# Health Insurance Mentors

## The new RSC health care plan is the best health care plan I have ever read.
URL: https://www.healthinsurancementors.com/faq/the-new-rsc-health-care-plan-is-the-best-health-care-plan-i-have-ever-read/

On October 22, 2019, the Republican Study Committee released the best health care proposal I have ever read. You can read it here. Below are the reasons why these common sense reforms will dramatically reduce health insurance premiums, increase consumer choice and protect our most vulnerable and those with preexisting conditions.
1.) Health insurance carriers would not be able to rescind, increase rates, or refuse to renew one’s health insurance simply because a person developed a new medical condition after enrollment.

2.) Individuals with high risk medical conditions would have affordable access to state-run Guaranteed Coverage Pools under which their health care costs would be subsidized with federal grants and further contained by any state-enacted premium-setting restrictions. This is is the way these risks were mitigated in 45 states before Obamacare.

3.) You can elect COBRA and then move to an individual plan with guarantee issue rights without having to exhaust COBRA first. The ACA currently prohibits those who have elected COBRA from moving to a lower priced Individual plan until the annual ACA open enrollment period begins in which case their coverage cannot begin until January 1st.

4.) Everyone seeking coverage in the individual marketplace would have guaranteed issue protections and could not be refused a plan based on the enrollee’s health status, medical condition, claims experience, receipt of health care, medical history, genetic information, evidence of insurability, or disability. However, proof of prior coverage consistent coverage would once again be required which will prohibit gaming the system by remaining uninsured for long periods of time and then simply purchasing health insurance when you are then sick. This simple restoration of a common sense provision enacted under 1996 HIPPA law will reduce premiums for everyone. If a person does not have twelve months of continuous coverage, the person could be subject to an exclusion period of up to twelve months for an existing condition. Prior periods of continuous coverage would reduce any exclusion period month-for-month. Additionally, as was the case under HIPAA, states would be able to satisfy the RSC plan’s portability protections through the implementation of a Guaranteed Coverage Pool providing these same portability protections. Again, 45 states had either a High Risk health insurance pool or a Guaranteed Issue Individual mandate provision enacted for many years before Obamacare.

5.) States can satisfy the RSC plan’s individual marketplace portability protections through the implementation of a Guaranteed Coverage Pool that provides such protections. Accordingly, the coverage pool would have to:
1) Provide immediate access to a plan and prohibit condition exclusions for individuals who have maintained twelve months of continuous coverage.
2) Cap any condition exclusion period at twelve months.
3) Reduce any exclusions month-for-month for individuals with less than twelve months continuous coverage. Consequently, everyone with an existing condition who is seeking coverage in the individual market would be provided a pathway to obtaining complete coverage of all their conditions within just twelve months.

States would also be free under the RSC plan to enact shorter exclusion periods. Prior to the ACA, the vast majority of states with high-risk pools capped their exclusion period at six months or shorter.
6.) To ensure that ample options exist for Americans to possess continuous coverage, short-term health plans would also count toward periods of continuous coverage under the RSC plan. Additionally, the RSC plan would codify the Department of Health and Human Services’ new rule allowing short-term, limited-duration plans to last for a term of one year (and renewable for up to 36 months).

7.) 1332 waivers – seven states, including Alaska, Maine, Maryland, Minnesota, New Jersey, Oregon and Wisconsin, were awarded waivers under Section 1332 of the ACA to deviate from certain ACA mandates and redirect ACA subsidies toward uniquely designed reinsurance programs. Alaska applied for and was (finally) granted a 1332 waiver from CMS on July 11, 2017 thanks to President Trump. That waiver allowed Alaska to separate the most expensive consumers from the rest of that state’s risk pool and as a result health insurance premiums dropped from an expected increase of 40% to an actual increase of only 7%. The same risk mitigation strategies are now being adopted by other states like Hawaii, Maine, Maryland, Minnesota, and Oregon.
Wisconsin applied for and received an ACA waiver allowing them to create a state based reinsurance program sponsored in part by the Federal government. The “Wisconsin Health Care Stability Plan” will pay 50% of insurers’ claims between $50,000 and $250,000. The state projects it will spend $34 million of its own funds for these claims next year, with the rest coming from the federal government. The feds, however, aren’t expected to shell out any new money because reinsurance also helps the federal government. The lower rates mean it will spend less on premium subsidies for those who qualify. Those savings will be redirected to the stability plan.

An additional five states (Colorado, Delaware, Montana, North Dakota, Rhode Island) project premium reductions of up to 16 percent in 2020 due to 1332 waivers.”

8.) The cost to implement these state based risk mitigation systems is $17 billion annually. That may not seem ideal but it sets up a sustainable path for the individual marketplace and deters our nation from heading toward a government-run, one-size-fits-all health care system that would cost taxpayers more than $30 trillion over the next decade.

9.) Use can FINALLY use your H.S.A. dollars to pay for health insurance premiums which will equalize the tax favored status between individual and employer sponsored plans. By allowing individuals to use health savings accounts funds to pay for their health care premiums, the RSC plan allows individuals to take advantage of the triple-tax advantaged status of health savings accounts. First, funds that are deposited in a health savings account are not subject to income tax or payroll taxes (including individual and employer payroll taxes) when they are earned. Once in the account, funds are not subject to taxation for any interest accrued. Nor are funds taxed when they are removed from the health savings account and spent on qualifying medical costs. An individual who utilized their health savings account in this way would no longer be penalized for choosing to shop for a plan on the individual market. Under current law, for 2019, $3,500 may be contributed to health savings accounts for an individual, and $7,000 for families.146 In 2018, the House of Representatives passed legislation to increase the contribution caps to $6,650 for an individual and $13,300 for a family.
This limits are currently way too low. According to the Kaiser Family Foundation, the average annual family premium per enrolled employee for employer-based health insurance in 2017 was $18,687.148 Because of this, under the RSC plan, contribution limits would be increased even more to $9,000 per individual and $18,000 for families. The RSC plan would also allow working seniors, or anyone on Medicare, to have a health savings accounts and continue to contribute to it. Individuals enrolled in other public health insurance programs, such as those with Tricare, Indian Health Service, or Veterans benefits, would also be able to contribute to a health savings accounts. Furthermore, FSA and HRA balances could be converted into a health savings account.

10.) The FMAP rate for the expansion population would eventually match normal FMAP rates. There is no reason why an able-bodied adult without any dependents should be more heavily subsidized than a poor pregnant woman, elderly person, child, disabled individual, or parent.

11.) Association Health Plans. The RSC plan urges codification of the reforms promulgated by the Department of Labor that ensure Americans have greater access to Association Health Plans (AHP). Association Health Plans currently work by allowing small businesses to band together by geography or industry to obtain health care coverage as if they were a single large employer. Importantly, AHPs offer benefits comparable to employer-sponsored plans and cannot discriminate against patients with pre-existing conditions. They also “strengthen negotiating power with providers from larger risk pools and [provide] greater economies of scale,” according to the Department of Labor.

12.) Unfortunately, many states have passed laws impeding the provision of telemedicine by banning or heavily restricting its progress. Notably, the position of the American Medical Association still calls for doctors to be physically present when rendering medical services. This will end and you’ll be able to log on and consult with your doctor without driving all the way to the doctor’s office and waiting for God knows how long in a waiting room.
Major Kudos to the Republican Study Committee. I could not have written a better plan!

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## ACA (Obamacare) Individual mandate repealed as of January 1, 2019
URL: https://www.healthinsurancementors.com/faq/obamacare-individual-employer-mandates-still-codified-irs-law-now-republicans-failed-pass-ahca/

The ACA (Obamacare) Individual Mandate was zeroed out (effectively repealed) by congress on 12/20/17. President Trump signed the Tax Cuts and Jobs Act of 2017 which zeroes out the mandate as Jan. 1, 2019.

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## Blue Cross Blue Shield of Illinois 2020 proposed premium increases for Individual and Small Group
URL: https://www.healthinsurancementors.com/faq/blue-cross-blue-shield-illinois-proposed-not-approved-2018-premium-increases/

Below are the 2020 proposed annual premium rate increases for both Individual and Small Group health insurance policies issued by Blue Cross in 2019. To search for other carrier’s policies in Illinois and around the nation visit Unified Rate Review at Healthcare.gov.

2020 PROPOSED ANNUAL PREMIUM INCREASES FOR 2019 RENEWING SMALL GROUP POLICIES

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## Group health insurance for couples ensures access to Chicago Teaching hospitals for small businesses owners.
URL: https://www.healthinsurancementors.com/faq/group-health-insurance-one-person-ensures-access-chicago-teaching-hospitals-small-businesses-owners/

In November of 2015, Chicagoland residents were shocked to learn that Northwestern Memorial hospital, University of Chicago medical center, Rush University medical center and the Ann & Robert H. Lurie Children’s hospital would no longer accept patients who have ACA (Obamacare) qualified individual health insurance plans.
This action led to a significant increase in the purchase of small group health insurance policies which still provide national PPO networks and still ensure access to the aforementioned teaching hospitals in Chicago.
For small corporations who could afford to insure themselves and 70% of their eligible full time employees (the minimum participation requirement), purchasing small group health insurance was a costly fix to the new narrow networks in the individual health insurance marketplace.
The ability to purchase group health insurance for you and your full-time employees is well known. What is not well known is the fact that you can purchase a small group health insurance policy without insuring your employees during a small window each year. This year that window begins on November 1st and ends on December 15th. The same time period that 2018 ACA Open Enrollment for individual plans begins and ends.
During this little known ‘relaxed underwriting’ period, an owner of a small corporation (less than 50 full-time employees) can purchase small group health insurance while employees ‘waive’ coverage without producing an eligible waiver. Normally, 70% of all full-time employees must participate in a group health insurance plan unless they have an eligible waiver such as an offer of group health insurance from a spouse’s employer or Medicare and Medicaid coverage.
If you are a small business owner who is seeking to purchase small group health insurance and cannot afford to insure your employees or, your employees simply do not want to participate in a group health insurance plan. Now is the time to learn more about “relaxed underwriting”. The cost for group health insurance is now commensurate with individual health insurance but the PPO network is much larger and far more inclusive than any of the narrow networks now available in the individual marketplace. Want to learn more? Click on “contact” above.

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## Senate “Better Care Act of 2017” makes important changes to the House American Health Care Act.
URL: https://www.healthinsurancementors.com/faq/senate-better-care-act-2017-makes-important-changes-house-american-health-care-act/

The U.S. Senate released their version of a heath care reform act this morning. It is entitled the “Better Care Reconciliation Act of 2017“.  It makes important changes to the “American Health Care Act” passed by the U.S. House of Reps back on May 4, 2017. Some of these changes I predicted, some I did not. Like the American Health Care Act, the Better Care Act does not achieve a full repeal of Obamacare but as I have explained, we cannot achieve a full repeal without 60 votes in the U.S. Senate. The Act is a far cry from a free market health care plan but taken in total, it further advances our flag and God willing will restore the individual health insurance marketplace to some semblance of normalcy via less regulations and billions and billions of your taxpayer dollars.  Below are the highlights of the Better Care Act of 2017.
Health Insurance Tax Credits will be means tested under this Act
The “American Health Care Act” contained a flat tax credit amount based solely on an applicant’s age. While this is a much simpler way to facilitate tax credits and would involve the I.R.S. as little as possible, it would also require those who are just above the income level necessary to qualify for Medicaid (currently 138% above FPL) to pay significantly more for health insurance than they would have under the P.P.A.C.A. (Obamacare). This is true because Obamacare, like the Better Care Act provides means tested health insurance tax credits. So, the lower your income is the larger your tax credit is. This will ensure that the working poor who are struggling to get off of Medicaid and on to private health insurance will be able to do so for a much more affordable premium than they would have had with the age based tax credits which were the only option included in the American Health Care Act.
Individual and Employer mandates REPEALED
The Better Care Act retains the repeal of both the Individual and the Employer mandates that were included in the American Health Care Act. So, the federal government will no longer be able to force you to purchase insurance using the threat of an I.R.S. penalty.
Obamacare taxes REPEALED and Cadillac Tax “delayed” until 2026
Let’s just be honest. The Cadillac Tax is never going to happen. The employer sponsored health insurance lobbying groups are just too powerful. Can we finally just admit this? That stated, repealing other Obamacare taxes is a great start. Here’s what goes bye-bye:
Tax on health insurance REPEALED
Tax on employee health insurance premiums REPEALED
Tax on health insurance plan benefits REPEALED
Tax on prescription medications REPEALED
Tax on OTC – Over The Counter – medications REPEALED
Tax on Medical Devices REPEALED
Tax on Chronic Care REPEALED
Tax increase on Medicare REPEALED
Tax on tanning REPEALED
Tax on net investment REPEALED
Tax on Health Savings Accounts REPEALED
Tax on Flexible Spending Accounts (where contributions are limited) REPEALED
Preexisting conditions COVERED but WHERE is the 30% penalty for system gamers?
The American Health Care Act allowed health insurers to apply a 30% underwriting load to those who attempt to wait until they are sick to buy health insurance. This was designed to prevent system gaming which increases the cost for everyone. Whilst the Better Care Act is clear on the fact that preexisting conditions are covered, it is not clear on whether or not insurers will be allowed to apply an underwriting load to system gamers. If this load or something like it is not added to the final legislation during conference you can kiss the entire individual health insurance market goodbye because there will be no reason for anyone to maintain health insurance on a consistent basis. Instead they will jump on an off plans when they “need” them and you can sayonara to the few remaining health insurers left in America. Hello Senators! Hello! McFly??!!!
Advance Premium Tax Credit eligibility threshold reduced to 350% above FPL
Under Obamacare, an individual with MAGI – Modified Adjusted Gross Income – higher than 400% of FPL – Federal Poverty Level – ($47,520 annually) would not qualify for an APTC – Advance Premium Tax Credit. Under the Better Care Act, that eligibility threshold is reduced to 350% of FPL or $42,300 annually. Below are charts on how APTC eligibility cut-offs will change based on your family size:
APTC eligibility cut-off under Obamacare
$47,520 for an individual
$64,080 for a couple or family of two
$80,640 for a family of three
$97,200 for a family of four
$113,760 for a family of five
$130,320 for a family of six
APTC eligibility cut-off under Better Care Act 
$42,300 for an individual
$57,000 for a couple or family of two
$71,500 for a family of three
$86,300 for a family of four
$101,000 for a family of five
$115,600 for a family of six
You can also use this convenient Federal Poverty Level calculator here.
Advance Premium Tax Credits will now be available to those UNDER poverty line
The Better Care Act will dramatically improve options for more than 2 million Americans who are stuck in a difficult situation in the 19 states that did not expand Medicaid under Obamacare.  These people have incomes that are too small to be eligible for Advance Premium Tax Credits used to buy private health insurance while also having income too high to qualify for Medicaid (incomes between 100% and 138% of Federal Poverty Level). So, they’re stuck between a rock and a hard place. The Better Care Act ensures they will now qualify for Advance Premium Tax Credits to purchase private health insurance. This should lead to a significant improvement in health outcomes for these people.
Cost Sharing Reduction subsidies to continue all the way to 2020 
Cost Sharing Reduction subsidies are an additional health insurance subsidy available to those with a MAGI lower than 250% of FPL. These subsidies lower deductibles, co pays, coinsurance and other out-of-pocket expenses the policy holder otherwise would incur. Continuation of these subsidies until 2020 may be the biggest bone of contention between the House and the Senate when the Better Care Act gets to the conference committee. This is because House Republicans sued to stop billions in Cost Sharing Reduction subsidies in 2014 since the money was never appropriated by congress, making those expenditures unconstitutional. A federal district court judge ruled in favor of House Republicans and thus far even though he has the power to stop them, President Trump has continued these subsidies tentatively. The Better Care Act ensures they will continue until the year 2020. The continuation of CSR’s will most likely induce some of the 83 health insurers who have left the individual market to return since the CBO estimates that H.H.S. will pay $7 billion in subsidies to health insurers and that total could rise to $16 billion by 2027 which is why the Better Care Act ends Cost Sharing Reduction subsidies permanently in 2020. That end date could result in a compromise.
Benchmark health plan changed from a “Silver” plan to a “Bronze” plan.
This action alone should be responsible for 15% or more in premium reductions across the board. Heretofore, states have being required to use a more expensive “Silver” plan as their benchmark plan resulting in higher premiums for millions of Americans.
States can opt out of EHBs but not Community Rating or Preexisting Conditions
The American Health Care Act allowed states to file for a waiver from the requirement to include EHBs – Essential Health Benefits – as defined by Obamacare and it also allowed them to file a waiver from the Community Rating requirement. The Better Care Act also allows states to file a waiver from EHBs but it does not allow them to file a waiver from the Community Rating requirement. While Community Rating does allow health insurers to vary the premium rate charged for an individual or small group plan based on family size, geography, age and tobacco use. It does not allow health insurers to vary premium rates based on an applicant’s expected health status or claims experience. So, preexisting conditions will continue to be covered in all states regardless of any waivers.
Hyde amendment wording is followed when restricting funding for abortion
Health insurance purchased using funding from the Better Care Act cannot cover abortions unless they are performed to save the life of the mother or for victims of rape and incest as originally outlined in the Hyde amendment.  Medical providers are also prohibited from using any funds allocated under this Act for abortions that are not specifically referred to in the Hyde amendment.
Medical Loss Ratios to be determined by the states NOT the Federal government.
Beginning in 2019 the Better Care Act will allow states to design their own MLR calculations. This action may also spur smaller health insurers to return to the individual market since (depending on the state) they may no longer be restricted to a 15% or 20% operating margin. This will also allow states to determine if Broker/Agent commissions should be included in MLR calculations. Just imagine if we had more licensed and experienced broker/agents and less inexperienced, unlicensed Obamacare “Navigators”. Excluding broker/agent commissions from the MLR calculation will once again entice broker/agents to return to the individual marketplace (there are very few of us left who cater to the individual marketplace). This action would save consumers hours and hours of frustrating time on the phone at Healthcare.gov. Time that is far too often spent without resolving issues and sometimes even exacerbating them.
Age based Community Rating restored to a 5 to 1 ratio
The American Health Care Act restored Age Based Community Rating from 3 to 1 as it was mandated under Obamacare to 5 to 1 which should entice the all important young invincibles to reenter the individual health insurance market place. The Better Care Act keeps this 5 to 1 ratio in place. Obamacare placed a heavy burden on younger people by requiring them to pay much more for health insurance in order to subsidize older people. With the Better Care Act, young people should see a significant drop in premiums because the amount they pay for health insurance will no longer be dramatically increased in order to provide a small reduction in premium for Americans in their 50s and 60s. Increasing premiums for young people does nothing but drive them out of the individual marketplace and when they leave, premiums increase for everyone which is exactly what we witnessed under Obamacare.
ERISA amended so states can cooperate with Fed on Small Business Health Plans
The language is a bit vague here but if this Act allows independent contractors or even members of certain trade associations to band together and share risk I am all for it. I do believe that is the intent behind the ERISA amendment in the Better Care Act.
Medicaid Expansion gone by 2020. States have Block Grants or Per Capita options.
Medicaid is unsustainable by all assessments. So, something has to be done to improve it. Throughout the Better Care Act, states are allowed the option to pursue new ways of improving care and controlling costs via flexible design and quality improvement metrics. If states meet those metrics there is an $8 billion fund they can tap into. In addition, the states have the option to design work requirements, none of which can apply to pregnant women, the blind, those attending school or the disabled. But those who can help themselves, should at least try to help themselves so that more money is left for those who are truly in need. The Better Care Act phases out Obamacare Medicaid expansion over the next four years with 90% of current federal funding for the year 2020 and then a reduction in that federal funding by 5% a year until 2023 when Obamacare Medicaid expansion will end for good. Also, single individuals without dependent children will not be allowed to join Medicaid under Obamacare Medicaid expansion after the year 2020. Advance Premium Tax Credits for private health insurance will however be available to those who lose eligibility for Obamacare Medicaid expansion as the program is slowly eliminated. In addition by 2025 Medicaid will be capped at the rate of growth for all goods, not just the inflation rate in medical prices. So, there is a strong impetus for states to start reforming their Medicaid programs now, not later.
HSA deposit amounts will now match your total health plan out-of-pocket risk.
This is a no brainer which is why it was also included in the American Health Care Act. In addition, a 60 day grace period will be allotted for those who purchase an HSA – Health Savings Account – qualified HDHP – High Deductible Health Plan – and incur claims before they have a change to set up their HSA. Those claims incurred before the HSA is set up (and after the HDHP is effective) will also be counted as Qualified Medical Expenses under IRS section 502. In addition, both spouses can now make additional make up contributions providing of course that they are both over the age of 55.
AND NOW FOR THE SPENDING
$62 billion appropriated for Long-Term state stability & innovation through 2026 
The following appropriations are made in the Better Care Act to establish or maintain a program or mechanism to provide financial assistance to help high-risk individuals, including by reducing premium costs for such individuals, who have or are projected
to have a high rate of utilization of health services, as measured by cost, and who do
not have access to health insurance coverage offered through an employer, enroll
in health insurance coverage under a plan offered in the individual market.
This money can also be used to establish or maintain a program to enter into arrangements with health insurers to help stabilize premiums and promote state health insurance market participation and choice in plans offered in the individual health insurance market place.
It can also be used to provide payments for health care providers for the provision of health care services, as specified by the administrator. To provide assistance to reduce out-of-pocket costs, such as copayments, coinsurance, and deductibles, of individuals enrolled in plans offered in the individual market place.
$8 billion for year 2019
$14 billion for year 2020
$14 billion for year 2021
$6 billion for year 2022
$6 billion for year 2023
$5 billion for year 2024
$5 billion for year 2025
$4 billion for year 2026
$50 billion Short-Term assistance to repair coverage access disruption through 2021

The following appropriations are made to fund arrangements with health insurers to address coverage and access disruption and respond to urgent health care needs
within States:
$15 billion for year 2018
$15 billion for year 2019 
$10 billion for year 2020
$10 billion for year 2021
$15 billion individual market stabilization fund for years 2019 through 2021
$5 billion per year is appropriated in order to stabilize premiums and incentivize health insurers to return to the individual marketplace during years 2019, 2020 and 2021.
Additional appropriations also included in the Better Care Act
Additional $422 million appropriated in 2017 for Community Health Centers
$2 billion to combat the opioid crisis.
$8 billion for states achieving quality performance metrics in improving Medicaid/CHIP
$500,000,000 appropriated to implement the Better Care Act.
You can read the entire Better Health Care Reconciliation Act of 2017 by clicking below:
https://www.budget.senate.gov/imo/media/doc/SENATEHEALTHCARE.pdf

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## H.H.S. Director Dr. Tom Price continues implementing “Phase 2” of the AHCA before the bill even passes the U.S. Senate
URL: https://www.healthinsurancementors.com/faq/h-h-s-director-dr-tom-price-continues-implementing-phase-2-ahca-bill-even-passes-u-s-senate/

H.H.S. director Dr. Tom Price continues implementing “Phase 2” of the American Health Care Act even before it passes the U.S. Senate. You know, that “Phase 2” that so many naysayers said would “never happen“. Yeah, that one. Dr. Price is allowing any state who wants a 1332 waiver to apply for one now, even before the American Health Care Act is voted on in the U.S. Senate. 1332 waivers allow states to implement risk mitigation programs like high risk pools so consumers experience immediate premium reduction.

Recent empirical evidence proves that 1332 waivers actually DO reduce premiums
The state of Alaska used a 1332 waiver last year to create their own high risk health insurance pool and saw premium reductions of 33% in their individual health insurance marketplace. A 33% premium decrease is a much better outlook for 2018 than yet another double digit premium increase that states like Virginia, Maryland and Connecticut are facing for 2018 right now, some as high as 60%! Why so high? Because the PPACA (Obamacare) destroyed healthy competition by causing 83 health insurers to leave the marketplace last year. This has left states like Virginia with only two health insurers left and states like Iowa with only one carrier left and possibly no carrier for 2018 if Medica follows through on their threat to throw in the towel after losing $100 million under Obamacare. My home state of Illinois just lost one of only four insurers left that offer individual products when Harken Health called it quits this week after losing $64 million just last year.

This isn’t the first time our H.H.S. & C.M.S. directors have taken corrective action
Last month, Dr. Price and our new C.M.S. director Seema Veerma stopped the reckless practice of Healthcare gov jet issuing policies to Special Enrollment applicants who claimed a ‘loss of income’ without requiring any proof that they actually did lose income before issuing the policy. Now, these Special Enrollment applicants have to prove a ‘loss of income’ before they get a policy. This action alone by Dr. Price and Seema Veerma stopped consumers from attempting to “game the system” by waiting to buy a health plan until they have scheduled medical treatment and then canceling that health plan shortly thereafter which drives up premiums for everyone.
Maybe, just maybe U.S. Senators can take a lesson from Dr. Price and Seema Veerma’s work ethic and pass the American Health Care Act now.  Why now? Because health insurers are required to submit their 2018 plans and premium rates for review by C.M.S. no LATER than June 21, 2017. Time is of the essence here if consumers want to experience premium relief and desperately needed restoration of competition in the individual marketplace before the next open enrollment period begins on Nov. 1, 2017.

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## President Trump’s C.M.S. implements common sense reforms to Obamacare Open and Special enrollment periods.
URL: https://www.healthinsurancementors.com/faq/president-trumps-c-m-s-implements-common-sense-reforms-obamacare-open-special-enrollment-periods/

Our new H.H.S. director Dr. Tom Price and our new C.M.S. director Seema Veerma are wasting no time in improving how both the Open and Special enrollment periods work under the PPACA (Obamacare). There will be no more “gaming of the system”. Below are the changes that will both lower premiums and restore desperately needed competition.

1.) The Open Enrollment period will be shortened from 90 days to 45 days. 2018 open enrollment begins on 11/1/2017 and will end on on 12/15/2017 (not January 31, 2018 as has been the rule). This will lead to less adverse selection and lower premiums.

2.) If you are eligible for “Special Enrollment” you now must prove you are before the health insurance policy will be issued. This will also lead to less adverse selection and lower premiums.

3.) If you try to dump a health insurance policy in the middle of the year by stopping payment and then attempt to reapply with the same insurer later in the year, that insurer can now require you to pay up to 3 months of back premiums that you would have owed had you kept your policy in place like you should have all year. This too will lead to less adverse selection and lower premiums.

4.) Health Insurers will finally be allowed some actuarial flexibility when designing new health insurance plans. This will lead to more health plan options with lower premiums. Most importantly it will provide an impetus for some of the 40 health insurers who left the marketplace since 2014 to re-enter and thereby restore some of the desperately needed competition that Obamacare destroyed.

With the new found endorsements of the American Health Care Act – AHCA – by the House Freedom Caucus and Club For Growth we may be getting much more relief from Obamacare very soon. Until then, these two brilliant appointees by President Trump are wasting no time ensuring that Americans get as much relief as possible before the 2018 Obamacare open enrollment period begins. For the 19 million Americans who purchase their own individual health insurance these reliefs can not come soon enough.

To read the new final rules click the link below: https://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2017-Press-releases-items/2017-04-13-2.html

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## Why health care policy experts support the GOP Obamacare replacement plan.
URL: https://www.healthinsurancementors.com/faq/health-care-policy-experts-support-gop-obamacare-replacement-plan/

It’s been a while since I’ve put fingers to keyboard to write about health care policy. That’s primarily due to the fact that I’ve been a bit busy for the last four months helping consumers navigate what is left of the individual health insurance marketplace during the annual PPACA (Obamacare) open enrollment period. I say “what is left” because we have lost 19 health insurance carriers since the passage of Obamacare and the taxpayer funded Obamacare co-op ‘health insurers’ that were supposed to replace them are also now bankrupt. This rapid demolition of the individual (non employer sponsored) health insurance market place has robbed my clients not only of access to their doctors but also to their preferred hospitals. Worse yet, they have lost their health plans every year now for 4 years in a row and their health insurance premiums have increased up to 150% since the passage of Obamacare. In other words, they have been forced to endure the exact opposite of what they were promised by Barack Obama and the Democrat party.
To say the individual health insurance marketplace in this country is in a dire situation is an understatement. In fact, if something is not done now to preserve what is left of that marketplace, we will have no health insurance carriers left to choose from in 2018. United Healthcare has already exited after losing more than a billion dollars. Aetna exited after losing more than half a billion dollars and Humana now has wisely exited the marketplace as well in most states. This leaves consumers with a monopoly dominated mostly by Blue Cross entities all of which have lost hundreds of millions of dollars since the inception of Obamacare. These few remaining carriers will not continue to contribute to their own demise forever. Something has to be done now, not later and that is the impetus behind the current GOP proposal to repeal and replace Obamacare. This is also why myself and other health care policy experts like Betsy McCaughey support the proposal. It is also important to note that because President Trump is an intelligent, informed and proven leader, he too supports this plan. Why? Because he understands how dire the situation currently is and how many people will be “hurt and hurt badly” if we do not act NOW. Watch his weekly address by clicking below:

 
 
 
To be frank, if you’re just reading this and you’ve never been on the other end of the phone with a woman with Ovarian cancer who’s calling you for help whilst she’s lying in her bed at Northwestern Memorial hospital weeping because she can no longer receive care there, you cannot possibly understand how dire the situation is. The worst part is that for the first time in my 20 year career as a licensed health insurance broker, there was nothing I could do to help this woman. There were literally no other options for her. There were only two other carriers I could offer her and those carriers offer only restrictive HMOs, none of which provide access to her preferred hospital or any of our other teaching hospitals. There are 19 million Americans just like her who are self employed sole proprietors and as such have to purchase their own health insurance in the individual marketplace. Their choices will soon be zero if something is not done now to incentivize health insurance carriers to once again reenter the individual health insurance marketplace. Already nearly 1/3rd of all counties in this nation have only ONE health insurance carrier to choose from. Soon it will be NONE.
The American Health Care Act

So, how do we accomplish that? The Republican party has chosen to do so in three phases. Paul Ryan did a power point presentation and I must say as a guy who has given hundreds of power point presentations, Ryan did a very good job explaining the process and I encourage you to watch it by clicking on the image below. I’m going to go a few steps further by breaking it down even more in bullet points listed below the video.

