverage can begin as soon as January 1, 2014.

Please give us some info about yourself so we can assist you more.




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Filed under Affordable Care Act, Child policy, Health Insurance, Individual insurance, Pre-existing conditions