Category Archives: Health Insurance

All Small Business Owners Need to Know Your Liabilities Regarding Group Benefits

Health Care Reform, Health Insurance

Your human resource person’s responsibilities now include administrating benefits for the employees (administration side of that job). That includes a lot more expertise, training, compliance and liability than ever before.

So, if I think of the HR person, whether that is your spouse, a hired employee or an entire department, whoever was responsible for these HR duties, typically had two sides to their job. We had the strategic side which included hire, attract and retain, quality employees for your business. Subsequently, there was testing and training whether this be on the job or in a classroom so that your employee could be most efficient and productive for your business. The strategic side of the HR person’s job also consisted of employee termination and possibly succession planning.

There’s also the administrative side of this person’s job. On the administrative side, a few things that come to mind would be enrolling the new hire (and possibly dependents) onto your group benefits platform of products. It would be removing them, COBRA administration, from wage garnishments to payroll, IRL liens, proper compliance with all of the current regulations in place, testing, non-discriminatory issues and 401(k) administration, to name a few. Consequently, with the new regulations, and laws that are now in place, it only makes good sense to address the liabilities your company has.

It’s highly recommended that this be done prior to any violations. My suggestion would be, leave the same people doing the same job that you’ve always had them do and call me for a consultation. It is possible to leave your same plan in place, if you choose to. We can examine and analyze your needs, your wants and your budget and make recommendations for planned changes, if it’s appropriate, in an attempt to save you premium dollars and transfer the liability of all of the administrative side of this person’s job to myself as a seasoned, licensed, experienced insurance broker. There are no fees associated with this offering. And my goal for all of my business owners is to keep everybody productive, maximize your dollars and reduce your liability. Please call me for your free assessment.

Decode the Jargon in a Jiffy…

Health Insurance

With fourth quarter rapidly approaching, it won’t be long until we will be in the open enrollment period.

Open enrollment period for 2017 runs from November 1, 2016 – January 31, 2017. This period of time allows us to make changes to our individual insurance plans. If you would like to price, shop and compare what you have to what other choices are available, I feel it would be very beneficial for you to understand some of the jargon and definitions as outlined here.

ARE YOU IN NETWORK? …  ARE YOU OUT OF NETWORK? … OR DO YOU KNOW?

Health Insurance

School has started and it is time to learn how your existing insurance will pay where your student is attending classes. And, let’s not forget to include in our thoughts the idea of a class trip or a study abroad program. I am referring to the “network” of providers that your health insurance may have.

Typically there are three choices of provider networks. They are referred to as PPO (Preferred Provider Organizations), POS (Point-of-Service) and HMO (Health Maintenance Organizations). These have been listed in the order of greatest to least access. That also means that the premium for the greatest access is obviously higher than the option with the least access. Many of the plans that I represent also include world-wide coverage.

I have always been a proponent of access as it is vital in a life threatening situation. To offset the cost of this luxury, one can opt for higher deductibles. An HSA (Health Savings Account) will offer some tax benefits and allow one to save for the catastrophic events that could lie ahead.

I encourage you to call me. 515.285.6766

Let’s discuss your needs, wants and budget and find a product that best suites your needs. I would not want you in a position where you cannot access the providers you need or want in a crisis.

To have a surprise of high or not covered expenses can be resolved ahead of the event with some simple planning.

I am including an article from the Kaiser Family Foundation for your reference.

Register for myWellmark!

Health Insurance

It is graduation time! It is vacation time! And we’re all ready to be on the move.

I strongly suggest that all of my Wellmark Clients register for myWellmark. This is where you can find information to manage your health, your health plan and your health care costs all in one place.

This link will take you to the myWellmark registration page and it will provide you with the 7 reasons why you should register. Everything to do with your insurance, your health care, questions you may have, prices for your prescriptions, member discounts, etc. It is all right at your finger tips. If you’re planning a vacation or have children off on an internship, please have this available. Illness and injuries are not scheduled. We’re here to help!

 

Employer Sponsored Small Group Benefits Can Offer Up Some Great Solutions…

Health Insurance

The employer sponsored plans have several options to consider. We offer many traditional plans with several provider network options. There is also an exciting new product introduced last year that is really worth taking a look at. It is called Blue Rewards.

Blue Rewards is traditional insurance with a twist, and the first of its kind in Iowa. This health plan is designed collaboratively by Wellmark Blue Cross and Blue Shield, Hy-Vee and UnityPoint Health.

Blue Rewards integrates true coordinated care with:

  • UnityPoint Health provider network,
  • The retail convenience of Hy-Vee’s pharmacy and their other health and wellness offerings,
  • An affordable, ACA-health insurance option from Wellmark Blue Cross and Blue Shield.

These new plans are available to employers located in 29 key Iowa counties. Employers offering Blue Rewards plans must be located in these counties, but their covered employees need not reside in the 29 counties.

Blue Rewards members can receive care at any provider. Their cost share will vary depending on which tier their provider is in. They will receive the lowest cost share when seeing a Tier 1 Wellmark Blue Rewards POS provider in Iowa. Blue Rewards plans are also available for individuals and families.

Some of the benefits are; coordinated care which has proven to reduce claims costs, keeping your employees healthy reduces absenteeism and when compared to a PPO plan you will likely see much less premium. Your employees will have lower out-of-pocket costs when comparing similar benefits of other plans in the market.