As aforementioned, three phases comprise the process of developing what will eventually be known as “The American Health Care Act“. They are as follows:
1.) The first phase of the GOP’s current proposal to repeal and replace Obamacare is the Budget Reconciliation Bill released on Monday March 6, 2017 which goes a long way towards doing so. Because it deals with only budgetary issues, it only requires 51 votes in the U.S. Senate to pass which means it should pass quickly. This budget reconciliation bill accomplishes the following:
a.) Repeals $600 billion in Obamacare taxes AND the individual & employer mandates. This means we will no longer be a ‘part time nation’ and individuals will no longer be unconstitutionally TAXED by a rogue I.R.S. for simply existing and refusing to purchase overpriced, government designed and mandated health insurance plans. It also repeals the 2.35% Obamacare payroll tax hike and the 3.8% tax on unearned income (capital gains).
b.) Puts caps on Medicaid enrollment to discourage over spending and allows states to structure their own Medicaid programs in order to better serve their Medicaid recipients.
c.) Creates innovation grants for states to redevelop health insurance risk abatement programs such as high risk pools which were abolished under Obamacare. These high risk pools help isolate and better control costs for those with the highest health care costs which makes health insurance for the healthy less expensive.
d.) DOUBLES the amount one can deposit into an HSA.
e.) STOPS all abortion funding under Obamacare.
f.) Creates a tax favored status for individual health plans by providing a refundable tax credit to purchase those plans. Currently there is no tax favored status for individual health insurance plans. Tax favored status has traditionally only been awarded to employer sponsored group health insurance plans. Ever try to deduct your health insurance premiums as a sole proprietor? Or for that matter deduct any of your medical costs above 10% of your A.G.I.? It isn’t possible now. If the American Health Care Act passes, sole proprietors will finally enjoy tax favored status for purchasing their own individual health insurance. It’s about damned time! In addition those who are not offered coverage via an employer will have a portable refundable tax credit to help pay for health insurance and a refundable tax credit is NOT a ‘subsidy’ that you did not EARN. It is simply a way of you keeping more of YOUR money by not paying as much in taxes so that you can use it to pay for health insurance. It is NOT a ‘new entitlement’ Rand Paul… but I digress.
g.) Covers preexisting conditions but rightfully penalizes those who attempt to game the system by waiting until they are sick to purchase health insurance. Such conduct increases health insurance costs for everyone and that is why that conduct was originally prohibited under 1996 HIPAA law. That law outlined specific waiting periods before one could qualify for coverage for preexisting conditions if they did not keep consistent health insurance coverage in place. There were also financial penalties for those who attempted to game the system that way. Obamacare allowed anyone who claimed a ‘loss of income’ to game the system throughout the year by jumping on and off health plans which resulted in massive losses to health insurers and their subsequent exit from the marketplace. That conduct MUST stop and the only way to do so is to penalize such bad behavior and no Rand Paul the 30% penalty (which is far too low) is not “another individual mandate”! It is instead proper management of risk. The Obamacare individual mandate was an unconstitutional IRS enforced penalty for simply existing and refusing to purchase overpriced, government designed and mandated health insurance! Without such proper management of risk which includes the aforementioned penalties for bad behavior we will have more of the same and by that I mean fewer choices, higher prices and a rapid collapse of the entire individual health insurance marketplace. “NeverTrumper” Rand Paul was WRONG about President Trump during the election and he is WRONG about the American Health Care Act. Period.
2.) The second phase will be performed by our new H.H.S. Secretary Dr. Tom Price who will roll back the massive pile of regulations that were put in place by the fourth branch of government known unaffectionately as the ‘administrative state’. There are 1,400 references in the Obamacare legislation that state “the secretary may” or “the secretary shall” so Dr. Price can fix or roll back a lot of things on his own as our new H.H.S. Secretary.
3.) The third phase is the final repeal legislation which will take an act of congress requiring 60 votes. It will take longer because of this to pass and be signed by President Trump but no longer in my estimation than summertime. This is so because health insurers have to begin providing their 2018 plans and prices for review by state and federal regulators in the early fall of this year. So, there isn’t a lot of time for this final bill to pass. Vice President Mike Pence stated that we could see this legislation by April and I concur. This legislation will include all other things that we Conservatives want in a repeal and replace legislation. Those things include:
a.) “Selling across state lines” a.k.a. repeal of the McCarron Ferguson Act which requires and act of congress and 6o votes and cannot be done via the budget reconciliation process.
b.) Repeal of the Obamacare mandates on health insurers so they can offer new plans that are less expensive and do not include all of the onerous Obamacare mandates, many of which required coverage for non medically necessary expenses like sexual reassignment surgery, maternity for 64 year old women and so much more. This of course also requires an act of congress and 60 votes and cannot be done via the budget reconciliation process.
c.) Association health plans so that groups of people who work in the same field can pool together and purchase lower priced, group health insurance plans.
d.) Medical Malpractice Reform a.k.a. “Tort” reform.
e.) Other parts of Dr. Tom Price’s reform legislation originally released in 2009 entitled “Empowering Patient’s First” which is the best piece of health care reform legislation I have ever read and I have read many. This is the template for the final repeal bill along with Paul Ryan’s “A Better Way” which he also worked with Dr. Price in devising.
But Steve! Why can’t we just suspend the filibuster and repeal and replace the whole thing all at once?! Because there is not enough political will to do so in the U.S. Senate and Senate Majority Leader McConnell has stated that he is not willing to do so. Why? Because there are political ramifications for doing so which could easily come back to haunt us in the future if we lose our narrow Senate majority. Just ask Harry Reid. Why expose ourselves to that risk if there is another way forward?
In conclusion as Dennis Prager said so eloquently “the BEST is the ENEMY of the BETTER“. In other words when you spend all your time screaming for the best you inhibit the progress currently being made on the better and the American Health Care Act is far, FAR better than Obamacare. As Dan Proft also said so eloquently, “instead of WAIVING the flag, help ADVANCE the flag.” This is the BEST shot we have had in 7 LONG years to repeal and replace Obamacare. Please everyone, let us work TOGETHER to get this done!
March 21, 2017 UPDATE:  7 EXCELLENT manager’s amendments added to President Trump’s American Health Care Act:
1.) End most of Obamacare taxes THIS year, not next year.
2.) BAR any new states from expanding Medicaid.

3.) Establish a WORK REQUIREMENT for Medicaid enrollee adults who aren’t disabled, elderly or pregnant; states that institute a work requirement would receive a 5% extra administrative payment.
4.) Give states the option to receive Medicaid funding in a BLOCK GRANT or receive it in the form of per-capita allocations.
5.) Increase the growth rate of capped federal payments to the states for elderly and disabled beneficiaries by the medical component of the consumer price index plus one percentage point.
6.) Delay implementation of the Obamacare excise tax on high-value employer health plans for an additional year, from 2025 to 2026.
7.) Establish a reserve fund of at least $75 billion for tax credits to help Americans between the ages of 50 and 64 better afford health insurance with larger tax credits. The original amount was $4,000 for those over the age of 60. Read all the amendments here.

For an excellent fact based comparison between the PPACA (Obamacare) and the AHCA -American Health Care Act – see this > Kaiser Family Foundation comparison grid.
P.S. To Daniel Horowitz. SHAME on you sir for writing this hyperbolic TRIPE at Conservative Review. The Budget Reconciliation bill which you shamefully refer to as “Obamacare 2.0” is NOT a ‘gift to illegals‘. You would know that if you had linked the ENTIRE Budget Reconciliation bill to your ridiculous piece. Instead, you linked only a small part of the actual bill leaving out 66 pages, including pages 19 & 20 which specifically requires PROOF of CITIZENSHIP or LEGAL residency status before receiving benefits. No one eats their own like Republicans aye Daniel? Pathetic.

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## Obamacare open enrollment for 2017. Highest premiums, fewest options and good luck finding a broker or agent.
URL: https://www.healthinsurancementors.com/faq/obamacare-open-enrollment-for-2017-highest-premiums-fewest-options-and-good-luck-finding-a-broker-or-agent/

November 1, 2016 will be the first day of the third national PPACA (Obamacare) open enrollment period. This will be the most challenging open enrollment period yet. Not only because we now have so few health insurers to choose from but also because residents in states like Illinois, Minnesota, Arizona, Montana, Oklahoma, Pennsylvania, Tennessee and new Mexico are now facing annual premium increases of 50% to 93%! The state hit hardest is Arizona with a historic 145% increase. These are the highest annual renewal increases in recorded history. I guess we’ll now have to wait until 2018 to enjoy that “$2,500 premium reduction for a family of four” that our dear leader promised us way back in 2009.
In my home state of Illinois a.k.a. “The People’s Republik of Madiganistan” we now have 17 LESS health insurance carriers to choose from than we did before the wonders of Obamacare were implemented. In fact, this year we’re now down to 3 major carriers. Namely, Aetna (and their company Coventry) United Healthcare (and their company Harken Health) and Blue Cross Blue Shield of Illinois. Of those three major carriers only one is offering ‘subsidized’ plans ‘on the exchange’. United Healthcare/Harken Health has pulled out of nearly every state exchange in the country and Aetna/Coventy has pulled out of 11 state exchanges, including ours. So, you can still buy Aetna, Coventry, United Healthcare and Harken Health plans but you cannot get a subsidy to lower the premiums even if you qualify. This should work out famously! Forward!
Why pay an agent or broker when you can have an unlicensed “Navigator” for free?
Oh, I almost forgot to mention! Commissions. Since the implementation of Obamacare thousands of licensed, experienced health insurance broker agents have left the industry entirely since our commissions were cut from an average of 20% of first year annualized premium to 6% but “hey, you’ll make it up in volume” the masterminds said. Tell me masterminds, how exactly are the few remaining licensed health insurance brokers like myself supposed to “make it up in volume” when Aetna, Coventry, United Healthcare and Harken Health have all made the decision to no longer pay ANY commissions? That’s right, all of these carriers have decided that they will no longer pay ANYTHING to agents and brokers. But never fear! You can always call your friendly unlicensed and inexperienced “Navigator” over at Healthcare gov to help you navigate the system. To all of my clients, don’t worry, you can still call me. I’ll figure out another way to eat.

Narrow PPO & HMO networks provide NO ACCESS to the best hospitals and specialists.
In the fall of 2015 our premier carrier, BCBSIL – Blue Cross Blue Shield of Illinois – made the decision to remove access to their “Broad PPO” for all policy holders who purchase their own individual and family policies (non-group plans). The “Broad PPO” includes access to Northwestern Memorial Hospital, the University of Chicago Medical Center, Rush University Medical Center and the Ann and Robert H. Lurie Children’s hospital (among others). That decision drove tens of thousands of unwitting Illinois consumers into the arms of “LOL Health” a.k.a. “Land of Lincoln Health” our state’s only Obamacare ‘co-op’. Last year, I warned every consumer I could via article, radio and in person that “LOL Health” had, at that time already suffered more than $90 million in net underwriting losses. They SHOULD have been placed into receivership BEFORE innocent Illinois consumers ended up without insurance. Sadly, it took our department of insurance an entire year to place “LOL Health” into liquidation. This action left many thousands of Illinois consumers without coverage and scrambling for alternatives one month BEFORE the next annual open enrollment period begins on November 1st. This, my friends is central planning at it’s absolute finest.
Great! What now? What am I supposed to do? My doctors are all at Northwestern?
Good question! There is still a way for individuals to buy a plan that includes a “Broad PPO” with access to Northwestern Memorial, University of Chicago Hospital and Rush University Medical Center and the Ann & Robert H. Lurie Children’s hospital BUT their is ONLY a 45 day window to do so. From November 1st to December 15th of 2016. To find out how, contact me after November 1st. Or, you can call those helpful “Navigators” over at Healthcare gov. I’m sure they have all the answers you need. Good luck with that.

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## Aetna is leaving EXCHANGES in 11 states NOT the states themselves.
URL: https://www.healthinsurancementors.com/faq/aetna-is-leaving-exchanges-in-11-states-not-the-states-themselves/

For clarification Aetna is not “leaving 11 states”. They are simply no longer offering SUBSIDIZED plans in those 11 states. If you purchased your Aetna plan OFF the exchange WITHOUT a subsidy you will most likely NOT lose your Aetna plan in 2017. Below is a statement from Aetna.

We will narrow our individual on-exchange participation for 2017 
Individuals and families
Aetna believes that everyone should have access to high-quality health care at an affordable cost.  Over the past three years, we made significant investments in the individual public exchanges, working closely with regulators and lawmakers to provide options for consumers.  Unfortunately, the public exchange environment remains more volatile than expected. 
Following a thorough business review, we will reduce our individual on-exchange participation for 2017 to 242 counties, maintaining an on-exchange presence in Delaware, Iowa, Nebraska and Virginia.  We will continue to offer an off-exchange individual product option for 2017 to consumers in the vast majority of counties where we offered individual public exchange products in 2016.
These changes do not affect coverage for the 2016 plan year.  We will communicate to impacted members before the 2017 open enrollment period begins, and provide resources to assist them in transitioning to other plans as appropriate.
Policy changes are needed for the public exchanges to remain viable. The public exchange model needs to evolve from its current state to address the inadequate risk adjustment mechanism, increase product diversity and attract the remaining uninsured population who could improve the risk pool. 
Moving forward, we are hopeful that we can work with policymakers to create a sustainable solution that meets the needs of the uninsured.  With that in mind, we may expand our footprint in the future should there be meaningful exchange-related policy improvements.
Thank you for your continued support.  As per our normal practice each year, we will publish 2017 commission schedules before the start of 2017 open enrollment.       
Aetna health insurance plans are underwritten by Aetna Life Insurance Company, Aetna Health Inc., and/or by Aetna Health of Utah Inc. (Aetna).

Coventry health insurance plans are underwritten by Aetna Health Inc., Aetna Health of Iowa, Inc., Aetna Health of Utah Inc. and/or the following affiliates of Aetna Life Insurance Company: Coventry Health and Life Insurance Company, Coventry Health Care of Florida, Inc., Coventry Health Plan of Florida, Coventry Health Care of Kansas, Inc., Coventry Health Care of Nebraska, Inc., Coventry Health Care of Illinois, Inc. and Coventry Health Care of Virginia, Inc. 

Coventry Health Care of Georgia, Inc., Coventry Health Care of the Carolinas, Coventry Health Care of Delaware, Inc, Coventry Health Care of Louisiana, Inc., and HealthAmerica Pennsylvania, Inc., plans are underwritten by Aetna Health Inc. (8/16)

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## Broker: Doomed business model, politics fuel Land of Lincoln failure
URL: https://www.healthinsurancementors.com/faq/broker-doomed-business-model-politics-fuel-land-of-lincoln-failure/

Broker: Doomed business model, politics fuel Land of Lincoln failure
LOCAL GOVERNMENT
Kim Sunderland | Jul 20, 2016

 Contributed photo
 
There is unquestionably a hefty amount of blame that should be laid on the role Illinois politicians played in the demise of Land of Lincoln Mutual Health Insurance Co., the Illinois Obamacare co-op that was in the Healthcare.gov marketplace, C. Steven Tucker, founder and principal broker at Health Insurance Mentors, said.

“The state has a tremendous responsibility,” Tucker said. “It’s not like they weren’t warned. It’s not like they didn’t know. A lot of this is ideological and political. People turned the other way because this was a co-op; and everybody wanted it to work because in their false ideas, they thought this was creating competition.”
Land of Lincoln is a 3-year-old nonprofit cooperative created under the Patient Protection and Affordable Care Act (PPACA), known colloquially as Obamacare, during Democratic Gov. Pat Quinn’s last term in office.
U.S. Rep. Randy Hultgren (R-Dist. 14) said the failure of Land of Lincoln and other co-ops like it, and Obamacare as a whole, has left health care consumers in worse shape than before the bill’s passage.
“The end of Land of Lincoln means the end of affordable health coverage for tens of thousands of people in my home state,” Hultgren said. “The ACA-mandated insurance exchange will now be left with even fewer, more expensive options as the law cripples under its own weight. States can’t take this anymore.”
The co-ops were created to spark competition in state insurance marketplaces. Land of Lincoln has some 10,000 policyholders who received coverage through their employers and roughly 39,000 enrollees who bought insurance on HealthCare.gov or through a broker, like Tucker.
The only nonprofit health insurer formed in Illinois under Obamacare went operational in 2013, after being passed by a Democrat-controlled General Assembly and signed into law by Quinn, with a $160 million loan from the U.S. government. Since then, financial issues had been strangling Land of Lincoln for months. The failed insurer had seen a loss of more than $90 million last year, and it owes a payment of $31.8 million to other insurers as part of the risk-balancing stipulations of the PPACA.
Prior to the Illinois Department of Insurance takeover on July 14, Land of Lincoln sued the federal government for an estimated $80 million the company said it is owed because the federal government allegedly violated federal law and cut funding for a federally authorized program.
Now the Illinois Department of Insurance has taken control of Land of Lincoln’s operations to ensure its claims are paid, debts are collected and assets are liquidated, the department, which is working with the federal government to institute a “special enrollment” period in the marketplace, said.
This special enrollment period would give Land of Lincoln policyholders 60 days to obtain new coverage from another plan on the Illinois exchange. If this special enrollment opens Aug. 1, as hoped, Land of Lincoln coverage would end Sept. 30.
So in the end, Tucker said, competition hasn’t been created.
“When you wipe out 17 health insurance companies since the passage of the PPACA, that’s where your competition went,” Tucker said. “The creation of taxpayer-funded entities to create so-called competition is not creating competition, and the evidence of that is the death of 17 of the 23 co-ops thus far.”
Furthermore, Tucker said the remaining co-ops will go under by the end of the year because their formation has been based on a bad business model that has set them up for failure, i.e., extremely low-interest-rate loans from the federal government, governing boards and CEOs inexperienced in the health insurance industry and no reserves to pay claims.
“But the Illinois Department of Insurance looked the other way because it’s Obamacare; it’s the president’s signature law,” Tucker said. “But when you look the other way, and you don’t do your job as a regulator, these are the consequences, and innocent people suffer.”
In addition, four of the state’s major teaching hospitals – the University of Chicago Medical Center, Northwestern Memorial Hospital, the Ann and Robert H. Lurie Children’s Hospital, and Rush University Medical Center, all in Chicago — should carry some of the burden, Tucker said.
“Most shamefully, besides the Department of Insurance not taking action when they should have, are these hospitals that promoted replacing Blue Cross Blue Shield of Illinois policies with Land of Lincoln health policies,” Tucker said.
Tucker said all four hospitals were recommending such policy replacements with Land of Lincoln health policies when the co-op was $90.8 million under water.
“So they recommended enrolling these people into a co-op that was already upside down,” Tucker said. “That is just reprehensible, and that’s why thousands of these consumers are now in this situation.”

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## Shutdown of Land of Lincoln leaves consumers with limited choices, expert says
URL: https://www.healthinsurancementors.com/faq/shutdown-of-land-of-lincoln-leaves-consumers-with-limited-choices-expert-says/

Shutdown of Land of Lincoln leaves consumers with limited choices, expert says
Kim Sunderland Jul. 19, 2016

The recent failure of the Land of Lincoln co-ops leaves consumers with limited choices, according to expert. | Courtesy of Shutterstock
For the last two years, Steven Tucker, a health activist, has been warning consumers about the pending demise of Land of Lincoln Mutual Health Insurance Co., Illinois’ Obamacare co-op on the HealthCare.gov marketplace.
Now that the shutdown of the company by the Illinois Department of Insurance has officially been announced, Tucker — who is also the founder and principal broker at Health Insurance Mentors — is relieved.
“Finally … the Illinois Department of Insurance has taken action and shut them down,”he recently told Patient Daily News. “Unfortunately, that’s going to disenfranchise about 49,000 people, who — if the Department of Insurance had acted when they should have prior to the last open enrollment period that began Nov. 1, 2015 — they would have protected thousands of those consumers from being in this situation.”
Land of Lincoln is a three-year-old nonprofit cooperative created under the Patient Protection and Affordable Care Act (PPACA), known colloquially as Obamacare. The co-ops were created to spark competition in state insurance marketplaces.
Land of Lincoln was created when Democrat Gov. Pat Quinn was in office,something Tucker said would have been unlikely if current Gov. Bruce Rauner, a Republican who took office in 2015, had been heading the state at the time. 
The only nonprofit health insurer formed in Illinois under Obamacare went operational in 2013 with a $160 million loan from the U.S. government. Since then, financial issues have been strangling the company for months. The failing insurer had seen a loss of more than $90 million last year, and it owes a payment of $31.8 million to other insurers as part of the risk-balancing stipulations of the PPACA.
Prior to the Illinois Department of Insurance takeover on July 14, Land of Lincoln sued Uncle Sam for an estimated $80 million the company claims it is owed because the federal government has allegedly violated federal law and cut funding for a federally authorized program.
Now the Illinois Department of Insurance has taken control of Land of Lincoln’s operations to ensure its claims are paid, debts collected and assets liquidated, according to the department.
Land of Lincoln has some 10,000 policyholders who received coverage through their employer and roughly 39,000 enrollees who bought insurance on HealthCare.gov or through a broker, like Tucker.
“This is the worst time for them to lose their coverage because we’re in the nap period, the period between open enrollment periods when you have to have a qualifying life event,” Tucker said. “Thankfully, the loss of coverage is a qualifying life event and they can get other coverage.”
But the tough part for Land of Lincoln policyholders is that the other insurance companies are no longer paying brokers like Tucker to sell health insurance or to advise them on obtaining new coverage.
“That means no commissions at all,” he said. “So it’s going to be very difficult for them to find brokers who are willing to work for free during this period to help advise them.”
While Tucker said that he will do it, there are a lot of brokers out there who will not.
“It’s a very, very caustic environment for these consumers — and for all consumers for that matter during the nap period — because their only advice then is a navigator on HealthCare.gov, and these are unlicensed people with very little experience in this industry,” he said. “It’s really a mess.”
The Illinois Department of Insurance, meanwhile, is working with the federal government to institute a “special enrollment” period on the marketplace that would allow Land of Lincoln policyholders 60 days to obtain new coverage from another plan on the Illinois exchange. If this special enrollment opens Aug. 1, as hoped, then Land of Lincoln coverage would end Sept. 30.
“At least now, because Land of Lincoln has officially gone under, now these people have a special enrollment period and they can seek other coverage,” Tucker said. “They’re just going to have difficulty getting that coverage because brokers aren’t being paid. That’s what you describe as a train wreck.”
By the end of the year, Tucker expects that the remaining six co-ops of the original 23 created under Obamacare will follow in the footsteps of Land of Lincoln and the other failed companies. He blames the Illinois Department of Insurance in this case.
“When you look the other way and you don’t do your job as a regulator, these are the consequences — and innocent people suffer,” he said.

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## Donald Trump’s health care plan is NOT a Single Payer Socialized medicine plan.
URL: https://www.healthinsurancementors.com/faq/donald-trumps-health-care-plan-is-not-a-single-payer-socialized-medicine-plan/

Long before Mr. Trump published his health care plans on his campaign web site on March 1, 2016 he outlined his plans in both of his books “Time To Get Tough” from 2011 and his latest book “Crippled America” from 2015. I have linked the pertinent sections pertaining to Mr. Trump’s health care policy proposals as outlined in those two books below.
CLICK HERE TO READ CHAPTER 8 of Mr. Trump’s book “Time To Get Tough“.
CLICK HERE TO READ CHAPTER 7 of Mr. Trump’s book “Crippled America.”
Contrary to a popular but false narrative, Mr. Trump does not propose a “Single Payer Socialized Medicine” plan now nor did he propose such a plan when he first penned his actual plans in his book “Time To Get Tough”. As you read through chapter 8 of “Time To Get Tough” and you read through chapter 7 of “Crippled America” you will not find Mr. Trump calling for a “Single Payer Socialized Medicine” health care plan anywhere. In fact, in chapter 7 of “Crippled America” you will find that Mr. Trump specifically disavows his tepid and earlier consideration of a Single Payer system as one of the options he was considering as a person in the private sector more than 15 years ago. Mr. Trump starts his plan with repeal and replacement of the PPACA a.k.a. “Obamacare”. This begs the question, replace with what?
In both of Mr. Trump’s books he calls for the following private sector reform alternatives. Some of which are also called for under both Senator Cruz’s “Health Choice Act of 2015” and Dr. Ben Carson’s plan among others. In addition to federal and state reforms, they include:
1.) Repeal of the McCarran Ferguson Act so health insurance can be sold across state lines.
2.) Expansion of Health Savings Accounts to promote price transparency & accountability.
3.) Tort (or Medical Malpractice Reform)
4.) Reform of our health care safety nets including block granting Medicaid back to the states so states have more control.
5.) Mr. Trump has most recently added necessary reforms to be made to our broken Veteran’s Administration health care system specifically because it, like all other Single Payer systems is an unmitigated disaster!
“But Steve, Trump said he wants “Universal Healthcare! I heard him say it on CBS!!” Yes, he did. So what does Mr. Trump mean by “universal” healthcare? For that we simply have to look up the definition of the word ‘universal”. According to Miriam Webster’s dictionary the term “universal” means “existing or available for everyone”. That does not mean ‘Single Payer’ nor does it mean ‘Socialized Medicine’. It does mean a health care system where everyone has access to some form of health care delivery. That is what I want. That is what Senator Cruz wants and that’s what nearly every politician on both sides of the isle wants. Affordable access to health care services for everyone. How do we do that? When it comes to Medicaid, you can look to former Governor Mitch Daniel’s reforms that worked in Indiana or more recently to Governor Scott Walker’s reforms that were made in Wisconsin. There are other ideas also.
Most importantly when it comes to the vast majority of Americans this is what Mr. Trump actually said at the end of chapter 7 of “Crippled America” and I quote:
“The government doesn’t belong in health care except at the very last resort. The main way the government should be involved is to make sure the insurance companies (not a top down, authoritative single payer health care system) are financially strong so that if there is a catastrophic event or they make some kind of miscalculation, they have the resources they need to handle it.”
Mr. Trump also said in the beginning of chapter 7 of “Time To Get Tough” and I quote:
“..we still need a plan to bring down health care costs and to make health care insurance (not a top down, authoritative Single Payer health care system) more affordable for everyone. It starts with increasing competition between insurance companies. Competition makes everything better and more affordable.”
Providing a safety net is NOT a “Single Payer Socialized Medicine plan for all Americans“
But Steve! Trump said “the government is going to pay for it.” I saw it on CBS!” Yes, he did. Firstly, the government pays for nothing. It confiscates wealth from taxpayers and redistributes it. Secondly, we taxpayers already pay to provide health care services to millions of our nation’s indigent and those who are developmentally disabled. Some of the health care programs that ‘the government pays for’ include:
1.) Ronald Reagan’s E.M.T.A.L.A which requires every hospital that accepts Medicare and Medicaid (which is nearly all of them) to care for any patient who presents with an emergency “regardless of their ability to pay.” Oh my gosh! Reagan was a SOCIALIST!??
2.) Medicaid which provides either taxpayer funded access to health care services or subsidized private health insurance on a sliding income scale for the indigent and the developmentally disabled.
3.) S.C.H.I.P which was a bipartisan piece of legislation written to ensure that children of parents – who make too much to qualify for Medicaid but too little to afford private health insurance – have access to health insurance on a sliding income scale.
We also subsidize programs such as Medicare Part C & D and other health care programs. We will continue to do so because Americans are compassionate people who seek to help those who are truly in need. I say truly in need because under the PPACA (Obamacare) we expanded Medicaid to single adults without children who happen to fall below 138% of the Federal Poverty Level. In doing so we robbed those finite resources from single mothers and the developmentally disabled. That is not helping those who are truly in need and this among other reasons is why Mr. Trump wants Obamacare repealed and replaced with a “universal” health care system that encourages more competition among private health insurers for most of us with an emphasis on reforming how taxpayers pay for our health care safety net.
In the video linked below, Johns Hopkins 2015​ Physician Of The Year, Ramin Oskoui​ confirms that Donald Trump​ is NOT proposing a “Sinle Payer Socialized Medicine” plan:

 
 
Handling preexisting conditions in the individual health insurance marketplace. 
What I found lacking in Mr. Trump’s proposals but clearly outlined in Senator Cruz’s proposal is specifically how preexisting conditions will be covered in the individual health insurance market place. Senator Cruz proposes a preexisting solution to preexisting conditions. He relies upon protections that existed before the PPACA as outlined in sections 2741 and 2744 of 1996 HIPPA law for those who are HIPAA qualified. This means that they have maintained existing coverage for at least 18 months with no lapse in coverage of more than 63 days. These insured members would have guaranteed access to coverage for preexisting conditions in the individual marketplace via:
A). A state high risk health insurance pool – which existed in 35 states long before the PPACA
B.) A guarantee issue individual mandate – which existed in 10 states – including Ohio – long before the PPACA
C.) A state mandated replacement policy – which is required to be offered in the states that did not have one of the two aforementioned options under section 2744 of HIPAA.
That is one option that Mr. Trump could consider. That option would require rebuilding and refunding that preexisting state infrastructure since that was largely abolished because it was no longer necessary upon full implementation of the PPACA in 2014.
This brings me to Mr. Trump’s other option. To keep our existing national 90 day open enrollment period which was originally an idea used by 10 different states long before the PPACA. However, if Mr. Trump chooses this option, he absolutely must correct the mistake made by the ‘masterminds’ who wrote the PPACA. That mistake was not allowing health insurers to underwrite normal paper throughout the year. This was allowed in states like Ohio (and 9 other states) long before the PPACA. In fact, that’s where the ‘authors’ of the PPACA got the idea of a short annual open enrollment period for those with preexisting conditions. The state of Ohio was doing that for all Ohio residents for years before the PPACA. However, Ohio regulators did not stop health insurers from underwriting individual health insurance coverage throughout the rest of the year. So, people with preexisting conditions that were severe enough to warrant a decline (cancer, diabetes, morbid obesity etc.) could purchase health insurance during the annual open enrollment window and everyone else could buy health insurance throughout the rest of the year whenever they wanted. Best part? That system worked remarkably well without the unconstitutional imposition of an ‘individual mandate’ to purchase health insurance.
By allowing health insurers to underwrite other consumers with less severe preexisting conditions like Hypertension or Hyperlipidimia throughout the rest of the year, health insurers were able to mitigate the risk they would have to assume during the annual open enrollment period. The ‘masterminds’ who wrote the PPACA decided that part wasn’t such a good idea to include. You know, because they didn’t want those ‘evil’ insurance companies ‘discriminating’ against anyone. How exactly is that ‘discriminating’ when the carriers were still offering those consumers coverage and covering their preexisting conditions? It’s not, but the masterminds of the PPACA decided to place their Leftist ideology ahead of time tested and proven business models. Surely we can do better.

