Laughlin Insurance Market Report

July 2024

Market Report

Oregon and Washington

Greetings Insurance Customers and Referral Partners. Our newsletter is designed with you in mind, and for anyone who you think can benefit from our specialized agent services. Our goal is to provide you with news, information, and resources that you can use, related to Health Insurance and the other types of insurance, and special programs that we offer here at the agency. We monitor the Health Insurance Marketplaces, Medicare Markets, Employer Group Programs, Favorable Tax Programs, Carrier Rate Filings, Financial Help, and more. During this time of year, we are completing our annual Medicare & Marketplace Agent Recertifications, and carrier specific training. This allows us to be best prepared to tell you all about the new year options and changes, so you can maintain the plans and programs that work best for you, from what is available in your area. We are here to help you anytime with your current programs, and will be here to help you during the 2025 Open Enrollment Periods, with an annual review, or plan changes, if you need us. Below are some updates for the Individual, Medicare, and Employer markets, followed by other topics, that we hope will be of interest to you.

Individual Marketplace Health Insurance continues to be stable for most consumers. The Advanced Premium Tax Credit has increased for many, and the tax credit has become available for some with higher income. Provider Networks, and Out of Pocket Maximums are stable, and the Special Enrollment Period for those within 150% of the Federal Poverty Level, has recently become permanent. The Individual Open Enrolment runs form Nov 1 through Dec 15 for Jan start date, and from Dec 16 through Jan 15th, for a Feb start date. Read More

Medicare Advantage Prescription Drug Plans (MAPD) are still showing stable premiums, reasonable out of pocket costs, and extras like dental, hearing, and vision. There are a variety carriers and plan types available in most areas, like HMO, PPO, and POS plans. Medicare Beneficiaries can make changes during the Medicare Open Enrollment Period that runs from Oct 15 to Dec 7th, for a Jan 1, 2025 start date. Read More

Medcare Supplement Plans (MediGap) are different than Medicare Advantage Plans, and are a popular choice for those who want low out of pocket costs, and access to a large number of providers who accept Original Medicare. Medicare Supplement premiums are usually higher than Medicare Advantage, and Medicare Supplement plans do not include Prescription Drug benefits, or extras, like hearing, dental, and vision. Read More

Medicare Prescription Drug Plans (PDP) are usually purchased by those who have Medicare Supplement Plans. There are numerous Medicare Prescription Drug Plans in most areas, and we can help you review your prescription drug needs, and help you purchase the plan that works best for your needs. You can also change Medicare Prescription Drug Plans during the Medicare Open Enrollment Period, if your pharmacy needs have changed, and a better prescription drug plan is offered in your area. Read More

Employer Benefit Programs are still a popular way for employers to help employees with their health insurance needs. Many employers offering group health plans, may also offer dental, life insurance, disability insurance plans, and Paid Leave Programs. We offer most major brands for employer Health Plan benefits in the Portland Metro and SW Washington areas. We recommend that employers review their employee benefit programs annually with their agent, to be sure the costs, coverage levels, contribution arrangements, tax & compliance responsibilities, administrative efficiencies, and employee communications are all set up in the way that works best for the employer and their employees. Read more

Employer Compliance

Employers who provide Health Insurance, Dental, and other benefits to employees, are required by numerous Regulatory Authorities to keep certain documents, and provide employees with certain disclosures, and notifications. Most of our employer customers have adopted documents, and published required employee disclosures and notifications, but there are still many employers are not aware of these responsibilities, and are at risk for significant penalties and business disruption. Affordable commercially available compliance solutions are available, and we offer compliance services from a variety of Professional Vendors and Administrators. We recommend an annual compliance review, and we can help you. It is very important that employers have personal awareness of their responsibility, even if they have benefit managers or payroll companies helping with plan administration, so please contact us, and we can help review your compliance status. Read More

Employer Health Insurance Coverage Affordability

For 2024, a job-based health plan is considered affordable if your share of the monthly premium in the lowest-cost plan offered by the employer is less than 8.39% of your household gross income. There are also affordability rules for dependent premiums on group plans also, so the Advanced Premium Tax Credit, may be available to help you pay monthly health insurance premiums on the marketplace. Be sure to contact us if you want to know if your employer health plan is affordable for you and your dependents, and if premium savings and financial help is availabe on the Marketplace. Employer Health Plan Affordability Calculator. Read more

Online Account Administration for Employers

Adding and removing employees to your benefit programs, or making employee changes and updates is easy, with online administration available through most health and dental insurance carriers. Most insurance companies allow us to support you with online administration, as your authorized representative. We have decades of experience in this space, and welcome the opportunity to support you with account administration. Read more

