Experts Answer Questions About Healthcare Exchange

By KOLR10 News

Published 10/01 2013 07:38AM

Updated 10/01 2013 09:40AM

Like it or not, today is the day - October 1, the first day Americans can enroll for affordable health care known as Obamacare.

Here to help us sort through it all are several local experts.   Also check out our special page with links to Missouri and Arkansas healthcare resources
We've got Nellie Lamers, a family financial education specialist from the University Of Missouri Extension.
Also Trevor Croley an insurance agent with Crowley Insurance And Financial.   
And finally Robert Baltzell  with RLB Financial.

1. Nellie, I want to start with you first... If you can take us through the timeline of this health care plan.  We know today is the first day people can sign up... January 1st is the day that coverage goes into effect and March 31 is when open enrollment ends

Nellie:  Open enrollment starts today and it goes through March 31 for this first period.  And the way that it works, if people sign up by December 15, their insurance will start January 1.  If they sign up December 16, it would be the following month, so February 1.   (March 31 is the deadline for open enrollment)

2. And Trevor Croley, I want to turn to you now. The number one question coming to your insurance agency right now is "how much will I pay?" We want to make sure people who have insurance through work know they can keep their insurance.  But for those without it, break these plans down for us.

Trevor:  Yes, the number one question is, what is it going to cost?   And really, the bottom line is, you're really going to have to take some time and figure it out.  Individuals will go to the marketplace.  They can determine if they are eligible for tax credits and subsidies.  That will be the number one question.  If you don't, then you'll have to look at an off-exchange plan.  The carriers out there that are working on exchange right now are Anthem Blue-Cross, Coventry, there might be a few others that surprise us here at the last minute.  But those are the ones that we know are in the marketplace.
And then off the marketplace, it's all the carriers they have today.  It's a matter of talking to your advisors and the navigators and finding out what's available.
 In Missouri, there are 17 plans, with four options; platinum, gold, silver, and bronze.  And individuals will have the ability to choose between those and within each carrier that's available they'll have different types of benefits and plans. You'll really just need to pay a lot of attention to what's available out there from company to company.

Premiums in Missouri were just released last week, a little lower than what we expected.  A mid-range plan for a family of 4 costs $798.  After tax credits a family of 4 with an income of $50,000 will pay $282.  The lowest cost plan for a 27-year-old is $162 and $87 after tax credits

3. Robert Baltzell a financial advisor also joining us this morning.  A lot of eyes are on the young uninsured Americans. How many of them will buy into this plan. The invincible group that often goes with the mindset if they are healthy they don't need insurance. Why is it important that they become insured?

Robert:   Those unexpected health crises can be a financial killer, especially in retirement.  It can lead to hundreds of thousands of dollars (in medical expenses) and disrupt the whole finance plan.  On top of that, we've been talking about how conrfusing it is.  All the surveys say most people are confused about it.  When people are confused, that's when the scammers jump in.

4. Nellie, I want to go back to you now.  There is a penalty people need to be aware of if they don't sign up for insurance.  Can you explain about that - it's 1% of your income in the first year?
Nellie:  That's correct - 1% of your income or $95 whichever is more, plus $47.50 per child.  But it caps at $285 in 2014, and then it phases in over the next couple of years so it increases.

Q: Do we know, at this point, how much it will be increasing, if you don't buy-in in the first two years?

Nellie - For the cap, in 2015, it will be $985 and in 2016 it will be $2085.

Back now with our panel here to talk about a little known healthcare plan that uninsured Americans can sign up for starting today, October 1.

Here to help us sort through it all are:
Nellie Lamers, a family financial education specialist from the University Of Missouri Extension.
Also Trevor Croley an insurance agent with Crowley Insurance And Financial.   
And finally Robert Baltzell  with RLB Financial.

1.  Trevor Croley, what information do folks need to have handy today if they plan to go online and sign up for a plan?

Trevor:  Well, a disclaimer - since nobody has gone through this process yet, we're not 100% sure what's needed.  But the basics that we do know, are you'll need things like your household income. You'll need to know if your employer has a qualified health plan that's affordable.  You'll also need to know dependent information.  The good thing that you don't have to know, is anything about your medical history.  Prior to this, people had to fill out an application with medical history - divulge those types of things.  That's not needed anymore.  But you will need basic financial information in order to help yourself through the system.

2.  Nellie Lamers, I want to turn to you once again. Talk about the major changes we're seeing in this plan.

Nellie:  People can't be turned down because of a pre-existing condition.  Also, premiums can be charged differently, depending on three things.  Family size: If the family is alrger, the premium can be larger.  Age:  Premiums can be charged more if people are older, but they can not be more than 3 times as much as a younger person's premium.   Tobacco use:  For tobacco use, people can be charged more for their premium.   So those are the things that are going to increase that.

3. Robert Baltzell,  I want to ask you about all the information we need to have ready.  A lot of times, someone calls us - we get something in the mail. And we think, I need to answer this person, there's a deal for us here.  But we've seen warnings from the Attorney General about scams already making their way around.  So tell us about what we may see and what we do NOT need to do.  You say "nothing" when it comes to people asking for your personal information.

