Spring 2014
By Sandra Henderson, Vice President, Insurance

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In the Individual Market

The Open Enrollment Period is now over. If you missed this enrollment deadline you will now have to wait until October of this year to be able to sign up for Individual coverage that will start January 1, 2015. That goes for any individual plan inside the Exchange (Covered California) or outside the Exchange directly with an insurance company. There are a few exceptions to the rule that will allow you to sign up now, but mostly it involves losing coverage due to no fault of your own (i.e. you lost your job and therefore your group coverage). The biggest challenge now that you may and may not have discovered, is the availability of physicians serving the individual marketplace. Our most frequent calls from individual policy holders are telling us that none of their doctors will take their insurance plan. And it really hasn’t mattered from one company to the next. (That doesn’t account for much since there are only 3 insurance carriers in Fresno/Clovis that offer individual health insurance plans.) So please call and talk to your doctor’s office or other providers to ask about your insurance company and be specific about your health plan (that it is an individual plan and whether or not it is through Covered California), to confirm whether or not they will accept it.

Remember, that preventive care benefits are NOT covered AT ALL if you are using a non-participating doctor for the care. Even though the coverage for preventive care is supposed to be at 100%, it is only paid for at a Preferred Provider.


If you are on a Group Plan

STAY ON A GROUP PLAN or join one if you have the opportunity to do so. Providers are not fleeing like they are for the individual plans. I’m still waiting to see what changes appear as the year unfolds but it has been non-stop rule changing and postponing since ObamaCare has been enacted. Stay tuned for more details as we near the end of the year.



Consult an accountant or attorney for advice on how insurance strategies apply to your own personal situation. This material contains the current opinions of the author but not necessarily those of Plan Financial and such opinions are subject to change without notice. This material is distributed for informational purposes only. PFI Insurance Services, a licensed insurance agency and division of Plan Financial, provides clients with access to insurance issued by leading insurance companies. Insurance products are underwritten and issued by participating insurance companies. This is not an offer or solicitation in any jurisdiction where the policies are not approved for sale. Any obligations under the policies are the exclusive obligations of the insurance companies and are subject to the financial conditions of the insurance companies. Information contained herein has been obtained from sources believed to be reliable, but not guaranteed. No part of this article may be reproduced in any form, or referred to in any other publication, without express written permission. Plan Financial is a trademark or a registered trademark of Plan Life & Wealth Management, Inc., in the United States. © 2014, Plan Financial.

Print Insurance Insights Spring 2014