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## 2016 ACA Open Enrollment begins today with higher prices, smaller networks and more canceled plans.
URL: https://www.healthinsurancementors.com/faq/2016-aca-open-enrollment-begins-today-with-higher-prices-smaller-networks-and-more-canceled-plans/

As we enter the third year of ‘full’ PPACA (Obamacare) implementation, policy holders in Illinois and around the country are once again facing higher prices, smaller PPO networks and even more canceled plans. On October 20, 2015, 173,000 Blue Cross Blue Shield of Illinois policy holders received cancellation letters like this one. The letter, among other things notifies these policy holders that not only has their health insurance policy been canceled (AGAIN) but that they have also been auto enrolled in new plans that do no include access to the top hospitals in Chicago and the Northern suburbs.
Instead of the “Broad” PPO that these members chose in 2014 which guaranteed them access to the top teaching hospitals in Chicago like Northwestern Memorial hospital, University of Chicago hospital, Rush University Medical Center and the Ann & Robert Lurie Children’s Memorial hospital, they are now auto enrolled into plans that no longer include access to any of the aforementioned top hospitals. Worse yet, none of the new networks offered to individuals and families who seek to purchase health insurance with Blue Cross and Blue Shield of Illinois in 2016 include access to these hospitals. I’ll present guidance on how to retain access to these hospitals in the following paragraphs.
In the quaint old days the before the PPACA one would actually have to sign a legal contract before they would be enrolled in a new health insurance plan but I digress into nostalgia. Keep in mind that this for many, is the third time their perfectly good policies have been cancelled since Barack Obama promised “if you like your plan, you can keep your plan “. I miss the old days when we could actually call our clients and tell them that they have a plethora of lower priced options to choose from a variety of carriers in a vibrant and competitive market. Unfortunately, that is no longer the case since 16 health insurance carriers have either closed their doors or been ‘consumed’ by larger carriers since the implementation of the PPACA. Economics 101 taught us that fewer carriers means less competition which always leads to higher prices. Monopoly isn’t just a board game.
Worse yet, the new 2016 plans are much more expensive. When I say “much more” I really mean it. You see, the majority of my clientele do not qualify for taxpayer-funded health insurance subsidies. Since they do not, they are suffering 2016 premium increases of 45% and higher. Since 2010 they have suffered increases of more than 105%. I guess they’ll have to wait until 2017 for Mr. Obama’s promised “$2,500 premium reduction for a family of four.”
So, what are your alternatives if you wish to retain access to the aforementioned teaching hospitals in Chicago? In my opinion, you have only three choices. They are as follows:
1.) If your company is incorporated you can purchase a small group health insurance plan with as little as two people. The Broad PPO has not changed for group health insurance plans. Northwestern Memorial hospital, Rush University Medical Center, the University of Chicago hospital and Lurie Children’s Memorial are still participating in the “Broad” PPO that is still included with Blue Cross Blue Shield of Illinois small and large group health plans. If this is an option for you contact me directly or send me your census information online at this link.
2.) If you live in Cook county there is a new health insurance start up called Harken Health, an independently operated subsidiary of United Health Group, America’s largest health insurer. Harken Health entered the Illinois health insurance marketplace on November 1st and we are just now getting a look at their prices. They are much more affordable than the options available to those living outside of Cook county who wish to retain access to the top teaching hospitals in Chicago.
What is unique about Harken Health is their networks, their prices and the unique ability to visit one of their “Harken Health Centers” and pay nothing. Harken Health’s networks include their ‘Preferred’network which includes the aforementioned top teaching hospitals and their ‘General’ network which together include approximately 850,000 physicians and care professionals and 6,100 hospitals and other care facilities nationwide. Included in Harken’s Preferred network is Northwestern Memorial hospital, Rush University Medical Center, the University of Chicago hospital and the Ann & Robert Lurie Children’s Memorial hospital. The hospitals within the Northshore University Health system are also in their Preferred network. To view the outlines of coverage for the Harken Health plans click here.
3.) All Illinois residents can also purchase health insurance from Coventry One which is now owned by Aetna insurance company. Using the Coventry One PPO provider search tool you will also find that Northwestern Memorial hospital, the University of Chicago hospital and the Ann & Robert Lurie Children’s Memorial hospital are all included in the Coventry One PPO network. Click the graphic below to see 2016 plans and prices from Coventry One and Aetna insurance company.

4.) There is a fourth option but not one that I would recommend to anyone. That is Land of Lincoln Health, one of the 23 troubled health care ‘co-ops’ 22 of which lost money last year. LOL Health ended 2014 with a $17.7 million loss and in the first 6 months of 2015 LOL’s claims outpaced premiums by $26 million and ended 2015 with a $90.8 million total operating loss. Unfortunately, LOL Health is at the top of Northwestern Memorial hospital’s list of recommended replacement carriers to replace Blue Cross policies and I have no idea why. My clients are also reporting that University of Chicago hospital, Rush University Medical Center and the Ann & Robert H. Lurie children’s hospital are also recommending LOL Health as the alternative to replace Blue Cross coverage. Is anyone at these hospitals doing any due diligence on the dire financial situation of LOL Health?
Lastly, if you want to keep the plan that BCBSIL automatically enrolled you in for 2016, or you want to choose another plan please follow the instructions in this document and visit www.StayBlueIL.com to accept the new plan or choose a different plan with Blue Cross Blue Shield of Illinois for the year 2016. Visit HealthInsuranceMentors.com for more expert guidance throughout the 2016 ACA Open Enrollment period.

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## Blue Cross Blue Shield of Illinois canceled plan members have new low priced option in Cook county including access to top teaching hospitals.
URL: https://www.healthinsurancementors.com/faq/blue-cross-canceled-plan-members-have-new-low-priced-option-in-cook-county-including-access-to-top-teaching-hospitals/

2016 ACA Open Enrollment is going on right now and the biggest health insurance story since the last time Blue Cross Blue Shield of Illinois canceled 185,000 individual health insurance policies in 2013 is their current decision to cancel 173,000 individual health insurance policies this year. What’s even worse is that this year, there has been no intervention from the White House (as there was in 2013) that allows at least some of these policy holders to keep their existing plans. Even worse is the fact that even though these former policy holders are willing to pay significantly more to keep access to the top teaching hospitals in Chicago like Northwestern Memorial, University of Chicago hospital, Rush University Medical Center and the Ann & Robert Lurie Children’s Memorial hospital, they are unable to do so. Instead, they are being auto enrolled into new plans that do not include access to any of the aforementioned teaching hospitals.
In an earlier article, I presented guidance for those living outside of Cook county to retain access to these hospitals. There is now a new and much lower priced option for those living inside Cook county. That option is a new health insurance start up called Harken Health, an independently operated subsidiary of United Health Group, America’s largest health insurer. Harken Health entered the Illinois health insurance marketplace on November 1st and we are just now getting a look at their prices. They are much more affordable than the options available to those living outside of Cook county who wish to retain access to the top teaching hospitals in Chicago.
What is unique about Harken Health is their networks, their prices and the unique ability to visit one of their “Harken Health Centers” and pay nothing. Harken Health’s networks include their ‘Preferred’ network which includes the aforementioned top teaching hospitals and their ‘General’ network which together include approximately 850,000 physicians and care professionals and 6,100 hospitals and other care facilities nationwide.
The best part about the presence of Harken Health is that Cook county residents no longer need to rely upon Land of Lincoln Health, one of the 23 troubled health care ‘co-ops’ which ended 2014 with a $17.7 million loss and in the first 6 months of 2015 had claims that outpaced premiums by $26 million and ended 2015 with a total operating loss of $90.8 million. There is now a far better option from a carrier that has the backing of the largest health insurer in the U.S. with tremendous financial reserves and a broad, inclusive nationwide PPO network.
Now for some navigation tips. You can find Harken Health’s 2016 plans, see their prices and search their networks by clicking the Harken Health/United Healthcare logo below. Then follow these 5 easy steps:
1.) When you begin your quote it will look as though you can only get quotes from United Healthcare. However, once the four recommended plans load just click on “ACA Medical” just above those plans and all of the ACA qualified plan options will load.
2.) When all plans load, look to the left of those plans and you’ll see a section that says “Doctor Network / Network Type”. Click the circle next to “Harken Health Network” and then only Harken Health plans will load. To view Harken plans available in Cook county Illinois click here:
3.) Simply find a plan you like and click on ‘Doctor Network: Harken Health Network‘ just to the left of the price of that plan.
4.) That will then load the easy to use Harken Health network search page. From their you can search for your preferred doctors, hospitals and other network providers.
5.) To find the outline of coverage for each plan simply click on “SBC” under each plan name and an Adobe PDF document will open and you can view and download the plan brochure.
As always, you can contact us directly for free guidance at (630) 582-1043 or email us at youracaquestions@gmail.com

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## The real reasons that United Healthcare has exited the ACA exchange.
URL: https://www.healthinsurancementors.com/faq/the-real-reasons-that-united-healthcare-has-exited-the-aca-exchange/

Crain’s Chicago Business wrote a piece today about United Healthcare wisely choosing to exit the ACA (Obamacare) exchange (Healthcare gov). Unfortunately, Crain’s neglected to mention the real reasons that United Healthcare has chosen to do so, so I will clarify. This decision was made for two reasons. They are as follows:
Firstly, the temporary “Three Rs” provision under the ACA (Obamacare) ends in 2017. The “Three Rs” provision (among other things) forces more profitable health insurers to redistribute their wealth to less profitable health insurers. Why would United Healthcare (the largest health insurer in America) voluntarily agree to continue to participate in such a foolish and misguided Socialist wealth redistribution scheme? A cursory review of human history proves that all other similar schemes have failed, and failed miserably. For example, Assurant Health did not survive after only one year of exchange risk exposure resulting in $63.7 million in losses in 2014 and projected operating losses of $80 million to $90 million for the first quarter of 2015.
Secondly, Republicans get very few victories in Washington D.C. They did however get one victory during the last budget battle in the fall of 2014. That victory was the END of taxpayer bail outs to health insurers. This victory was the impetus behind the rapid demise of companies like Land of Lincoln Health, one of the 23 troubled health care ‘co-ops’ which ended 2014 with a $17.7 million loss and in the first 6 months of 2015 had claims that outpaced premiums by $26 million.
Since selling health insurance off the exchange (Healthcare.gov) is still a viable option for now, it would be incredibly foolish for any carrier to continue to provide health insurance on the exchange. United Healthcare has wisely chosen not to continue contributing to their own demise. Other insurers should follow suit.

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## Blue Cross Blue Shield of Illinois and other HCSC members to receive $1.2 Billion in PPACA reinsurance cash.
URL: https://www.healthinsurancementors.com/faq/blue-cross-blue-shield-of-illinois-other-hcsc-members-to-receive-1-2-billion/

Important information for the 16 million members insured by one of the Blue Cross entities owned by HCSC – Health Care Service Corporation. These include Blue Cross and Blue Shield of Illinois, Texas, Montana, New Mexico and Oklahoma. HCSC reported unprecedented losses of $282 million in 2014, and $434 million in net losses for the first half of 2015. What is not being widely reported is that HSCS will receive roughly $1.2 BILLION in PPACA reinsurance money which will more than cover those losses. 

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## 2016 ACA Open Enrollment begins on November 1 2015
URL: https://www.healthinsurancementors.com/faq/2016-aca-open-enrollment-begins-on-november-1-2015/

The next ACA Open Enrollment period begins on November 1, 2015 and will continue through January 31, 2016. During this annual Open Enrollment period you can purchase health insurance on a guaranteed issue basis (no preexisting conditions) without a Qualifying Life Event. Policies purchased after November 1, 2015 will become effective January 1, 2016. 

After Open Enrollment is over you will not be able to purchase health insurance again until November of 2016 without experiencing a Qualifying Life Event and as such qualify for a Special Enrollment period. Below are examples:

1.) You move to a new area that offers you different plans,
or isn’t covered by your HMO or PPO network.
2.) You get married.
3.) You have or adopt a child.
4.) You lose other health coverage due to job loss, a decrease in work hours,
end of COBRA coverage or other reasons.
5.) You become a U.S. citizen.
6.) Your income changes, or some other event changes your income or household status.
7.) You can prove that your health insurance company violated its contract with you.
8.) You are no longer covered on a family member’s policy because you turned 26,
you have legally separated from or divorced your spouse,
or the policy holder has passed away.
9.) You become a member of an American Indian and Alaska Native tribe.
10.) You experience an error or other complication when trying to enroll
11.) You experience other events that qualify for special enrollment.
12.) 2015 Special Enrollment guide from Blue Cross Blue Shield of Illinois. 
How does Special Enrollment work?
In most cases, you have 60 days after the Qualifying Life Event to enroll in or change
your health plan. If you have insurance through your job, you may only have 30 days
to enroll. If you qualify for Special Enrollment click the logo below to compare plans
and find the right health insurance plan for you and your family.
 

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## Blue Cross Blue Shield of Illinois to accept OFF exchange applications starting March 9, 2015. ON exchange applications will be accepted starting March 15, 2015.
URL: https://www.healthinsurancementors.com/faq/blue-cross-blue-shield-illinois-accept-off-exchange-applications-starting-march-9-2015/

 

On March 6, 2015 Blue Cross Blue Shield of Illinois announced that they will begin accepting guaranteed issue (no preexisting conditions) applications completed off the exchange beginning Monday, March 9, 2015. Off exchange applications are applications completed by those who have incomes to high to qualify for a subsidy via the “Marketplace” a.k.a. Healthcare.gov This new ‘Special Enrollment Period’ will last until April 30, 2015. For those who do qualify for a subsidy, Blue Cross Blue Shield of Illinois will be accepting on exchange applications completed via the “Marketplace” a.k.a. Healthcare.gov beginning March 15, 2015 and ending April 30, 2015. Below is the new announcement from Blue Cross Blue Shield of Illinois:
Tax Filing Special Enrollment Period Available for On- and Off- Marketplace Enrollment SEP for Off-Marketplace Plans Opens March 9!
As was announced last week, the Centers for Medicare and Medicaid Services (CMS) has approved a new Special Enrollment Period (SEP), meant to help consumers avoid tax penalties for not obtaining health insurance coverage this year.
The SEP for Marketplace enrollment begins Sunday, March 15.
We will offer this SEP for off-Marketplace enrollment also. To assist more of our customers with getting coverage beginning April 1, we are opening the tax SEP for coverage purchased from us on Monday, March 9. This gives them an extra week to enroll for an April 1 effective date when choosing an off-Marketplace plan.
Below are instructions on how to enroll OFF the exchange during this new Special Enrollment Period:

You will need to use this paper application.
On the paper application, you will need to select #8 (“Other”) as the SEP reason and must write “TAX SEP” in the Home Use Only box in the upper right corner. Paper applications for an off-Marketplace plan sent to us will only be accepted under the SEP if the application has the SEP designation selected.
You can then fax the application to (630) 582-1043. Or you can mail the application to:
Small Business Insurance Services Inc.
430 Northampton Lane
Roselle, IL. 60172
Or, you can email the application to yourACAquestions@gmail.com. This manual process is only necessary for the special tax SEP.

Below are instructions on how to enroll ON the exchange during this new Special Enrollment Period
If applicants are subsidy eligible and want to apply for financial assistance, they will need to apply directly online on the Marketplace starting March 15 via healthcare.gov. Using a broker to guide you through this process costs you nothing extra. It is highly recommended to call a licensed broker toll free at 866-724-7123 to help guide you through the application process at Healthcare.gov
Enrollment effective dates will follow the 15th of the month rule, as follows:

Applications submitted from March 9 through March 15 will have an April 1 effective date.
Applications submitted March 16 through April 15 will have a May 1 effective date.
Applications submitted April 16 through April 30 will have a June 1 effective date.
Members cannot ask for a different effective date.

By indicating “TAX SEP” on the application for insurance, the applicant is self-attesting that they qualify for the special enrollment period because they:

had to pay a penalty for not having coverage in 2014,
are not currently enrolled in a plan on healthcare.gov, and
only found out about the tax penalty or understood the implications when they had to pay a tax penalty with their income tax return for 2014.

To see prices and plan options click the Blue Cross Blue Shield of Illinois logo below. Then click the orange “Just Browsing” button at the bottom of the “Are you eligible for special enrollment” page:

For expert guidance in Illinois please call (630) 674-1551. Outside of Illinois please call toll free (866) 724-7123.

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## CMS announces new ACA Special Enrollment Period from March 15, 2015 to April 30, 2015
URL: https://www.healthinsurancementors.com/faq/cms-announces-new-aca-special-enrollment-period-3515-43015/

CMS – Centers for Medicare & Medicaid Services announces new Special Enrollment Period for 2015 Tax Season
Eligible consumers have from March 15 through April 30 to enroll in coverage
On February 20, 2015, the Centers for Medicare & Medicaid Services announced yet another new Special Enrollment Period (SEP) for individuals and families who did not have health coverage in 2014 and are subject to the fee or “shared responsibility payment” when they file their 2014 taxes in states which use the Federally-facilitated Marketplaces (FFM). 7 states including Illinois, have a state-federal partnership exchange. A state-federal partnership exchange is a federally facilitated exchange until such time that the state chooses to adopt the responsibilities required to run their own state-based exchange. As of this writing, Illinois has not chosen to do so.
This Special Enrollment Period will allow those individuals and families who were unaware or did not understand the implications of this new requirement to enroll in 2015 health insurance coverage through the FFM. For those who were unaware or did not understand the implications of the fee for not enrolling in coverage, CMS will provide consumers with an opportunity to purchase health insurance coverage from March 15 to April 30.  If consumers do not purchase coverage for 2015 during this special enrollment period, they may have to pay a fee when they file their 2015 income taxes. As of this writing, Blue Cross Blue Shield of Illinois has not decided as to whether or not they will offer off the exchange applications during this new Special Enrollment Period. If and when they do, I will update this post.
Those eligible for this special enrollment period live in states with a Federally-facilitated Marketplace and:

Currently are not enrolled in coverage through the FFM for 2015,
Attest that when they filed their 2014 tax return they paid the fee for not having health coverage in 2014, and
Attest that they first became aware of, or understood the implications of, the Shared Responsibility Payment after the end of open enrollment (February 15, 2015) in connection with preparing their 2014 taxes.

The special enrollment period announced today will begin on March 15, 2015 and end at 11:59 pm E.S.T. on April 30, 2015.  If a consumer enrolls in coverage before the 15th of the month, coverage will be effective on the first day of the following month.
Other than this 45 day window, the only way to get health insurance that covers preexisting conditions before 2016 is if you qualify under the normal rules of Special Enrollment. Click ‘Start Shopping Now’ to explore Special Enrollment options. If you are in Illinois and need guidance call (630) 674-1551. Outside of Illinois, call toll free at (866) 724-7123.
Read the full CMS announcement here.

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## There are 46 days left in 2015 to get health insurance that covers preexisting conditions without a Qualifying Life Event.
URL: https://www.healthinsurancementors.com/faq/46-days-left-2015-get-health-insurance-covers-preexisting-conditions-without-qualifying-life-event/

If you need health insurance that covers preexisting conditions, you have until Sunday February 22, 2015 at 11:59 p.m. to apply for health insurance with Blue Cross Blue Shield on or off the exchange (Healthcare gov). After that, you will be unable to purchase health insurance again unless you have filed your 2014 taxes and can prove that you are subject to the tax for not buying health insurance. In this case, you will have a 45 day window from March 15, 2015 to April 30, 2015 to get health insurance again. After that, you can not get health insurance that covers preexisting conditions again until 2016 without experiencing a ‘Qualifying Life Event‘. If you miss these Special Enrollment dates and do not experience a Qualifying Life Event you can purchase non renewable Short-Term or Temporary health insurance that does not cover preexisting conditions any time throughout the year.

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## Obamacare subsidy repayment amounts are capped based on your income level.
URL: https://www.healthinsurancementors.com/faq/obamacare-subsidy-repayment-amounts-capped-based-income-level/

If you have received a notice from the IRS stating that you estimated your income level incorrectly last year and as such received an Advance Premium Tax Credit (subsidy) that was incorrect. The chances are very good that you won’t have to pay back the full amount. In fact, only those with income levels above 400% of FPL – Federal Poverty Level – will have to pay back the full amount. For the rest of us, the repayment amount is capped based on our income level.
Below is a chart that states the maximum amount you will have to pay back to the IRS regardless of how large of a subsidy that you took incorrectly. How much will this ‘subsidy forgiveness’ cost taxpayers? That number has yet to be determined.

Income, based on federal poverty level
 
Annual Household Income for an Individual
 
Individual Payback of Obamacare Premium Assistance
Annual Household Income for a Family of Four
 
Family Payback of Obamacare Premium Assistance

Less than 200%
 
Under $22,980
 
Capped at $300
 
Under $47,100
 
Capped at $600

At or above 200% to 300%
 
$22,980 – $34,470
 
Capped at $750
 
$47,100 – $70,650
 
Capped at $1,500

At or above 300% to 400%
 
$34,470-$45,960
Capped at $1,250
$70,650 – $94,200
 
Capped at $2,500

Greater than 400%
 
$45,961 and higher
Full amount received
$94,201 and higher
Full amount received

 

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## How to understand your health insurance plan
URL: https://www.healthinsurancementors.com/faq/understand-health-insurance-plan/

To understand the difference between different health insurance plans and to know which one is best for you it is best to read through the plans being offered. Here is a concise explanation of basic health insurance concepts to help you navigate your options when shopping for the right health insurance.
Deductible: This is the total amount that you must pay before your insurance starts to cover the cost of medical care that is not covered on a first dollar basis (see first dollar benefits).  If you need medical attention that is not covered on a first dollar basis, you must pay for it yourself until your deductible is reached. Then your insurance begins to pay (but not necessarily for all of it, see coinsurance).
First dollar benefits: First dollar benefits are defined as benefits you receive without paying your health plan deductible. These benefits include outpatient doctor office visits, outpatient prescription drugs and preventive care.
Out-of-Pocket Maximum: This is the most you will have to pay out of pocket for the entire year calendar year. This maximum is reached by satisfying your health plan deductible, coinsurance and any service deductibles you are required to pay in order to reach your out of pocket maximum.
Copay: This is a fixed number that you must pay in order to see a doctor or to purchase an outpatient prescription drug.
Coinsurance: This is the amount your insurance company will pay after you have satisfied your health plan deductible versus what you must pay after the deductible is reached. For example, your insurance company may pay 80% of your bills after you have satisfied your deductible. This means you still must pay 20%, the coinsurance amount. However, all the money you pay for your coinsurance is also counted towards your calendar year out-of-pocket maximum. Once you reach your calendar year out-of-pocket maximum, you will no longer have to pay coinsurance and your insurance company will pay 100% of the rest of your bills for the rest of the calendar year.
Call us today if you have any additional questions about health insurance terminology. The best decision is an informed one.

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## If I never get sick, why do I need health insurance?
URL: https://www.healthinsurancementors.com/faq/never-get-sick-need-health-insurance/

There are both legal and precautionary reasons to have health insurance. People who claim bankruptcy most often do so because of medical bills resulting from an unpredictable accident.
If something happens to you, you need to make sure that your medical bills do not financially drain you and your family.
Imagine your 401K or your child’s college fund being used to pay off hospital bills. Health insurance will protect you from life’s unforeseen medical needs. Legally speaking, it is now mandated by the federal government for every individual to have health insurance according to the Affordable Healthcare Act (otherwise known as Obama Care).
Does everybody really have to have health Insurance? Are some people exempt?
There are a few exceptions to the federal mandate. In order to qualify for these exceptions, you will need to prove on your tax documents that these were your circumstances. Below is a basic summary of exceptions recognized by the government.

 You went less than 3 months without insurance. So most of the year, you had insurance. You will not be fined for those 3 months.
You don’t make enough money. If the cheapest health insurance costs more than 8% of your income, or you don’t have to file tax returns because your annual income is too low then you will not be fined.
You belong to a group that is exempt. If you qualify to get insurance through an Indian Health Services provider or you are a member of a recognized religious sect that has religious objections to insurance then you may qualify for an exemption.
You are/were not physically in the U.S. You were incarcerated or not lawfully residing in the U.S.
For a complete list of exemptions click here.

Call us today and we can help determine if you qualify for the exemptions and how to apply for them.

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## What is the difference between high & low deductible health insurance?
URL: https://www.healthinsurancementors.com/faq/difference-high-low-deductible-health-insurance/

Every health insurance plan pays out different amounts for different health care services. We can help you find a plan that is most practical for you. For example, if you need medicine or go to the doctor often then you would want a very low deductible.
So if you rarely see the doctor, it is better for you to have a high deductible plan because there is a small chance you will reach that number. Your monthly bills will be lower. Also, depending on the high deductible health plan you choose you may qualify for additional tax advantages not available with a low deductible health plan. To learn more about these unique tax advantages click here.

Call us today to discuss the pros and cons of having a low or high deductible health plan to find out which is most advantageous for you.

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## Podcasts
URL: https://www.healthinsurancementors.com/podcasts/

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Radio commentary on under 65 health insurance, Medicare and Medicaid by principal broker C. Steven Tucker
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Mr. Tucker joined Dan Proft on Chicago’s Morning Answer Re: TrumpRx.gov and other reforms coming soon – 02/06/2026

 
 
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Mr. Tucker joined Dan Proft on Chicago’s Morning Answer to discuss EMTALA, Cost Shifting & new Short Term rules – 08/14/2025

 
 
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Mr. Tucker joined Dan Proft and Amy Jacobson on Chicago’s Morning Answer on AM 560 The Answer to discuss the impact of the “Inflation Reduction Act” in Medicare Part D and enhanced ACA health insurance subsidies now extended to 2026.  – 08/17/2022.

 
 
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Mr. Tucker joined Attorney Steven Leahy and Jim Leahy on the Trust Radio Network on Chicago’s AM560 The Answer to discuss health insurance policy, Medicare and much more. – 10/30/2020.

 
 
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Mr. Tucker joined a panel to debate U.S. health care policy and more on the nationally syndicated TV/Radio show “Beyond the Beltway with Bruce Dumont‘ from the Museum of Broadcasting in Chicago – 7/30/17.

 
 
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C. Steven Tucker responds to “Obamacare architect” Jonathan Gruber’s insulting comments on the Stephanie Trussell show on Chicago’s WLS AM890  – 11/17/2014.

 
 
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C. Steven Tucker on the passage of the PPACA by U.S. Supreme Court on the Don Wade & Roma show on Chicago’s WLS AM890 with guest hosts Jonathan Hoenig and Bruce Wolf. July 5, 2012

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Mr. Tucker joined Dan Proft on Chicago’s Morning Answer Re: President Trump’s “Great Health Care Plan” – 01/16/2026

 
 
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Mr. Tucker joined Dan Proft on Chicago’s Morning Answer to discuss the One Big Beautiful Bill’s impact on Medicaid – 07/05/2025

 
 
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Mr. Tucker joined Illinois’ 6th congressional district candidate for U.S. congress Jeanne Ives to discuss the proper role of government in the health insurance marketplace post Obamacare and Covid-19. – 04/29/2020

 
 
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Mr. Tucker joins Dan Proft and Shaun Thompson on Chicago’s Morning Answer to discuss President Trump’s Executive Order on non-ACA qualified Short Term health insurance which will become law on October 2, 2018 – 08/22/2018.

 
 
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C. Steven Tucker joins Dan Proft and Amy Jacobson on Chicago’s AM 560 The Answer to discuss the newly released GOP Obamacare replacement bill entitled “The American Health Care Act” – 03/07/2017

 
 
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C. Steven Tucker joins Dan Proft on Chicago’s Morning Answer on AM560TheAnswer to discuss the passage of “The American Health Care Act” in the U.S. House of Representatives and how the U.S. Senate can improve the bill. – 05/05/2017

 
 
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C. Steven Tucker joined a panel to debate the U.S. Senate’s “Better Care Reconciliation Act” on the nationally syndicated “Beyond the Beltway with Bruce Dumont‘ TV/Radio show at Museum of Broadcasting in Chicago – 7/2/17.

 
 
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Mr. Tucker joined Dan Proft on Chicago’s Morning Answer Re: New GOP legislation on health insurance subsidies – 12/10/25

 
 
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Mr. Tucker joined Dan Proft and Amy Jacobson on Chicago’s Morning Answer on AM 560 The Answer to discuss 15 years of the ACA – Affordable Care Act – known colloquially as “Obamacare” – 12/13/2024 

 
 
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Mr. Tucker joined Dan Proft and Amy Jacobson on Chicago’s Morning Answer on AM 560 The Answer to discuss the ongoing impact of federal regulations imposed upon the health care and health insurance industry. – 09/19/23

 
 
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Mr. Tucker joins Chicago’s Morning Answer’s Dan Proft and Amy Jacobson on AM560TheAnswer to discuss your options if you are furloughed or lose your job and with it your health insurance. – 04/13/2020 
                  
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Mr. Tucker joins Dan Proft and Amy Jacobson on Chicago’s Morning Answer to discuss the “Medicare for all” and his evening with President Trump. – June 28, 2019
                  
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C. Steven Tucker discusses the coming third annual Obamacare open enrollment period for 2017 on The Big John Howell and Ramblin’ Ray show on Chicago’s WLS AM890 11/01/2016.  

 
 
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C. Steven Tucker responds to SCOTUS ruling on King v. Burwell on Chicago’s Morning Answer with Dan Proft & Bruce Dumont. 6/26/2015

 
 
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Mr. Tucker joined Jeanne Ives on Am 560 The Answer Re: Enhanced Obamacare subsidies & Medicaid for illegal immigrants during government shutdown – 10/12/25

 
 
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Mr. Tucker on the Real Story with Jeanne Ives providing a timely update on ACA-qualified individual health insurance and Medicare – 11/26/23

 
 
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Mr. Tucker joined Dan Proft and Amy Jacobson on Chicago’s Morning Answer to discuss new options available during 2021 ACA open enrollment, the truth about preexisting conditions and Joe Biden’s health care policy proposals. – 10/29/2020

 
 
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C. Steven Tucker joins Dan Proft and Amy Jacobson on Chicago’s Morning Answer on AM560 to discuss the release of the discussion draft on the U.S. Senate’s “Better Care Reconciliation Act of 2017”. – 06/23/2017

 
 
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C. Steven Tucker discusses Governor Scott Walker’s Obamacare replacement plan with Dan Proft and John Kass on Chicago’s AM560The answer – August 20, 2015.

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Mr. Tucker joined John Anthony on Detroit’s Morning Answer: Re: IRA enhanced subsidy expiration & path forward for Republicans – 11/12/25

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Mr. Tucker joins Chicago’s Morning Answer’s Dan Proft and Amy Jacobson on AM560TheAnswer to discuss the Republican Study Committee’s new health care plan. “The best plan he has EVER read”.  – 11/1/2019. 
                  
