This document summarizes key aspects of healthcare reform in the United States, including changes taking effect in 2014. It outlines elements like the individual mandate requiring health insurance, subsidies for low-income individuals and families, coverage of pre-existing conditions, open enrollment periods, and the roles of licensed insurance agents versus navigators in assisting with plan selection and enrollment. The reform will lead to major rate increases for individual plans, so the document advises working with a licensed agent to find an affordable plan on or off the new insurance exchanges.

1. Healthcare Reform
Billy Jordan, Jr.|The Jordan Insurance Agency

2. What does it mean for you?
Understanding the impact of Healthcare Reform

3. Objectives : Healthcare Reform
 Healthcare Law pass in March 2010
 Preventive Services law changed in September 2010
 Change in benefits for Individual plans in 2014
 Non-grandfather vs. grandfather plans
 Pre-existing condition law starting Jan 2014
 Open enrollment period
 Rates Increase 40-100% for Individual Plans
 Subsidy and how to qualify ( 1.2 million will qualify)
 Penalty for not buying qualified health insurance (QHP)
 Insurance Carriers participating in North Carolina exchange
 Licensed Insurance Agents
 Navigators (20 hours training ) No licensed or Error & Omission Insurance required

4. Subsidies for Individuals and Family
100% 133% 150% 200% 300% 400%
1. 11,490 15,282 17,235 22,980 34,470 45,960
2. 15,510 20,628 23,265 31,020 46,530 62,040
3. 19,530 25,975 29,295 39,060 58,590 78,120
4. 23,550 31,322 35,325 47,100 70,650 94,200
5. 27,570 36,668 41,355 55,140 82,710 110,280
6. 31,590 42,015 47,385 63,180 94,770 126,360
7. 35,610 47,361 53,415 71,220 106,830 142,440
8. 39,630 52,708 59,445 79,260 118,890 158,520

5. Pre-existing condition rule in 2014
 Kids with pre-existing conditions cannot be turned down for insurance (2010)
 Adults with Pre-existing conditions can not be turned down for major medical health insurance
( 2014)
 Guaranteed Access to health insurance in all 50 states (2014)
 Jan 1, 2014 All pre-existing conditions, medicine, and treatment covered

6. Mandated Insurance changes : Essential Benefits
:
• Ambulatory patient services
• Emergency services
• Hospitalization
• Maternity and newborn care
• Mental health and substance use disorder services, including behavioral health treatment
• Prescription drugs
• Rehabilitative and habilitative services and devices
• Laboratory services
• Preventive and wellness services and chronic disease management
• Pediatric services, including oral and vision care

7. Open Enrollment:What you need to know to get
started?
• October 1- March 31st (6mos ) 1 st year only
• Tax Return filed with IRS for year (2012)
• Federal application for Subsidy
• Health application for Insurance
• Licensed Insurance Agent Navigator ( New position created by Federal Government )

8. LicensedAgent vs. Navigator :Who can I trust?
• 40 hours of classroom required with state exam of 70%
• 24 C.E. credits required every 2 years
• Error & Omission Insurance
• Background Check
• Receive ongoing training from various carriers and new products on a monthly basis
• No-fee for using licensed insurance agent
• Customer Advocate

9. Licensed Agent vs. Navigator :What is a Navigator and
what is there roles?
• 20 hours of training and must pass exam
• (Reduced from 30hrs because not enough time to train before Oct 1)
• Not Licensed
• E& O Insurance not required
• Fee charged by Exchanged for plans purchased that helps pay for Navigator
• Little to no experience with health insurance or insurance in general
• Limit product knowledge (Cannot discuss any plans or carriers outside of the exchange)

10. Ways to handle the huge rate increase coming for Individual
plans?
 Have a strategy for getting the right insurance plan (On and Off exchange)
 Know what your needs are and how to determine the right plan
 Find a licensed Independent Agent or Agency to work with (Don’t go alone)
 Shop Insurance Carriers
 Customer Reviews of agents past customers (Look for someone with the heart of a teacher)

11. Recap of Changes in Healthcare in 2014
 Open Enrollment- Don’t Wait!
 $1.2 millions subsidy individual and families in North Carolina
 All pre-existing conditions will be covered
 Choosing a LicensedAgent or Navigator

12. “QUESTIONS”

13. Contact Information
Billy Jordan, Jr.
704-926-7565 Office
www.thejordaninsuranceagency.com
13860 Ballantyne Corporate Place Suite 120 A
Charlotte, NC 28277
Joyce Palmer
JP Financial Services, LLC
704- 543-6269
301 McCullough Drive
Charlotte, NC 28262

14. Notes