All posts by Debbie Sears

Small Group Coverage

I have many Clients that are entrepreneurs. If your business is recognized via a tax-return of its own or shows up on your personal income taxes, and meets the criteria necessary for Wellmark to consider you as a small group, this is another opportunity to shop benefit plans and rates.

When I sit down with a Client that meets this definition, we have our current position and what that renewal is going to look like into 2017. We have an individual quote with several options and prices and we can also look at leaving the individual market (with its generally higher cost and renewals and stepping into the small business market. The plans and the benefits are similar with the networking opportunities for HSAs, deductibles and maximum out of pockets, but it may offer you a lower rate. It may offer you tax advantages (we offer no tax advice or recommendations, but your advisor may find value in this for you) as a pre-tax advantage. Because everybody’s situation is unique and different, the best way to learn more about this would be to call me for a free consultation.

BlueSimplicity from Wellmark

You may have received correspondence from your insurance company telling you that your plan is going to end. They could have told you that your current plan is going to end and offer you an alternate. Or they could have told you that you could stay on the plan you’re on and pay a 42% increase if you’re in the individual ACA market. So, none of these look to be good choices.

Wellmark has developed several new plans for 2017 that are definitely worth looking at. Some of the things to consider when you are looking for options to compare to your current situation, would be to understand some key terms. Bluesimplicity is the name of a product carefully developed by Wellmark to meet the needs of most of our individual market in Iowa. There are some important questions regarding Wellmark’s network, your prescription coverage and the premium. There are also many benefits that are built into the Wellmark promise such as BeWell24/7, Blue365 and MyWellmark that will be excellent reference tools for you and any of your children that may be traveling whether it be for sports or school or college. Within this product, there are co-pay plans so you would know a specific dollar amount that it would cost you to use a particular provider and there’s also the high deductible plans for those that understand and would like to take advantage of HSA options.

These are meant to be simple, hence their name, and they truly are. Change is change, but there’s always good to be found. I’m finding in working with a lot of folks that we’re able to fit them into a plan better suited to their needs with a little time and effort.

Bring It Home Event

We just celebrated our first five years by acknowledging key achievements of the Healthiest State Initiative.

In doing so, there is a new structure and a new program being announced at an event called Bring It Home. There are some infographics on here that help illustrate the structure.

hsi_bringingithome_logo

This new program is available for all communities. The Healthy Home, powered by Wellmark, is also introduced. There are a lot of good resources there that could be used by anybody. Please take a look at this. It is quite exciting. This does include a link to Healthy Home Town.

We don’t necessarily like the changes that have brought us to the juncture we’re at with the ACA because our price has gone through the roof, but we must understand that this is a reflection of the health of our nation and our state. Governor Branstad has invested a lot of time and effort into creating an awareness for all of us here, and in the end, we are the personal winners for being good custodians of our health.

This Healthiest State Initiative is proud to boast about their leadership, their investors and the approach it has been taking in improving the physical, social and emotional well-being of Iowans. It’s our vision to become the healthiest State in the nation. To accomplish that, we need to create an awareness of challenge, connect the needs with the resources to achieve our goals and improve the health of Iowans and the communities we live in. The goals for this program are to increase the number of Iowans living an active and healthy lifestyle, increase emotional well-being and decrease the number of Iowans who use tobacco. If these goals can be met, we would find that we would be happier and healthier. It would be a more attractive place to do business since improved well-being is linked to higher productivity, less absenteeism, higher retention, better engagement and lower health care costs.

I find this to be rather exciting and it is good reading for right after our Thanksgiving dinner. Setting some goals personally can be done quietly and internally, but the point of the matter is, be aware of your own personal health and set up some goals for yourself. The resources are endless, we couldn’t live in a better environment. To be in the Midwest of the United States of America, offers more bounty than anywhere I could never imagine. The choice is yours.

The Health of Iowans Page 1

The Health of Iowans Page 2

The Health of Iowans Page 3

Small Business Owners

If you are a small business owner, let’s talk.

First of all, let’s define what is “small business”. There are calculations and a formula that are used to determine if you are a small employer or a large group employer. These determinations were established by the Department of labor and the Internal Revenue Service.

And what we used to know as full time and part time is only partly the case in today’s world. We have what we call full time eligible, also known as FTE. People that would be FTE may be people that are seasonal employees, farmers or any person that would have a heavy schedule for four or five months of the year and then have an off-season with very few hours.