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C. Steven Tucker joins Dan Proft and Amy Jacobson on Chicago’s Am560TheAnswer to discuss 2016 ACA Open Enrollment and provide solutions for the 173,000 Blue Cross policyholders who had their plans canceled again. November 2, 2015

 
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Click below to hear Mr. Tucker discuss existing solutions for the uninsurable on The Michael Medved Show 9/8/09 Fast forward to 3:08 if using iTunes or 32:43 with Windows Media Player to hear his comments.

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Mr. Tucker joined Dan Proft on Chicago’s Morning Answer Re: Govt shutdown & enhanced ACA subsidy expiration – 10/1/25

 
 
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Mr. Tucker joined Dan Proft and Amy Jacobson on Chicago’s Morning Answer on AM 560 The Answer to discuss Biden’s effectively useless ‘fix’ to the ObamaCare “Family Glitch” – 04/08/2022.

 
 
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Mr. Tucker joined Dan Proft and Amy Jacobson on Chicago’s Morning Answer to discuss changes to the ACA via the “American Rescue Plan” – 03/16/2021.

 
 
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C. Steven Tucker joins Dan Proft on Chicago’s Morning Answer on AM560TheAnswer to discuss the EPIC FAILURE of the Freedom Caucus to pass “The American Health Care Act” which would have provided much need relief to millions of Americans suffering under Obamacare. – 03/28/2017

 
 
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Mr. Tucker joined John Anthony aboard Free Spirit Yacht in Chicago on the Black & Right show to discuss the truth about preexisting conditions 10 24 2020

 
 
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Mr. Tucker joins Bruce Wolf and Amy Jacobson on Chicago’s Morning Answer to discuss the potential of ACA (Obamacare) repeal after President Trump’s D.O.J. refuses to defend the ACA against the Texas lawsuit. – 04/03/19

 
 
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Mr. Tucker joins attorney Steven Leahy and Jim Leahy on  AM560TheAnswer to discuss ACA open enrollment, Medicare and how doing the right thing can sometimes get you in BIG trouble.  – 10/11/2019
                  
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Mr. Tucker joins Dan Proft and Amy Jacobsen on Chicago’s Morning Answer to discuss the truth about Republicans and Preexisting conditions. – 11/06/2018.

 
 
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C. Steven Tucker reacts to the second presidential debate on Chicago’s Morning Answer on AM560TheAnswer 10/10/2016. 

 
 
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C. Steven Tucker discusses the latest Republican alternative to Obamacare with Stephanie Trussell on AM890 WLS Chicago on 9/21/2014.

 
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## Television
URL: https://www.healthinsurancementors.com/press/

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PROFESSIONAL COMMENTARY ON LOCAL AND NATIONAL TELEVISION AND RADIO STATIONS
Mr. Tucker joined Dan Proft on Chicago’s Morning Answer Re: TrumpRx.gov and additional reforms coming soon – 02/06/26

Mr. Tucker joined Dan Proft on Chicago’s Morning Answer Re: President Trump’s “Great Healthcare Plan” – 01/16/26

Mr. Tucker joined Dan Proft on Chicago’s Morning Answer Re: New GOP legislation on health insurance subsidies – 12/10/25

Mr. Tucker joined John Anthony on Detroit’s Morning Answer: Re: IRA enhanced subsidy expiration & path forward for Republicans – 11/12/25

Mr. Tucker joined Jeanne Ives on Am 560 The Answer Re: ACA subsidies & Medicaid for illegal immigrants – 10/12/25

Mr. Tucker joined Dan Proft on Chicago’s Morning Answer Re: Govt shutdown & enhanced ACA subsidy expiration – 10/1/25
Health Care Debate Takes Center Stage Amid Shutdown

Mr. Tucker joined Dan Proft on Chicago’s Morning Answer to discuss EMTALA, Cost Shifting & new Short Term rules – 08/14/2025

Mr. Tucker joined Dan Proft on Chicago’s Morning Answer to discuss the One Big Beautiful Bill’s impact on Medicaid – 07/05/2025

Mr. Tucker joined Dan Proft & Amy Jacobsen. Re: 15 years of the ACA – Affordable Care Act – known colloquially as ‘Obamacare’ – 12/13/2024

Mr. Tucker on the Real Story with Jeanne Ives providing a timely update on ACA-qualified individual health insurance and Medicare – 11/26/23 

Mr. Tucker joined Dan Proft and Amy Jacobson on Chicago’s Morning Answer on AM 560 The Answer to discuss the ongoing impact of federal regulations imposed upon the health care and health insurance industry. – 09/19/23

Mr. Tucker joined Dan Proft and Amy Jacobson on Chicago’s Morning Answer on AM 560 The Answer to discuss the impact of the “Inflation Reduction Act” in Medicare Part D and enhanced ACA health insurance subsidies now extended until 2026. – 08/17/2022. 

Mr. Tucker joined Dan Proft and Amy Jacobson on Chicago’s Morning Answer on AM 560 The Answer to discuss President Biden’s effectively useless ‘fix’ to the ACA “Family Glitch” – 04/08/2022. Replay below:

Mr. Tucker joined Dan Proft & Amy Jacobson on Chicago’s Morning Answer to discuss changes to the ACA via the “American Rescue Plan” – 03/16/2021.

Mr. Tucker joined Attorney Steven Leahy and Jim Leahy on The Trust Radio Network on Chicago’s AM560 The Answer to discuss health insurance policy, Medicare and much more. – 10/30/2020.

Mr. Tucker joined Dan Proft and Amy Jacobson on Chicago’s Morning Answer to discuss new options during the 2021 ACA open enrollment period, thetruth about preexisting conditions and Joe Biden’s health care policy proposals. – 10/29/2020.

Mr. Tucker joined John Anthony on the Black and Right Cruise to discuss the truth about preexisting conditions. – 10/24/2020

Mr. Tucker joined Illinois’ 6th congressional district candidate for U.S. congress Jeanne Ives to discuss the proper role of government in the health insurance marketplace post Obamacare and Covid-19. – 4/29/2020

Mr. Tucker joined Chicago’s Morning Answer’s Dan Proft and Amy Jacobson to discuss your options if you are furloughed or lose your joband with it your health insurance. – 04/13/2020. Read Jeanne Ives’ health insurance reform proposals at this link.

Mr. Tucker joined Chicago’s Morning Answer’s Dan Proft and Amy Jacobson to discuss the Republican Study Committee’s new health care plan.“The best plan he has EVER read.” – 11/01/2019

Mr. Tucker joined attorney Steven Leahy and Jim Leahy on Chicago’s Am560TheAnswer to discuss ACA (Obamacare) open enrollment, Short Term health insurance, Medicare and how doing the right thing can sometimes get you in really BIG trouble. – 10/11/2019.

Mr. Tucker joined a panel to debate U.S. health care policy and more on the nationally syndicated TV/Radio show “Beyond the Beltway with Bruce Dumont‘ from the Museum of Broadcasting in Chicago – 7/30/2017 and 7/02/2017.

 
 
 
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Mr. Tucker joins a panel on WTTW’s “Chicago Tonight” to discuss the “American Health Care Act” –  3/23/2017

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Click here to read how Mr. Tucker helped a man with cancer get his health insurance policy reinstated after it was cancelled because of Obamacare. Watch the story below as told on the Emmy award winning TV show “Facing Life Head On“. 
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C. Steven Tucker debates U.S. Congressman Luis Gutierrez on ABC7 Windy City Live in Chicago 10/14/13.
 
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C. Steven Tucker on the real cost of Obamacare for the Fox Business television network. 9/30/13
 
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C. Steven Tucker on the Fox Business television network 3/28/2012
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Watch the latest video at <a href=”http://video.foxbusiness.com”>video.foxbusiness.com</a>
 
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## About
URL: https://www.healthinsurancementors.com/about/

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About Health Insurance Mentors
HealthInsuranceMentors.com is the online presence for Small Business Insurance Services Inc. An Illinois licensed business entity and Illinois domiciled insurance brokerage firm with no allegiance to any insurance company. We are A+ rated with the Better Business Bureau and a Google approved health insurance provider. Our agents are also multi-state licensed. We will shop all major carriers for you so you always get the best plan at the lowest price. Each plan can be customized to fit your specific needs and budget. There are many ways for consumers to purchase health insurance. The smart way is to use an experienced broker, most especially since it costs nothing extra to do so. Call us directly at (630) 674 1551. If you are outside of Illinois call us toll free at (866) 724 7123 for a free no obligation telephone consultation from one of our licensed brokers.

Click our logo below to hear our commercial on Am560TheAnswer
                                                       
Biography for C. Steven Tucker, Founder & Principal Broker at HealthInsuranceMentors.com
   
           ​
Mr. Tucker’s distinguished credentials extend beyond his 30-year licensed career as a health insurance broker. Representing clients in commercial business and individual consumer-driven Health & Life insurance in 17 states, he has garnered a notable reputation in informing and navigating through the far-reaching complexities of comprehensive insurance coverage on behalf of families and small business.
In addition to his outside advice and guidance to clients, Mr. Tucker has earned the moniker and trademark of ‘subject matter expert’ in the public policy arena of health insurance reform, most notably, the Patient Protection and Affordable Care Act (PPACA), known colloquially as Obamacare. From Keynote Speaker to author of numerous published reports and commentary, Mr. Tucker has been quoted in several prestigious publications and national news outlets on his keen understanding of medical insurance reform, spanning The Wall Street Journal, Fortune Small Business Magazine, Fox News Business and various other industry association and business journals. Mr. Tucker is also a regular expert commentator on television and radio stations around the country.
With an arsenal of insurance reform knowledge and real-world expertise, Mr. Tucker actively engages as a regularly featured speaker delivering a unique insight and perspective to business employers, associations and advocacy groups and brings into context the new laws ramifications and impact on business and consumers. With acumen and recognition under his belt, his pointed-delivery encompasses all aspects of what ails the health insurance system in America while dissecting the changes and looming challenges of the Affordable Care Act’s provisions.
Considered one of the leading authorities on small group market reforms, high-risk pools, HIPAA compliance, Medicare reform, and the Affordable Care Act’s new mandated taxes and regulatory measures, Mr. Tucker, an advocate for the family and small business, is not afraid to charter new water in exposing the never-ending challenge of a demanding global insurance marketplace, bringing to bear the relative significance of ‘cost shifting’, and the prevalent problems and re-examination of how health care insurance is delivered.
Founder of HealthInsuranceMentors.com and Small Business Insurance Services Inc. an independent agency for the last two and a half decades, Mr. Tucker continues to actively specialize in meeting the health insurance needs of the self-employed and small business owner. He also continues to educate groups and conferences on public policy matters regarding insurance reform.
Mr. Tucker joined Dan Proft on Chicago’s Morning Answer Re: TrumpRx.gov and additional reforms coming soon – 02/06/26

Mr. Tucker joined Dan Proft on Chicago’s Morning Answer Re: President Trump’s “Great Healthcare Plan” – 01/16/26

Mr. Tucker joined Dan Proft on Chicago’s Morning Answer Re: New GOP legislation on health insurance subsidies – 12/10/25

Mr. Tucker joined John Anthony on Detroit’s Morning Answer: Re: IRA enhanced subsidy expiration & path forward for Republicans – 11/12/25

Mr. Tucker joined Jeanne Ives on Chicago’s AM560 The Answer Re: Govt shutdown & enhanced ACA subsidy expiration – 10/12/25

Mr. Tucker joined Dan Proft on Chicago’s Morning Answer Re: Govt shutdown & enhanced ACA subsidy expiration – 10/1/25

Mr. Tucker joined Dan Proft on Chicago’s Morning Answer Re: EMTALA, Cost Shifting & new Short Term rules – 08/14/2025

Mr. Tucker joined Dan Proft on Chicago’s Morning Answer Re: One Big Beautiful Bill impact on Medicaid – 07/05/2025

Mr. Tucker joined Dan Proft & Amy Jacobsen. Re: 15 years of the ACA – Affordable Care Act – known colloquially as ‘Obamacare’ – 12/13/2024

 
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Principal Broker C. Steven Tucker quoted in following business journals:

The Wall Street Journal
Fortune Small Business Magazine
Fox Business Television Network
Chicago Tribune
Crain’s Chicago Business
North Cook County News
 
Testimony delivered to state legislators in Springfield, IL. 

A.M. Best Review Magazine (Pg.52)
AIS Health Plan Week Washington D.C
AIS Conference Washington D.C (MP3)
Real Estate Executive Magazine
The Nashville Business Journal
Serenity for the Self Employed
Multiple Sclerosis Central
The Tennessean
DHL Worldwide

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Mr. Tucker joined Dan Proft and Amy Jacobson on Chicago’s Morning Answer to discuss the ongoing impact of federal regulations imposed upon the health care and health insurance industry. – 09/19/23

 
Mr. Tucker joined Dan Proft and Amy Jacobson on Chicago’s Morning Answer to discuss the impact of the “Inflation Reduction Act” on Medicare Part D and enhanced ACA health insurance subsidies now extended until 2026 – 08/17/22. 

C. Steven Tucker and Jeanne Ives discuss federal and state health insurance policy post COVID-19

C. Steven Tucker on Chicago’s “Big 89” WLS Am890 with Big John Howell 
 

C. Steven Tucker on WTTW Chicago Tonight

C.  Steven Tucker on Beyond The Beltway with Bruce Dumont

 
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After three years and thousands of pages of legislation, very few of us truly understand the full implications of ObamaCare for our families, our businesses, and our country. The astonishing complexity and length of the law makes it almost impossible to speak about without drifting off into arcane medical and legal gibberish. Since the passage of ObamaCare, I have had the extraordinary experience of knowing and listening to C. Stephen Tucker as we’ve traveled together and spoken at seemingly innumerable venues both political and otherwise. With unequaled wit, a captivating speaking style and a razor-sharp intelligence, Stephen translates what has become a legal and economic Tower of Babel into straightforward language. In doing so Stephen gives his audience the tolls to prepare for what is in reality the greatest shift in American health care since the days of Benjamin Rush. As a physician and health care policy devotee, I cannot be more enthusiastic in recommending C. Stephen Tucker as a speaker to anyone who desires an energetic, immensely enjoyable, and truly informative experience. As the weight of this massive law bears down upon us all, Stephen’s ability to provide guidance and insight will become increasingly more important. There is no doubt in my mind that C. Steven Tucker will play an increasingly pivotal role in the political discourse yet to come and I for one couldn’t be more excited!
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I have known Steve for almost a year and have served on several healthcare panels with him.  To date I have not met anyone who possessed the same level of knowledge regarding PPACA as Steve.  He has the ability to express himself in a manner that results in most people in the audience fully understanding the issues at hand.  The trait of an outstanding teacher is one who can make the most difficult topic understandable to ones audience. Steve possesses that trait.  If ever I need someone to speak on the topic of PPACA I immediately think of him.  The public is fortunate to have such a qualified speaker as Steve to educate them regarding this most important topic.
[/et_pb_testimonial][et_pb_testimonial author=”Rich Ferollo” job_title=”M.D.” portrait_url=”https://www.healthinsurancementors.com/wp-content/uploads/2014/10/rich-ferolo.jpg” _builder_version=”4.16″ background_size=”initial” background_position=”top_left” background_repeat=”repeat” border_radii_portrait=”on||||” use_border_color=”off” border_color=”#ffffff” border_style=”solid” global_colors_info=”{}”]

I was thoroughly impressed with Steve’s knowledge of the effects/impact of the Patient Protection & Affordable Care Act. Steve spoke to the constituents of Illinois’ 8th district providing education at a level that made the program understandable. I was impressed with his ability to breakdown the program and present the facts as it pertains to the public. It was a pleasure to listen and dialogue with someone who understands the program. I doubt you will find someone anymore knowledgeable on the PPACA then Steve.

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Steve Tucker is very knowledgeable and well versed regarding the PPACA (Obamacare).  I have heard him speak multiple times and continue to be impressed with his knowledge base as well as insights into effects of the law as well as alternative solutions.
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“Steve is the most integral, helpful, and aware Insurance Agent you will ever meet. He will be there to serve your needs and solve your problems. You will be blown away … really. Steve is the model that all professionals, in any service field, should strive to emulate.” – James Roswell Quinn August 26, 2008

James Roswell Quinn – Keynote Speaker & Author of “Controlling Others for Love & Profit” www.globalkeynote.com 
Top qualities: Great Results, Expert, High Integrity James hired C. Steven Tucker as a Insurance Agent in 1995, and hired him more than once.
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“Steve has been a great help to me and my family in obtaining affordable health insurance. He is always looking for the best placement and helps us through the process. I have gladly referred him to associates, and he has promptly helped all of them.” March 24, 2009

Kathleen Hittle – Attorney at Law, Owner at Glaser & Hittle Law Practice
Top qualities: Great Results, Expert, On Time Kathy hired C. Steven as a Insurance Agent in 2000, and hired him more than once.
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“I called SBIS on a friend’s reference for my health insurance. Everything was handled fine, but what really surprised me is that two months before my policy expired, Steve Tucker called to verify my status so he could find me a better value. Before SBIS, the past 30 years only consisted of rate increase notifications. I was impressed that SBIS would assume this responsibility acting as an advocate for me and my family.” April 4, 2002

Mark Del Monaco, Owner – Specs, Inc.
Top qualities: Subject Matter Expert, Ethical, Responsive Mark hired C. Steven Tucker as an Insurance Agent in 2002, and hired him more than once.
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“When hiring Steve we received a very knowledgeable insurance agent that helped us greatly. He answered all our questions and made the process of applying for insurance extremely easy. Not only is he personable he was able to get for us exactly what we needed for our coverage. We will only deal with Steve for our insurance needs.” – 8/17/08

Cindy Stec, Owner – Escape from Clutter
Top qualities: Great Results, Personable, Expert Cindy hired C. Steven Tucker as an Insurance Agent in 2000, and hired him more than once.
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“Steve worked really hard trying to keep the best rates and insurance plans for my family. He is extremely knowledgeable in his field and does what he say’s or commits to do. Should the need ever arise for me I will call him in a heart beat.” August 20, 2008

Steve Holden, Owner – Second Time Around Furniture
Top qualities: Personable, Expert, High Integrity Steve hired C. Steven Tucker as a Insurance Agent in 2000, and hired him more than once.
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“C. Steven Tucker is very helpful to us when it comes to insurance by recommending to our family the best possible insurance for the best possible price. He will work with us to get the best insurance. Thank you.” – August 19, 2008

Gloria Velazquez and family
Top qualities: Personable, Expert, High Integrity Gloria Velazquez hired C. Steven Tucker as a Insurance Agent in 2005, and hired him more than once.
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“To All: Steve Tucker sells insurance and was recommended by a real estate attorney I frequently do business with. He’s currently reviewing our health care insurance needs and I must say I found Steve to be a straight shooter, very knowledgeable in the industry and quite the problem solver. I rarely recommend anyone but have no reservation whatsoever in this instance. If you’ve been paying high premiums and have riders on your policy perhaps it’s worthwhile to phone him for a quote. I think its well worth the cost of a phone call and a few minutes of your time.” 4/08/2006

Julie Canoura, Charles Rutenberg Realty www.sellingadwelling.com
Top qualities: Personable, Expert, Responsive Julie hired C. Steven Tucker as an Insurance Agent in 2005, and hired him more than once.
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“C. Steven Tucker, owner of Small Business Insurance Services, Inc., is truly an expert in the insurance industry. I have been a health insurance client of Steve’s for many years and have recommended Steve’s services to many of my clients and business associates. Steve is trustworthy, personable and extremely knowledgeable. Steve has been an invaluable resource over the years and his level of responsiveness and professionalism far exceeds that of other insurance agents in the industry. Steve takes the frustration out of shopping for health and business insurance and strives to help his clients understand their options so they can make fully informed purchasing decisions. I highly recommend C. Steven Tucker and Small Business Insurance Services, Inc. without hesitation. Steve should be the first person you should call if you are in need of insurance advice!” 8/16/08

 Jean Kulig, President – Intelicorp Business Solutions Inc. www.intelicorp.us
Top qualities: Personable, Expert, High Integrity Jean hired C. Steven Tucker as a Insurance Agent in 2004, and hired him more than once.
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“We have worked with Steve for 10 years and trust him completely with managing our health insurance. He continuously works hard to locate the best health insurance and most cost effective solutions for our family’s needs. He is extremely knowledgeable about the insurance industry and explains everything clearly, patiently and in a friendly manner. He is easily reachable and responds quickly. He truly is a pleasure to work with and we would highly recommend him (and have!) to our family and friends. Aug 25 2008

Leo and Demetra, Project Coordinator – Track Data Corporation
Top qualities: Personable, Expert, High Integrity Demetra & Leo hired C. Steven Tucker as a Insurance Agent in 1999, and hired him more than once.
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“C. Steven Tucker, is extremely professional when it comes to dealing with his clients. He is very personable and treated me more like a friend then just a number. He worked with me consistently over a short period of time until he found the best deal for my situation. I will keep dealing with his company in the future and will definitely refer him to others.” August 19, 2008

Fiona Herbert, Graphic Designer – Genuine Wellness Inc.
Top qualities: Personable, On Time, High Integrity Fiona hired C. Steven Tucker as an Insurance Agent in 2007
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“Steve is TrainSmart’s insurance broker and he is always on top of which insurance products are best for our healthcare insurance needs. He is always proactive, positive, creative and responsive. His customer service is next to none. I highly recommend that you talk to Steve for your insurance needs.” August 18, 2008

Leslie Ciborowski, Owner – A+ Trainsmart Inc. www.atstrain.com Top qualities: Good Value, High Integrity, Creative Leslie hired C. Steven Tucker as an Insurance Agent in 2001, and hired him more than once.
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“It’s a pleasure to recommend the services of Steve Tucker. I am a practicing physician (general internal medicine) and was taking the medical insurance offered by my group (large, multi-specialty) since I joined them in 1985. It was good coverage and very convenient. It turns out the costs were relatively high even with the pre-tax payments. Last year my wife and I were directed to Steve Tucker by an old (more long-time and trusted than “old”) friend of my wife. Steve was a pleasure to deal with from the beginning. We both found him congenial, patient, intelligent, very informative and responsive. We did find the medical insurance that suited our needs and did save money”. September 15, 2008

Dr. P., Physician – Private Practice
Top qualities: Congenial, patient, intelligent, very informative and responsive. Dr. P. hired C. Steven Tucker as an Insurance Agent in 2007.
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## Blue Cross
URL: https://www.healthinsurancementors.com/blue-cross/

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The 2026 ACA (Obamacare) open enrollment period ended on January 15, 2026. 
On January 1, 2026, the state of Illinois moved from HealthCare.gov to their own state-based health insurance exchange at GetCovered.Illinois.gov. If you live in Illinois you can purchase federally subsidized health insurance via that site only. After February 1, 2026, you must have experienced a qualifying life event in order to qualify for a 60 day special enrollment period. Qualifying life events occur after the involuntary loss of other health insurance. Examples of qualifying life events are the loss of employer sponsored coverage and the offer of COBRA. The exhaustion of COBRA after 18 months. The loss of eligibility for Medicaid and finally the involuntary loss of coverage when one moves from one state to another. If you reside in Illinois and have experienced a qualifying life event visit GetCovered.Illinois.gov to apply under special enrollment. 
Residents of all other states, please click here or click the Blue Cross logo to apply under special enrollment.
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New improvements for 2026 include the addition of the Northwestern Medical Group, the Endeavor Health Medical Group and Rush University Medical Center into the Blue Choice Preferred PPO network. As in past years, the entire Advocate Medical Group will remain outside of the PPO network for 2026. To gain access to the Advocate Medical Group you must purchase the BlueCare Direct with Advocate plans. We do not recommend doing so because the BlueCare Direct HMO network is the smallest and most restrictive Blue Cross HMO network. Blue Cross Blue Shield of Illinois was named one of America’s best insurance companies by Forbes.
 
Determining your eligibility for federal health insurance subsidies.

Depending on your total household M.A.G.I. – Modified Adjusted Gross Income – you may qualify for one or both federal subsidies. The first being an A.P.T.C. – Advance Premium Tax Credit – which reduces monthly premiums. The second being C.S.R. – Cost Sharing Reduction – which reduces out of pocket costs but only on Silver level plans.

PLEASE NOTE: If your income is lower than the Federal Poverty Level Information in your state, which is less than 138% of the FPL – Federal Poverty Level in states that expanded Medicaid and less than 100% of the FPL in states that did not. You will be offered Medicaid and as such will not be able to qualify for subsidized private health insurance. You can purchase private health insurance even if you qualify for Medicaid but you must do so without a subsidy. Click the chart below to determine the current Federal Poverty Level & percentages above it.

PLEASE NOTE: If you qualify for a federal health insurance subsidy and your state has expanded CHIP – Children’s Health Insurance Plan and your A.G.I. is lower than 138% above the F.P.L. – Federal Poverty Level (see chart above.) You will not be able to insure your children on your policy if they are under the age of 19. Healthcare.gov will instead send a referral to your state’s CHIP – Children’s Health Insurance Plan. In Illinois, that program is “All Kids Covered“. There will most likely be no premium required to insure your children. There will also be little to no copays or deductibles required. You may wish to purchase a Child Only health insurance policy instead at full price for your children if you cannot find a Pediatrician who will accept “All Kids Covered”.

Preventive Care: All ACA-qualified (Obamacare) health insurance policies must cover all of these preventive care tests and exams at no cost to you. Click on “For all Adults”, “For Women” & “For Children” to see entire list.

2026 Blue Cross Blue Shield of Illinois individual health insurance

BLUE CHOICE PREFERRED PPO PLANS FOR 2026
Blue Choice Preferred PPO network search tool.
Blue Choice Preferred Bronze PPO 701 – PPO
Blue Choice Preferred Bronze PPO 201 – PPO
Blue Choice Preferred Bronze PPO Standard – Select Rx
Blue Choice Preferred Silver PPO 801 – PPO
Blue Choice Preferred Silver PPO 203 – PPO
Blue Choice Preferred Silver PPO Standard – Select Rx Copays – PPO
Blue Choice Preferred Gold PPO 204 – PPO
Blue Choice Preferred Gold PPO 901 – PPO
Blue Choice Preferred Gold PPO Standard – Rx Copays – PPO

BLUE PRECISION HMO INDIVIDUAL PLANS FOR 2026
Blue Precision HMO network search tool
Blue Precision Bronze HMO Standard – Select Rx Copays – HMO
Blue Precision Bronze HMO 701 – HMO
Blue Precision Bronze HMO 205 – HMO
Blue Precision Silver HMO 206 – HMO
Blue Precision Silver HMO 704 – HMO
Blue Precision Silver HMO Standard – Select Rx Copays – HMO
Blue Precision Gold HMO 207 – HMO
Blue Precision Gold HMO 703 – HMO
Blue Precision Gold HMO Standard – Rx Copays – HMO

MYBLUE PLUS POS INDIVIDUAL PLANS FOR 2026
MyBlue Plus POS network search tool
MyBlue Plus Bronze 903 POS
MyBlue Plus Bronze Standard – Select Rx Copays – POS
MyBlue Plus Bronze 912 – POS
MyBlue Plus Silver 906 – POS
MyBlue Plus Silver 905 – POS
MyBlue Plus Silver Standard – Select Rx Copays – POS
MyBlue Plus Gold 910 – POS
MyBlue Plus Gold 909 – POS
MyBlue Plus Gold Standard – Select Rx Copays – POS

BLUECARE DIRECT HMO INDIVIDUAL PLANS FOR 2026
BlueCare Direct HMO network search tool
As in past years, the entire Advocate Medical Group will remain outside of the Blue Choice Preferred PPO network and the Blue Precision HMO network for 2026. To gain access to the Advocate Medical Group you must purchase one of the BlueCare Direct with Advocate HMO plans. We do not recommend doing so because the BlueCare Direct HMO network is the smallest and most restrictive Blue Cross HMO network restricting you only to Advocate Medical Group providers.
BlueCare Direct Bronze Standard – Select Rx Copays with Advocate – HMO
BlueCare Direct Silver Standard – Select Rx Copays with Advocate – HMO
BlueCare Direct Gold℠ Standard – Rx Copays with Advocate – HMO

To shop for individual dental insurance. Click the Delta dental icon below. Delta is the only individual dental insurance carrier that provides both a national PPO network and credit for prior coverage. If you provide evidence of at least 12 months of consistent prior dental insurance coverage when switching to a Delta dental individual policy, you will receive credit towards waiting periods for basic and major services.

