Land of Lincoln update # 5 –July 28, 2016
Tips for the Special Enrollment period – (Individual plan members only)
From the Desks of Castle Group Health Inc. –Jeff Greenberg, Mark Zisook, Brent Caldwell (retired) & Mark Gurda
As it stands, Land of Lincoln will cease to operate as of 10/1/2016. There are efforts, in this election year, to try and make some accommodation for its members. I doubt that anything comes from the efforts, but, our advice is:
DO NOT RUSH to sign up for a new plan in the first week or two beginning August 2nd. Just get comfortable with your options and make sure you have an active and working Healthcare.gov account. We also anticipate issues for early enrollees with HEalthcare.gov in allowing people to make an easy transition.
What to do now:
If you already have a Healthcare.gov account, please verify that your user name and password works. If you do not have a Healthcare.gov account, see attached instruction sheets in PDF. You do not need to go farther than this sheet at this time.
You should continue to make timely premium payments for August and September. If your Land of Lincoln plan terminates for Non-Payment, you will NOT be eligible for a special enrollment period. Your claims and benefits are guaranteed by the Illinois Health Guaranty Association.
Going uninsured for the balance of 2016 or purchasing short-term or a non ACA plans will have a preexisting condition clause and will subject you to the “Shared responsibility fine/tax” of up to 2.5% of your income. https://www.healthcare.gov/exemptions-tool/#/results/2015/details/short-gap
Our Agent ID’s:
Jeff Greenberg ID: Jeffgr30: NPN #1919871
Mark Gurda: ID Castlegroup: NPN #1486813
Mark Zisook; ID Zizkid: NPN #52549
Brent Caldwell (retired) – to avoid changing in 2017, please use one of the agent’s ID’s above.
OVERVIEW of the carriers offering coverage in the Chicago Area on Exchange:
Aetna – On Exchange – HMO’s, off exchange PPO, Comments – Off Exchange went to paper applications only and the process can be burdensome. The HMO does include North Shore System, but not Northwestern. The PPO does include both. PPO done only off exchange, no subsidy and paper application only.
Blue Cross and Blue Shield of IL – PPO (Blue Choice Only) Two HMOs – Advocate Direct or Blue Precision. The Blue Choice PPO is a limited PPO network. Many left Blue Cross in 2016 due to their dropping of the full PPO. Northwestern, Rush and North Shore are not in the small PPO network. The Advocate HMO is a no PCP, no referral HMO. See any Advocate facility in an open HMO environment.
Coventry – Illinois PPO only – Although expensive, includes Northwestern and North Shore Systems in PPO. Everything out of State is out of network. That can make it difficult. High price.
Harken Health – COOK COUNTY ONLY – This is an excellent choice from a carrier that will be here in 2017 although Harken will become an HMO in 2017. For those that can get Harken in 2016, we believe that those wanting full access to all the major, local systems, with the United Healthcare Open Access PPO network on a National basis, this is your choice. All plans are 100% after deductible, include an Rx card and $0 copay care at any Harken Center. All other expenses are subject to deductible.
Humana – HMO – We don’t find a reason to do Humana in any area. They are always, at least, a second choice.
United Healthcare – HMO – United Healthcare HMO offers a competitive HMO, but we find that there is no reason to choose United Healthcare. UHC has already said that they will not be back in 2017 as they pull out of Obamacare at the end of this year. Like Humana, no reason to choose them.
For assistance contact:
Mark H. Gurda President- Castle Group Health Inc.
Tel: 847-559-8100
Mark Gurda x 1201
Mark Zisook x 1202
Jeff Greenberg x1206