Depending on the time of the year, if the calculations used by the department of labor are true, they would be eligible and known as an FTE. Therefore, they would be entitled to the opportunity to participate in coverage. Please let me help you define the market or markets that you could be eligible for. Within those markets, we will run rates and show you every plan and by process of elimination, we can determine together what best suits your needs and your budget.

Your Enrollment Choices

During this Open Enrollment Period (OEP), you can make changes to your plan for effective date January 1, 2017. This opportunity will end December 15, 2016. If by chance you are a small business owner and do not offer coverage to your employees, or if you work by yourself and do not have employees, but you are recognized as a small business owner, please call me immediately.

There are two markets, one market is individual, another market is small group. If you’re in the individual market for 2017 and own an ACA plan, you will see an approximate 42% increase in your existing premium. I do not want you to overlook this opportunity if indeed you are eligible to compare the small group market to what you may currently have. Don’t panic, call me. If you choose to stay in the individual market and you want to make a planned change, this is also THE time.

Some Plans May Be Discontinued in 2017

In an effort to stay compliant with the Affordable Care Act (ACA), there will be product changes starting January 1. 2017. Each year Wellmark reviews their product offering to ensure they’re providing plans that are being used by their members and that they’re meeting the ACA requirements. While analyzing their products for 2017, there were several discoveries. Changes had to be made to some plans based on recent rules issued by the Federal Government.

These changes resulted in some plans looking very similar to plans they already offer:

Some plans have a small number of members enrolled costing more to maintain and administer than other plans.

As a result, effective January 1, 2017, they will no longer offer 10 ACA individual and famliy plans and 11 ACA small group plans.

You will be receiving a letter to this effect. Don’t panic. Call me. For the plans that are being discontinued, there are options that you can move into for 2017. Your coverage will be consistent and the transition will be seamless so that you will not be one minute without coverage. This applies to some individual and family plans as well as some group plans. Please call me if you get any letters to this effect. We have your best interests at heart and can make this as easy as possible.

Why I Wellmark

Sears Insurance prides itself in providing you with nothing but the best. It is quite the compliment to have you ask me to help you with your finances and your health. I consider these your two most valuable assets outside of your first born.

When it comes to health insurance, we are an independent agent and we represent several carriers. However, getting back to the integrity and quality that we stand for, Wellmark is our premier insurance carrier for your health insurance needs. There are a lot of reasons for that.

One of the greatest things that comes to my mind is the strength of the provider networks that you would have access to when using Wellmark. In the State of Iowa, they have 100% participation of hospitals and 99% participation of doctors. Their payment innovation yields the lowest cost of care without sacrificing quality of care. 95% of every dollar is spent on health care costs, which has netted Wellmark an A financial security rating from AM Best.

Their story is contained in this article and I think it’s imperative that you understand that they started over 100 years ago, they have been extremely well managed and consequently have adequate reserves to pay even the most catastrophic claims you may imagine.

Please enjoy this article and call me for quotes. Within this company, there’s a product that is suitable for everyone’s needs and their budget. Whether you are an individual under age 65, an individual over age 65 or if you are a business owner with a small or large business, this information is very important. Our quotes are free and I’m always happy to help.

Make the Fourth Quarter Count!

An easy way for me to share with you some important dates would be to provide you my Women of Worth (WOW) article. I contribute an article for every publication of the Women of Worth magazine that you will find in many professional locations, such as your doctor’s office. This particular article is for the October/November publication which takes into account the time frames for open enrollment, annual enrollment, initial enrollment, many important dates, whether you’re under age 65 or over age 65. I have also included in this article some information for small and large group owners and/or administrators as well as some basic information on life insurance and long-term care. Please know that we are always focused on disability income coverage as well. If you have any questions, any needs, or would like to know more specific information as it pertains to your specific information, please call us.

 

Fall means many things to many people. The weather changes, we start wearing warm, comfy clothes, and for some, it’s a time to watch football all season long! The fourth quarter is by far the most important part of the game. The teams with the most depth often come back from near defeat to pull out a victory in the final minutes of the game. Why are they able to win? Because the coaches and players have prepared for adversity, planned well, and were able to draw upon the inner strength needed to finish strong.

In the insurance world, the fourth quarter is important, too. It’s that time of year when businesses and individuals need to start positioning themselves for the New Year. Whether or not you are a group or individual, take this time to start thinking about your insurance “game plan” for 2017. This article will serve as a reference guide for important dates and information that you need to know.

Under Age 65 • Important Dates for 2017 Enrollment:

November 1, 2016 – This is the first day you can enroll in a 2017 Marketplace plan.  2017 plans and prices will be available for preview the third week of October 2016.  Until then, you can still get coverage for 2016 if you qualify for a special enrollment period due to a life change like marriage, having a baby or losing other coverage, etc.

December 15, 2016 – The last day to enroll in or change plans for new coverage to start January 1, 2017.

January 1, 2017 – Coverage starts for those who enroll or change plans by December 15.

January 15, 2017 – The last day to enroll in or change plans for new coverage to start February 1, 2017.

January 31, 2017 – Open Enrollment ends; any enrollments or changes made between January 16-31 take effect March 1, 2017.

If you miss the January 31 deadline, you can’t enroll in a health insurance plan for 2017 unless you qualify for a Special Enrollment Period.

Over Age 65 • Important Dates for 2017 Enrollment in Medicare Part D:

  • Initial Enrollment Period – This is the first time you can enroll and it is a seven-month period that begins three months before you first become eligible for Medicare.
  • Annual Enrollment Period – The timeframe when you can enroll or switch plans is from October 15 to December 7 with changes effective January 1.

The determination of which plan you should choose is done by providing a list of your meds and dosages. The plans work with a premium, sometimes an annual deductible and co-pays for the different tiers of the meds you are taking.  I could recommend one plan for you and a different plan for your friend. Monetarily, it is well worth the while to get this right.

Small & Large Groups

On the group side, there are a lot of changes happening now and also scheduled to take place in the upcoming year. Schedule an appointment so that I can look at your current benefits and past reports to understand better what your members utilize. Do you have the right plan? Is it in direct correlation to the amount you a re paying?  Let’s look and see just exactly where you are and if you need to make a change; you will have options.

Life Insurance and Long-Term Care

From basic coverage to extreme estate planning and business succession, there is something for every need. Long-term care protection is a necessity, but did you know that it can be incorporated into your life insurance? If you do not use it, you have not paid premiums for no gain. Disability income protection is also extremely important. If your income stops it affects a lot of people… your family, your co-workers and your business partners.

Let us help you make the transition into 2017 without the rush and the pain that usually goes along with the insurance process. As always, we are so thankful for your business throughout the year as well as your referrals. The professional confidence that you have placed in me and my agency is the greatest compliment you could express.

Sears Insurance has been trusted by families and businesses spanning four generations for their health insurance needs.  We have been recognized as being in the Top 1% for Wellmark Blue Cross and Blue Shield in Iowa. Learn more about us on our website www.searsinsurance.info, or follow our RSS feed and “like” us on Facebook to receive the most current information.

Ask about Blue Rewards – a product that is a collaborative effort utilizing the homegrown and trusted resources of Wellmark, Hy-Vee and UnityPoint.

Under Age 65 – Open Enrollment

If you are under age 65, this is the time of the year referred to as “Open enrollment”. You will be able to enroll or change your plan for an effective date of January 1, 2017.

In the meantime, I have an opportunity to share with you some basics. Why you need health insurance, the cost, the coverage and the benefits and how to choose a doctor.

The first article that I’d like to share with you is called, “Helping you understand health insurance“. This covers the importance of health insurance starting with the basics, including the affordable care act.

The next article is health insurance costs. This will explain to you how to keep your costs down, how to get the facts on the premiums and how to control your out of pocket costs.

By law, every health insurance plan has to cover a few of the basics, called EHB or essential health benefits. There are 10 benefits and I have those for your reference by category.

And the final ones are referred to as, “Your benefits in action“. This entails choosing a personal doctor and knowing where to go an explanation of your benefits when to file your claims and pre-service reviews along with information on your ID card as well as what is referred to as your blue card.

I will be posting important dates for you going forward, so please stay in touch. If you have questions, I’m always here.

Medicare 101

I will be discussing more about important dates for people over 65 in the very near future.

In the meantime, for those of you that are new to Medicare or, anybody that wants a quick and easy refresher course, Wellmark offers Medicare 101. This explains the original Medicare and the various parts.

The parts of Medicare are referred to with alphabetical categories as you will see in scrolling through this article. It will also tell you how to choose so your specific needs are best addressed. It will let you know when you are eligible and how you can enroll.

After a person enrolls in Medicare, they would need to buy a Medicare supplement plan and a prescription drug plan. You will notice towards the bottom of this article that you will have the ability to view the plans that are available. I am a large proponent of Medicare supplement plan F. This gives you the most comprehensive coverage. In light of our medical costs in today’s world, this is more important than ever. On the Part D which is the prescription drug coverage, you will see an opportunity to view the plans available.

Stay in touch as I will be sharing more information for you and important dates in the near future.

Related Posts Plugin for WordPress, Blogger...