If you are an employer group that has a January 1 renewal, your deadline is tomorrow.
This is your opportunity to renew your group employee benefit package as is or adopt new changes. Please do not wait until the last minute on the last day to do this. It usually does not net a smooth transition. Call me. It’s very important you review these documents to know where you are. P.S. your payroll department will appreciate this.
The product portfolio for small group employers would have four distinct plan types. These are very easy to navigate and they cross all networks.
Four plans will be offered and four networks of providers for those plans, so you’ll have 16 choices available to you. The idea for this was to make things easier, better pricing and something for everyone from the least compensated to the greatest compensated employee in the workplace. Please call me for details.
There are changes in the Small Group market coming in 2020.
All Small Group ACA plans will have a point of service network option available. This plan design provides a lower price point option for groups who prefer an HMO network, but would like the protection for out of network needs. There will also be modified plans which will be available across all Wellmark networks and metallic tiers. This lessens confusion with no co-insurance, one out-of-pocket amount (your deductible and your out-of-pocket maximum are the same), with familiar cost-share structures.
If you have Medicare and a Medicare supplement policy, you also will need a Part D prescription drug plan.
Wellmark is the plan that has been most favored over the years and the new plan designs for 2020 and their pricing will be available when you contact me.
There’s also another plan that can be considered, called Journey Rx. And there are a couple options for that choice as well. The way to determine which plan you would want is based on your prescription drug list which would include the drug name, the dosage and how many times per day you take it. We would use a drug calculator that will show you in black and white what the bottom line looks like so that you are making good choices going forward.
If you feel that you are confused each year about your health insurance, particularly at about this time of the year, you are not alone. I am available for consultations by appointment. I am going to give you some glossary terms so that you can decipher the industry jargon. It is an important time of the year for Medicare enrollees or Medicare eligible people, with opportunities to make changes in your plans for 2019.
Medicare open enrollment (OEP) – also known as the annual election period (AEP) or annual coordinated election period – refers to the annual period during which Medicare plan enrollees can reevaluate their coverage — whether it’s Original Medicare with supplemental drug coverage, or Medicare Advantage — and make changes if they want to do so.
During Medicare open enrollment, a beneficiary can switch Medicare Advantage plans, switch from Medicare Advantage back to Original Medicare or vice versa, join a Medicare Part D prescription drug plan, switch from one Part D plan to another, or drop Medicare Part D coverage entirely. But the annual open enrollment does not apply to Medigap plans, which are only guaranteed-issue in most states during a beneficiary’s initial
enrollment period, and during limited special enrollment periods.
Medicare open enrollment begins on October 15 and ends on December 7, with changes effective on January 1.
The best window of time to buy a Medigap policy begins on the first day of the month in which you turn 65 and have enrolled in Medicare A and B (you have to be enrolled in both Medicare A and B in order to get a Medigap plan). The Medigap enrollment period includes three months prior to your birth month, your birth month, or three months after your birth month. This window of time is known as your Initial Enrollment Period (IEP).
Self-employed persons should consider purchasing benefit packages for your employees as a group plan. These plans are a great opportunity for you to attract and retain quality employees. It is very costly to recruit, interview, hire, train and get an employees productive… if they work out. This represents a lot of time and cash lay out. To ensure that your efforts are most effective, benefits are important. They are important to the employer for the ways outlined above. They are very important for the employees. The individual market in Iowa is very limited and expensive. So, we encourage small employers to look at this option. We work with CPAs to make sure that this is implemented properly so that you are not faced with eligibility and audit issues mid term. You will discover that there are tax advantages for both the employer and the employee to explore this as an option. If you do the best for your employees, they, in turn, will make your business prosper.
Iowa Continuation and COBRA: These are employer laws. We do not involve ourselves with labor laws – neither do the CPAs. However, because most employers fail to be compliant without encouragement, we try to be of assistance. We can provide the form letter and the employer must complete and mail it to the last known address of the departing employee. There are instructions with these letters including how the envelope should be addressed and the recommended mailing option. We encourage our business owners to incorporate into their plan a partnership agreement with the insurance company to assist with the COBRA process. If an employer does that, after the initial letter goes out, the insurance company will communicate with the departing employee taking all of the responsibility away from the employer. For groups with 20 or less full-time employees, Iowa Continuation is offered by the employer to the departing employee. The employee may elect to stay on the employer plan for 9 months, so long as the payment agreement has been met each month. COBRA laws apply to an employer that has greater than 20 full-time employees.
I cannot stress enough the importance of knowing your options. I have 40 years of knowledge and experience to share with you. I will help you manage your health care risks and liabilities, safekeeping your family’s financial protection.
