Category Archives: Health Insurance

Deductibles and Maximum Out of Pocket Expenses for 2014

December 8, 2014Health Care Reform, Health Insurance, Healthcare updatesDebbie Sears

The most you pay during a policy period (which is usually a calendar year) before your health insurance or plan starts to pay 100% for covered essential health benefits. This limit includes your deductibles, your co-insurance, co-payments or other charges, required of an individual which is a qualified medical expense for essential health benefits. This limit does not count premium balance billing amounts or spending for non-essential health benefits.

As mentioned in my previous post,the maximum out of pocket limit for any individual “market place” plan for 2015 can be no more than $6,600 for an individual or $13,200 for a family plan. If you have medical needs that have been unmet and you have met your maximum out of pocket expense, you may want to schedule procedures yet this year. If you are a Wellmark policy holder, you could go to www.mywellmark.com to track this topic. I encourage you while you have a little downtime from work over the holidays to download this handy tool.

There’s Still Time to Fund Your HSA Account!

December 1, 2014federal compliance, Health Care Reform, Health Insurance, Healthcare updatesDebbie Sears

As our taxes creep up, deductions are always of interest.

If you have an HSA account, it’s not too late to make contributions. Individuals may contribute $3,300 (up $50 from 2013) and families can contribute $6,550 (up $100 from 2013). The high deductible health plans requiring deductibles for an HSA did not change between 2013 and 2014. We view this as being a good thing. On a high deductible health plan (HDHP), $1,250 for self coverage and $2,500 for family coverage.However, the maximum out of pocket expenses which includes deductibles, co-payments and other amounts (not premiums) are $6,350 for individuals (up $100 from 2013) and $12,700 for family coverage (up $200 from 2013).

HSAs are “IRAs on steroids” with triple tax advantages. You have tax deductible contributions, tax free accumulation of interest and tax free distributions for “qualified medical expenses”. This should not be taken as legal or tax advice. Seek out the appropriate professionals.

Please be cautious about spending your HSA dollars for unqualified medical expenses. The tax penalty is 20% of the HSA distribution. I highly recommend that you seek the advice of an independent agent and a CPA. But, if you want one more deductible for the year, this is something to look at.

Wellmark Traditional Health Plans

November 24, 2014Health InsuranceDebbie Sears

This is a very busy time of the year and we have been inundated with decisions that need to be made in a timely manner: politics, year-end planning, holidays, family, travel, etc.

I think the best thing I can do is to keep it simple. By clicking here, you have access to 19 comprehensive health plans specifically for Iowa small businesses. There is a good fit for every size business and every need.

If we invest the time to make your plan best suit your needs, generally speaking, it will also meet your budget. This page will show you plans that fall into four categories. Copay plans, Coinsurance plans, Max plans and HSAs.

If you are doing any year-end tax planning and you have an interest in the tax benefits of an HSA, you may have an opportunity to fund your current HSA plan. Please don’t overlook this. In addition to these plans, please look at my last post about BlueRewards.

Wellmark Blue Rewards

November 17, 2014Health InsuranceDebbie Sears

Wellmark Blue Cross Blue Shield has developed a new plan called Blue Rewards.

This is traditional insurance as you know it, but with a twist. It’s the fist of it’s kind in Iowa. The plan is designed collaboratively by Wellmark Blue Cross Blue Shield, Hy-Vee and UnityPoint Health.

Please read about all of the details. We are super excited about this because the intentions are to get true coordinated care, which has been proven to reduce claims cost. The intention is to encourage healthy behaviors for your employees and at the end of the day, lower premiums. This has got a three-tier system meaning that you have a choice. The three tiers are different cost-sharing for you and Wellmark pending your choices of providers.

Call me for more details. This is too good not to know more about.

Blue365 Member Discounts and Services

November 10, 2014Health InsuranceDebbie Sears

In preparation for the holidays, I want to make sure you know that as a Wellmark member, you have access to exclusive deals and discounts from your favorite brands with Blue365.

You can receive a wide range of savings from top health and wellness brands such as Jenny Craig, Reebok, Healthways – Fitness Your Way, SNAP Fitness, TruHearing and more.

Please don’t overlook some of the wonderful benefits that are included with your membership. You can sign up – it’s free – it’s easy and it helps you save on health all 365 days of the year.

WellMark GoMobile App!

November 3, 2014Health InsuranceDebbie Sears

If you have an individual or family plan or are enrolled in a Wellmark wellness program through your employer, you’ll find this app very useful. You can log into myWellmark through the app and access health and wellness information powered by WebMD.

This is a free download and it will give you access to claims and benefits and get your questions answered. It’s also serves as your mobile ID Card which includes wellness services. You can find doctors, hospitals and 24/7 help.