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There are four Individual Dental insurance policies offered by Blue Cross Blue Shield of Illinois. To check if your dentist is in the BCBSIL Dental PPO click BlueCare® Dental (DPPO)
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[/et_pb_accordion_item][et_pb_accordion_item title=”States that offer individual PPO plans in the Individual Marketplace” _builder_version=”4.23.1″ _module_preset=”default” global_colors_info=”{}” open=”off”]Planning your exit strategy? Blue Cross now offers Individual PPO plans in 21 states (including Illinois) and in Washington D.C. There are also 3 additional states that offer Individual PPO plans but they are not Blue Cross plans. The complete list is as follows:

Alabama -Blue Cross
Alaska – Moda Health and Premera Blue Cross 
Arizona – Blue Cross
Arkansas – Ambetter QualChoice and Blue Cross
California – Blue Cross and Health Net – Ambetter
Connecticut – Anthem Blue Cross
Delaware – Highmark Blue Cross
Hawaii – H.M.S.A – Hawaii Medical Service Association – Blue Cross
Idaho – Blue Cross
Illinois – Blue Cross 
Louisiana – Blue CrossMaine – Maine Community coop and Blue Cross
Maryland – CareFirst Blue Cross
Michigan – Blue Cross
Minnesota – Blue Cross and Health Partners
Montana – Pacific Source no Blue Cross  
North Carolina – Blue Cross Blue Shield
North Dakota – Blue Cross
Oklahoma – Oscar, Medica, Ambetter and Blue Cross
Oregon – Pacific Source no Blue Cross
Pennsylvania – Independence Blue Cross
Rhode Island – Blue Cross
South Dakota – Sanford and Avera no Blue Cross
Washington D.C. – CareFirst Blue Cross
West Virginia – HighMark Blue Cross 
Wyoming – Mountain Health Co-op and Blue Cross

 
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2025 Blue Cross Blue Shield of Illinois individual health insurance
BLUE CHOICE PREFERRED PPO PLANS FOR 2025
Click here to search the outpatient prescription drug Formulary list for PPO Individual ACA-qualified (Obamacare) plans.
Click here to search the outpatient prescription drug Formulary list for HMO and POS (Point Of Service) Individual ACA-qualified (Obamacare) plans.
Blue Choice Preferred PPO network search tool.
Blue Choice Preferred Bronze PPO 701 – PPO
Blue Choice Preferred Bronze PPO 201 – PPO
Blue Choice Preferred Bronze PPO Standard – Select Rx
Blue Choice Preferred Bronze PPO 202 – HSA-qualified OFF exchange (unsubsidized) ONLY
Blue Choice Preferred Silver PPO 801 – PPO
Blue Choice Preferred Silver PPO 203 – PPO
Blue Choice Preferred Silver PPO Standard – Select Rx Copays – PPO
Blue Choice Preferred Silver PPO 303 – OFF exchange (unsubsidized) ONLY
Blue Choice Preferred Gold PPO 204 – PPO
Blue Choice Preferred Gold PPO 901 – PPO
Blue Choice Preferred Gold PPO Standard – Rx Copays – PPO
Blue Choice Preferred Security PPO 200 – Catastrophic plan for those under age 30 only
 
BLUE PRECISION HMO INDIVIDUAL PLANS FOR 2025
Blue Precision HMO network search tool
Blue Precision Bronze HMO Standard – Select Rx Copays – HMO
Blue Precision Bronze HMO 701 – HMO
Blue Precision Bronze HMO 205 – HMO
Blue Precision Silver HMO 206 – HMO
Blue Precision Silver HMO 704 – HMO
Blue Precision Silver HMO Standard – Select Rx Copays – HMO
Blue Precision Silver HMO 306 – HMO – OFF exchange (unsubsidized) ONLY
Blue Precision Gold HMO 207 – HMO
Blue Precision Gold HMO 703 – HMO
Blue Precision Gold HMO 707 – HMO
Blue Precision Gold HMO Standard – Rx Copays – HMO
 
BLUECARE DIRECT HMO INDIVIDUAL PLANS FOR 2025
BlueCare Direct HMO network search tool
As in past years, the entire Advocate Medical Group will remain outside of the PPO network for 2025. To gain access to the Advocate Medical Group you must purchase the BlueCare Direct with Advocate plans. We do not recommend doing so because the BlueCare Direct HMO network is the smallest and most restrictive Blue Cross HMO network.
BlueCare Direct Bronze Standard – Select Rx Copays with Advocate – HMO
BlueCare Direct Silver Standard – Select Rx Copays with Advocate – HMO
BlueCare Direct Gold℠ Standard – Rx Copays with Advocate – HMO

MYBLUE PLUS POS INDIVIDUAL PLANS FOR 2025
MyBlue Plus POS network search tool
MyBlue Plus Bronze 903 POS
MyBlue Plus Bronze Standard – Select Rx Copays – POS
MyBlue Plus Bronze 912 – POS
MyBlue Plus Silver 906 – POS
MyBlue Plus Silver 905 – POS
MyBlue Plus Silver Standard – Select Rx Copays – POS
MyBlue Plus Gold 910 – POS
MyBlue Plus Gold 909 – POS
MyBlue Plus Gold Standard – Select Rx Copays – POS

2025 BLUECARE INDIVIDUAL DENTAL PLANS
BlueCare Dental PPO network search tool
BlueCare Dental 1A 1B 1C & 1D brochure
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## Home
URL: https://www.healthinsurancementors.com/

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Medicare supplement and individual and family health insurance.
For expert guidance on Medicare click here. Have questions? Call (630) 674-1551 or click contact.HealthInsuranceMentors.com is A+ rated with the Better Business Bureau and a Google approved health insurance provider. The 2026 ACA (Obamacare) open enrollment period ended January 15, 2026. To see if you qualify for special enrollment click here. Small business owners, click group insurance.
 
      
                 
 
 
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					Welcome to HealthInsuranceMentors.com – the web presence for Small Business Insurance Services Inc. We are A+ rated with the Better Business Bureau and a Google approved insurance provider. Our insurance brokerage firm is dedicated to helping you find the right insurance plan for you, your family and your business. Our firm is domiciled in Illinois. We are a multi-state licensed brokerage firm serving Illinois, Indiana, Iowa, Wisconsin, Michigan, Missouri, Florida, Ohio, Texas, Kentucky, Alabama, Tennessee, North Carolina, South Carolina, Mississippi, Minnesota, Arizona and Virginia. We have been in business since 1995. We are well-versed on Medicare and the ACA – Affordable Care Act a.k.a. “Obamacare”. We will help you purchase Medicare Supplement as well as both “on exchange” (subsidized) and “off-exchange” (unsubsidized) ACA-qualified health insurance. We also offer non ACA-qualified Short Term health insurance, group health insurance and Life insurance. We will help you determine which policies fit you, your family and your budget best.
Health insurance can be a challenge for anyone to navigate. Now with the ACA being the law of the land, there are many significant changes that have been made in the health care and health insurance systems that are important to consider. There were also significant changes made to Medicare Part D under the 2022 IRA – Inflation Reduction Act. We work with clients to make sure they understand how both laws impact their choices when it comes to health insurance. We inform and empower our clients to get the most from their policy. We’re proud that our brokerage firm has helped protect American lives for more than 28 years. We always go the extra mile because the “Best Policy is a Great Agent“.
We will provide you the very latest relevant information about Open Enrollment and Special Enrollment, and an extensive list of health insurance plans available during these two purchasing time periods. Our founder, C. Steven Tucker is a regularly featured expert on radio and television stations such as Chicago’s AM560 The Answer, WLS AM890, CBS2 Chicago, ABC7, WTTW Chicago, Beyond The Beltway and the Fox Business television network. Illinois residents, please call us directly at (630) 674-1551. Outside of Illinois call Toll Free (866) 724-7123 for guidance. 
 
 
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## Short Term health insurance
URL: https://www.healthinsurancementors.com/short-term-health-insurance/

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Short Term health insurance banned in Illinois – January 1 2025
ON July 10, 2024, Illinois Governor J.B. Pritzker signed HB2499 into law. That law known as Public Act 103-0649 rendered all Short Term policies illegal for sale in the state of Illinois as of January 1, 2025.
 
SHORT TERM HEALTH INSURANCE LIMITED TO 3 MONTHS IN DURATION NATIONWIDE AS OF 09/01/2024.
On March 28, 2024, HHS – Health & Human Services published this finalized rule authored by the former Biden administration. This rule limits all Short Term health insurance policies to no more than 3 months in duration. Worse yet, the rule prohibits the ability to purchase another 3 month policy from the same insurer after the first 3 month policy ends. This being the case, Short Term policies are no longer safe to purchase in any state after September 1, 2024 unless you need the coverage for only the last 3 months of a calendar year.
 
SHORT TERM HEALTH INSURANCE RESTORED TO 12, 24 & 36 MONTHS IN DURATION AS OF 08/07/2025.
On August 7, 2025, the U.S. Departments of Labor, HHS, and the U.S. Treasury announced in this memo that they will not prioritize enforcement of the aforementioned Biden finalized rule that limited Short Term Medical health insurance to a maximum of 4 months in duration as of September 1, 2024.
Following that memo, insurance companies like United Healthcare and Allstate Health Solutions will now once again sell Short Term health insurance policies with the aforementioned durations in states that allow Short Term health insurance. States that have banned all Short Term health insurance via separate legislation are Illinois, California, Connecticut, Hawaii, Massachusetts, Maine, New Jersey, and New York.
Mr. Tucker joined Dan Proft on Chicago’s Morning Answer Re: EMTALA, Cost Shifting & new Short Term rules – 08/14/2025

SHORT TERM HEALTH INSURANCE FROM UNITED HEALTHCARE AND ALLSTATE INSURANCE COMPANIES
If you live outside of the state of Illinois and need Short Term health insurance. United Healthcare’s Short Term policies are the most comprehensive non ACA-qualified Short Term health insurance policies available. Unlike other Short Term policies, these policies cover outpatient prescription drugs and your health plan deductible is waived for Urgent Care visits. United Healthcare also covers each insured member to $2,000,000. United Healthcare’s Short Term policies also include their national “Choice Plus” PPO network which includes in network access to Chicago’s Teaching hospitals such as Northwestern Memorial, University of Chicago, Rush university medical center and the Lurie Children’s hospital. To search for in network PPO providers within United Healthcare’s Choice Plus PPO please click here. For quotes and to apply online click the United Healthcare logo below.

The second best priced and best designed Short Term health insurance policies are available from Allstate Health Solutions. Their Enhanced Short Term policies cover each insured member up to $1,000,000. Allstate’s Short Term policies also include a national PPO network. That network is Aetna’s Open Choice PPO network. It also includes in network access to Chicago’s Teaching hospitals including Northwestern Memorial, University of Chicago medica center, Rush university medical center and Lurie Children’s hospital. You can search for in network providers PPO providers within Aetna’s Open Choice PPO network by clicking here. For quotes and to apply online click the Allstate Health Solutions logo below:

PLEASE NOTE: There are two other health insurance carriers offering Short Term health insurance policies in the state of Illinois. They are Independence American via IHC – Independence Holding Group and “Pivot Health” products via Companion Life insurance company. These carriers offer Indemnity policies on a Short Term basis. Indemnity policies do not include a PPO contract. These Indemnity policies pay reasonable and customary charges only. Without a PPO contract included with your policy, a medical provider can balance bill you for charges above the reasonable and customary amount. For this reason we do not recommend purchasing Short Term Indemnity policies from Independence American or Companion Life.
Please also note: Non ACA-qualified Short Term health insurance plans are not required to cover certain “Essential Health Benefits” that are covered with ACA-qualified plans. These benefits are:
1.) Maternity and newborn care2.) Mental health and substance use disorder services3.) ACA mandated Preventive care benefits. However, routine mammograms, birth control and cancer screenings ARE COVERED with non ACA-qualified Short Term health insurance policies in states like Illinois where these Preventive care benefits are mandated.4.) Pediatric Services (including both oral care and vision care).
The ACA (Obamacare) Individual Mandate was REPEALED by congress on 12/20/17. The Tax Cuts and Jobs Act of 2017 zeroed out the Individual Mandate on January 1, 2019.
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## Medicare Supplement
URL: https://www.healthinsurancementors.com/medicare-supplement/

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The Four-Legged Medicare stool
Traditional Medicare contains four ‘parts’. Part A (inpatient coverage), Part B (outpatient coverage) Medicare Supplement a.k.a. “MediGap” (Plan G being the most comprehensive) and Part D which ensures you have coverage for outpatient prescription drugs. Below is more information about each part of Traditional Medicare and the costs related to each.
 
What’s covered by Medicare?
Is the item, test or service you need covered by Medicare? Find out by clicking here.
 
When can I sign up for Medicare Part A (inpatient coverage) & Medicare Part B (outpatient coverage)?
 

When you’re first eligible for Medicare, you have a 7-month Initial Medicare enrollment period to sign up for Part A and/or Part B. For example, if you are eligible when you turn 65, you can sign up during your 7-month initial Medicare enrollment period. It begins 3 months before the month in which you turn 65, includes the month in which you turn 65 and ends 3 months after the month in which you turn 65.
To sign up for Medicare Part A (inpatient coverage) and Medicare Part B (outpatient coverage) click this link from the Social Security website at SSA.gov.
 
General Enrollment Period for Medicare
If you didn’t sign up for Part A and/or Part B (for which you must pay premiums) when you were first eligible and you aren’t eligible for a Special Enrollment Period (see below), you can sign up during the General Enrollment Period between January 1–March 31 each year. In that scenario, your coverage will start on July 1st. You may have to pay a higher premium for late enrollment in Part A and/or a higher premium for late enrollment in Part B.
 
National Open Enrollment Period for Medicare
If you miss the General Enrollment Period, you cannot apply again until the National Open Enrollment period begins on October 15th and ends on December 7th. In this scenario, your coverage will not begin until July 1st of the following year. You will also have to wait to enroll in Part D (outpatient prescription drug coverage) until the next National Medicare Open Enrollment period begins again on October 15th and ends on December 7th. You can also change your Part D plan and Medicare Advantage plan during this window with no underwriting (guaranteed issue) but the change will not become effective until January 1st.
 
Special Enrollment Periods for Medicare
Once your initial Medicare enrollment period ends, you may still be able to sign up for Medicare during a Special Enrollment Period. If you’re covered under a group health plan based on current employment, you have a Special Enrollment Period to sign up for Part A and/or Part B any time as long as you or your spouse (or family member if you’re disabled) is working, and you’re covered by a group health plan through the employer or union based on that work. If you are enrolling in Medicare after age 65 and still have employer sponsored coverage you and your employer must also complete form CMS-L564. This document provides evidence that you have retained qualified coverage since the age of 65. Completing this form and submitting it to the Social Security department will ensure that you are not penalized later for late enrollment. Only those who remain uninsured after age 65 are penalized.
You also have an 8-month Special Enrollment Period to sign up for Part A and/or Part B that starts the month after the employment ends or the group health plan insurance based on current employment ends, whichever happens first. Usually, you don’t pay a late enrollment penalty if you sign up during a Special Enrollment Period.
Regulatory update in the state of Illinois effective January 1, 2022.
On January 1, 2022, Public Act 102-42 becomes law in the state of Illinois. On that date, all Illinois residents between the ages of 65 and 75 can switch to a new Medicare Supplement (a.k.a. “MediGap”) policy with the same carrier that is equal in design (or provides fewer benefits) regardless of their health status (Guaranteed Issue) during an annual open enrollment period. That annual open enrollment commences on their birthdate and continues for a 45 day period.
 
Monthly costs for Medicare
Most taxpayers do not pay a premium for Medicare Part A but Medicare Part B requires a base monthly premium. The standard Medicare Part B monthly premium will be $202.90 in 2026 for single tax filers with a M.A.G.I. – Modified Adjusted Gross Income – of less than $109,000 and less than $218,000 for married couples who file jointly. For those with a higher M.A.G.I there will be an I.R.M.A.A – Income Related Monthly Adjustment Amount – added to both Medicare Part B and Part D premiums. See the charts below. Also, the annual deductible for all Medicare Part B beneficiaries will be $283 in 2026. Click “Medicare & You” below to download the 2026 official U.S. government handbook.
 

 
Medicare out of pocket expenses without Medicare Supplement
Without a Medicare Supplement (“MediGap”) policy you are exposed to these Medicare Part A & B out of pocket expenses outlined below:
 
Medicare Part A premium and deductible
Medicare Part A covers inpatient hospitals, skilled nursing facilities, hospice, inpatient rehabilitation, and some home health care services. About 99% of Medicare beneficiaries do not have a Part A premium since they have at least 40 quarters of Medicare-covered employment, as determined by the Social Security Administration.
The Medicare Part A inpatient hospital deductible that beneficiaries pay if admitted to the hospital will be $1,736 in 2026. The Part A inpatient hospital deductible covers beneficiaries’ share of costs for the first 60 days of Medicare-covered inpatient hospital care in a benefit period. In 2026, beneficiaries must pay a coinsurance amount of $434 per day for the 61 through 90 day of a hospitalization in a benefit period and $868 per day for lifetime reserve days. For beneficiaries in skilled nursing facilities, the daily coinsurance for days 21 through 100 of extended care services in a benefit period will be $217 in 2026.

 
Medicare Part B Premium and Deductible
Medicare Part B covers physicians’ services, outpatient hospital services, certain home health services, durable medical equipment, and certain other medical and health services not covered by Medicare Part A.
Each year, the Medicare Part B premium, deductible, and coinsurance rates are determined according to provisions of the Social Security Act. The standard monthly premium for Medicare Part B enrollees will be $202.90 in 2026. The annual deductible for all Medicare Part B beneficiaries will be $283 in 2026.
Beginning in 2023, individuals whose full Medicare coverage ended 36 months after a kidney transplant, and who do not have certain other types of insurance coverage, can elect to continue Part B coverage of immunosuppressive drugs by paying a premium. For 2025, the standard immunosuppressive drug premium is $110.40.
When can I buy Medicare Supplement a.k.a. “MediGap”?
During your Initial Medicare enrollment period.—A one‑time-only, 7-month period when federal law allows you to buy any Medicare Supplement policy you want that’s sold in your state. It starts in the first month that you’re covered under Medicare Part B, and you’re 65 or older. During this period, you can’t be denied a Medicare Supplement policy or charged more due to past or present health problems. Some states (like Illinois) now have additional Open Enrollment rights under state law.
If you miss this initial Open Enrollment period, you have other guaranteed issue rights depending on the circumstance outlined in detail in this document provided by CMS – Centers for Medicare and Medicaid Services.
If you still do not qualify during the Special Circumstances outlined in that document, there is one carrier in Illinois that will issue you a Medicare Supplement policy any time throughout the year on a guaranteed issue basis (no preexisting conditions) regardless of your age or health history. That carrier is Blue Cross Blue Shield of Illinois. Because Blue Cross is the only guarantee issue carrier (to any age, regardless of your health history) they are the most expensive.
Medicare Supplement (“Medigap”) plan G is the best priced and best designed Medicare Supplement policy. Without MediGap Plan G, you will be exposed to all of these Medicare out of pocket costs which are quite large in the hospital. When you have Medigap Plan G and Medicare Part A and B, your total out of pocket cost for all medical claims covered by Medicare will be capped at no more than the Medicare Part B deductible which is $283 annually in 2026. The lowest priced national Medicare Supplement carrier in the state of Illinois (and most other states) with the lowest annual renewal rates (only 3% in 2024 and 7.5% in 2025) is Cigna insurance company. Most especially if your spouse also has a Cigna Medicare Supplement policy or if you live with someone 18 years of age or older. Cigna’s exceptional management of medical risk was one of the reasons why Health Care Service Corporation (who owns Blue Cross Blue Shield of Illinois) spent $3.3 billion in 2025 to purchase Cigna. Cigna is now a local Illinois based insurance carrier renamed as “Health Spring” as of January 1 2026. To view their rates and apply online, click the Cigna logo below or contact us for guidance.
 
                                                  
To view MediGap rates for all other carriers, please click “Start Your Free Quote” below: 
 
    
 
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2026 Part B premiums & IRMAA – Income Related Monthly Adjustment Amounts

Since 2007, a beneficiary’s Part B monthly premium has been based on his or her income. These income-related monthly adjustment amounts affect roughly 8 percent of people with Medicare Part B. The 2026 Part B total premiums for high-income beneficiaries with full Part B coverage are shown in the following table. To view the 2026 IRMAA brackets, please click here.

 
Medicare Part D Income-Related Monthly Adjustment Amounts
Since 2011, a beneficiary’s Part D monthly premium has been based on his or her income. These income-related monthly adjustment amounts affect roughly 8 percent of people with Medicare Part D. These individuals will pay the income-related monthly adjustment amount in addition to their Part D premium. Part D premiums vary plan and regardless of how a beneficiary pays their Part D premium, the Part D income-related monthly adjustment amounts are deducted from Social Security benefit checks or paid directly to Medicare. Roughly two-thirds of beneficiaries pay premiums directly to the plan while the remainder have their premiums deducted from their Social Security benefit checks. The 2026 Medicare Part D income-related monthly adjustment amounts for high-income beneficiaries are shown in the following table:

 

Reducing IRMAA when your income declines:
If at any point your income falls below the columns above you do not have to wait until you file your tax return in order to reduce or eliminate the I.R.M.A.A. upcharge. Instead, complete form SSA-44 and then either upload it via this link or take it to your local Social Security office. After review, your I.R.M.A.A. upcharge will either be reduced or eliminated based on the evidence you provide proving a reduction in income.
 

When can I buy Medicare Part D for outpatient prescription drug coverage?
The Open Enrollment period for Medicare Part D – for outpatient prescription drug coverage is October 15th through December 7th. The Medicare Part D deductible is $590 annually in 2025. It will increase to $615 annually in 2026. That deductible is only required to be paid for outpatient prescription drugs that are considered Tier 2 Generic and “Brand name drugs” as well as Specialty drugs. On most insurance company formulary lists, those drugs are considered “Tier 3” or higher. If you are not taking Tier 2 Generic drugs or Brand name or Specialty drugs when you are first eligible for part D you may be best positioned by purchasing the lowest priced part D plan available in your area because again, there is no deductible required on most part D plans for Tier 1 Generic drugs.
There are four payment stages with a Medicare part D plan.
1.) Deductible (required for Tier 2 Generic and Brand and Specialty drugs only)2.) Initial coverage period3.) Coverage ‘gap’ (formerly known as the “Donut hole”)4.) Catastrophic
There are many Medicare part D plans available to purchase once you have your Medicare part A (inpatient) and Medicare part B (outpatient) coverage in place. To determine which part D plan is best for you, please visit this page of the Medicare.gov website and click on “Drug Plan (Part D)”. Then, enter your zip code and county. Then, begin by entering the names and dosages of all of your current outpatient prescription drugs. The system will then provide an unbiased list of the part D plans that will expose you to the lowest annual out of pocket expense based on total expenditures in both premiums, co pays, deductibles and coinsurance. The Part D plan listed at the top of the first page is the plan you should purchase because that will be the plan that will expose you to the lowest out of pocket expense which includes your monthly premium, copays and the annual deductible (if applicable).
The 2026 Medicare Part D IRMAA amounts are linked here.
The Medicare Savings Programs (MSPs) help more than 10 million people with coverage of Medicare premiums and, in most cases, other cost sharing. In their continued efforts to improve access to health care and lower costs for millions of Americans, the Department of Health and Human Services (HHS), through CMS, recently finalized a rule to streamline enrollment in MSPs, making coverage more affordable for an estimated 860,000 people. In addition, the Part D low‑income subsidy (LIS) helps pay for the Part D premium and lowers the cost of prescription drugs. Further, the Inflation Reduction Act recently expanded the number of people eligible for full LIS.
Immunosuppressive drug usage:
Beginning in 2023, certain Medicare enrollees who are 36 months post kidney transplant and no longer eligible for full Medicare coverage, can elect to continue Part B coverage of immunosuppressive drugs by paying a premium. For more information click here.
 
Changes to Part D via 2022 I.R.A. – Inflation Reduction Act
In 2022, congress passed the Inflation Reduction Act. Besides implementing government price controls on certain prescription drugs, it also made the following changes to Part D which will result in lower out of pocket costs for Part D policyholders:

Caps out-of-pocket spending for Medicare Part D enrollees & makes other Part D benefit design changes, beginning in 2024

Limits monthly cost sharing for insulin to $35 for people with Medicare, beginning in 2023

Eliminates cost sharing for adult vaccines covered under Medicare Part D and improve access to adult vaccines in Medicaid and CHIP, beginning in 2023

Expands eligibility for full benefits under the Medicare Part D Low-Income Subsidy Program, beginning in 2024

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Principal Broker, C. Steven Tucker joined Dan Proft and Amy Jacobson on Chicago’s Morning Answer to discuss the impact of the “Inflation Reduction Act” on Medicare Part D and enhanced ACA health insurance subsidies now extended until 2026 – 08/17/2022. Replay below:  

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Differences between Medicare Supplement MediGap plans & Medicare Advantage
One of the most common questions we receive about Medicare supplement insurance is how it differs from a Medicare Advantage plan. Below are 5 basic differences for you to consider. In our view, Traditional Medicare with a Medicare supplement policy is the best option for seniors looking to fill in the gaps left by basic Medicare. This is especially true after the U.S. Department of Health and Human Services Office of Inspector General released this detailed report on April 27, 2022 which detailed millions of medically necessary claims that were denied by Medicare Advantage insurers “in an attempt to increase profits“. In 2023, CMS – Centers for Medicare & Medicaid Services – began restricting television ads for Medicare Advantage. CMS also began to scrutinize agents and brokers who sell them due to extremely high complaint volumes. This July 2024 article from the Chicago Sun Times and this September 2023 article from Barron’s Financial and Investment news detail the onerous ramifications of making the wrong choice when it comes to Medicare. This December 2023 report from Becker’s Hospital Review revealed that hospitals across America are “dropping Medicare Advantage Plans left and right.” This November 2024 Wall Street Journal report highlights why the sickest patients are leaving Medicare Advantage plans. Both Humana and United Healthcare have had their Medicare Advantage star ratings dropped by CMS for 2025. This October 2023 article from the Wall Street Journal also provides guidance on avoiding “big mistakes” when it comes time for Medicare. The biggest mistake of all is enrolling in Medicare Advantage. This is especially true when it pertains to access. Traditional Medicare is accepted by 98% of physicians nationwide. That is not the case with Medicare Advantage. Medicare Advantage networks are limited. Medicare Advantage plans are often provided at no cost to those who enroll because the largest insurers who offer them not only employ physicians but then incentivize those physicians to misdiagnose patients in order to increase their profits as alleged in this Wall Street Journal article dated December 29, 2024. That WSJ expose led to United Healthcare being investigated by the U.S. Department of Justice as of February 21, 2025.
Insurance companies claim they offer Medicare Advantage plans in order to improve patient care and reduce mortality rates. Data compiled by the MedPac – Medicare Payment Advisory Commission – in the 1990s did reveal that mortality rates were lower with Medicare Advantage recipients. Since 2008 though the mortality rate between Traditional Medicare and Medicare Advantage recipients is now statistically indistinguishable. Worse yet, according to this June 2024 study completed Dr. Adam Gaffney, Dr. Stephanie Woolhandler and Dr. David Himmelstein with the Harvard Medical School and the Cambridge Health Alliance, Medicare Advantage plans have raised Medicare’s costs by $612 billion since 2007, including $82 billion in 2023 alone. Why hundreds of billions of taxpayer dollars are continuing to be funneled to Medicare Advantage insurers when studies provided by the aforementioned physicians and others around the nation reveals no distinguishable difference in mortality rates between Traditional Medicare recipients and Medicare Advantage recipients is a question that must be addressed by policymakers.
Consider the following:
1.) Medicare Advantage plans are NOT Medicare Supplements. Medicare Supplements and Medigap are interchangeable terms – the two terms refer to the same type of standardized plans that work with Medicare. Medicare Advantage plans do NOT “supplement” Medicare; they take the place of it.
2.) Medicare Advantage plans have widely varying benefits that can be found on plan “Summary of Benefit” documents. These range from plan to plan, change each year, and are very long (i.e. different co-pays for different procedures, in-network vs. out of network, etc.). Medicare Supplement plans are all required to go by the Federally-standardized plans chart.
3.) The plans work very differently. The easiest way to explain it is that Medicare Supplement/Medigap plans pay AFTER Medicare pays. They “supplement” Medicare. Medicare Advantage plans pay INSTEAD of Medicare. More importantly, the U.S. Department of Health and Human Services Office of Inspector General released this detailed report on April 27, 2022 which detailed millions of medically necessary claims that were denied by Medicare Advantage insurers “in an attempt to increase profits“. Please watch the video below from Health & Human Services Office of Inspector General warning seniors about Medicare Advantage:

4.) Medicare Advantage plans have an annual enrollment period at the end of each year. This is because the plans change, benefits and premium, each year. Medicare Supplement plans do NOT have an annual enrollment period. You can change plans at any time of the year, but the benefits never change on these types of plans.
5.) The ‘M.O.O.P.” – Maximum Out Of Pocket – risk with Medicare Advantage plans is $9,350 each year. In stark contrast, when you have Traditional Medicare Part A and B and Medicare Supplement (a.k.a. “MediGap”) Plan G, your total out of pocket cost for all medical claims covered by Medicare will be capped at no more than the Medicare Part B deductible which will be $283 annually in 2026.
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No Network Restrictions
Any doctor, hospital, or other medical provider that accepts Medicare must accept your Medicare supplement insurance plan. You can choose to see any doctor in any city when you want. 98% of all physicians nationwide accept Traditional Medicare. This is not the case with most Medicare Advantage “Part C” plans since many Medicare Advantage plans are coupled with an HMO which limits your choices as to which doctors or hospitals you can choose from.
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Easy To Compare Plans
All Medicare supplement insurance policy are standardized. This means that you can be sure that plans from different companies all have the exact same coverage (plan designated by letter – C, F, N, etc…)
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Stable Pricing
While some companies have rate increases each year, the premiums for your plans remain fairly steady. Especially if you work with an independent agent who can shop all the best companies for you.
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No Restricted Enrollment or Change Deadlines
With a Medicare supplement insurance policy you can change your plan at any time for any reason. You don’t have to rush around at the end of the year worried about getting stuck in a bad plan. Of course health conditions play a factor when buying a new policy, but again a quality independent agency has multiple companies all with different underwriting guidelines.
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You Can Cover 100% Of Out of Pocket Expenses
Medicare Supplement (“Medigap”) plan G is the best priced and best designed Medicare Supplement plan on the market today. Without MediGap Plan G, you will each be exposed to all of these Medicare out of pocket costs which are quite large in the hospital. When you have Medigap Plan G, your total out of pocket cost for all medical claims covered by Medicare will be capped at no more than the Medicare Part B deductible (which is $283 annually in 2026). This is not the case with Medicare Advantage plans. Medicare Advantage plans have a “M.O.O.P” – Maximum Out Of Pocket cost each year of $9,600.
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Medicare Plan F used to be the most comprehensive Medicare Supplement plan available. Medicare plan F was replaced by Medicare plan G on January 1, 2020. To learn more about the new Medicare Supplement plan G click the tab below. The best priced any hospital, any doctor Medicare Supplement plans are available from Cigna (a.k.a. Health Spring) insurance company. Call us at (630) 674-1551 to learn more about Medicare Supplement plan G from Cigna or click the “Contact” button at the top of this page. To view the outline of coverage and a detailed comparison between all of the Medicare Supplement plans offered by Cigna click this link.
 
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Medicare Supplement (“Medigap”) plan G is the best priced and best designed Medicare Supplement plan on the market today. Without MediGap Plan G, you will each be exposed to all of these Medicare out of pocket costs which are quite large in the hospital. When you have Medigap Plan G, your total out of pocket cost for all medical claims covered by Medicare will be capped at no more than the Medicare Part B deductible (which is $283 annually in 2026).