Life Insurance

Life Insurance is a contract between an insurance company and policyholder, where the insurance company promises to pay the beneficiary a sum of money upon the death of the insured person. Life Insurance may be purchased as an Individual, and Employers may also purchase Life Insurance for Employees. Life Insurance benefits are typically tax-free and can help to fund end of life expenses, debts, childcare expenses, college tuition, business obligations, and other costs. We offer Group and individual Life Insurance from various carriers, and are here to help you get the policy you need. Read More

Disability Insurance

Many Americans can't afford to miss one paycheck, and most are not financially prepared to be off work if they get sick or injured. Disability insurance protects your paycheck by replacing a portion of your income if an illness or injury prevents you from performing the substantial and material duties of your occupation you have education, training, or experience to perform. Disability Income Replacement Plans may be purchased as individuals, and employers may also purchase disability insurance for employees, and for business partners. Read More

Income Related Monthly Adjustment Amount (IRMAA)

If you are approaching Medicare age, or if you are already on Medicare, and have higher than average income, then this information may be of interest to you. The Medicare Income Related Monthly Adjustment Amount (IRMAA) is an additional premium that you may pay in addition to the standard Medicare Part B Premium. The rates are based on your Gross Income, from two years ago. We can help you to review the income and rate guidelines. Some Medicare Beneficiaries may want to customize their incomes during the two years prior to becoming Medicare eligible, and may be able to minimize IRMAA rates by customizing their income, while on Medicare, with support form their Financial and Tax Advisors. Read more

Paid Leave Oregon

In 2019, the Oregon legislature enacted the Paid Leave Oregon program (PLO), which was implemented on September 3, 2023. Under PLO, if a worker cannot work because of a serious health condition, or for other specific reasons, the worker can be entitled to paid medical leave. Employers can learn about the program, and employees can learn what it means to them, and how to apply Here.

1095 Tax Forms

It will soon be time to gather tax forms related to health insurance, and include them in your tax filing. If you are an individual marketplace consumer, then it is recommended that you keep tax returns current to avoid potential disruption of the Advanced Premium Tax Credit (APTC), or Cost Sharing Reduction benefits (CSR). Read more

Featured Agency Programs

WiredEnroll is our popular online Small Employer quoting and enrollment system that allows us to provide Small Employers with live, web based, group health insurance and dental options from participating carriers, and then enroll business owners and their employees in group health insurance and dental plans, electronically. If you are a small business with 50 or fewer employees, and would like a comparison of health insurance options, let us know, and we can have quick turn-around on rates and options. Contact us for proposals.

HealthSherpa is our online comparison and Marketplace enrollment tool for individual health and dental plans in Oregon. This tool allow us to review marketplace plans in your area, check to see what plans your providers contract with, estimate pharmacy costs, incorporate the Advanced Premium Tax Credit, if available, and enroll you electronically in the health and dental plans you want, by phone with your agent. Feel free to shop and compare HERE.

Individual Disability Insurance Quoting Portal is a good way to see how much a disability income replacement benefits you may be eligible for. The premium may be about 2%-5% of your gross income, but the benefits can replace the majority of your pre disability income, to retirement age, upon disability from illness or injury. We offer numerous leading carriers. Request a quote HERE.

Washington Health Plan Finder is the online health insurance marketplace that we use to help those in Washington, to compare individual health and dental plans, and enroll in you the plans you want, with the advanced tax credit, if you qualify. Browse & Compare plans HERE.

Employer Benefit Programs Custom Web Sites. We are now making a handy catch all employer benefit programs landing page for employer customers. The web page includes documents, forms, and links for employees including; benefit summaries, enrollment forms, premium contribution details, notices, provider search links, and more. If you are one of our current emloyer customers, be sure to give the web page link to your employees. We update these landing pages as needed, and at each renewal. Contact us for free custom benefit website and support.

Coredocuments.com is a compliance document vendor for employers. They provide ERISA Wrap Document, 125b Pre-tax program services, and other compliance services for employers for reasonable fees. There are a lot of administrators that offer different levels of service and fees, but Core Documents is an affordable solution for your compliance needs. We can help employers with Core Document programs and setup.

Standard Insurance Equivalent Oregon Paid Medical and Family Leave programs can be a good alternative to the state program. Standard Insurance is a leader in this space as the first approved program in the state. An equivalent plan has less bureaucracy, and may have quicker payouts to those on claim. There is a reasonable added premium to have private equivalent plan, and most employers who have had the equivelent plans over the last year, are keeping it for the new year.

Project Access Now Premium Support Program is an approved third-party support program that can help qualified marketplace consumers with premiums, outpatient prescription expenses, and also help request support from participating hospitals. The income guidelines for this program have increased, space is limited, and there is currently a waiting list. Contact us today to see if you may be eligible for this special program.