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Individual Market Update for 2018

Individual Email Template


Send this email to your non-grandfathered individual clients to inform them about the various options available to them for 2018 coverage.

Download the email template by clicking the button below.

As an alternative, you can copy the text below, modify the language as necessary, add the attachments, and email to your clients.

Body of Email:

Dear :


Open enrollment for individual Affordable Care Act (ACA) policies begins on November 1st and ends on December 15th for a January 1st effective date. This is different than previous years when open enrollment lasted until January 31st.


There will be fewer options available this year as many of the carriers have dropped out of the market. Cigna, Humana, United, and Aetna are no longer offering individual policies in our market. BCBSTX will continue to offer individual polices both on and off the exchange, however they will offer fewer plans. Baylor Scott and White (BSW) will offer just one HMO plan and one EPO plan (same as a PPO, but no out of network benefits). Please see the attached flowchart for the 2018 individual policy options.


As required by government regulations, you will receive a notice from BCSTX or BSW that your plan will end as of 12/31/2017 because most ACA plans are being discontinued due to modifications to deductibles, out of pocket maximums, and prescription benefits. This notice will arrive around October 1, 2017.


All currently enrolled BCBSTX members will be mapped to a 2018 plan with BCBSTX. You will receive a letter on or about 11/1/2017 from BCBSTX advising you of the new plan and the 2018 premium. If you take no action, you will be auto enrolled in that plan. If you are on a Silver or Gold plan, BCBSTX will also give you rates on two lower benefit plans. If you wish to change to one of those options, please contact us to assist you in enrolling in the plan. We will then be able to confirm receipt with BCBSTX and assist with any issues or concerns. These changes must be completed between 11/1/2017 and 12/15/2017. Be sure to make your January premium payment whether auto enrolled or if you select an alternate BCBSTX plan.


If you are currently on a BSW HMO plan, you will be auto-enrolled for 2018. You must pay the January premium to be effectuated. Do not delay paying the premium. You can change plans or carrier only between 11/1/2017 and 12/15/2107.


If you are on a BSW PPO plan, you must select a new plan. BSW is replacing the PPO plan with an EPO (same network), but it has no out of network benefits. You can choose either the BSW HMO or EPO plan and then contact us to assist you to enroll in that plan. Or you can choose to move to a BCBSTX plan and we will assist you to enroll in that plan.


Please let us know if you are married and a sole proprietor of a business filing a schedule C with your taxes, as you may qualify for a small group policy with BCBSTX or Baylor Scott and White which will give you access to PPO plans.


Please call with questions or if you need assistance. Thank you for being our client.

Documents to Include:

Open and save these documents, then attach them to the email.