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Outpatient prescription drug coverage under Medicare part D
There are many Medicare part D plans available to purchase once you have your Medicare part A (inpatient) and Medicare part B (outpatient) coverage in place. To determine which part D plan is best for you, please visit this page of the Medicare.gov website and click on “Drug Plan (Part D)”. Then, enter your zip code and county. Then, begin by entering the names and dosages of all of your current outpatient prescription drugs. The system will then provide an unbiased list of the part D plans that will expose you to the lowest annual out of pocket expense based on total expenditures in both premiums, co pays, deductibles and coinsurance.
Please note: Even if you have not been prescribed any outpatient drugs, you still need to purchase a part D plan to avoid being penalized for not doing so. The penalty gets larger the longer you wait to purchase part D so even if you are not taking any outpatient prescription drugs, you still need to purchase a part D plan to avoid the penalty which will be applied once you do enroll in part D, if you wait. Waiting until you ‘need’ part D can cost you a lot of money in penalties and those penalties are applied in perpetuity. So, it is best to avoid them by purchasing part D at the lowest price possible when you are first eligible to do so.
Medicare Part D deductible: 
In 2026, the Medicare part D deductible is $615 each year. That deductible is only required to be paid for outpatient prescription drugs that are considered Tier 2 Generic and “Brand name drugs”. On most insurance company Formulary lists, those drugs are considered “Tier 3” or higher. If you are not taking Tier 3 drugs when you first are eligible for Medicare part D you may be best positioned by simply purchasing the lowest priced part D plan available in your area because again, there is no deductible required on most part D plans for Generic prescription drugs.
There are four payment stages with a Medicare part D plan.
1.) Deductible (required for Tier 2 Generic and Brand and Specialty drugs only)2.) Initial coverage period3.) Coverage ‘gap’ (formerly known as the “Donut hole”)4.) Catastrophic
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Paying for prescription drugs can be quite costly, which is why Medicare Part D was created as part of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (also known as the Medicare Modernization Act or MMA). Meant to help subsidize the cost of prescription drugs, Medicare Part D came into effect in 2006. Below is some general information on Medicare Part D and what to expect as a result of some changes in the future.

Those who have Medicare Part A and Medicare Part B are eligible for Medicare Part D. There are two options for receiving Medicare Part D benefits. One can choose to enroll in a Medicare Advantage plan with prescription drug coverage, or one can enroll in a Prescription Drug Plan (PDP). Enrollment for Medicare Part D lasts from November 15 through May 15 of the following year. 
 
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There are four payment stages with a Medicare part D plan. They are:
1.) Deductible2.) Initial coverage3.) Coverage ‘gap’ (formerly known as the “Donut hole”)4.) Catastrophic
In 2022, congress passed the Inflation Reduction Act. Besides implementing government price controls on certain prescription drugs, it also made the following changes to Part D which will result in lower out of pocket costs for Part D policyholders:

Caps out-of-pocket spending for Medicare Part D enrollees & makes other Part D benefit design changes, beginning in 2024

Limits monthly cost sharing for insulin to $35 for people with Medicare, beginning in 2023

Eliminates cost sharing for adult vaccines covered under Medicare Part D and improve access to adult vaccines in Medicaid and CHIP, beginning in 2023

Expands eligibility for full benefits under the Medicare Part D Low-Income Subsidy Program, beginning in 2024

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Individuals who are eligible for Medicare will notice that there are certain gaps in medical treatment that are not covered by Medicare Part A or Medicare Part B. To cover these gaps, there are multiple options available, but it fundamentally comes down to a choice of a Medicare Advantage plan (which is a private alternative to Traditional Medicare) or Traditional Medicare a Medicare Supplement insurance plan. When choosing between the two, you need to consider a number of different factors. Below are some general considerations for those deciding between Medicare Advantage plans and Traditional Medicare with a Medicare Supplement plan.
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Medigap plans never change – they are guaranteed renewable and your benefits will never change. Medicare Advantage plans change on an annual basis. Their changes include formulary changes, benefit changes, network changes, premium changes, deductible changes, etc.

Medigap plans are not currently being threatened by recent health care reform changes which greatly reduced funding to the Advantage plans (which are Federally-subsidized). These recent changes led to many top Advantage plan providers pulling completely or partially out of this market (CIGNA, Wellcare, etc.). It is a universal assumption that Medigap plans have greater long-term viability and stability.

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Medicare Advantage plans have deductibles, co-pays and coinsurance that can range from service to service. This is a complex system of co-pays and deductibles that, in a good year, may not be a problem, but if you have any health problems, can quickly add up to a large expense. These expenses are capped at $8,850 each year. In addition to the high out of pocket risk, recent reporting has exposed systematic denial of claims by Medicare Advantage insurers. This July 2024 article from the Chicago Sun Times and this September 2023 article from Barron’s Financial and Investment news detail the onerous ramifications of making the wrong choice when it comes to Medicare. This October 2023 article from the Wall Street Journal also provides guidance on avoiding “big mistakes” when it comes time for Medicare. The biggest mistake of all is enrolling in Medicare Advantage. This is especially true when it pertains to access. Traditional Medicare is accepted by 98% of physicians nationwide. That is not the case with Medicare Advantage. Medicare Advantage networks are limited. Please watch the video below from the Health & Human Services Office of Inspector General warning seniors about Medicare Advantage:

Medigap or “Medicare Supplement” plans, at the top few levels, have no (or very small) out of pocket costs. They are designed to fill in the gaps in Medicare. The top Medigap plan, which 43+% of people have, Medigap Plan F, fills in all the gaps in Medicare so you don’t have any out of pocket co-pays or deductibles at the doctor or hospital. Plan G replaced plan F on January 1, 2020.

Medicare Advantage plans have networks of doctors/hospitals that you must stay within to receive full coverage. These networks are, generally speaking, regional in nature. So if, for example, you are traveling, you may be hard pressed to find a doctor that works with your plan. Medicare Supplements can be used anywhere that takes Medicare, nationwide. If they take Medicare, they have to take one of the standardized Medigap plans, regardless of what insurance company it is.

When you are first eligible for Medicare, you can choose either type of plan – Advantage or Supplement – in your initial open enrollment period. After that point, you can always move from a Medicare supplement to a Medicare Advantage plan, because Advantage plans do not use medical underwriting. Regardless of your health (with the exception of ESRD), there are no pre-existing conditions. However, you can NOT always go the opposite way. In almost all states (NY, CA, MO are exceptions), Medicare Supplement companies use medical underwriting. This means you can be denied coverage or made to pay more for pre-existing conditions. Changes to Medicare Advantage – The Health Care Reform Bill

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Changes to Medicare Advantage – The Health Care Reform Bill
On March 23, 2010, the Patient Protection and Affordable Care Act (PPACA) was signed into law. The provisions of this law not only apply to individuals, business owners, and health insurance companies, they will also have some effect on Medicare. While the PPACA will not require seniors to change their Medigap coverage, there are some changes that current and future Medicare recipients should be aware of. Below is a general look at some of the ways that the health care reform bill will alter Medicare.
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While there will be no cuts for Original Medicare plans, there will be some enhancements in coverage as a result of health care reform. Medicare will start paying for wellness visits each year. As it stands at the moment, only a general check up is paid for when a person initially enrolls in Medicare.
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In 2022, congress passed the Inflation Reduction Act. Besides implementing government price controls on certain prescription drugs, it also made the following changes to Part D which will result in lower out of pocket costs for Part D policyholders:

Caps out-of-pocket spending for Medicare Part D enrollees & makes other Part D benefit design changes, beginning in 2024

Limits monthly cost sharing for insulin to $35 for people with Medicare, beginning in 2023

Eliminates cost sharing for adult vaccines covered under Medicare Part D and improve access to adult vaccines in Medicaid and CHIP, beginning in 2023

Expands eligibility for full benefits under the Medicare Part D Low-Income Subsidy Program, beginning in 2024

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Medicare Advantage saw a number of spending cuts as a result of the health care reform bill, amounting to $156 billion over a decade. There was also a $40 billion reduction on Medicare payments for home health care and a $22 billion reduction on certain Medicare payments to hospitals. Those cuts resulted in our nation’s largest health insurer being forced to drop hundreds of doctors from their Medicare Advantage network. This adversely affected Medicare Advantage recipients all over the country. This resulted in a large and rapid response from the A.M.A. – American Medical Association, 43 national specialty societies, 40 state medical associations and several state Attorney Generals. All to no avail. The payment reductions were implemented, physician contracts were cancelled and many Medicare Advantage recipients switched back to Traditional Medicare with a Medicare Supplement plan. The ones who really suffered were the ones who could not afford to do so and they still today have less access to medical providers than those who can afford a Medicare Supplement plan.
There is also a new threat to the integrity of Medicare Advantage plans. That threat is coming from C.M.S. – Centers for Medicare and Medicaid Services. C.M.S. found more than $14 billion in overpayments which have been made in recent years under Medicare Advantage (most likely to compensate for the aforementioned cuts under the ACA) and now they want those overpayments back. If collected, that would cost health insurers that provide Medicare Advantage billions and that in turn will affect Medicare Advantage policy holders adversely. The U.S. Department of Health and Human Services Office of Inspector General released this detailed report on April 27, 2022 which detailed millions of medically necessary claims that were denied by Medicare Advantage insurers “in an attempt to increase profits“. Please read that report and the information below so you can make an informed decision. This September 2023 article from Barron’s Financial & Investment news details the onerous ramifications of making the wrong choice when it comes to Medicare. This December 2023 report from Becker’s Hospital Review revealed that hospitals across America are “dropping Medicare Advantage Plans left and right.” Both Humana and United Healthcare have had their Medicare Advantage star ratings dropped by CMS for 2025. This October 2023 article from the Wall Street Journal also provides guidance on avoiding “big mistakes” when it comes time for Medicare. The biggest mistake of all is enrolling in Medicare Advantage. This is especially true when it pertains to access. Traditional Medicare is accepted by 98% of physicians nationwide. That is not the case with Medicare Advantage. Medicare Advantage networks are limited. This November 2024 Wall Street Journal report highlights why the sickest patients are leaving Medicare Advantage plans. According to a 2024 JAMA Internal Medicine study, privatized Medicare Advantage plans are a bad deal for taxpayers. Medicare Advantage plans have raised Medicare’s costs by $612 billion since 2007, including $82 billion in 2023 alone. Medicare Advantage insurers pocketed 97% ($592 billion) of Medicare’s overpayments for their overhead and profits, which consume 14% of their total revenues, seven-fold more than the 2% overhead with traditional Medicare. The most important reason to choose a MediGap or “Medicare Supplement” plan over a Medicare Advantage plan is the “M.O.O.P” – Maximum Out Of Pocket costs. These are capped at $8,850 each year. Out of pocket costs are little to nothing with Medicare Supplement plans. With Plan G they are capped at the Medicare Part B deductible which is $257 annually in 2025.
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Individuals earning more than $200,000 a year and couples earning more than $250,000 a year will experience a 0.9% increase in their Medicare payroll tax. Beginning in 2013, individuals earning more than $200,000 a year and couples earning more than $250,000 a year will also experience a 3.8% surtax on investment income.
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Still have questions? Call us at (630) 674-1551 for a free no obligation Medicare Supplement telephone consultation from one of our multi-state licensed Brokers. Remember, it costs you nothing more to use a Broker.
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## Group Insurance
URL: https://www.healthinsurancementors.com/group-insurance/

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SMALL GROUP FROM BLUE CROSS BLUE SHIELD OF ILLINOIS
Small Business Insurance Services Inc. is a brokerage firm that has no allegiance to any insurance company. Our agents are also multi state licensed. We will shop all major carriers for you so you always get the best plan at the lowest price. There are many ways for consumers to purchase health insurance. The best way is to use an experienced broker, most especially since it costs nothing extra to do so.
Call us directly at (630) 674 1551. If you are outside of Illinois call us toll free at (866) 724-7123 for a free no obligation telephone consultation from one of our licensed brokers. Or, complete the form below to submit your group’s census so we can prepare quotes for your business. If you have a copy of your company census, please also upload that in the section provided.
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Group health insurance carriers represented by HealthInsuranceMentors.com
 

Blue Cross Blue Shield of Illinois was named as one of America’s best insurance companies by Forbes magazine.
 
2026 QHP Small Group Policy Documents
 
Platinum Plans
Blue PPO Platinum Plans
Off Exchange

P503PPO Blue PPO Platinum 119
P5E1PPO Blue PPO Platinum 136
P5M1PPO Blue PPO Platinum 501
P5AAPPO Blue PPO Platinum 601

Blue Choice Preferred PPO Platinum Plans
Off Exchange

P5E2BCE Blue Choice Preferred Platinum PPO 119
P5E1BCE Blue Choice Preferred Platinum PPO 136
P5M1BCE Blue Choice Preferred Platinum PPO 501
P5AABCE Blue Choice Preferred Platinum PPO 601

Blue Precision Platinum Plans
Off Exchange

P506PSN Blue Precision Platinum HMO 107
P5E1PSN Blue Precision Platinum HMO 110
P5J1PSN Blue Precision Platinum HMO 200
P5ACPSN Blue Precision Platinum HMO 603

Blue Options Platinum Plans

P5N1OPT Blue Options Platinum PPO 403

Gold Plans
Blue PPO Gold Plans
Off Exchange

G530PPO Blue PPO Gold 101
G531PPO Blue PPO Gold 102
G532PPO Blue PPO Gold 107
G533PPO Blue PPO Gold 113
G534PPO Blue PPO Gold 114
G535PPO Blue PPO Gold 115
G536PPO Blue PPO Gold 116
G537PPO Blue PPO Gold 123
G5M2PPO Blue PPO Gold 502
G5ABPPO Blue PPO Gold 602

Blue Precision Gold HMO Plans
Off Exchange

G532PSN Blue Precision Gold HMO 101
G5J2PSN Blue Precision Gold HMO 201
G5N1PSN Blue Precision Gold HMO 402

Blue Options Gold Plans
Off Exchange

G506OPT Blue Options Gold PPO 101
G507OPT Blue Options Gold PPO 102
G508OPT Blue Options Gold PPO 106
G5K1OPT Blue Options Gold PPO 200
G5M3OPT Blue Options Gold PPO 503

BlueChoice Preferred Gold PPO Plans
Off Exchange

G530BCE Blue Choice Preferred Gold PPO 101
G531BCE Blue Choice Preferred Gold PPO 102
G532BCE Blue Choice Preferred Gold PPO 107
G533BCE Blue Choice Preferred Gold PPO 113
G534BCE Blue Choice Preferred Gold PPO 114
G535BCE Blue Choice Preferred Gold PPO 115
G536BCE Blue Choice Preferred Gold PPO 116
G537BCE Blue Choice Preferred Gold PPO 123
G5M2BCE Blue Choice Preferred Gold PPO 502
G5ABBCE Blue Choice Preferred Gold PPO 602

Silver Plans
Blue PPO Silver Plans
Off Exchange

S531PPO Blue PPO Silver 104
S535PPO Blue PPO Silver 105
S532PPO Blue PPO Silver 120
S534PPO Blue PPO Silver 133
S5J1PPO Blue PPO Silver 200

Blue Precision Silver HMO Plans
Off Exchange

S530PSN Blue Precision Silver HMO 102
S531PSN Blue Precision Silver HMO 106

BlueChoice Preferred Silver PPO Plans
Off Exchange

S531BCE Blue Choice Preferred Silver PPO 104
S535BCE Blue Choice Preferred Silver PPO 105
S532BCE Blue Choice Preferred Silver PPO 120
S534BCE Blue Choice Preferred Silver PPO 133
S5J1BCE Blue Choice Preferred Silver PPO 200

Blue Options Silver PPO Plans
Off Exchange

S506OPT Blue Options Silver PPO 104
S507OPT Blue Options Silver PPO 107
S5N1OPT Blue Options Silver PPO 404

Bronze Plans
Blue PPO Bronze Plans
Off Exchange

B535PPO Blue PPO Bronze 106
B536PPO Blue PPO Bronze 132
B5N1PPO Blue PPO Bronze 401

BlueChoice Preferred Bronze PPO Plans
Off Exchange

B535BCE Blue Choice Preferred Bronze PPO 106
B536BCE Blue Choice Preferred Bronze PPO 132
B5N1BCE Blue Choice Preferred Bronze PPO 401

2025 QHP Small Group Summary of Benefits & Coverage
 

Blue Choice Preferred PPO Platinum Plans

P5E2BCE Blue Choice Preferred Platinum PPO 119
P5E1BCE Blue Choice Preferred Platinum PPO 136
P5M1BCE Blue Choice Preferred Platinum PPO 501

Blue Choice Preferred Gold PPO Plans

G530BCE Blue Choice Preferred Gold PPO 101
G531BCE Blue Choice Preferred Gold PPO 102
G532BCE Blue Choice Preferred Gold PPO 107
G533BCE Blue Choice Preferred Gold PPO 113
G534BCE Blue Choice Preferred Gold PPO 114
G535BCE Blue Choice Preferred Gold PPO 115
G536BCE Blue Choice Preferred Gold PPO 116
G537BCE Blue Choice Preferred Gold PPO 123
G5M2BCE Blue Choice Preferred Gold PPO 502

Blue Choice Preferred Silver PPO Plans

S531BCE Blue Choice Preferred Silver PPO 104
S535BCE Blue Choice Preferred Silver PPO 105
S532BCE Blue Choice Preferred Silver PPO 120
S534BCE Blue Choice Preferred Silver PPO 133
S5J1BCE Blue Choice Preferred Silver PPO 200

Blue Choice Preferred Bronze PPO Plans

B535BCE Blue Choice Preferred Bronze PPO 106
B536BCE Blue Choice Preferred Bronze PPO 132
B5N1BCE Blue Choice Preferred Bronze PPO 401

Blue Options Platinum Plans

P5N1OPT Blue Options Platinum PPO 403

Blue Options Gold Plans

G506OPT Blue Options Gold PPO 101
G507OPT Blue Options Gold PPO 102
G508OPT Blue Options Gold PPO 106
G5K1OPT Blue Options Gold PPO 200
G5M3OPT Blue Options Gold PPO 503

Blue Options Silver PPO Plans

S506OPT Blue Options Silver PPO 104
S507OPT Blue Options Silver PPO 107
S5N1OPT Blue Options Silver PPO 404

Blue PPO Platinum Plans

P503PPO Blue PPO Platinum 119
P5E1PPO Blue PPO Platinum 136
P5M1PPO PPO Platinum 501

Blue PPO Gold Plans

G530PPO Blue PPO Gold 101
G531PPO Blue PPO Gold 102
G532PPO Blue PPO Gold 107
G533PPO Blue PPO Gold 113
G534PPO Blue PPO Gold 114
G535PPO Blue PPO Gold 115
G536PPO Blue PPO Gold 116
G537PPO Blue PPO Gold 123
P5M2PPO Blue PPO Gold 502

Blue PPO Silver Plans

S531PPO Blue PPO Silver 104
S535PPO Blue PPO Silver 105
S532PPO Blue PPO Silver 120
S534PPO Blue PPO Silver 133
S5J1PPO Blue PPO Silver 200

Blue PPO Bronze Plans

B535PPO Blue PPO Bronze 106
B536PPO Blue PPO Bronze 132
B5N1PPO Blue PPO Bronze 401

Blue Precision Platinum HMO Plans

P506PSN Blue Precision Platinum HMO 107
P5E1PSN Blue Precision Platinum HMO 110
P5J1PSN Blue Precision Platinum HMO 200

Blue Precision Gold HMO Plans

G532PSN Blue Precision Gold HMO 101
G5J2PSN Blue Precision Gold HMO 201
G5N1PSN Blue Precision Gold HMO 402

Blue Precision Silver HMO Plans

S530PSN Blue Precision Silver HMO 102
S531PSN Blue Precision Silver HMO 106

 
 
2025 Fully Insured Small Group Policy Design Changes
Click here to download small group policy design changes coming in 2025.
 
2025 Fully Insured Small Group Summary of Dental Benefits
Contributory

BlueCare Dental PPO – DILHR30
BlueCare Dental PPO – DILHR31
BlueCare Dental PPO – DILHR32
BlueCare Dental PPO – DILHR33
BlueCare Dental PPO – DILHR34
BlueCare Dental PPO – DILHR35
BlueCare Dental PPO – DILLR36
BlueCare Dental PPO – DILHM38
BlueCare Dental PPO – DILHM40
BlueCare Dental PPO – DILLM41
BlueCare Dental PPO – DILHM42
BlueCare Dental PPO – DILHR50
BlueCare Dental PPO – DILLM51
BlueCare Dental PPO – DILHM57
BlueCare Dental PPO – DILLR58
BlueCare Dental PPO – DILHR61
BlueCare Dental PPO – DILLR62

Voluntary

BlueCare Dental PPO – DILHR43
BlueCare Dental PPO – DILHM44
BlueCare Dental PPO – DILHR45
BlueCare Dental PPO – DILHM46
BlueCare Dental PPO – DILLR47
BlueCare Dental PPO – DILLR48
BlueCare Dental PPO – DILLM49
BlueCare Dental PPO – DILHR53
BlueCare Dental PPO – DILLR54
BlueCare Dental PPO – DILLM55
BlueCare Dental PPO – DILLM56
BlueCare Dental PPO – DILHM59
BlueCare Dental PPO – DILLR60

2025 Embedded Pediatric Dental Benefit for Medical Plans

IL PPO Medical Plan
IL HMO Medical Plan

 
Click here to search the 2024 BCBSIL outpatient prescription drug Formulary list for PPO and HMO ACA-qualified (Obamacare) plans. Once at that page, scroll down and click on “Prescription Drug Lists for Employer-offered Metallic Plans: Small Group (1-50)“
2024 BCBSIL Blue Choice Preferred PPO Small Group Health Insurance plan offerings:
B5N1BCE Blue Choice Preferred Bronze PPO 401 for 2024B536BCE Blue Choice Preferred Bronze PPO 132 for 2024 – (HSA-qualified)B535BCE Blue Choice Preferred Bronze PPO 106 for 2024 – (HSA-qualified)
S535BCE Blue Choice Preferred Silver PPO 105 for 2024S534BCE Blue Choice Preferred Silver PPO 133 for 2024 – (HSA-qualified)S532BCE Blue Choice Preferred Silver PPO 120 for 2024S531BCE Blue Choice Preferred Silver PPO 104 for 2024S5J1BCE Blue Choice Preferred Silver PPO 202 for 2024 – (HSA-qualified)
G535BCE Blue Choice Preferred Gold PPO 115 for 2024 – (HSA-qualified)G533BCE Blue Choice Preferred Gold PPO 113 for 2024 – (HSA-qualified)G532BCE Blue Choice Preferred Gold PPO 107 for 2024 G531BCE Blue Choice Preferred Gold PPO 102 for 2024G530BCE Blue Choice Preferred Gold PPO 101 for 2024 
P5E2BCE Blue Choice Preferred Platinum PPO 119 for 2024P5E1BCE Blue Choice Preferred Platinum PPO 136 for 2024
2024 BCBSIL Blue Options PPO Small Group Health Insurance plan offerings:
S506OPT Blue Options Silver PPO 104 for 2024S507OPT Blue Options Silver PPO 107 for 2024 – (HSA-qualified)
G506OPT Blue Options Gold PPO 101 for 2024G507OPT Blue Options Gold PPO 102 for 2024G508OPT Blue Options Gold PPO 106 for 2024G5K10OPT Blue Options Gold PPO 200 for 2024 – (HSA-qualified)
2024 BCBSIL Blue PPO Small Group Health Insurance plan offerings:
B5N1PPO Blue PPO Bronze 401 for 2024B536PPO Blue PPO Bronze 132 for 2024 – (HSA-qualified)B535PPO Blue PPO Bronze 106 for 2024 – (HSA-qualified)
S535PPO Blue PPO Silver 105 for 2024S534PPO Blue PPO Silver 133 for 2024 – (HSA-qualified)S532PPO Blue PPO Silver 120 for 2024S531PPO Blue PPO Silver 104 for 2024S5J1PPO Blue PPO Silver 200 for 2024 – (HSA-qualified)
G537PPO Blue PPO Gold 123 for 2024G536PPO Blue PPO Gold 116 for 2024G535PPO Blue PPO Gold 115 for 2024 – (HSA-qualified)G534PPO Blue PPO Gold 114 for 2024G533PPO Blue PPO Gold 113 for 2024 – (HSA-qualified)G532PPO Blue PPO Gold 107 for 2024G531PPO Blue PPO Gold 102 for 2024G530PPO Blue PPO Gold 101 for 2024
P503PPO Blue PPO Platinum 119 for 2024P5E1PPO Blue PPO Platinum 136 for 2024
2024 BCBSIL Blue Precision HMO Small Group Plan Brochures:
S531PSN Blue Precision Silver HMO 106 for 2024S530PSN Blue Precision Silver HMO 102 for 2024
G532PSN Blue Precision Gold HMO 101 for 2024G5J2PSN Blue Precision Gold HMO 201 for 2024
P506PSN Blue Precision Platinum HMO 107 for 2024P5J1PSN Blue Precision Platinum HMO 200 for 2024P5E1PSN Blue Precision Platinum HMO 110 for 2024
Fully Insured Small Group Summary of Dental Benefits
Contributory

BlueCare Dental PPO – DILHR30
BlueCare Dental PPO – DILHR31
BlueCare Dental PPO – DILHR32
BlueCare Dental PPO – DILHR33
BlueCare Dental PPO – DILHR34
BlueCare Dental PPO – DILHR35
BlueCare Dental PPO – DILLR36
BlueCare Dental PPO – DILLR37
BlueCare Dental PPO – DILHM38
BlueCare Dental PPO – DILHM40
BlueCare Dental PPO – DILLM41
BlueCare Dental PPO – DILHM42
BlueCare Dental PPO – DILHR50
BlueCare Dental PPO – DILLM51
BlueCare Dental PPO – DILHM57
BlueCare Dental PPO – DILLR58

Voluntary

BlueCare Dental PPO – DILHR43
BlueCare Dental PPO – DILHM44
BlueCare Dental PPO – DILHR45
BlueCare Dental PPO – DILHM46
BlueCare Dental PPO – DILLM49
BlueCare Dental PPO – DILHR52
BlueCare Dental PPO – DILHR53
BlueCare Dental PPO – DILLR54
BlueCare Dental PPO – DILLM55
BlueCare Dental PPO – DILLM56
BlueCare Dental PPO – DILHM59
BlueCare Dental PPO – DILLR60

Embedded Pediatric Dental Benefit for Medical Plans

IL PPO Medical Plan
IL HMO Medical Plan

 
2023 BCBSIL Blue Choice Preferred PPO Small Group Health Insurance plan offerings:
B536BCE Blue Choice Preferred Bronze PPO 132 for 2023 – (HSA-qualified)B535BCE Blue Choice Preferred Bronze PPO 106 for 2023 – (HSA-qualified)
S535BCE Blue Choice Preferred Silver PPO 105 for 2023S534BCE Blue Choice Preferred Silver PPO 133 for 2023 – (HSA-qualified)S532BCE Blue Choice Preferred Silver PPO 120 for 2023S531BCE Blue Choice Preferred Silver PPO 104 for 2023S5J1BCE Blue Choice Preferred Silver PPO 202 for 2023 – (HSA-qualified)
G535BCE Blue Choice Preferred Gold PPO 115 for 2023 – (HSA-qualified)G533BCE Blue Choice Preferred Gold PPO 113 for 2023 – (HSA-qualified)G532BCE Blue Choice Preferred Gold PPO 107 for 2023 G531BCE Blue Choice Preferred Gold PPO 102 for 2023G530BCE Blue Choice Preferred Gold PPO 101 for 2023 
P5E2BCE Blue Choice Preferred Platinum PPO 119 for 2023P5E1BCE Blue Choice Preferred Platinum PPO 136 for 2023
2023 BCBSIL Blue Options PPO Small Group Health Insurance plan offerings:
S506OPT Blue Options Silver PPO 104 for 2023S507OPT Blue Options Silver PPO 107 for 2023 – (HSA-qualified)
G506OPT Blue Options Gold PPO 101 for 2023G507OPT Blue Options Gold PPO 102 for 2023G508OPT Blue Options Gold PPO 106 for 2023G5K10OPT Blue Options Gold PPO 200 for 2023 – (HSA-qualified)
2023 BCBSIL Blue PPO Small Group Health Insurance plan offerings:
B536PPO Blue PPO Bronze 132 for 2023 – (HSA-qualified)B535PPO Blue PPO Bronze 106 for 2023 – (HSA-qualified)
S535PPO Blue PPO Silver 105 for 2023S534PPO Blue PPO Silver 133 for 2023 – (HSA-qualified)S532PPO Blue PPO Silver 120 for 2023S531PPO Blue PPO Silver 104 for 2023S5J1PPO Blue PPO Silver 200 for 2023 – (HSA-qualified)
G537PPO Blue PPO Gold 123 for 2023G536PPO Blue PPO Gold 116 for 2023G535PPO Blue PPO Gold 115 for 2023 – (HSA-qualified)G534PPO Blue PPO Gold 114 for 2023G533PPO Blue PPO Gold 113 for 2023 – (HSA-qualified)G532PPO Blue PPO Gold 107 for 2023G531PPO Blue PPO Gold 102 for 2023G530PPO Blue PPO Gold 101 for 2023
P503PPO Blue PPO Platinum 119 for 2023P5E1PPO Blue PPO Platinum 136 for 2023
2023 BCBSIL Blue Precision HMO Small Group Plan Brochures:
S531PSN Blue Precision Silver HMO 106 for 2023S530PSN Blue Precision Silver HMO 102 for 2023
G532PSN Blue Precision Gold HMO 101 for 2023G5J2PSN Blue Precision Gold HMO 201 for 2023
P506PSN Blue Precision Platinum HMO 107 for 2023P5J1PSN Blue Precision Platinum HMO 200 for 2023P5E1PSN Blue Precision Platinum HMO 110 for 2023
 
2022 BCBSIL Blue Choice Preferred PPO Small Group Health Insurance plan offerings:
B536BCE Blue Choice Preferred Bronze PPO 132 for 2022 – (HSA-qualified)B535BCE Blue Choice Preferred Bronze PPO 106 for 2022 – (HSA-qualified)
S535BCE Blue Choice Preferred Silver PPO 105 for 2022S534BCE Blue Choice Preferred Silver PPO 133 for 2022 – (HSA-qualified)S532BCE Blue Choice Preferred Silver PPO 120 for 2022S531BCE Blue Choice Preferred Silver PPO 104 for 2022S5J1BCE Blue Choice Preferred Silver PPO 202 for 2022 – (HSA-qualified)
G535BCE Blue Choice Preferred Gold PPO 115 for 2022 – (HSA-qualified)G533BCE Blue Choice Preferred Gold PPO 113 for 2022 – (HSA-qualified)G532BCE Blue Choice Preferred Gold PPO 107 for 2022 G531BCE Blue Choice Preferred Gold PPO 102 for 2022G530BCE Blue Choice Preferred Gold PPO 101 for 2022 
P5E2BCE Blue Choice Preferred Platinum PPO 119 for 2022P5E1BCE Blue Choice Preferred Platinum PPO 136 for 2022
2022 BCBSIL Blue Options PPO Small Group Health Insurance plan offerings:
S506OPT Blue Options Silver PPO 104 for 2022S507OPT Blue Options Silver PPO 107 for 2022 – (HSA-qualified)
G506OPT Blue Options Gold PPO 101 for 2022G507OPT Blue Options Gold PPO 102 for 2022G508OPT Blue Options Gold PPO 106 for 2022G5K10OPT Blue Options Gold PPO 200 for 2022
2022 BCBSIL Blue PPO Small Group Health Insurance plan offerings:
B536PPO Blue PPO Bronze 132 for 2022 – (HSA-qualified)B535PPO Blue PPO Bronze 106 for 2022 – (HSA-qualified)
S535PPO Blue PPO Silver 105 for 2022S534PPO Blue PPO Silver 133 for 2022 – (HSA-qualified)S532PPO Blue PPO Silver 120 for 2022S531PPO Blue PPO Silver 104 for 2022S5J1PPO Blue PPO Silver 200 for 2022 – (HSA-qualified)
G537PPO Blue PPO Gold 123 for 2022G536PPO Blue PPO Gold 116 for 2022G535PPO Blue PPO Gold 115 for 2022 – (HSA-qualified)G534PPO Blue PPO Gold 114 for 2022G533PPO Blue PPO Gold 113 for 2022 – (HSA-qualified)G532PPO Blue PPO Gold 107 for 2022G531PPO Blue PPO Gold 102 for 2022G530PPO Blue PPO Gold 101 for 2022
P503PPO Blue PPO Platinum 119 for 2022P5E1PPO Blue PPO Platinum 136 for 2022
2022 BCBSIL Blue Precision HMO Small Group Plan Brochures:
S531PSN Blue Precision Silver HMO 106 for 2022S530PSN Blue Precision Silver HMO 102 for 2022
G532PSN Blue Precision Gold HMO 101 for 2022G5J2PSN Blue Precision Gold HMO 201 for 2022
P506PSN Blue Precision Platinum HMO 107 for 2022P5J1PSN Blue Precision Platinum HMO 200 for 2022P5E1PSN Blue Precision Platinum HMO 110 for 2022
2022 BCBSTX Small Group Plans summary of benefits. 
Blue Cross Blue Shield of Texas 2022 Small Group Plans.
BlueCare Dental PPO (Small Group) Plans
To help you make an informed decision about your dental coverage, a Small Group (1 to 50 employees) Summary of Dental Benefits document is available for each of our fully insured plans. The summary describes key features such as:

Program basics
Covered services
Orthodontic services

Pediatric dental coverage is included in all small group qualified health plans as an essential health benefit embedded into the medical plan.

