Important Special Enrollment Period Update

The Open Enrollment period to enroll in ACA compliant health insurance in CA is over; that ended January 31. Special Enrollment is a provision in the ACA law that protects those that have a disruption (called a Qualifying Event) in their existing health insurance outside of the Open Enrollment period. Common among these events include the loss of group insurance, the exhaustion of COBRA, and moving to another state. In most cases, you’ll have 60 days prior to the qualifying life event and 60 days after the event to enroll in available ACA compliant insurance with the effective being the first of the month following your enrollment, but no earlier than the date of the qualifying event. Here is more information about qualified life events and eligibility: Qualifying Life Events for special enrollment. Contact our office about your specific situation to learn more about the options available.

Anthem Blue Cross grandfathered members: Unique to some states including California is a qualifying event that protects those who are impacted by a rate increase to their grandfathered health plans. Grandfathered plans were those in place prior to when the ACA law took effect and didn’t have to comply with many of the ACA requirements. In California, Anthem Blue Cross will have an April 1, 2020 rate increase on their remaining grandfathered plans. Those effected by this increase will qualify for special enrollment and be allowed move to any ACA complaint plan if they wish with the enrollment period being the same as stated above. Contact us for more information about this special enrollment opportunity.

New Short Term Special Enrollment: California has just announced a new special enrollment opportunity for those who remain unaware of the new state subsidy and new state penalty. With the federal government removing the penalty for not carrying qualified insurance, California has installed their own penalty for those residents who do not carry compliant insurance in 2020. In addition, Covered California, the state’s public marketplace, has added new state subsidies that goes beyond what the Affordable Care Act’s financial assistance provides. Those “uninformed” of these new changes can take advantage of this special short term enrollment opportunity through April 30, 2020. Specifically, this allows the uninsured additional time to enroll in coverage (and avoid a penalty) and those currently insured in the private market who wish to enroll through Covered California to take advantage of new state subsidies. For more information and assistance about this enrollment opportunity, visit:

Happy to answer your questions.

Phil Dougherty

2020 California Health Insurance Marketplace

OnlyHealthInsurance will once again be assisting our clients and their referrals with health insurance from the private market (also referred to as off-exchange). In 2020, there are two important changes to the California health insurance marketplace; one that applies to those enrolling through the public exchange (CoveredCA), and another that applies to both the public and private exchanges.

1). California is implementing a new state subsidy program which is estimated to qualify 235,000 more Californians for assistance in paying insurance premiums who previously did not qualify. The income limits for the subsidy are higher than the federal ACA premium tax credit subsidy. Where the federal subsidy provided assistance to households with incomes under 400% of the federal poverty line, the state program will provide subsidies to households with incomes between 400% and 600% of the federal poverty level. Subsidies are only available to those who enroll through CoveredCalifornia, the state’s public marketplace. See income chart below. For more information about CoveredCA plans and subsidies visit, or call CoveredCA at 800-300-1506.

2). Along with a few other states, California is implementing its own individual tax penalty mandate. The previous penalty on the federal level was removed by law and no penalty applied in 2019. In 2020, permanent CA residents who can afford health insurance but choose not to purchase it, whether through CoveredCA or the private market place, may be subject to a tax penalty which they will see in their state tax filing. The penalty is 2.5 percent of household income or $696 per adult whichever is greater. The money raised will go towards funding the new state subsidy program. To learn more about the penalty and exemptions, visit:

To learn more about the California health insurance marketplace, visit our web page where you can also view an explanatory video: California Health Insurance. For private market insurance information and quotes, visit OnlyHealthInsurance .

2020 Subsidy

Travel Insurance for the Frequent Traveler


Medicare and most domestic medical insurance policies offer little or no coverage when traveling abroad, so travel insurance fills a significant gap. With the frequency of travel increasing for all demographics, the market has responded in kind. Annual policies that cover each trip taken in a twelve month period are now available. And, with just two or more trips in a year, these policies are typically cheaper than buying policies on a trip by trip basis. “Multi-Trip” travel plans provide the medical insurance and evacuation benefits found on traditional travel insurance, and some carriers even include coverage for services resulting from a pre-existing condition. To learn more, give us a call or visit our web  page:

Happy travels,

Phil Dougherty

Special Enrollment Period Reminder Update

With the 2017 Open Enrollment Period ending January 31st, the opportunity to enroll in ACA compliant Individual or Family health insurance is now limited to those with a qualifying life event.

If you experience a qualifying life event, you can take advantage of a special enrollment period (SEP) to make changes to your existing individual health plan or buy a new one. In most cases, you’ll have 60 days prior to the qualifying life event and 60 days after the event to enroll with the effective date being first of the month following your enrollment.

Here is more information about qualified life events and eligibility: Qualifying Life Events for special enrollment

It should be noted that an eligible life event does not in itself guarantee enrollment. Documentation showing proof of such an event is needed and requirements and deadlines do vary among the different insurance carriers.  Some are stricter than others. Some for example, may require two or more pieces of evidence to show proof of residency and/or prior insurance.

Special note to Anthem Blue Cross members of terminating plans: A qualifying life event includes an individual health insurance policy (including “grandfathered” and “non-grandfathered” health insurance plan) that has expired or will soon expire. Anthem Blue Cross of CA is terminating some of their Grandfathered contracts Feb. 28, 2018, and would qualify as a life event for policyholders to obtain a replacement ACA compliant policy through the private market or public exchange (CoveredCA).

Let me know if you have any questions.

Phil Dougherty

Health Insurance Open Enrollment Continues

We are in the third and final month of open enrollment. This is the time when one can enroll in individual or family health insurance or change health plans for the next calendar year. With the new year already in progress, the next available effective date is February 1. To obtain a February 1 effective date you just enroll by January 15th. Enrolling from Jan 16 through Jan 31 results in a March 1 effective date (the last available effective date of open enrollment).

For those who leave an employer sponsored plan, move, get married, or have another qualified life event, there is a special enrollment opportunity to enroll in coverage.

Note: This open enrollment period is not for those in Medicare.

Let us know if you have any questions or need help finding coverage.

Thanks, Phil Dougherty

2018 HSA Guidelines & More

The Treasury Department and Internal Revenue Service (IRS) issued the 2018 guidelines on the maximum contribution levels for Health Savings Accounts (HSAs), the minimum deductible amounts and the out-of-pocket maximum amounts.

The 2108 requirements are:

HSA Contribution Limits

  • Individual Contribution Limit: $3,450
  • Family Contribution Limit: $6,900

HSA Deductible Amounts

  • Individual Minimum Deductible: $1,350
  • Family Minimum Deductible: $2,700

HSA Out-of-Pocket (OOP) Amounts

  • Individual OOP Maximum: $6,650
  • Family OOP Maximum: $13,300

Please note: an individual or family plan that meets the deductible and out-of-pocket requirements, doesn’t necessarily qualify one to open an HSA. A plan designated as High Deductible Health Plan (HDHP) will meet these and other requirements necessary for HSA participation. Make sure your plan has HDHP included in its name and/or summary of benefits.

HDHP plans are available through the ACA (CoveredCA and private market) from many carriers and typically are found in the Bronze level of plans, a lower premium category. With rising premiums, HDHP plans coupled with a HSA account, may provide a more balanced long term health insurance solution.

For more information about HSA’s and how they work, visit our web page: