BCBSAZ 2016 Individual/Family Plan Renewal

August 27, 2015

bcbsaz logo

This week, Blue Cross Blue Shield of AZ (BCBSAZ) unveiled their new proposed plan and premium information for individuals and families in 2016.

There are many changes, and many customers will be required to take action to avoid losing coverage at the end of the year.  We are prepared to assist these customers with this process as early as September 9th.

Although BCBSAZ will be sending written notification to all affected members in the coming months, we wanted to provide the information in advance to help better prepare these customers for this year’s renewal.

These are the most important changes to know for 2016:

  1. Metal level plans (Platinum, Gold, Silver, Bronze) are considered ACA-compliant plans, since these were plans purchased and effective from January 2014 to now.
  • In 2015, these plans included three networks:  Statewide PPO, Alliance HMO, and Select HMO.   For 2016, BCBSAZ will only offer the two HMO networks in Maricopa County…the Statewide PPO plan is being deleted.   If you have an ACA-compliant plan with the Statewide PPO network, either purchased through the federal marketplace or directly from BCBSAZ, you MUST select a new plan by December 15th to avoid losing coverage on January 1st.  Customers living in all other counties will have access to the Statewide PPO network, as well as another regional network.  Note: the HMO plans do NOT require a primary care physician assignment, NOR do they require a referral to see a specialist.  However, it is important to check the list to make sure desired doctors participate in the network or else they are not covered.
  • The BlueEssential & Copay Complete plans have been deleted, so these customers will need to move to a new plan, as well.
  • For customers on a plan with either the Alliance or Select network, BCBSAZ will automatically enroll in the next closest available plan available for 2016.  This does not preclude you from changing your plan during open enrollment (November 1 – January 31), so contact our office if alternative choices are desired.
  • BCBSAZ ACA-compliant plans experienced an average rate increase of 21.4%.

2.  Grandmothered Plans are those plans purchased and effective between 2010-2013, and will include the word ‘Plus’ in the name of the plan.

  • All of these plans are being renewed without any changes to benefits or to the PPO network.
  • The average rate increase on these plans is 21.2%, however, the new rate will be guaranteed until April 30, 2017.  This will lock in the rates for a full 16 months.
  • Despite the increase, these plans continue to offer greater premium savings over the ACA-compliant plans.  Most customers in these plans will want to keep what they have.
  • Nothing is required to keep these plans, but customers still have the ability to either 1) change the deductible to lower the premium, or 2) consider moving to an ACA-plan during open enrollment (November 1 – January 31) if desired.  If a member moves away from a Grandmothered plan, they cannot get it back later.  We are able to assist with customers with this evaluation.
  • BCBSAZ will be sending a letter to each affected customer on October 12th.

3.  New Dental Plan

  • BCBSAZ is now offering their group BluePreferred Dental plans to individuals and families.
  • Contact our office if interested in private PPO dental coverage from BCBSAZ

We suspect there will be many changes in 2016 from all of our carrier partners.  We know there will be many questions, and we are here to answer them.  Please keep in mind that this is an extremely high-volume time of the year, so time is of the essence…the sooner you take action, the smoother the process will go for you.

Thank you to all 266 of our individual BCBSAZ customers.  We look forward to serving you during this time of change.



Supreme Court Rules on ‘OBAMACARE’

June 25, 2015

June 25, 2015

Last night, a key provision of the Affordable Care Act (ACA) was upheld by a 6-3 Supreme Court vote which rules that federal subsidies for private health insurance plans remain available in all states, including states where consumers use the Federally Facilitated Marketplace (FFM) to obtain subsidies.  You can read the full decision here.

This includes the state of Arizona; your health care coverage remains unaffected and any subsidy you are receiving will continue, as long as you continue to meet the current eligibility requirements of the law.

L&A Services will continue to focus on serving clients to help make good decisions on coverage for care in our ever changing US health care system.

Health Insurance Enrollment Deadline Extended…again

February 20, 2015

CMS Announces Special Health Insurance Enrollment Period for Tax Season

Eligible consumers now have from March 15 through April 30 to enroll in coverage.

The Centers for Medicare & Medicaid Services (CMS) announced today a special enrollment period (SEP) for individuals and families who did not have health coverage in 2014 and are subject to the fee or “shared responsibility payment” when they file their 2014 taxes in states which use the Federally-facilitated Marketplaces (FFM). This special enrollment period will allow those individuals and families who were unaware or didn’t understand the implications of this new requirement to enroll in 2015 health insurance coverage through the FFM.

For those who were unaware or didn’t understand the implications of the fee for not enrolling in coverage, CMS will provide consumers with an opportunity to purchase health insurance coverage from March 15 to April 30.  If consumers do not purchase coverage for 2015 during this special enrollment period, they may have to pay a fee when they file their 2015 income taxes.