We are 40 years strong as an independent insurance agency, built on folks just like yourself. We are proud to say that we are 100% referral based. We are serving 3 and 4 generations of the same families. The professional confidence that you have placed in me and my agency and the continual flow of referral to your friends and family is the greatest compliment you could ever pay me. Thank you for your friendship and your business! Call me – our quotes and consultations are FREE!

Has Anybody Heard of the Cadillac Tax?

Health Care Reform, Health Insurance, Healthcare updates

Here’s a great article from the Huffington post about what you need to know about the Cadillac Tax. This was originally posted in June 2015, however, it is quick and easy to read and nothing had changed at that time. Please read through this so you know how you are affected and what this means for you. It is a costly item as part of the Affordable Care Act.

Below is a picture (click to enlarge) that gives you a snapshot of the different years and provisions of the affordable care act that you might find easy to use. The good news, is that it’s been delayed!

Congress’ Christmas present to all business owners who provide benefits to their employees is to put a two year delay on this tax that was originally to start in 2018. However it all shakes down: this buys us some time to reassess your plans. If it’s repealed completely, then we will keep you informed accordingly. If it’s not repealed, then it gives us an opportunity for better positioning of your benefits moving forward.

If you find this whole thing confusing, guess what. The United States of America and every involved: CPAs, attorneys, doctors, hospitals, insurance companies, insurance agents, etc., are waiting for the next newspaper headlines to tell us what’s changed. Whatever I tell you today, if it changes, I’ll tell you what it’s changed to tomorrow.

Prescription Drug Plan Annual Enrollment Period Ends December 7th, 2015

Health Care Reform, Health Insurance, RX drug
The Medicare Annual Enrollment Period (AEP) allows individuals to switch, change, or drop Medicare Advantage (MA), Medicare Advantage – Prescription Drug (MA-PD) plans and Prescription Drug (PDP) plans. Individuals can make as many elections as they want during the AEP and it is the last enrollment choice made that will become effective January 1st 2016.

 

Please give us a call at 515.285.6766 for any questions you may have – we are enrolling all day today and are glad to help.

Part D Prescription Drug coverage for 2016

Health Insurance, Healthcare updates, Part D, RX drug

Every year, Medicare’s open enrollment period is October 15 – December 7. Medicare health and drug plans can make changes each year—things like cost, coverage, and what providers and pharmacies are in their networks. October 15 to December 7 is when all people with Medicare can change their Medicare health plans and prescription drug coverage for the following year to better meet their needs.For all persons in need of Part D Prescription Drug coverage for 2016, please know that the window of time is coming to an end December 7.  Please call me for quality plans.

Governor Branstad signed legislation effective July 1, 2015 changing the copays you would be responsible for when utilizing a physical therapist. The copay is that of your Primary Care Provider (PCP). This is a tremendous value for patients that need PT. Please call the number on the back of your health insurance ID card for verification.  Here are two links for your reference.
When you take just a minute to review Jon Schultz’s LinkedIn profile you know why it is real easy for me to refer my clients to him. He is just a very dedicated and accomplished PT within his industry. He is in private practice and can/will give you the individualized attention that you need and deserve.  Please note that he will help a wide range of activities and ages.

Make the Fourth Quarter Count

Health Insurance

It’s the time of the year for you to make decisions for your health care plans for 2016. If you have a plan that is a non-ACA plan, you may want to consider what changes you can make (or not) to possibly lower your premium without going to an ACA plan.

My fear is that an ACA plan has the potential for greater rate increases from year to year going forward. The reason I feel that potential risk is out there is because these plans require no medical underwriting. This is the only insurance that I’m aware of that can be purchased without underwriting.

Life insurance is underwritten. As is your home owners insurance, auto insurance, disability income insurance, long-term care. This process assesses a proper rate to the risk that the insurance company is willing to accept. If we ask an insurance company to provide coverage without knowing what any of the potential risks are that are insuring you, they do the best to price the product; however, it’s after the fact that the discovery comes if the price was even close.

Therefore, Wellmark sent letters out this year advising people in the individual market that the Iowa Insurance Division granted them a 26% increase in premium to off-set some of the unknown liabilities they have taken.

So, give me a call. We will look at all options so that when you set your compass for 2016, you know how and why you did it. One other thing is, what does it cost to have no insurance. Outside of the obvious, please look at this link as it will explain the individual penalties that will be assessed in 2016 for those opting not to insure.

Open Enrollment

Health Insurance, Healthcare updates

Some points to consider if you’re an employee that has employer benefits available to you.

Sit down with all options available to you. During this period of time, starting November 1, you are in the open enrollment period, which means that you can explore your options and make your moves accordingly for 2016.

Whether you want to lay these out in your mental buckets of individual, employer plan (self) and possibly employer plan (spouse), I would start with: What are my summary of benefits coverage (SBC). Ask your employers for a copies of your SBC (hopefully they’ll know what you’re talking about, too). Then, figure your cost for yourself, your spouse and your children under each of these buckets.

After you’ve done your homework, you might be well satisfied to stay where you are. However, I have had folks come to me with some discoveries and some questions and realize that they had been passing up some opportunities, whether that be benefits, whether that be the network of providers they have access to or their premium costs.

If you do not know anything about an HSA account, I encourage you to look into that. There are generally speaking, lower premium costs and opportunities for some tax savings. If you want me to help you evaluate your choices so that you can make the best decision for you and your family, please feel free to call me.

Related Posts Plugin for WordPress, Blogger...