Embedded Pediatric Dental Benefit for Medical Plans

IL PPO Medical Plan 
IL HMO Medical Plan 

Fully Insured Small Group Summary of Dental Benefits
Contributory

BlueCare Dental PPO – DILHR31 
BlueCare Dental PPO – DILHR32 
BlueCare Dental PPO – DILHR33 
BlueCare Dental PPO – DILHR34 
BlueCare Dental PPO – DILHR36 
BlueCare Dental PPO – DILLR37 
BlueCare Dental PPO – DILHM38 
BlueCare Dental PPO – DILHM40 
BlueCare Dental PPO – DILLM41 
BlueCare Dental PPO – DILHM42 
BlueCare Dental PPO – DILHR50 
BlueCare Dental PPO – DILLM51 
BlueCare Dental PPO – DILHM57 
BlueCare Dental PPO – DILLR58 

Voluntary

BlueCare Dental PPO – DILHR43 
BlueCare Dental PPO – DILHM44 
BlueCare Dental PPO – DILHM46 
BlueCare Dental PPO – DILHR52 
BlueCare Dental PPO – DILHR53 
BlueCare Dental PPO – DILLR54 
BlueCare Dental PPO – DILLM55 
BlueCare Dental PPO – DILLM56  
BlueCare Dental PPO – DILHM59 
BlueCare Dental PPO – DILLR60 

Principal Broker, C. Steven Tucker joined Dan Proft and Amy Jacobson on Chicago’s Morning Answer to discuss the impact of the “Inflation Reduction Act” on Medicare Part D and enhanced ACA health insurance subsidies now extended until 2026 – 08/17/2022. Replay below:  

2021 BCBSIL Small Group Health Insurance PPO and HMO outpatient prescription drug Formulary lists:
Click here to search the outpatient prescription drug Formulary list for PPO ACA-qualified (Obamacare) plans. Once at that page, scroll down and click on“Prescription Drug Lists for Employer-offered Metallic Plans: Small Group (1-50)“
2021 BCBSIL Blue Choice Preferred PPO Small Group Health Insurance plan offerings:
B536BCE Blue Choice Preferred Bronze PPO 132 for 2021 – (HSA-qualified)B535BCE Blue Choice Preferred Bronze PPO 106 for 2021 – (HSA-qualified) 
S535BCE Blue Choice Preferred Silver PPO 105 for 2021S534BCE Blue Choice Preferred Silver PPO 133 for 2021 – (HSA-qualified)S532BCE Blue Choice Preferred Silver PPO 120 for 2021S531BCE Blue Choice Preferred Silver PPO 104 for 2021S501BCE Blue Choice Preferred Silver PPO 135 for 2021S5J1BCE Blue Choice Preferred Silver PPO 202 for 2021 – (HSA-qualified)
G535BCE Blue Choice Preferred Gold PPO 115 for 2021 – (HSA-qualified)G533BCE Blue Choice Preferred Gold PPO 113 for 2021 – (HSA-qualified)G532BCE Blue Choice Preferred Gold PPO 107 for 2021 G531BCE Blue Choice Preferred Gold PPO 102 for 2021G530BCE Blue Choice Preferred Gold PPO 101 for 2021 
P532BCE Blue Choice Preferred Platinum 119 for 2021P5E1BCE Blue Choice Preferred Platinum 136 for 2021
2021 BCBSIL Blue Options PPO Small Group Health Insurance plan offerings:
S506OPT Blue Options Silver PPO 104 for 2021S507OPT Blue Options Silver PPO 107 for 2021 – (HSA-qualified)
G506OPT Blue Options Gold PPO 101 for 2021G507OPT Blue Options Gold PPO 102 for 2021G508OPT Blue Options Gold PPO 106 for 2021
2021 BCBSIL Blue PPO Small Group Health Insurance plan offerings:
B536PPO Blue PPO Bronze 132 for 2021 – (HSA-qualified)B535PPO Blue PPO Bronze 106 for 2021 – (HSA-qualified)
S535PPO Blue PPO Silver 105 for 2021S534PPO Blue PPO Silver 133 for 2021 – (HSA-qualified)S532PPO Blue PPO Silver 120 for 2021S531PPO Blue PPO Silver 104 for 2021S501PPO Blue PPO Silver 135 for 2021S5J1PPO Blue PPO Silver 200 for 2021 – (HSA-qualified)
G537PPO Blue PPO Gold 123 for 2021G536PPO Blue PPO Gold 116 for 2021G535PPO Blue PPO Gold 115 for 2021 – (HSA-qualified)G534PPO Blue PPO Gold 114 for 2021G533PPO Blue PPO Gold 113 for 2021 – (HSA-qualified)G532PPO Blue PPO Gold 107 for 2021G531PPO Blue PPO Gold 102 for 2021G530PPO Blue PPO Gold 101 for 2021
P503PPO Blue PPO Platinum 119 for 2021
2021 BCBSIL Blue Precision HMO Small Group Plan Brochures:
S531PSN Blue Precision Silver HMO 106 for 2021S530PSN Blue Precision Silver HMO 102 for 2021
G532PSN Blue Precision Gold HMO 101 for 2021G5J2PSN Blue Precision Gold HMO 201 for 2021
P506PSN Blue Precision Platinum HMO 107 for 2021P5J1PSN Blue Precision Platinum HMO 200 for 2021P5E1PSN Blue Precision Platinum HMO 110 for 2021
Group health insurance for ONE PERSON ensures access to Chicago Teaching hospitals for small businesses owners.
In November of 2015, Chicagoland residents were shocked to learn that Northwestern Memorial hospital, University of Chicago medical center, Rush University medical center and the Lurie Children’s hospital would no longer accept patients who have ACA-qualified (Obamacare) individual health insurance plans. This action led to a significant increase in the purchase of small group health insurance policies which still provide national PPO networks and still ensure access to the aforementioned teaching hospitals in Chicago.
For small corporations who could afford to insure themselves and 70% of their eligible full time employees (the usual minimum participation requirement), purchasing small group health insurance was a costly fix to the new narrow networks in the individual health insurance marketplace. The ability to purchase group health insurance for you and your full-time employees is well known. What is not well known is the fact that you can purchase a small group health insurance policy without insuring any of your employees during a small window each year. That window begins on November 1st and ends on December 15th. The same time period the annual ACA Open Enrollment for individual plans begins and ends.
During this little known ‘relaxed underwriting’ period, an owner of a small corporation (less than 50 full-time employees) can purchase small group health insurance while employees ‘waive’ coverage without producing an eligible waiver. Normally, 70% of all full-time employees must participate in a group health insurance plan unless they have an eligible waiver such as an offer of group health insurance from a spouse’s employer or Medicare and Medicaid coverage. If you do decide to offer coverage to your full-time W2 employees during this Special Enrollment period, you do not have to insure any of your employees and instead can only insure yourself and or your family without insuring employees. Normal 70% minimum participation requirements are waived.
If you are a small business owner who is seeking to purchase small group health insurance and cannot afford to insure your employees or, your employees simply do not want to participate in a group health insurance plan. Now is the time to learn more about “relaxed underwriting period”. The cost for group health insurance is now commensurate with individual health insurance but the PPO network is much larger and far more inclusive than any of the narrow networks now available in the individual marketplace. Want to learn more? Call us for a free consultation at (630) 582-1043 or click on “contact” at the top of this page.

                
                        
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2021 Mid Market Small Group Health Plan Offerings: 
MIEEE2060 Summary of Benefits
MIESA210 Summary of Benefits

               Other small group carriers brokered by HealthInsuranceMentors.com
 
United Healthcare Small Group plans for Chicagoland 2021

Chicago Multi-Choice Package IL021
Chicago Multi-Choice Package IL022
Chicago Multi-Choice Package IL023
Chicago Multi-Choice Package IL024

NW Indiana Plans

NW IN Multi-Choice Package NW014
NW IN Multi-Choice Package NW015
NW IN Multi-Choice Package NW016
NW IN Multi-Choice Package NW017

51+ lives – Small Group Product Portfolio Illinois & Northwest Indiana

Chicago/NW IN 51+ ATNE

 

 

2020 BCBSIL Blue Precision HMO Small Group Health Insurance Plan Brochures:
P506PSN Blue Precision Platinum HMO 107
P5E1PSN Blue Precision Platinum HMO 110
G532PSN Blue Precision Gold HMO 101
G533PSN Blue Precision Gold HMO 109
S531PSN Blue Precision Silver HMO 106
S530PSN Blue Precision Silver HMO 102
2020 BCBSIL Blue Choice Preferred PPO Small Group Health Insurance plan offerings:
P5E1BCE Blue Choice Preferred Platinum PPO 136
P5E2BCE Blue Choice Preferred Platinum PPO 119
G530BCE Blue Choice Preferred Gold PPO 101
G532BCE Blue Choice Preferred Gold PPO 107
S531BCE Blue Choice Preferred Silver PPO 104
S532BCE Blue Choice Preferred Silver PPO 120
S535BCE Blue Choice Preferred Silver PPO 105
HSA-qualified BCBSIL Blue Choice Preferred PPO Small Group offerings: 
G533BCE Blue Choice Preferred Gold PPO 113
G535BCE Blue Choice Preferred Gold PPO 115
S534BCE Blue Choice Preferred Silver PPO 133
B536BCE Blue Choice Preferred Bronze PPO 132
B535BCE Blue Choice Preferred Bronze PPO 106
2020 BCBSIL Blue Options PPO Small Group Health Insurance plan offerings:
G506OPT Blue Options Gold PPO 101
G508OPT Blue Options Gold PPO 106
G507OPT Blue Options Gold PPO 102
S506OPT Blue Options Silver PPO 104
S507OPT Blue Options Silver PPO 107 HSA-qualified plan
2020 BCBSIL Blue PPO Small Group Health Insurance plan offerings:
P503PPO Blue PPO Platinum 119
P5E1PPO Blue PPO Platinum 136
G534PPO Blue PPO Gold 114
G532PPO Blue PPO Gold 107
G536PPO Blue PPO Gold 116
G537PPO Blue PPO Gold 123
G531PPO Blue PPO Gold 102
G530PPO Blue PPO Gold 101
S532PPO Blue PPO Silver 120
S501PPO Blue PPO Silver 135
S531PPO Blue PPO Silver 104
S535PPO Blue PPO Silver 105
HSA-qualified BCBSIL Blue PPO Small Group offerings: 
G533PPO Blue PPO Gold 113
G535PPO Blue PPO Gold 115
S534PPO Blue PPO Silver 133
B536PPO Blue PPO Bronze 132
B535PPO Blue PPO Bronze 106
2019 BCBSIL Small Group Health Insurance Plan Brochures:
P503PPO Blue PPO Platinum 119
P500 PPO Blue PPO Platinum 019
G536PPO Blue PPO Gold 116
G512PPO Blue PPO Gold 011
G515PPO Blue PPO Gold 014
G533PPO Blue PPO Gold 113
G530PPO Blue PPO Gold 101
S531PPO Blue PPO Silver 104
S534PPO Blue PPO Silver 133
B535PPO Blue PPO Bronze 106
B535BCE Blue Choice Preferred Bronze PPO 106
S531BCE Blue Choice Preferred Silver PPO 104
S530PSN Blue Precision Silver HMO 102
G506OPT Blue Options Gold PPO 101
G508OPT Blue Options Gold PPO 106
G507OPT Blue Options Gold PPO 102
S506OPT Blue Options Silver PPO 104
S507OPT Blue Options Silver PPO 107
BCBSIL B520 PPO Blue PPO Bronze 006
BCBSIL S508 PPO Blue PPO Silver 030
BCBSIL S500 PPO Blue PPO Silver 031
BCBSIL B501PPO Blue PPO Bronze 032
P502PSN Blue Precision Platinum HMO 007
Blue Precision HMO 2016 group certificate
2018 BCBSIL Small Group Health Insurance Plan Brochures:
S534PPO Blue PPO Silver 133
S534BCE Blue Choice Preferred Silver PPO 133
S532BCH Blue Care Direct Silver 106 with Advocate
2017 BCBSIL Small Group Health Insurance Plan Brochures:
p500ppoblueppoplatinum019
g515ppoblueppogold014
g511ppoblueppogold010
g510ppoblueppogold002
g517ppoblueppogold016
g518ppoblueppogold023
g509ppoblueppogold001
s506ppobluepposilver020
s501ppobluepposilver029
s503ppobluepposilver004
s508ppobluepposilver030
s502ppobluepposilver003
p502ppoblueppoplatinum027
g519ppoblueppogold024
g512ppoblueppogold011
g520ppoblueppogold025
s500ppobluepposilver031pdf
b501ppoblueppobronze032
b520ppoblueppobronze006
g521ppoblueppogold026
2016 BCBSIL Small Group Health Insurance Plan Brochures:
P500 PPO Blue PPO Platinum 019
G512PPO Blue PPO Gold 011
G515PPO Blue PPO Gold 014
BCBSIL B520 PPO Blue PPO Bronze 006
BCBSIL S508 PPO Blue PPO Silver 030
BCBSIL S500 PPO Blue PPO Silver 031
BCBSIL B501PPO Blue PPO Bronze 032
P502PSN Blue Precision Platinum HMO 007
Blue Precision HMO 2016 group certificate
BlueCare Dental DILHR03
BlueCare Dental DILHR04
BlueCare Dental DILLM11
BlueCare Dental DILLM15
2015 BCBSIL Small Group Health Insurance Plan Brochures:
BCBSIL 2015 Small Group P500PPO Platinum 019
BCBSIL 2015 Small Group G515PPO Blue PPO Gold 014
BCBSIL 2015 Small Group G511PPO Blue PPO Gold 010
BCBSIL 2015 Small Group G510PPO Blue PPO Gold 002
BCBSIL 2015 Small Group G517PPO Blue PPO Gold 016
BCBSIL 2015 Small Group G518PPO Blue PPO Gold 023
BCBSIL 2015 Small Group G509PPO Blue PPO Gold 001
BCBSIL G511CHC Blue Choice Gold PPO 007
BCBSIL 2015 Small Group S506PPO Blue PPO Silver 020
BCBSIL 2015 Small Group S503PPO Blue PPO Silver 004
BCBSIL S508 PSN Blue Precision Silver HMO 002
BCBSIL S503CHC Small Group plan 2015
BCBSIL 2015 Small Group S502PPO Blue PPO Silver 003
BCBSIL 2015 Small Group B519PPO Blue PPO Bronze 005
BCBSIL 2015 Small Group P501PPO Blue PPO Platinum 022
BCBSIL 2015 Small Group G519PPO Blue PPO Gold 024
BCBSIL 2015 Small Group G512PPO Blue PPO Gold 011
BCBSIL 2015 Small Group G520PPO Blue PPO Gold 025
BCBSIL 2015 Small Group G513PPO Blue PPO Gold 012
BCBSIL 2015 Small Group B520PPO Blue PPO Bronze 006
BCBSIL 2015 Small Group G521PPO Blue PPO Gold 026
BCBSIL RHHHB10C Blue Advantage HMO Small Group 2015
BCBSIL P501PSN Blue Precision Platinum 004 Small Group
BCBSIL RPPC3424 Blue Advantage Entrepreneur PPO Small Group 2015
BCBSIL Blue Advantage Entrepreneur Small Group PPO Certificate Of Coverage
BCBSIL Small Group PPO Blue Care Dental Freedom policy
BCBSIL Ancillary Small Group Dental Insurance Plan Brochures:
BlueCare Dental DILHR01
BlueCare Dental DILHR03
BlueCare Dental DILHR04
BlueCare Dental DILLM11
BlueCare Dental Group Dental Plans 2019

[/et_pb_text][et_pb_text _builder_version=”4.16″ background_size=”initial” background_position=”top_left” background_repeat=”repeat” text_orientation=”center” module_alignment=”center” global_colors_info=”{}”]
Small and large employer obligations under the Patient Protection & Affordable Care Act (Obamacare)
[/et_pb_text][et_pb_tabs _builder_version=”4.16″ background_size=”initial” background_position=”top_left” background_repeat=”repeat” global_colors_info=”{}”][et_pb_tab title=”Beginning in 2015″ _builder_version=”4.16″ background_size=”initial” background_position=”top_left” background_repeat=”repeat” global_colors_info=”{}”]
Employers with 100 or more FTE – Full Time Equivalent – employees are required to offer “affordable health insurance” (employee’s share of the annual premium for self-only coverage is no greater than 9.5% of annual household income) to all of their Full Time employees and their dependent children (first 30 Full Time employees are excluded) or pay a non tax deductible “Employer Shared Responsibility” payment to the IRS.
This does not include spouses in the definition of “dependents.” Therefore, employers do not have to extend health insurance to an employee’s spouse. In addition, the PPACA “Obamacare” does not require that coverage offered to dependent children be “affordable” or subsidized at the same level as employee coverage.
To comply with reform, the coverage that employers offer their employees must be considered “affordable.” The IRS says coverage is “affordable” for an employee (under an employer-sponsored plan) if the employee’s premium cost for employee-only coverage does not exceed 9.5% of the employee’s household income.”
Click here to determine how many ‘Full Time Equivalent’ employees you have.
[/et_pb_tab][et_pb_tab title=”Beginning in 2016″ _builder_version=”4.16″ background_size=”initial” background_position=”top_left” background_repeat=”repeat” global_colors_info=”{}”]Employers with 50 to 100 FTE – Full Time Equivalent – employees are required to offer affordable health insurance to all their Full Time employees and their dependents (children under 26) or pay a monthly non tax deductible “Employer Shared Responsibility” payment to IRS for all but 30 of their Full Time Equivalent employees.
This does not include spouses in the definition of “dependents.” Therefore, employers do not have to extend health insurance to an employee’s spouse. In addition, the PPACA “Obamacare” does not require that coverage offered to dependent children be “affordable” or subsidized at the same level as employee coverage.
To comply with reform, the coverage that employers offer their employees must be considered “affordable.” The IRS says coverage is “affordable” for an employee (under an employer-sponsored plan) if the employee’s premium cost for employee-only coverage does not exceed 9.5% of the employee’s household income.”
Click here to determine how many ‘Full Time Equivalent’ employees you have.
[/et_pb_tab][et_pb_tab title=”Employer Shared Responsibility payment triggers and assessments” _builder_version=”4.16″ background_size=”initial” background_position=”top_left” background_repeat=”repeat” global_colors_info=”{}”]
The “Employer Shared Responsibility” payment is triggered and assessed in one of two ways:

1.) $2,000 per employee penalty to employers that do not offer affordable, qualified health insurance to their Full Time Equivalent employees and their dependent children. This does not include spouses in the definition of “dependents.” Therefore, employers do not have to extend health insurance to an employee’s spouse. In addition, the PPACA “Obamacare” does not require that coverage offered to dependent children be “affordable” or subsidized at the same level as employee coverage.
To comply with reform, the coverage that employers offer their employees must be considered “affordable.” The IRS says coverage is “affordable” for an employee (under an employer-sponsored plan) if the employee’s premium cost for employee-only coverage does not exceed 9.5% of the employee’s household income.”
2.) $3,000 per employee penalty to employers that do offer health insurance but that health insurance is deemed either not ‘affordable’ or not a ‘qualified health plan’ and one or more Full Time employee buys health insurance on the exchange and receives an APTC – Advance Premium Tax Credit – (subsidy). In this scenario the employer would be assessed a $3,000 penalty for each employee who received a subsidy.
How does an employer know whether the coverage it offers is affordable?
If an employee’€™s share of the premium for employer-provided coverage would cost the employee more than 9.5% of that employee’€™s annual household income, the coverage is not considered affordable for that employee. Because employers generally will not know their employee’s household incomes, employers can take advantage of one or more of the three affordability safe harbors set forth in the final regulations that are based on information the employer will have available, such as the employee’€™s Form W-2 wages or the employee’€™s rate of pay. If an employer meets the requirements of any of these safe harbors, the offer of coverage will be deemed affordable for purposes of the Employer Shared Responsibility provisions regardless of whether it was affordable to the employee for purposes of the premium tax credit.

The three affordability safe harbors are (1) the Form W-2 wages safe harbor, (2) the rate of pay safe harbor, and (3) the federal poverty line safe harbor. These safe harbors are all optional. An employer may use one or more of the safe harbors only if the employer offers its full-time employees and their dependents the opportunity to enroll in minimum essential coverage under an eligible employer-sponsored plan that provides minimum value for the self-only coverage offered to the employee. An employer may choose to use one or more of the safe harbors for all of its employees or for any reasonable category of employees, provided it does so on a uniform and consistent basis for all employees in a category. If an employer offers multiple healthcare coverage options, the affordability test applies to the lowest-cost self-only option available to the employee that also meets the minimum value requirement.

The Form W-2 wages safe harbor generally is based on the amount of wages paid to the employee that are reported in Box 1 of that employee’s Form W-2. The rate of pay safe harbor generally is based on the employee’s rate of pay at the beginning of the coverage period, with adjustments permitted, for an hourly employee, if the rate of pay is decreased (but not if the rate of pay is increased). The federal poverty line safe harbor generally treats coverage as affordable if the employee contribution for the year does not exceed 9.5% of the federal poverty line for a single individual for the applicable calendar year. The  final regulations provide additional information on these affordability safe harbors.

How does an employer know whether the coverage it offers provides minimum value?

A plan provides minimum value if it covers at least 60 percent of the total allowed cost of benefits that are expected to be incurred under the plan. The Department of Health and Human Services (HHS) and the IRS have produced a  minimum value calculator. By entering certain information about the plan, such as deductibles and co-pays, into the calculator employers can get a determination as to whether the plan provides minimum value. Additionally, on May 3, 2013, Treasury and the IRS issued proposed regulations regarding the other methods available to determine minimum value.

If an employer offers health coverage that is affordable and that provides minimum value to its full-time employees and offers health coverage to the dependents of those employees, will it be subject to an Employer Shared Responsibility payment if some of its employees purchase health insurance through a Marketplace or if some of its employees enroll in Medicare or Medicaid?

No. An applicable large employer will not be subject to an Employer Shared Responsibility payment solely because one, some, or all of its employees purchase health insurance coverage through a Marketplace or enroll in Medicare or Medicaid. An employer will not be liable for an Employer Shared Responsibility payment unless at least one full-time employee receives a premium tax credit. In general, an employee will not be eligible for a premium tax credit if the employer has offered that employee health coverage that is affordable and that provides minimum value, even if that employee rejects the offer of coverage and instead enrolls in coverage through a Marketplace or enrolls in Medicare or Medicaid. If no full-time employee receives a premium tax credit, the employer will not be subject to an Employer Shared Responsibility payment.

If an employer offers health coverage that is affordable and that provides minimum value to its full-time employees and offers health coverage to the dependents of those employees, will it be subject to an Employer Shared Responsibility payment if an employee’s spouse purchases health insurance through a Marketplace, or if a spouse enrolls in Medicare or Medicaid?

No. To avoid a potential Employer Shared Responsibility payment an applicable large employer must offer health coverage that is affordable and provides minimum value to its full-time employees and must offer health coverage to the dependents of those employees. For this purpose, a spouse is not a dependent. An applicable large employer will not be subject to an Employer Shared Responsibility payment solely because it does not offer health coverage to an employee’s spouse or if the spouse purchases health insurance coverage through a Marketplace or enrolls in Medicare or Medicaid. An employer will not be liable for an Employer Shared Responsibility payment unless a full-time employee receives a premium tax credit. If no full-time employee receives a premium tax credit, the employer will not be subject to an Employer Shared Responsibility payment. Thus, even if an employee’s spouse receives a premium tax credit, the employer will not be subject to an Employer Shared Responsibility payment.

If an applicable large employer offers health coverage that is affordable and that provides minimum value to a full-time employee’s spouse, the spouse will not be eligible for the premium tax credit.  For more information about eligibility for the premium tax credit, see our  final regulations and  questions and answers.
All penalties are collected by the Internal Revenue Service and enforced by the Department of the U.S. Treasury.

[/et_pb_tab][et_pb_tab title=”Nov 15th – Dec 15th annual Group open enrollment period ” _builder_version=”4.16″ background_size=”initial” background_position=”top_left” background_repeat=”repeat” global_colors_info=”{}”]Under the PPACA – Patient Protection and Affordable Care Act – employer group plans now must offer an annual open enrollment period which begins November 15th and ends December 15th of each calendar year.
[/et_pb_tab][et_pb_tab title=”Special enrollment periods for Group health plans” _builder_version=”4.16″ background_size=”initial” background_position=”top_left” background_repeat=”repeat” global_colors_info=”{}”]Special enrollment periods for Group health insurance plans.
[/et_pb_tab][et_pb_tab title=”Small Group Frequently Asked Questions” _builder_version=”4.16″ background_size=”initial” background_position=”top_left” background_repeat=”repeat” global_colors_info=”{}”]Small Group Frequently Asked Questions
[/et_pb_tab][/et_pb_tabs][/et_pb_column][/et_pb_row][/et_pb_section]

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## Medicare seminar Alpha Wealth Group Sept 25 2025
URL: https://www.healthinsurancementors.com/medicare-seminar-alpha-wealth-group-sept-25-2025/

Thursday, September 25, 2025 | 6:00-8:00pm
 
You may have your financial plan ready for retirement, but are you confident you understand how to navigate the complexity of Medicare?
When you turn 65, you’re eligible for Medicare, but there are several things you need to be prepared for before you sign up.
That’s why we’re hosting a complimentary Medicare educational session for our valued clients and their friends/family. We welcome you to bring a friend, colleague, or family member with you who may be interested in learning more about Medicare as well.
Healthcare expert, Steve Tucker, is our featured guest, and he’s eager to fill you in on what you absolutely need to know about Medicare in advance of your retirement.
In this session, you’ll learn:
•  What are the “four legs” of the Medicare stool
•  The differences between Traditional Medicare and Medicare Advantage
•  What is I.R.M.A.A and how it may impact you
•  What are the historic reforms to Medicare Part D under the Inflation Reduction Act
•  If you should retain employer sponsored coverage at age 65 or enroll in Medicare at that time (and how to avoid late enrollment penalties)
•  What happens to your spouse’s coverage if he or she is younger than you and also insured on your employer’s plan when you become Medicare-eligible
•  The difference between applying during your Medicare Initial Enrollment Period (IEP) and applying during a Special Enrollment Period (SEP)
•  How and where to apply for Medicare during your IEP or SEP
•  Which additional forms are necessary if you apply during an SEP
•  What you need to know about traveling internationally with Medicare coverage
Steve also plans to answer all of your questions after his presentation.
We’re confident this will be a valuable information session, and we’re excited to make it available to you. If you’re interested in attending, please click on the RSVP button.
The event is scheduled for Thursday, September 25 at 6:00 p.m. The event will be held at the Double Tree Suites by Hilton, 2111 Butterfield Rd, Downers Grove, IL 60515, in the Cypress Elm Hawthorne room.
We look forward to hearing from you.
Sincerely,
Tom Fortino

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## Term Life Insurance
URL: https://www.healthinsurancementors.com/insurance-exchange/

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Term Life insurance is the lowest priced way to insure your family. Today’s Term Life insurance policies include guaranteed level premiums for the duration of the policy. To view quotes from all carriers use our Simplicity Life quote engine linked here or click “Get Quotes” below. Have questions? Call (630) 674-1551 or click contact.  
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Get Life Insurance Quotes Now 
Do not leave your family unprotected. Get quotes now for affordable Term life insurance which will leave your family financially secure if you are no longer there to provide for them. Click the image below for Term Life insurance quotes.

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NATIONALLY RECOGNIZED EXPERTS ON THE IMPORTANCE OF TERM LIFE INSURANCE 

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## Florida home
URL: https://www.healthinsurancementors.com/florida-home/

Scroll down for pictures which all link to videos of our Harmony home. 
Entrance to Buck Lake

Front Door

Front Porch

Front Room

Breakfast Nook

Kitchen

Great Room

Pool Deck 

Master Bedroom

Master Bathroom

First Back Bedroom 

First Floor Bathroom between back bedrooms 

Back Bedroom 

Second Floor

Stair descent

Laundry Room

Garage 

Why we chose Harmony Florida. 