Those eligible for this special enrollment period live in states with a Federally-facilitated Marketplace and:

  • Currently are not enrolled in coverage through the FFM for 2015,
  • Attest that when they filed their 2014 tax return they paid the fee for not having health coverage in 2014, and
  • Attest that they first became aware of, or understood the implications of, the Shared Responsibility Payment after the end of open enrollment (February 15, 2015) in connection with preparing their 2014 taxes.

The special enrollment period announced today will begin on March 15, 2015 and end at 11:59 pm E.S.T. on April 30, 2015.  If a consumer enrolls in coverage before the 15th of the month, coverage will be effective on the first day of the following month.

This year’s tax season is the first time individuals and families will be asked to provide basic information regarding their health coverage on their tax returns.  Individuals who could not afford coverage or met other conditions may be eligible to receive an exemption for 2014. To help consumers who did not have insurance last year determine if they qualify for an exemption, CMS also launched a health coverage tax exemption tool today on HealthCare.gov and CuidadodeSalud.gov.

“We recognize that this is the first tax filing season where consumers may have to pay a fee or claim an exemption for not having health insurance coverage,” said CMS Administrator Marilyn Tavenner.  “Our priority is to make sure consumers understand the new requirement to enroll in health coverage and to provide those who were not aware or did not understand the requirement with an opportunity to enroll in affordable coverage this year.”

Most taxpayers, about three quarters, will only need to check a box when they file their taxes to indicate that they had health coverage in 2014 through their employer, Medicare, Medicaid, veterans care or other qualified health coverage that qualifies as “minimum essential coverage.”  The remaining taxpayers – about one-quarter – will take different steps. It is expected that 10 to 20 percent of taxpayers who were uninsured for all or part of 2014 will qualify for an exemption from the requirement to have coverage. A much smaller fraction of taxpayers, an estimated 2 to 4 percent, will pay a fee because they made a choice to not obtain coverage and are not eligible for an exemption.

Americans who do not qualify for an exemption and went without health coverage in 2014 will have to pay a fee – $95 per adult or 1 percent of their income, whichever is greater – when they file their taxes this year.  The fee increases to $325 per adult or 2% of income for 2015.  Individuals taking advantage of this special enrollment period will still owe a fee for the months they were uninsured and did not receive an exemption in 2014 and 2015.  This special enrollment period is designed to allow such individuals the opportunity to get covered for the remainder of the year and avoid additional fees for 2015.

The Administration is committed to providing the information and tools tax filers need to understand the new requirements. Part of this outreach effort involves coordinating efforts with nonprofit organizations and tax preparers who provide resources to consumers and offer on the ground support. If consumers have questions about their taxes, need to download forms, or want to learn more about the fee for not having insurance, they can find information and resources at www.HealthCare.gov/Taxes or www.IRS.gov. Consumers can also call the Marketplace Call Center at 1-800-318-2596.  Consumers who need assistance filing their taxes can visit IRS.gov/VITA or IRS.gov/freefile

Consumers seeking to take advantage of the special enrollment period can find out if they are eligible by visiting https://www.healthcare.gov/get-coverage Consumers can find local help on www.healthplansarizona.com or by calling L & A Services at 602-996-6010.  The call is free.

Additionally, here are helpful links on Tax Roll-out:

Blog.CMS.gov blog


HealthCare.gov blog English:

Is your Form 1095-A correct?

Spanish version:
¿Está correcto su Formulario 1095-A?

Press Release:


Exemption Tool:



February 5, 2015

bcbsaz logocignabannerHealthNet LogoAetna LogoHumana Logo

All individuals who have yet to enroll for health insurance coverage for 2015:  REMINDER – Sunday February 15th is the FINAL DAY of OPEN ENROLLMENT for the plan year 2015. 

Also, remember that the “shared responsibility payment” imposed for 2015 will be 2% of an individual’s adjusted gross income. Seek a tax expert if necessary. 

Those who still need to enroll for a policy and would like to see if their household’s income qualifies for a federal subsidy in the form of a tax credit or premium assistance you may CONTACT OUR OFFICE or go directly to Healthcare.gov to confirm the amount. 

Once your application is submitted call our office at 602-996-6010 for help choosing a plan.

Your enrollment has to be completed by Sunday 2/15/15 for coverage effective 3/1/15.    

At Healthcare.gov please include your agent, Ben Rosky’s information so L&A Services is established as your Broker Of Record (BOR).  Use the NPN number:  6747133.   

Email ben@lnaservices or help@lnaservices.com with any questions.  

Thank you.  We appreciate our friends and we value their trust in L & A Services, Inc. for their insurance needs for almost 30 years.