Other Wellmark Products and Services

October 27, 2014Health Care Reform, Health Insurance, Healthcare updatesDebbie Sears

Enhance your benefits package with other products to help protect employees and keep them healthy:

Dental – Once you’ve determined your base health coverage plan and cost, I would like you to know what your options are for other products and services. There are some very cost effective dental plans that will provide you with preventative care, basic restorative orthodontics and more.
Flexible Spending Administration – Your flexible spending administration is intended to reduce your payroll taxes and offer employees a way to save on their health expenses and independent care. Wellmark offers a complete administration for these products.
GeoBlue Global Health Care Products – These products are for groups with international travelers.
Standard COBRA Administration – This is available to groups with 20 or more employees.
Vision plans – Choose from vision coverage options with a choice of copays and benefit levels to fit a variety of needs.

Shopping for Health Care

October 20, 2014federal compliance, Health Care Reform, Health Insurance, Healthcare updatesDebbie Sears

EVERYONE is eligible to look at different plans in the individual health market from November 15, 2014 – February 15, 2015. Some people will want to keep their plans if they were written before January 1, 2014. Those with ACA (Affordable Care Act) plans may keep your current plan or make a change. To start your thought process, I’ve got three points I’d like you to be aware of and then call me, because I’m sure you’ll have questions:

If your plan has not changed since September 2010, you have what’s called a “grandfathered plan”. If you have a plan that was written between September 2010 and December 2013, you have a “grandmothered plan”. Nick Gearhardt, Iowa Insurance Commissioner, has allowed these plans to stay in force until 2016. A good share of these plans are Wellmark Blue Cross Blue Shield of Iowa plans. There has been a request for a premium increase, however, the good news is, it should be a single digit increase. Hopefully, this will mean that the plan still fits your needs and you may not find it necessary to make any change at all.

If you have an ACA (Affordable Care Act), you can keep it and not make any changes if you still find it affordable. But, you can look at all plans. The expected premium increase on these plans will be much higher. The reason for that is pretty self-explanatory. These plans were written as a first-time-ever, meeting the guidelines of ACA, with no underwriting and consequently, there was no actuarial history to determine how these plans should be priced. The experience so far has been that an adverse selection (older, not necessarily insurable people) purchased a plan, has a procedure done, and did not renew, driving up the rates on the remainder of the policy holders. Until these have had a few years of history, the rates will undoubtedly experience a substantial increase. I recommend holding on to your traditional plans as long as possible.

Marketplace products. If you purchased your plan through www.healthcare.gov, you like your plan, your income has not changed from 2014 – 2015, perhaps it’s in your best interest to stay put. However, if your income is different in 2015, then 2014, I would encourage you to have a review before you incur a tax liability for 2016.

In summary of those three points, there are quality companies and products for us to choose from. I feel that our market has become more fragmented than ever before. What I mean is we have very low cost plans (you get what you pay for). We have some median coverage and price plans and of course, we have very quality products that would be priced possibly higher. The important thing is to have your agent review all of your options and by understanding your needs and your budget, assist you in making the right choice for you and your family. Call me, I’m sure you will have questions.

Blue Magazine Summer 2014

September 29, 2014Health InsuranceDebbie Sears

To get the most from your health plan, Wellmark has their seasonal Blue Magazine. They have one for the under 65 population and one for the over 65 population. I will soon be sending you the one for Fall as it becomes available and I hope to have both issues for your reference. But, for today, I realize we’re working on all kinds of things as we prepare for the 4th quarter, but this little magazine is just full of good stuff! Everything from nutrition and fitness, to their exciting 75th birthday. Take time to click on 75 Days Ways to learn more about how Wellmark is giving back to the community. There’s an opportunity to vote on your favorite project on a daily basis. Check into this and see if there’s anything there that is of interest to you.

Now that our kids are back to school, please know your benefits. Your child may be “out of network”. Know how that works. I encourage you to download My Wellmark Membersite on your phone. This will give your student access to personal health assistance 24/7. Finding a dentist, finding a facility or finding a doctor. We realize that most scheduled visits happen at home with illnesses and injuries that are, of course, not scheduled….Your Wellmark is with you anytime, anywhere…in the world. Please visit their site or call me. I’m happy to help you anyway that I can.

Do You Know Who’s Paying the New Obamacare Tax? YOU!

September 15, 2014Health InsuranceDebbie Sears

Kaiser Health News is a source that the insurance industry feels very confident about as they are not an insurance company and they are not a government entity, but a private research firm that has been highly accredited for many years. This article concerns the Affordable Care Act and what kind of money it represents and where it is going to come from.

While there are pros and cons to any legislation, we feel that after 40 years as an independent health insurance agency, that this is perhaps the greatest change we have experienced. As America works its way through all of the provisions as they are enacted from year to year, there will be a huge shift of money to fund the plan as it stands today. Please read this article and know that visiting with an independent agent to know your choices and contain your costs undoubtedly is in your best interest. My intention here is to create an awareness so that you can be as informed as possible.