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Signing up for health coverage? Check for more than monthly premiums

Published: Saturday, Oct. 5, 2013 5:30 a.m. CDT • Updated: Saturday, Oct. 5, 2013 8:40 a.m. CDT

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From what Mike Deagle has seen, in 2014, most people should have little trouble finding a health insurance plan that carries a monthly premium they can afford.

The problem, Deagle said, a health insurance broker and owner of Batavia-based Deagle Benefit Group, comes in the many other ways health insurance policies are changing next year.

“The premiums have not been as crazy as I’d feared,” Deagle said. “But while the prices might seem OK, there are other things to watch out for.”

The so-called health insurance marketplaces opened Tuesday, allowing Americans who will be required to purchase health insurance next year to explore their options under the Affordable Care Act.

The electronic marketplaces have opened to conflicting reviews, with government officials and ACA supporters cheering “high demand” and Obamacare critics lamenting glitches and low service levels.

Deagle, president of the Illinois State Association of Health Underwriters, said the “actual process has been slow” so far. To that end, he is advising clients to wait “a couple of weeks, until things die down.”

But unless someone wants to qualify for a subsidy or tax credit to offset their costs, they should avoid the government marketplaces and head to the private market, he said.

Deagle said the choice of plans is greater outside the government marketplaces. However, no matter the plan, Deagle said individuals and small employers should examine the plans carefully.

While premiums may appear reasonable, he said deductibles and out-of-pocket costs may have been increased sharply.

He noted that an individual plan he examined increased the maximum out-of-pocket cost from $5,200 a year to $12,700.

Additionally, Deagle said those purchasing insurance should look at other terms. For instance, he noted that, to hold costs down, some insurers have trimmed the size of their provider networks. Many who obtain health insurance through employers likely will see little change in their coverage.

Deagle said many employers with whom he works have opted for an early enrollment option through insurers, under which employers are allowed to keep the plans they now have for 2014. However, even with re-enrollment options, some employers are facing steep cost hikes next year.

Marcia Boyce, owner of Boyce Body Werks in Batavia, said her costs will rise by 32 percent next year, if she re-enrolls now. That followed a 33 percent increase earlier this year.

While she had intended to provide health insurance to her workers, she said now she may just follow the lead of many other employers, large and small, across the country, and offer her employees stipends to purchase individual coverage in the ACA marketplaces.

“It’s very discouraging,” Boyce said. “I wish I didn’t have to, but rates have increased so drastically, I’m just going to have to gamble and see what happens when my plan comes up for renewal in March.”

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