Robert:  That's a good rule of thumb.  The Federal Trade Commission also announced all the scams.  There are scams about fake health insurance - claiming it costs $29.95 a month, only 20 spots left - give us your personal information.  Seniors on Medicare, scammers are saying you need a new ID card or you'll lose your coverage - give us your Medicare ID number.  They're also saying they need your bank account number to send it to you.  They're calling up with medical discount plans, saying they meet the minimums on Obamacare, but they actually don't.  They are discounts for doctors and pharmacists.  In fact the Federal Trade Commission says most of them are scams.  The bottom line is, with seniors, you don't have to do anything.  They're also calling and saying you need a new medical ID card, or you're not going to be able to be treated by a doctor.  It's all to get your Social Security number, your bank account number, your personal information.  The best rule of thumb is don't give them any of that kind information and if you do, make sure you report it.  The best thing to do is educate yourself on programs like this - go to  There are fake website out there, face emails, sometimes they have even threatened jail time if you don't sign up. So there is a lot of confusion with this, trying to take advantage of people.

Trevor:  Use common sense about it - use people that you know and trust - name companies you are familiar with.  Know the locations of people you are dealing with too.

People have a lot of questions about the implementation of the Affordable Care Act, specifically if -- and how -- to sign up for health plans under the exchange system.  Many of our viewers posted questions on our Facebook page and we'll attempt to answer some of the most frequently asked questions with our panel of experts.

Here to help us sort through it all are:
Nellie Lamers, a family financial education specialist from the University Of Missouri Extension.
Also Trevor Croley an insurance agent with Crowley Insurance And Financial.   
And finally Robert Baltzell  with RLB Financial.

1.  First, for people who may be in the lower income ranges, how this will affect them and what this plan looks like for them.
Nellie Lamers:  Well,  people who are between 100% and 400% of the federal poverty level, those are the people who are going to be eligible for tax credits.  To give you an idea, for 1 person, 100% is $11,490.  400% of the federal poverty level is $45,960.  So, somebody within that range will be eligible for tax credits.  For a family of four, that range is $23,550 up to $94,200.

2.  What about those folks who say, 'I don't have a job.  I don't see myself getting a job in the next few months.'  What does that mean for them?
Trevor Croley:  Well, it means that their options are to try to go for these subsidies and tax credits, see if those apply.  Unfortunately, we know there is a percent of the population who will say 'I'm just going to wait it out for a year and take the penalty.'  We don't want that, but it's going to come down to economics as well. 

3.  If enough people are not signing up for this, could it potentially collapse on us?
Croley:  This is the federal government, so they're just going to dig a little deeper from everybody's pocket, more than likely.  But the theory of insurance is that the healthy pay for the healthy, and some day your day will come.  So the more people in the system, certainly the better the system's going to be.  This is going to be reevaluated from year to year.  I'm sure, politically, it's going to create other things down the road.  They'll be repeals on certain things, but today - it's here.

4.  Robert, as a financial advisor, folks really need to go and do the side by side comparison about what's best for them.  What would you advise them as far as what's best for their household.
Robert Baltzell:  Well, of course, get the cheapest plan that is best for your household, what is the deductible, and talk to a profession to see what's best for you.  For some folks, their costs are going to go up, and their hours are going to get cut.  So they're going to have to budget for that and make sure they can handle that until we work the bugs out of the system. 

If the new healthcare exchange system under the Affordable Care Act has you confused, there are places you can go in Springfield to help get answers to make your decisions.

Here to help us sort through it all are:
Nellie Lamers, a family financial education specialist from the University Of Missouri Extension.
Also Trevor Croley an insurance agent with Crowley Insurance And Financial.   
And finally Robert Baltzell  with RLB Financial.

1.  So many people have questions about this new system, we want to make sure everyone knows there are resources out there and opportunities for folks to get well-informed about this entire plan.  Nellie Lamers, tell us about that.
Nellie:   University of Missouri Extension is providing education sessions for anybody.  They're free of charge to help Missourians get informed so they can make good decisions about their healthcare insurance.  People can call any Extension office, so every county has an Extension office, to find out about training.

2.  Trevor Croley, you have a substation in Springfield to help people in person?
Trevor:  Yes, Anthem Marketplace at 1943 S. Glenstone.  People can actually walk in.  We can calculate the subsidies for you, show you what you are eligible for and then look at your options.

3.  And Robert, the thing people need to keep in mind is just consider all the options.  Just because we're saying it's October 1 doesn't mean people have to run to the computer today and sign up.
Robert:  Exactly.  And when you get your options, how are you going to budget for that?  Consider that.  This is a major financial decision.  Most people do more research on buying a TV than they do on making major financial decisions.  Make sure you pick the best plan and once you do, make sure you budget for it.  If it's going up, it's a fact of life and we have to deal with it. 

4.  Trevor, I want to go back to you because during commercial breaks, we've had a lot of our crew asking lots of questions.  It comes down to households that have two separate insurance plans, how will this affect those families?
Trevor:  Recently, if you work for an employer, you should have received a notification called a "marketplace notification" which would inform you whether or not your health plan through your employer is affordable (federal definition is 9.5% of your gross income).  If it is below that it is deemed affordable.  If it is above that, that might still qualify you for some subsidies.  It is also based on your household.  So if your spouse and you both have access to group health insurance or one does and the other doesn't, it may negate you from getting subsidies and tax credits.  So you really need to pay attention.  Don't rush in and try to get this done on a single day.

And a reminder, today (Oct. 1) is the first day for enrollment to begin.  If you sign up by Dec. 15, your coverage starts on January 1.   Open enrollment closes on March 31.  So important dates to keep in mind.

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