Working the thermostat 

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## Contact
URL: https://www.healthinsurancementors.com/contact/

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HealthInsuranceMentors.com – a Google approved health insurance provider – is an unbiased multi-state licensed brokerage firm here to help protect your health and life. From our family to yours, don’t take unnecessary risks. 
Call or write for a free consultation of your needs and an immediate quote for all your health and life insurance needs. 
Call us toll free at (866) 724 7123 or you can email us.Small Business Insurance Services Inc.9 Plainview CourtBolingbrook, Illinois 60440
 
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## Press
URL: https://www.healthinsurancementors.com/press-2/

Principal Broker C. Steven Tucker quoted in following business journals:

The Wall Street Journal
Fortune Small Business Magazine
Fox Business Television Network
Chicago Tribune
Crain’s Chicago Business
Chicago’s Morning Answer – AM560TheAnswer
WLS AM890 with Big John Howell
Chicago City Wire 
The Will County News 
Prairie State Wire
Prairie State Wire
North Cook County News 

A.M. Best Review Magazine (Pg.52)
AIS Health Plan Week Washington D.C
AIS Conference Washington D.C (MP3)
Real Estate Executive Magazine

The Nashville Business Journal
Serenity for the Self Employed
Multiple Sclerosis Central
The Tennessean
DHL Worldwide

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## HSA
URL: https://www.healthinsurancementors.com/hsa/

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Tax Qualified Health Insurance Can Save You Money & Boost Your Retirement
One of the most popular (and lowest priced) types of Tax Qualified health insurance plans is the HSA qualified HDHP. HSA stands for “Health Savings Account”, more commonly referred to as a “Medical IRA”. HDHP stands for High Deductible Health Plan. HSA qualified HDHP’s are a unique way to attractively manage your health insurance costs. For a brief introduction to Consumer Driven Tax Qualified health insurance please watch the following short but informative videos:
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Contrary to popular belief, you can still purchase an HSA qualified HDHP in 2014 and beyond. The “Bronze” plan under the PPACA (Obamacare) is an HSA qualified HDHP. In fact, there are many more benefits included with HSA qualified HDHPs than there were before Obamacare. This is so because all health insurance plans sold after January 1, 2014 must now include 63 preventive care test and exams with no deductible or co pay required. To view all of those test and exams click the banner below:

HSAs were originally named MSAs or Medical Savings Accounts.  MSA Plans were first taken to the marketplace in 1995 by Golden Rule Insurance Company prior to any federal or state statutory (tax shelter) protections.  The original idea was to find a way to more fully engage the policy owner’s “skin in the game” beyond co-payments.  The premise was simple.  Raise the deductible, lower the premiums, take the savings from the lower premiums and fund the MSA bank/trust account.  The MSA policy owner would have to meet their deductible without co-pays before the insurance portion of the plan would kick in. Consumers would be more cost conscience on medical expenses below the deductible and would not be so quick to access and then over-utilize the insurance portion of the MSA Plan.
Simple enough, but there was not enough room to sufficiently fund the MSAs with after-tax dollars leaving the policy owner facing too much risk.  Without legislative action to tax shelter the MSA funds, MSA Plans could not be mass marketed. Enter Representative Bill Archer (R) of Texas.  Representative Archer took up the cause and championed the MSA provisions that finally became law as a part of the 1996 HIPAA legislation.  MSAs where then known as Archer MSAs.
In 2003, Chairman of the Committee on Ways and Means, Representative Bill Thomas, introduced HSAs that would replace Archer MSAs. The HSA legislation, as it was written, contained a variety of elements that would significantly affect the salability of HSA Plans in the marketplace.  The most serious of these discriminated against the family of any spouse who was covered under an HSA Plan and then earned a health insurance benefit from other employment.  Provided a health insurance benefit was earned by a spouse, and the spouse accepted the insurance coverage, the legislation stated the any funds accumulated in the HSA could not be used to cover qualified medical expenses of the spouse.  The family had to make a decision.  Either accept the earned insurance benefit and forfeit the use of any funds in the HSA or forfeit the earned insurance benefit.
Terry Holman, a licensed insurance broker at the time and former lead consultant to Golden Rule Insurance Company on Medical Savings Accounts, knew the content of the legislation and that HSA Plans could not be mass marketed without removing or altering the text of the legislation.  Terry appealed directly to the tax writer for the Committee on Ways and Means.  The tax writer immediately understood the issue and made the structural changes necessary to allow HSA Plans to be mass marketed.
To illustrate how Terry’s idea works in the real world. We will use a real world example. Tony & his wife are currently paying $1,134 a month for Cobra continuation coverage from a previous group plan. In comparison, the monthly premium for an HSA qualified HDHP (High Deductible Health Plan) which covers each insured family member up to and unlimited lifetime coverage amount is less than half of the premium that they are paying now ($550.64 monthly to be exact). This is a yearly savings of $7,000.32 or a monthly savings of $583.36. This is a significant difference. However the insured has to give up all of their outpatient co pays. Is this worth it? This was the question posed to Terry when he approached Congress back in the late 1990’s. His answer to Congress was simply “make it worth it”.
In other words, he asked Congress to make it worth it to the insured. Allowing the policy holder to save that extra money each year on a tax deferred basis makes it worth it. For the year 2017 the maximum contribution a couple or a family can make to their HSA (Health Saving Account) is $6,750. In addition, any family member who is 55 years of age or older can deposit an additional $1,000 annually (more on the age 55 allowance below). This means that the total amount that Tony and his wife can deposit per calendar year is $8,550 since he and his wife are both over the age of 55. The best part is they can take a 100% tax deduction for that contribution similar to an IRA.
Furthermore, if you do incur medical expenses that arise throughout the course of the year that are subject to the deductible (i.e. prescriptions, doctor’s office visit charges, etc.) the IRS will allow you to pull out that money that you put into your tax deductible, tax deferred Health Savings Account to pay for those expenses. When you use their HSA money to pay for those expenses the IRS will allow you to write those expenses off at a 100% tax deduction. The list that the IRS allows you to spend your HSA money on is very liberal and includes things like dental, orthodontics, eyeglasses, Radial keratotomy (Lasik corrective eye surgery), alternative medicines etc. Click here to see the entire list of allowable expenses.
Arguably the most attractive tax advantage to owning an HSA is the fact that the money left over in the HSA account that was not used on medical expenses at the end of the year is “rolled over” into the next year and awarded a higher rate of tax deferred interest. The insured also has the option to roll those unused funds into no load mutual funds, thereby building an extra tax deferred retirement account with money they would have normally given to the insurance company each and every year whether or not they had any claims that year.
It should also be noted that not having a “co pay” with your plan does not mean that your outpatient doctor visits and outpatient prescription drugs will not be a covered expense. With most HSA qualified HDHP’s these charges are a fully covered expense just as they would be with a Traditional Health Insurance Plan. The only difference is these charges will be subject to the health plan deductible.
Being “subject to deductible” does not mean that you will pay full price for these charges either. If you stay within your PPO network, your outpatient doctor office visit charges will be discounted by as much as 40%. Your prescriptions will also be discounted significantly as well by staying within the Rx prescription network.
Let’s break that down in plain English. Let’s say your doctor’s office charges you $100 for a “sick visit”. If you use a PPO provider those office charges will be “re-priced” down to roughly $60. Now compare that to a Traditional plan which provides you with a $30 “co pay”. The difference to you is $30 out of pocket for that doctor’s office visit. But is that all you are really saving? Not if you add in the monthly premium savings between the two plans. The typical monthly premium savings between a Traditional plan and an HSA qualified plan for a family is $200 monthly. This equates to an annual savings of $2,400.
Now let’s take that $2,400 annual savings and deposit it into a tax deferred, tax deductible interest bearing account. Let’s go a step further and imagine you find an HSA account that bears you NO interest AT ALL (which is not that hard to imagine in this economy). You’re still saving $2,400 annually and you’re deducting that amount from your adjusted gross income. This means less reportable income which means less taxes.
Now lets imagine you have no major medical claims in year two and you deposit the same amount. Now in year three you have a worse case scenario occur. Now you have $4,800 to help pay your plan deductible. Not to mention any additional funds you deposit into your Health Savings Account during that same time frame.
In summary, the advantages to owning a Health Savings Account are as follows:
1.) Unlike any other IRA, a Medical IRA (HSA) allows you to withdraw funds at any time with no penalty for “qualified medical expenses“. Most importantly, when you withdraw your HSA funds to pay for any of the qualified medical expenses on that list, those expenses themselves become 100% tax deductible.
2.) Here’s the key point though. If you have just ONE year without any significant claims and you even partially fund your Medical IRA, then if the worse case scenario occurs, you will have those funds available and be able to withdraw them with no penalty and use that money to help pay your calendar year health plan deductible. In year 2 (with no major claims) you are that far ahead of the risk management game. In fact, no other kind of Health Insurance actually allows you to lower your risk the longer you own it by hedging money you would have otherwise given an insurance company for a Traditional plan.
I say this because, there is no other kind of IRA that you can withdraw from at any time with no penalties and then use those withdrawals to pay for medical costs and receive a 100% tax deduction for those expenditures. In fact, the longer you own an HSA qualified HDHP, the lower your risk becomes since the more years that pass, the larger your balance in your HSA account becomes. This is so because each year your remaining balance rolls over and continues to earn tax deferred interest.
The longer you look at HSA qualified HDHPs the more sense they make. This is why they have caught on like wildfire and will continue to do so. The only inhibitor to the spread of HSA’s is lack of education (as is the case with any other financial vehicle) The “Whole Foods” supermarket chain chose HSA qualified Health Insurance. It worked so well for them that they were recently featured on the ABC 20/20 episode entitled “Sick In America” with John Stossel:
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Now you can help fund your HSA account by purchasing every day items! www.RetailBenefits.com (formerly MyHSARewards)
To learn more about HSAs and the recent federal legislation that has made them even more attractive to people over the age of 55 click here to read all about them on the Federal Government’s HSA educational web site. To learn more about HSAs in a power point presentation format please click here: www.hsacenter.com and click on the informative videos on the right.
If you are an employer and are considering HSA qualified plans for your employees consider this. An individual’s employer can make contributions that are not taxed to either the employer or the employee. The combined income and payroll tax deductibility leads to discounts for health insurance of over 40% in some cases relative to other forms of insurance. For more details for the employer http://www.treas.gov/offices/public-affairs/hsa/faq_employer-participation.shtml
For the best interest rates you will find just about anywhere on a Health Savings Account CLICK HERE
Please “Contact Us” with questions about HSA qualified HDHPs. If you have a C.P.A. or tax advisor please feel free to ask he or she about the advantages of owning an HSA as well.
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## Life Insurance
URL: https://www.healthinsurancementors.com/life-insurance/

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September was LIAM
Life Insurance Awareness Month.
MVP quarterback and sportscaster Boomer Esiason is raising awareness about the necessity of Life insurance. His mother died when he was only seven years old. His life was more difficult because his mother had no life insurance. Today more than 95 million adult Americans have no life insurance. To determine how much life insurance you need click here.

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Get Life Insurance Quotes Now 
Critical Illness, Dental & Vision
Do not leave your family unprotected. Get quotes right now for affordable Term life insurance which will leave your family financially secure if you are no longer there to provide for them. Watch the video to the left to determine how much Life insurance you actually need. Click the image below for Life insurance, Critical Illness, Dental & Vision quotes.

GUARANTEED ISSUE LIFE INSURANCE
If you are uninsurable due to preexisting conditions, you can now purchase guaranteed issue Term life insurance up to $150,000 or Whole life insurance up to $250,000 with no health questions, no exam. Please click the image below to view quotes. Please contact us for more information.

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Life insurance with “Living Benefits”
Life insurance is an important way to protect your loved ones. But for many families the need for protection is increasingly due to costs associated with the rising incidence of illnesses like strokes, heart attacks, cancer and other chronic and critical illnesses. More families are dealing with the unexpected costs that illnesses such as these place on them and their families. People need access to funds while they are alive to cover costs that their health insurance does not cover such as mortgage payments, car payments, groceries, utilities and other daily living expenses.
Why Do I Need Living Benefits?
Statistics show that large numbers of Americans may become terminally, critically or chronically ill.

Every 40 seconds someone has a stroke

Every 34 seconds someone has a heart attack

The average cost of a severe heart attack, including direct and indirect costs, is about $1 million

1 in 2 men and 1 in 3 women develop cancer in their lifetime

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Chronic and critical illnesses may result in the inability to perform activities of daily living such as bathing or dressing yourself without help or assistance. While many of us have health insurance, medical bills continue to be a leading cause of bankruptcy in the United States. Watch the Butler’s story about how their policy with “Living Benefits” literally saved their family fortune. Click the image below for critical illness quotes as well as Life insurance quotes which contain accelerated benefits for a critical illness.

Life insurance with living benefits provides the option to access the face amount and receive cash while the insured is alive. The Accelerated Death Benefits can provide funds at a time that the insured and his/her family need them most. Most life insurance policies only protect your family after you pass away. A life insurance policy with living benefits still does that but may also give you valuable access to cash while you are alive, and when the funds are most needed. People see this as a smart way to have funds they need without having to access a retirement fund, 401(k) or liquidate CDs. Once you decide on a plan you like, you can apply quickly and easily online using this link or click contact us for a free no obligation quote customized for your specific needs.
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## Group health insurance for ONE PERSON ensures access to Chicago Teaching hospitals for small business owners
URL: https://www.healthinsurancementors.com/grouphealthrelaxedunderwriting/

In November of 2015, Chicagoland residents were shocked to learn that Northwestern Memorial hospital, University of Chicago medical center, Rush University medical center and the Lurie Children’s hospital would no longer accept patients who have ACA-qualified (Obamacare) individual health insurance plans.
This action led to a significant increase in the purchase of small group health insurance policies which still provide national PPO networks and still ensure access to the aforementioned teaching hospitals in Chicago.
For small corporations who could afford to insure themselves and 70% of their eligible full time employees (the usual minimum participation requirement), purchasing small group health insurance was a costly fix to the new narrow networks in the individual health insurance marketplace.
The ability to purchase group health insurance for you and your full-time employees is well known. What is not well known is the fact that you can purchase a small group health insurance policy without insuring any of your employees during a small window each year. That window begins on November 1st and ends on December 15th. The same time period the annual ACA Open Enrollment for individual plans begins and ends.
During this little known ‘relaxed underwriting’ period, an owner of a small corporation (less than 50 full-time employees) can purchase small group health insurance while employees ‘waive’ coverage without producing an eligible waiver. Normally, 70% of all full-time employees must participate in a group health insurance plan unless they have an eligible waiver such as an offer of group health insurance from a spouse’s employer or Medicare and Medicaid coverage. If you do decide to offer coverage to your full-time W2 employees during this Special Enrollment period, you do not have to insure any of your employees and instead can only insure yourself and or your family without insuring employees. Normal 70% minimum participation requirements are waived.
If you are a small business owner who is seeking to purchase small group health insurance and cannot afford to insure your employees or, your employees simply do not want to participate in a group health insurance plan. Now is the time to learn more about “relaxed underwriting period”. The cost for group health insurance is now commensurate with individual health insurance but the PPO network is much larger and far more inclusive than any of the narrow networks now available in the individual marketplace.
Want to learn more? Click “GROUP HEALTH” at the top of this page and scroll down to see the Summary of Benefits for the small group health insurance policies offered by Blue Cross Blue Shield of Illinois. Have questions? Call us for a free consultation at (630) 582-1043 or click on “CONTACT” at the top of this page.

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## Auto Draft
URL: https://www.healthinsurancementors.com/auto-draft/

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## Special Enrollment
URL: https://www.healthinsurancementors.com/special-enrollment/

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What is a Qualifying Life Event which qualifies one for Special Enrollment?
1.) You move to a new area that offers you different plans, or isn’t covered by your HMO or PPO network.
 2.) You get married.
 3.) You have or adopt a child.
 4.) You lose other health coverage due to job loss, a decrease in work hours, end of COBRA coverage or other reasons.
 5.) You become a U.S. citizen.
 6.) Your income changes, or some other event changes your income or household status.
 7.) You can prove that your health insurance company violated its contract with you.
 8.) You are no longer covered on a family member’s policy because you turned 26, you have legally separated from or divorced your spouse, or the policy holder has passed away.
 9.) You become a member of an American Indian and Alaska Native tribe.
 10.) You experience an error or other complication when trying to enroll.
 11.) You experience other events that qualify for special enrollment.
12.) Special Enrollment guide from Blue Cross Blue Shield of Illinois. 
How does Special Enrollment work?
In most cases, you have 60 days after the qualifying life event to enroll in or change your health plan. If you have insurance through your job, you may only have 30 days to enroll. If you qualify for Special Enrollment click the logo below to compare BCBSIL plans and find the right health insurance plan for you and your family.
 

What if you don’t qualify for Special Enrollment?
If you missed open enrollment and don’t qualify for the special enrollment period, you can still stay insured by buying short-term health insurance from BCBSIL. They offer affordable short-term plans that can keep you covered until the next open enrollment period begins on November 15, 2014.
Please note: Short-term plans give you basic health care coverage, but they don’t meet the Patient Protection and Affordable Care Act’s minimum essential coverage requirements. As a result, you may still have to pay a fine for having a plan that doesn’t meet these requirements.
Depending on your income, you may qualify for Medicaid or CHIP. There is no special enrollment period for those government offered coverage options – you can apply at any time.
Members of American Indian tribes can enroll any month, not just during open enrollment. You can even apply for cost assistance. Click below to shop for Short-term health insurance with BCBSIL.
 
 
 
© Copyright 2000 S.B.I.S. Inc.
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## FAQ
URL: https://www.healthinsurancementors.com/faq/

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Browse Through Our Most Frequently Asked Health Insurance Questions
We’re here to help answer any or all of your Health Insurance related questions so that you can make informed and careful decisions in choosing what’s right for you and your family. Don’t see a question or an answer you’re looking for? Feel free to give us a call at the number at the top of the screen. For a list of Frequently Asked Questions pertaining to Small Group coverage click here.
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## Qualifying Life Event
URL: https://www.healthinsurancementors.com/qualifying-life-event/

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What is a Qualifying Life Event which qualifies one for Special Enrollment?
1.) You move to a new area that offers you different plans, or isn’t covered by your HMO or PPO network.
 2.) You get married.
 3.) You have or adopt a child.
 4.) You lose other health coverage due to job loss, a decrease in work hours, end of COBRA coverage or other reasons.
 5.) You become a U.S. citizen.
 6.) Your income changes, or some other event changes your income or household status.
 7.) You can prove that your health insurance company violated its contract with you.
 8.) You are no longer covered on a family member’s policy because you turned 26, you have legally separated from or divorced your spouse, or the policy holder has passed away.
 9.) You become a member of an American Indian and Alaska Native tribe.
 10.) You experience an error or other complication when trying to enroll
 11.) You experience other events that qualify for special enrollment.
12.) 2015 Special Enrollment guide from Blue Cross Blue Shield of Illinois. 
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In most cases, you have 60 days after the qualifying life event to enroll in or change your health plan. If you have insurance through your job, you may only have 30 days to enroll. If you qualify for Special Enrollment click the logo below to compare plans from all carriers and find the right health insurance plan for you and your family. 
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If you missed open enrollment and don’t qualify for the special enrollment period, you can still stay insured by buying Short-Term health insurance. Short-Term or Temporary health insurance plans can keep you covered until the next open enrollment period begins again in November of 2015 for January 1, 2016 effective dates. Please note: You must also understand that you will be subject to a 2% of your MAGI ‘fine’ (TAX) for purchasing temporary health insurance since these plans do not include the “essential health benefits” under the PPACA (Obamacare).  As such temporary policies are not considered ‘qualified health plans’. Rest assured though, if you are self employed and do not over pay your taxes you will never pay that ‘fine’ (TAX) for the only recourse the IRS has to collect that fine is to hold your tax refund. All criminal penalties for non compliance were removed from the health care law prior to passage.
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Click the United Healthcare logo for Short-Term health insurance quotes

Our recommendation for Short-term health insurance is United Healthcare insurance company. United Healthcare is one of the only companies with Short-Term health insurance that also covers outpatient and inpatient prescription drugs the same as any other illness. Most other carriers who offer  Short-Term health insurance do not cover outpatient prescription drugs or if they do, they only cover a small amount after you have paid your health plan deductible. This can lead to catastrophic out of pocket expenses for those who develop a major medical illness outside of open enrollment.
To get quotes & apply online for United Healthcare’s Short-term health insurance click on their logo above.
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## Health
URL: https://www.healthinsurancementors.com/health/

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The last date to purchase individual, renewable health insurance during the first open enrollment period in 2014 was March 31st. Unless you qualify for a special enrollment period, you will not be able to buy renewable individual, health insurance again until the next open enrollment period which begins on November 15, 2014 with coverage effective dates starting no sooner than January 1, 2015.
 

 
If you qualify for special enrollment you may also qualify for a federal subsidy to lower your premium.
Depending on what your 2014 total household MAGI – Modified Adjusted Gross Income – will be, you may qualify for an “Advance Premium Tax Credit” (a federal subsidy) under the new health care law which will immediately lower your premiums. Below are the income levels necessary to qualify.
If your 2014 total household MAGI – Modified Adjust Gross Income – will be lower than:
$46,680 for an individual
$62,920 for a couple
$79,160 for a family of three
$95,400 for a family of four
$111,640 for a family of five
$127,880 for a family of six
$144,120 for a family of seven
$160,360 for a family of eight
you will be better off financially by buying a new health insurance plan inside the health insurance exchange implemented by the PPACA – “Patient Protection & Affordable Care Act” – otherwise known as “Obamacare”. By doing so, you will qualify for an APTX – Advance Premium Tax Credit (federal subsidy) – to reduce the cost of either the Bronze, Silver, Gold or Platinum health insurance plans offered inside the health insurance exchange.
If you do not qualify for special enrollment you can stay insured between open enrollment periods.
You can stay insured between open enrollment periods by purchasing non renewable, short-term health insurance. Our recommendation is Assurant health insurance company. Assurant health is one of the only companies with temporary health insurance that also covers outpatient and inpatient prescription drugs the same as any other illness. Many of the other carriers who offer temporary health insurance do not cover outpatient prescription drugs or if they do, they only cover a small amount after you have paid your health plan deductible. This can lead to catastrophic out of pocket expenses for those who develop a major medical illness outside of open enrollment.
About Assurant
Assurant, a Fortune 500 company and a member of the S&P 500, is traded on the New York Stock Exchange under the symbol AIZ. Assurant has approximately $29 billion in assets and $8 billion in annual revenue. Assurant has approximately 14,500 employees worldwide and is headquartered in New York’s financial district. Assurant Health’s products are underwritten and issued by John Alden Life Insurance Company, Union Security Insurance Company and Time Insurance Company, which has been in business since 1892. Headquartered in Milwaukee, Wisconsin, Assurant Health employs approximately 2,000 employees. Assurant Health is rated A-(Excellent) by A.M. Best ratings.
To get quotes & apply online for Assurant Health’s temporary health insurance click their logo below:

You will owe a non compliance ‘fine’ to the IRS for buying short term insurance
You must also understand that you will be subject to a 1% of your MAGI ‘fine’ (TAX) for purchasing temporary health insurance since these plans do not include the “essential health benefits” under Obamacare such as Maternity for 62 year old women and single men, drug rehab coverage for those who do not have chemical dependency problems and pediatric dental for those without children. As such temporary policies are not considered ‘qualified health plans’. Rest assured though, if you are self employed and do not over pay your taxes you will never pay that ‘fine’ (TAX) for the only recourse the IRS has to collect that fine is to hold your tax refund. All criminal penalties for non compliance were removed from the health care law prior to passage.
Those with 2013 Individual health plans that renew in 2014 now qualify for “Special Enrollment”.
The new May 2, 2014 bulletin also allows those who purchased 2013 plan from the ‘old market’ to qualify for a ‘special enrollment’ period if their 2013 plan renews in 2014. The applicants can apply for a QHP up to 60 days before their plans terminate and they may also apply up to 60 days after their plan’s renewal date. In this April 8, 2014 article I noted that before this new bulletin Assurant Health was the only carrier that was offering a QHP to those with plans from the ‘old market’ outside of ‘open enrollment’ periods. With this new May 2, 2014 bulletin all carriers will eventually need to comply. As of the date of this writing Blue Cross Blue Shield of Illinois had not stated when they will comply. If and when they do I will add their statement to this post.
If your pre-2014 individual plan is renewing in 2014 that is a ‘qualifying event’ with Assurant.
Assurant Health announced yesterday that they are now honoring this regulation that states quite clearly that if you have an ‘old’ policy from the ‘old’ market (pre 2014) and that plan renews you can purchase a 2014 ‘qualified’ Bronze, Silver, Gold or Platinum health insurance plan on or off the exchange on a guaranteed issue basis between open enrollment periods. This is very good news for anyone how has an ‘old policy’ that renews this year and is facing a large premium increase and/or has exclusion riders on their existing policy and wishes to purchase a new 2014 plan without exclusion riders.
At this juncture, Assurant Health is the only carrier that is honoring the aforementioned regulation and as such they have a corner on the market until the next open enrollment period begins on November 15, 2014 for coverage effective dates beginning no sooner than January 1, 2014. As I stated in this recent article, many health insurance carriers like Aetna and Humana are not even offering short term (temporary) health insurance products until the next open enrollment period. The few carrier who are, offer them with dangerously low lifetime maximum coverage amounts. It must also be reiterated that if you purchase short term coverage, these policies do not cover preexisting conditions and you will be subject to a 1% of your MAGI ‘fine’ (TAX) from the IRS if you purchase short term coverage because those plan are not considered ‘qualified health plans’ under CMS and HHS regulations.
If your old health insurance plan is renewing in 2014 and you wish to get quotes from Assurant Health for a qualified replacement plan click their logo below. There is now a new section on the application where you will need to either upload a copy of your existing health insurance ID card proving that you have a policy from the ‘old market’ or you can fax a copy of your old ID card to the fax number provided on the application. This is necessary to prove that you qualify for a special enrollment period and an applicant with a qualifying event.
 

 
HSA – Health Savings Account qualified HDHPs – High Deductible Health Plans are still available.
Contrary to popular belief you can still purchase an HSA qualified HDHP in 2014 and beyond. The “Bronze” plan under the PPACA (Obamacare) is an HSA qualified HDHP. In fact, there are many more benefits included with HSA qualified HDHPs than there were before the PPACA. This is so because all health insurance plans sold after January 1, 2014 must now include 63 preventive care test and exams with no deductible or co pay required. Click here to learn more about Health Savings Accounts
Most other insurers will not offer health insurance again until November 15, 2014
The last date to purchase individual, renewable health insurance during the first open enrollment period in 2014 was March 31st. If you missed the first open enrollment period and do not qualify for a special enrollment period, you can still stay insured between open enrollment periods by purchasing non renewable, short-term health insurance from Blue Cross Blue Shield of Illinois. BCBSIL offers affordable, quality short-term health insurance plans that can keep you covered until the next open enrollment period which begins on November 15, 2014 with effective dates starting January 1, 2015. Whether you have experienced a ‘qualifying life event’ and qualify for a ‘special enrollment period, or you wish to shop for temporary health insurance click the logo below to compare BCBSIL plans and find the right health insurance plan for you and your family.
 

 
United HealthOne is no longer offering health insurance products of any kind in Illinois as of January 1, 2014. They do offer fixed indemnity plans, these are not health insurance products and we do not recommend purchasing fixed indemnity plans. The risk exposure is too great. United HealthOne is offering temporary health insurance outside of Illinois between open enrollment periods in 2014. Click the United HealthOne logo to apply for health insurance on or off the health insurance exchange. These plans will be available for sale again on November 15, 2014 with effective dates beginning January 1, 2015.
 

 
Click the Humana logo below to apply for coverage with Humana inside or outside of the new health insurance exchange. These plans will be available for sale again on November 15, 2014 with effective dates beginning January 1, 2015. Humana is not offering temporary health insurance coverage between open enrollment periods in 2014.
 

 
Click the Aetna logo below to apply for coverage with Aetna inside or outside of the new health insurance exchange. These plans will be available for sale again on November 15, 2014 with effective dates beginning January 1, 2015. Aetna is not offering Temporary health insurance between open enrollment periods in 2014.
 

 
Click the “Health Care Reform” banner below to shop for renewable Medal health insurance plans from all carriers in all 50 states both on or off the health insurance exchange. These plans will not be available for sale again until November 15, 2014 with effective dates of January 1, 2015.

Supplemental Accident coverage
Since many consumers are now purchasing the 2014 “Medal” health insurance plans with high deductibles it makes great sense to purchase a Supplemental Accident plan so that you receive a cash payment ($5,000, $7,500 or $10,000) each time any member of your family suffers from an accidental injury (cuts, breaks, sprains, bruises etc). This cash can payment can help you pay your health plan deductible. Since accidental injuries are far more likely to occur than major medical illnesses (most especially when you have active children) many families are choosing to purchase supplemental accident expense plans. Supplemental Accident Expense plans are also a great way to save money because you can choose a higher deductible than you would normally choose knowing you will not have to pay that deductible if an accidental injury occurs to any member of your family. Click the WBA “Learn More” button below to shop for Supplemental Accident coverage:
 
 
 
 
Critical Illness coverage
Approximately 1.2 MILLION people suffer heart attacks each year. Approximately 780,000 people suffer strokes each year. More than 1.4 MILLION new cancer cases were estimated for diagnosis in 2007 alone. Between 1994 and 2004, the death rate declined approximately 31% for heart attacks and almost 24% for strokes. (Source: American Heart Association, Heart and Stroke Statistical Update, 2008.) The possibility of surviving a Critical Illness before age 65 is almost twice as great as dying. (Source: National Center for Health Statistics.)
WOULDN’T A CHECK BE BETTER THAN A GET WELL CARD? Critical Illness benefits are paid directly to you. You choose how to spend the benefit at a time when you and your family may need extra cash the most. For example:

Home Health Care
Cost of Caregivers
Lost Income of Self or Spouse
Daily Living Expenses
Co Pays, Deductibles & Co-Insurance
Non -Covered “Experimental Treatments
Housekeeping or Child Care Expense
Maintenance of Your Family’s Quality of Life

Colorado Bankers Life insurance company has partnered with Dearborn National to offer a Critical Illness plan that is extremely well priced. Adding this product to any health insurance plan would alleviate the worry of paying your health plan deductible if you or a family member were to develop a critical illnesses such as life threatening Cancer, Stroke, or Heart Attack. For more information about this unique and affordable plan click the brochure below. If you have questions please contact us.

Medicare Supplemental coverage
If you’re over 65 or nearing that age and are looking for information and multiple free quotes on plans that will cover your Medicare deductibles and other out of pocket expenses. Visit our Medicare Supplement page
 

 
Life Insurance
Click the banner below for Term Life insurance quotes from all carriers:
 

 
© Copyright 2014 Small Business Insurance Services Inc.
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## Answers
URL: https://www.healthinsurancementors.com/answers/

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