Happy Thanksgiving to you and your families. Thank you for the professional confidence that you place in me and my agency.
There will be several changes in the Medicare product selections for 2020.
Medicare Supplement Plan F will no longer be available for new sales. There will be a couple exceptions to that pending your Medicare eligibility dates and your employment status. You’ll be able to call me for further details on that. Anybody with an existing Medicare Supplement Plan F will be allowed to keep that indefinitely. What will be available is a Plan G. This is not going to mean anything to you unless you’re looking at some marketing materials that you may be able to find online. Feel free to call me for further details and pricing on that product. Other options available will be Advantage plans. Sometimes known as Part C of your Medicare. Again, please call me on this. There are many variables that you would want to consider before making a selection.
Just as a reminder, Medicare open enrollment period begins Tuesday, October 15 and continues to Saturday, December 7 for your 2020 coverage. During that annual enrollment period, you can make changes to various aspects of your coverage.
Per the Centers of Medicare and Medicaid guidelines, I will not be able to contact anyone until October 15 to have a conversation or schedule appointments regarding your Medicare choices for open enrollment for 2020.
However, you are welcome to call me and I can have conversation with you and schedule an appointment. This time of year gets hectic and we have a short window to get everyone’s questions answered so you feel confident about January 1, 2020.
The Medicare Supplement Plan F will not be available January 1 going forward. However, those of you that are lucky enough to already have it, are allowed to keep it. There are other good choices and I’d be happy to point you in the right direction, show you your choices in advance so you can get this done in a timely manner for the smoothest transition into 2020. My consultations are free – include phone number.
Do you want to make changes to your Medicare coverage? For MedicareAdvantage (also known as Medicare Part C) and Medicare prescription drug plans, there’s an Annual Election Period (AEP) when you can sign up for, change, or dis-enroll from the plan. The AEP runs from October 15 to December 7 each year.
There are many different types of Medicare Enrollment Periods. These enrollment periods fall into two categories.
First, open enrollment, available to anyone who is eligible for Medicare. Then, special enrollment periods, which are based on your circumstances.
If you want to change the coverage you currently have, you can during a Medicare Enrollment Period.
Medicare enrollment periods can be confusing because different enrollment periods have different dates for different purposes.
Here’s a glossary of terms to help you understand enrollment periods, when they happen, and who they apply to.
There are many different types of Medicare Enrollment Periods. Understanding which ones apply to you is crucial for your benefits
There are many enrollment periods for people signing up for benefits for the first time.
If you’re receiving Social Security or Railroad Retirement benefits when you turn 65, you’ll automatically be enrolled in Original Medicare.
Enrollment periods are an opportunity to enroll in these plans as well as Part D, or to replace Original Medicare coverage with a Medicare Advantage plan.
It’s highly recommended that you take advantage of the Medicare sign up period.
One Medicare enrollment period is the Initial Enrollment Period (IEP). This allows you to sign up for Medicare Parts B and D when you turn 65.
Your IEP begins three months before the month you turn 65, includes your birthday month and ends three months after the month you turn 65.
For example, if your birthday is June 15th, you can enroll in Medicare between March 1st and September 30th.
Another enrollment period that is also 7-months is the Initial Enrollment Period 2 (IEP2). This is for people who were already eligible for Part A and B before they turned 65.
During the IEP2, you can sign up for a Medicare Advantage or Part D prescription plan. The IEP2 runs for the same seven-month period as the IEP.
One of the most complicated Medicare enrollment periods is the Special Enrollment Period (SEP). This is when you can make changes to your Medicare Advantage and Medicare Prescription Drug coverage when certain events happen in your life.
Events include situations such as if you move or lose other insurance coverage.
An example is losing health insurance through you or your spouse’s employer.
When you qualify for a SEP, you’ll have up to 60 days following the event to enroll in coverage. Rules about when you can make changes and the type of changes you can make are different for each SEP.
Another example of a SEP would be if you’re switching from employer coverage to enrollment for Medicare.
Another Medicare enrollment period is the Initial Coverage Election Period (ICEP). This is your first opportunity to choose a Medicare Advantage plan instead of Original Medicare.
During the ICEP, you can also sign up for prescription drug coverage.
If you enroll in Part B when you turn 65, your ICEP is the same as your IEP. When you enroll later, your ICEP is the three-month period before your Medicare Part B coverage takes effect.
During the General Enrollment Period from January 1st to March 31st, you can enroll in Parts A and B. You may pay a penalty if you didn’t enroll in Part B during an IEP or SEP.