HealthNet Update for 2015

October 9, 2014

HealthNet Logo

HealthNet of Arizona, Inc. (HealthNet) is streamlining their Individual & Family Plan HMO portfolio for 2015 with fewer plans.

In 2014, Health Net offered more than one HealthNet CommunityCare HMO health plan in each of the metal tiers: Platinum, Gold, Silver, and Bronze.  We are expecting this to change for 2015.

Automatically, members who enrolled directly with Health Net (i.e., off the marketplace) will be moved to similar plans.  If you like the new plan, you don’t have to do anything to keep it.

However, your agent, L&A Services, Inc. is available to assist you in choosing a new plan for 2015 if you would like to explore your options.

Members who enrolled via the Marketplace are asked to go back to HealthCare.gov during Open Enrollment and actively choose the plan they want for 2015. Don’t forget you need your broker’s name (Benjamin Rosky) and National Producer Number (6747133) to ensure proper service.

Contacting the Marketplace is also necessary for members who qualify for tax credits to get the right amount for 2015.

Member Notifications

90-day plan closure notices to members mailed October 2, 2014.

NOTE:  Regulatory approval is still pending for 2015 plans. Once approved, plan information details will be communicated here.  Until then, Health Net does not have any plan information to release.

Am I getting a check in the mail? Medical Loss Ratio Rebate Update

July 22, 2014

The Affordable Care Act requires insurance companies to spend a certain percentage of the premiums they collect on medical services & programs that directly benefit their insureds. If an insurance company fails to meet this requirement by not spending enough on medical benefits, they must issue a refund to the policyholders during the summer of the following plan year.  This is known as a Medical Loss Ratio Rebate.

These calculations are based on a number of aggregated factors, including the type of plan (small group, large group, or individual) and the state where the plan is set up.

Rebates for the 2013 plan year have already started. Below you will find general rebate information received from the different insurance companies for Arizona policyholders:

Company                                                                   Rebate?
HealthNet                                                                    None
BCBSAZ                                                                        Small Group only
Aetna                                                                            Yes
United HealthCare (Small Group)                           No
Aetna (Small Group)                                               HMO plans only
Assurant Health                                                        Small Group Only
IHC Health Solutions                                              Small Group Only

Individuals and families receiving a rebate may use it as they wish.

Employers, on the other hand, must spend the rebate for the benefit of the plan participants in a fair and equitable manner .  Contact us for recommendations on how to do this properly.

Arizona approves extending health plans

May 8, 2014

Great news!  This morning, I received the following press release from AZ Department of Insurance announcing they will allow insurance companies to continue non-Affordable Care Act compliant plans for another year…to 2015!  We still have to wait to see how the insurance companies will react, so there are no guarantees on how this will affect you and your health insurance policy.  We will post more on this topic as we receive timely and relavent information.





2910 North 44th Street, Suite 210, Phoenix, Arizona 85018-7269 · (602) 364-3471 · FAX: (602) 364-3470

Media Contact:

Erin H. Klug
Life & Health Division
(602) 364-3762


For Immediate Release
May 8, 2014

Director Announces ACA Extended Transitional Policy Decision


Phoenix – The Arizona Department of Insurance today announced that insurers that renewed existing plans, on or before December 31, 2013, that otherwise would have been modified or canceled under the Affordable Care Act (ACA), may renew that coverage. “Following our December 2013 announcement allowing insurers to early renew these plans, a significant number of Arizona policyholders that had the opportunity to keep those policies chose to do so,” Insurance Director Germaine Marks said. 

On November 14, 2013, the Center for Consumer Information and Insurance Oversight (CCIIO) announced a policy that permitted health insurance issuers to continue to renew plans for individuals and small businesses for plans in place as of October 1, 2013. CCIIO determined it would not apply nor enforce certain provisions of the ACA to the policies that do not meet minimum coverage requirements and financial protections under the ACA.  On March 5, 2014, CCIO issued a bulletin addressing the extended transition of these policies and left the decision to the states whether or not to adopt the extension.
Marks said listening to insurers who want to continue offering these plans and to consumers who wish to be able to keep them led to the Department’s decision. Arizona law, read in conjunction with CCIIO’s bulletin, does not preclude insurers from renewing this group of policyholders’ coverage.  “Ensuring that Arizona’s consumer have choice in the insurance market and encouraging insurers to provide that choice, when appropriate, is consistent with the Department of Insurance’s mission.”
As before, the Department will not compel any carrier to renew the early renewed policies.  Carriers will assist policyholders who choose not to keep these policies with finding alternative affordable coverage.
About the Arizona Department of Insurance
The Arizona Department of Insurance, an agency of the State of Arizona, is responsible for the education and protection of insurance consumers and for oversight of the insurance industry in the state.