April 2019
Laughlin Insurance Report
Portland Oregon and SW Washington
2019 Health Insurance Market Conditions
The 2019 health insurance markets are stabilizing, after a number of difficult years. Carrier participation is growing and expanding across the country, providing more choice and may provide lower rates. The individual tax credit and small business tax credits are still available. The small employer association plans and short term medical plan regulatory changes are not showing improved opportunities at this time.

Health insurance continues operating under many of the core provisions of the Affordable Care Act (ACA), although there has been some disruption to some of the laws provisions. Popular provisions include guaranteed issue plans, no waiting periods for pre-existing conditions, free preventive care, unlimited benefits, tax credits, and more. Most consumers are reporting to us that they are happy with the rules, options, rates, tax credits, coverages, and more. Some individual customers over age 50 with higher income are seeing very high rates, because they are not eligible for premium relief from the government, and there is no planned government premium relief for this consumer group at this time.

We are here for you all year long. Be sure to contact us any time you have questions or need assistance.
Health Insurance and Tax Forms
Consumers must provide the IRS with information about the type of health insurance that was in force for the tax filing year. You may be an individual health insurance consumer, or you may have health insurance through your employer, or you may be on Medicare or Medicaid.

Be sure to ask your tax advisor about the health insurance reporting that needs to be included with your tax return. If you have more than one health insurance plan during the tax year, then you may have more than one 1095 type form. Let us know if you have questions, or if you need help with the tax forms related to your health insurance. Read more here.

  • Enrolled through the marketplace; 1095-A
  • Enrolled in individual market or government sponsored plan; 1095-B
  • Enrolled in large employer plan; 1095-C
  • Reconcile advance payments; Form 8962
  • Health coverage Exemptions; Form 8965
Do you have a Special Enrollment Period?
Since 2014, American health insurance consumers must purchase individual qualified health plans during the annual open enrollment period, or during a special enrollment period . Open enrollment is from Nov 1st through December 15 for a January start date. Special enrollment periods allow consumers to purchase health insurance outside of the open enrollment period. Those with a special enrollment period must purchase a qualified health plan within 60 days of the start of their special enrollment period. If you have lost qualifying coverage, got married, had a baby, or have experienced other life changing events, then you may be eligible for a special enrollment period. Contact us if you need help with marketplace eligibility, and enrollment. Read more Here .
Have you claimed your Small Business Health Care Tax Credit?
There is a valuable small business health care tax credit for eligible employers. If you are an employer that offers group health insurance, have fewer than 25 employees, contribute at least 50% of the single party rate, have a qualified health plan option, then you may be eligible for the small employer health care tax credit. This tax credit can provide employers with a tax credit of up to 50% of their premium contribution for up to two years.

Do not miss out on this valuable tax credit. We are Small Health Options Program (SHOP) Certified Brokers, and can help you determine if you are eligible for the tax credit, and how much the tax credit may be for you, and how to get the tax credit. You can read more about the tax credit at healthcare.gov , irs , and OregonHealthCare.gov.
Medicare Planning & Enrollment - Are You Ready for Medicare?
There are about 10,000 people turning age 65 daily in the US and becoming eligible for Medicare. If you are approaching Medicare age, or eligible due to disability, then you may want to enroll in a Medicare health plan. The planning and setup process can be challenging to navigate, but we can help make it easier for you. Once you get set up, it is fairly easy to understand and manage, with long-term stability reported by most Medicare beneficiaries. We offer various Medicare Advantage Prescription Drug Plans and Medicare Supplement & Pharmacy plans in the area and can help you with your Medicare review, enrollment, and ongoing broker services.

Contact us about 4 months before you turn age 65, and we can help you with social security income questions, how to set up your Medicare parts A and B, plan review, enrollment, and more. If you are eligible for Medicare due to disability, contact us when you apply for disability, so you don't miss your Medicare health plan eligibility date. We are certified agents with The Centers for Medicare & Medicaid Services (CMS), and are contracted with numerous popular plans in the Oregon and Vancouver Washington areas.

Marketplace Income changes or other life changes
If you're enrolled in a Marketplace plan and your income or household changes, you should update your application with your changes as soon as possible. These changes, like higher or lower income, adding or losing household members, or getting offers of other health coverage, may affect the coverage or savings you’re eligible for. Read more here .
Programs and Services Spotlight
Small Business Health Care Tax Credit. This is a valuable tax credit for eligible small businesses who contribute to qualified group health plans for employees. We can help you with your eligibility determination and tax credit estimates. You can estimate your tax credit here .

Advanced Premium Tax Credit. This tax credit can pay some of the monthly individual health insurance premiums for those who qualify. We are marketplace certified brokers, and can help you with tax credit eligibility determinations.

Total Administrative Services Corporation (TASC) . TASC offers a complete suite of compliance and administrative services, and we are affiliated representatives. the financial risk and business disruption risk for non-compliance can be significant, if you are audited. Proactive compliance is recommended.

Ameritas Individual Dental ; Network dental plan, no application, no membership fee, no waiting periods, coverage for preventive, basic, major, orthodontics, and implants. Ameritas also has a PPO dental provider network.

What we are reading
Connect with Laughlin Insurance
Paris Laughlin, Agent, President (503) 282-0827

Stuart Ouellette, Agent (503) 282-0827

Victoria Monteblanco, Agent, Account Manager

Kai Krokum, Agent, Office Support

Yong Phou, Office Support

503-282-0827 Office | (503) 282-0830 Fax | (877) 779-0788 Toll-Free

Laughlin Insurance Report is a quarterly publication featuring the latest news of interest to employer, individual, and Medicare health insurance consumers. mat ion provided herein.