There are three enrollment periods for people signing up for benefits who are already enrolled in Original Medicare. During open enrollment, you can make changes to your Medicare plans and add additional coverage.
Your Open Enrollment Period (OEP) begins the 1st day of the month you turn 65 years old and your Medicare Part B has become effective. Many beneficiaries take advantage of this Medicare sign up period.
For example, if your birthday was August 31st and your Medicare Part B effective date was October 1st, then your OEP begins October 1st.
Your OEP lasts for 6 months, you’ll be granted Medicare Supplement Guaranteed Issue rights.
During this time, you can sign up for a Medicare Supplement Plan, also known as Medigap.
If you didn’t sign up for a Medicare Advantage or a Medicare Prescription Drug Plan during your IEP, the AEP is your next chance to make changes. There are exceptions for those who qualify for a Medicare Special Enrollment Period.
During the Annual Election Period (AEP) from October 15th to December 7th, you can:
You can find the AEP checklist here.
Starting in 2019, the Medicare Advantage Disenrollment Period (MADP) will be discontinued and replaced with the return of the Medicare Open Enrollment Period.
The Medicare Open Enrollment Period is for only those enrolled in Medicare Advantage. This period will start in 2019 and run from January 1st through March 31st.
During the Open Enrollment Period you can:
September is Life Insurance Awareness Month to help educate Americans about the importance of life insurance and as a rallying point for the industry. Please take the time to listen for 3 minutes to this video – you should be thinking about this before you make retirement decisions.
Small business owners need to rethink their role concerning employee benefits. It’s very important that these benefits reflect the mission statement, needs, goals and values of the company. An independent agent is your best source for quoting, placement, supplemental benefits, compliance, education and service.
SUPPLEMENTAL BENEFITS – To get the attention of the current employees for the sake of retention and to attract young and eager talent, you must offer more than just health benefits. The competition up the street can easily offer wages within the market range, but take the talent with a more robust offering of benefits. Supplemental benefits can include dental, vision, life, long-term care, accident and disability insurance. A recent study by The Guardian reports that since 2015, the number of small businesses offering access to supplemental health coverage has increased by 30 percent. It is further predicted that this will continue to ride in years to come. Sears Insurance offers all of these products and includes them in the FREE quoting.
PROMOTE WELLNESS – A great place to start is to focus on wellness. It is not just a trendy thought, but is a popular business initiative. More employers than ever before are offering workplace wellness programs and athletic club memberships. It has been proven for many years that a healthy workplace, both physically and mentally, can boost the employee productivity and satisfaction. As a result, the wellness programs can lower the number and the cost of the claims for employer’s health plans and workers compensation claims, as employees become healthier. We believe this strongly enough that Sears Insurance has partnered with Aspen Athletic Clubs to create custom packages for companies to offer their employees. They are locally-owned and very well managed – truly something for everyone under their memberships. This is a perk that can benefit the entire family!
VIRTUAL CARE – Seeing a doctor can be very inconvenient and very costly from the employee and the employers’ standpoint. If an employee lives outside of the metro and has to drive back and forth for themselves or a child, the time, scheduling, copays, coinsurances, and deductibles really add up. The Wellmark plans have a tremendous online toolkit for employees to access. The Doctor On Demand is used by many and I train employers and employees on how to download this on their phones and have it ready in a moment’s notice.
DIRECT CARE – In addition to online services, Sears Insurance has a relationship with Dr. Jon Van Der Veer, Founder of Exemplar Care. Exemplar Care is a direct primary care provider (DPC) that you pay a monthly retainer to and have quick and easy access to your primary care physician, services, imaging MRIs, labs, pharmacy benefits, etc. at very reduced prices. If you understand using the concept of a high deductible health plan (HDHP or HSA), this service pairs very well with those plans – you have the best of both worlds. A recent example that is one I like to share is the patient who was in need of an MRI of his knee. The cost decreased from $1,900 to $250! If you are paying this all out of your own pocket and it is being applied to your maximum out of pocket, you just saved a lot of money and time, resulting in a better outcome for your health. Please take a look at his website or call me for more information.
COMPLIANCE – It can be challenging for businesses to stay up to speed on the changes to federal and state regulations concerning the Affordable Care Act. There are also guidelines, timelines, and eligibility requirements that affect healthcare benefits being offered by companies. We are in our 41st year of business and we have this! We have chosen to be a river and not a reservoir – what I mean by that is that I am here to share with you not only information (which is free compliments of Google), but the experience and knowledge to implement the information… ALL FREE! Please give us a call for an audit of your benefits packages. We can create plans for your consideration, saving you dollars and providing more for your money.
