- Since it was launched in 2013, the health exchange
website created after the Affordable Care Act went into
effect has had a reputation of experiencing technical
issues and being a slow process, but Healthcare.gov was
modified in time for the 2015 enrollment period,
allowing Americans to assess their options faster. And
in Wisconsin, the benchmark health insurance plan
offered through the exchange will increase less here
than the national average.
Modified marketplace website
Sandy Raasch, sales professional for
Platinum Benefits Group, said the expectation for when
enrollment began this past Sunday on Healthcare.org is
that it would run smoother and the renewal process would
be faster because of site modifications.
“They should be able to go in, reconcile
and reconfirm their policy if they know they want to
keep plans; it should take about 10 minutes,” Raasch
That’s a dramatic difference from the
nightmare that the site was in 2013 and 2014, she said,
but navigating the options remains challenging.
“Everyone I talk to and who are highly
educated, it still difficult to understand. I don’t know
how a person is able to completely do it alone,” Raasch
said, adding the hardest part isn’t filling out the
application, but determining which network to select.
An agent handling different health
insurance policies, like herself, is better able to
understand the nuances of the options, she said. One
plan may have lower premiums, but the coverage may not
be as comprehensive as a more expensive plan.
“I would just encourage (people) to
remain optimistic,” Raasch said. “The older people get
the bigger tax credits even if their income is the same,
it’s worth their time to go in and check.”
page of HealthCare.gov's website.
One of the most significant changes
individuals can expect when selecting health insurance
in 2016, Raasch said, is that several companies have
exited the market, including Assurant which is
discontinuing its health insurance division on Dec. 31,
2015; and Anthem Blue Cross and Blue Shield which will
no longer sell ACA-compliant individual health insurance
policies in Milwaukee, Racine and Kenosha counties.
She said there are still good health
insurance options separate from the marketplace.
Some of the people returning to the
health exchange website will be forced to switch plans
for 2016 because some health insurance cooperatives have
collapsed since they were formed. Data released Friday
showed a choice of 50 plans per county overall, compared
to 58 per county in 2014, and an average decline of two
plans per insurer.
credits and cost
Raasch said it’s important to maintain
documentation for selected health insurance plans,
especially if an individual really likes that particular
plan. She said representatives for the federal
marketplace do not go into an individual’s account to
verify that the income and all other information
remained the same, so the person could possibly lose her
income tax credit as of Jan. 1. So it’s important for an
individual to make sure the forms online are reconciled.
Raasch said she has found that health
insurance premiums are consistent on and off the
marketplace, but deductibles will tend to be lower
While the Affordable Care Act does make
health insurance more affordable for some, that’s not
the case for everyone, Raasch said.
“ACA is not affordable for the
middle-income person,” she said, citing that some plans
come with a $6,800 maximum out-of-pocket.
Last week, the U.S. Health and Human
Services Department said the cost of its benchmark plan
on Healthcare.gov would increase less in Wisconsin than
the national average. According to an Associated Press
report, the silver plan rates will go up 4.7 percent in
Wisconsin compared to 7.5 percent nationally. Some
states will have rates increasing by double digits while
other states will have a decline in rates. Nationally,
about eight in 10 returning customers will be able to
buy a plan for less than $100 per month after tax
Peter Frittitta, who handles client
strategic services for R&R Insurance Services, Inc.,
said the cost of insurance on the marketplace has
stabilized; however, he said pressure is increasing from
some employees forced onto the marketplace who found it
affordable two years ago, but now witness costs
Tammy Yager, consultant for T.E. Brennan
Company, said individuals should check prices and look
for the best value.
The classic example is an MRI, which can
cost $750 through a private company and around $2,500 at
Scott Fuller, senior vice president of
employee benefits practice group leader for Associated
Financial Group, LLC, said now that more individuals are
paying for their health insurance they are more willing
to shop around for the best price for a procedure.
To keep costs down, Fuller also
recommends that employees take an active role in their
health, including taking “advantage of preventative care
which the ACA mandated be covered at 100 percent.”
“The healthier we are the lower the costs
will be,” he said.
Kurt Janavitz, CEO of Integrated Health
Network based in Brookfield, said he believes there will
be more price transparency in the future.
Fuller worries that if health insurance
remains such a complicated problem, people will become
“I think it’s one of the biggest fears is
that if we don’t find a way to simplify it, people may
get so frustrated they don’t want to deal with it. It is
a challenging and complex problem,” Fuller said.
Janavitz said individuals are determining
what they want out of health insurance for what cost.
“People are still trying to figure out
what price point is OK to have less choice,” he said.
Overwhelmed, people pick health insurance based on cost
compared to quality.
“We are going to continue to see more and
more options that are attempting to do something
different,” Janavitz said.
While some people may want the additional
options, he said health insurance will also get more
“Get counsel and advice,” Janavitz said.
“Health insurance is morphing.”
Health insurance continues to evolve