Is it Time for a Health Insurance Coverage Check-up?

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Think you’re all set with your health insurance coverage? You might want to take a closer look. In today’s rapidly evolving healthcare landscape, what worked for you last year might not be the best choice for this year, and just as you schedule regular check-ups for your health, your insurance coverage deserves an annual review.

Why annual insurance check-ups matter

The healthcare industry is always changing. From shifting provider networks to updates in medication coverage, what you signed up for initially might look quite different today. “The costs and the benefits and the laws change every single year and sometimes more frequently,” says Rebecca Yates, CEO of Ark Insurance Solutions. These aren’t minor adjustments. They can significantly impact both your wallet and your access to quality healthcare, which is why it’s important to know how they’ll affect you personally.

It’s also worth considering how your own life changes year over year. Your needs may have evolved, and the medications covered under your current plan may have changed. All of these factors can affect not only the cost of your plan but also its effectiveness in meeting your healthcare needs. Without regular review, you might find yourself paying more than necessary or even worse, lacking coverage in crucial areas.

Recent changes make reviews more critical than ever

New developments in the healthcare sector have made insurance check-ups absolutely crucial. The government has implemented new security measures to protect consumers after incidents involving rogue insurance brokers making unauthorized changes. While these measures provide additional protection, they also illustrate the importance of regularly reviewing your coverage to make sure it aligns with your expectations and requirements.

Insurance companies regularly update their networks, change their formularies, and adjust their coverage terms. Without regular reviews, you might miss important changes that could affect your access to care or your out-of-pocket costs.

Signs you need an insurance check-up

There are a few red flags that suggest it’s time to review your health insurance coverage:

1. Your healthcare needs have changed since last enrollment, such as recent medical issues, new medications, or a recent expansion of your family. These life changes often require adjustments to your coverage so that you’re getting the care you need at the best possible rate.

2. You’re unsure about your current coverage. If you can’t confidently say what your plan covers or what your out-of-pocket expenses might be, it’s time for a review. Understanding your coverage shouldn’t feel like solving a puzzle – if it does, you could benefit from some expert guidance and clarification about your coverage.

3. Your preferred healthcare providers or medications have changed. Network changes can affect your ability to see specific doctors or obtain certain medications at preferred rates. A review can help ensure you maintain access to the care and prescriptions you need without unexpected costs.

4. Your employer has experienced growth or restructuring. Changes in employee numbers or company structure can impact group insurance plans and might open up new, more beneficial options.

What to expect during your insurance check-up

A comprehensive insurance review examines your plan in a few key areas:

Network Evaluation

This is a thorough examination of your current healthcare providers and whether they remain in-network. This includes primary care physicians, specialists and preferred hospitals. Your broker will help identify any potential network changes that could affect your access to care and suggest alternatives if needed. They’ll also look for opportunities to optimize your network access based on your specific healthcare needs.

Prescription Coverage Review

By conducting an in-depth analysis of your current medications and their coverage status, your broker can help you identify if there are more cost-effective options available, or if recent changes might affect your out-of-pocket expenses. They can also help you understand if there are pharmacy benefit programs or mail-order options that could save you money while maintaining access to your necessary medications.

Cost Analysis

A cost analysis is a detailed review of your premium costs, deductibles, and out-of-pocket maximums compared to your actual healthcare usage and budget. This analysis goes beyond simple premium comparisons by looking at your actual total healthcare spending and identifying opportunities for savings. Your broker will help you understand how different plan structures might affect your overall costs based on your specific healthcare needs.

Benefits Assessment

This is a comprehensive evaluation of whether your current benefits align with your needs, including specialized services, mental health coverage and wellness programs. This assessment looks at both your current healthcare requirements and anticipates potential future needs to ensure your coverage provides enough protection for the coming year.

The value of professional guidance

While you might be tempted to handle this kind of review independently, working with a licensed health insurance broker can provide invaluable insights and save you considerable time and effort. Brokers stay current with market changes, policy updates, and new offerings from different insurance providers. And much like you’d call an accountant to do your taxes, or an attorney for a legal matter, brokers know the health insurance landscape inside and out, and will look out for your interests.

One common misconception is that working with a broker adds extra costs to your actual insurance. However, this isn’t the case. “The best part is it doesn’t cost you anything extra to work with us. You can go to the carrier or you can go to us directly. Those premiums are the same,” says Yates.

Making the most of your check-up

To maximize all of the benefits of getting an insurance review, you should come prepared with the following:

– Gather together your current plan documentation and any recent medical bills or prescription costs. This information helps your broker understand your current healthcare spending patterns and so they can identify potential areas for savings.

– List any changes in your healthcare needs or preferences over the past year. Include new medications, healthcare providers, or potential future medical procedures.

– Don’t be shy about asking questions pertaining to your coverage, or discussing areas that you find confusing or concerning. Your broker can help clarify complex terms and ensure you fully understand your benefits.

– It’s a sensitive topic for most, but be ready to discuss your budget and any financial constraints affecting your healthcare decisions. This helps your broker find solutions that balance coverage and your costs effectively.

Making sure your coverage works for you

For the average person, healthcare needs are always evolving, and insurance options will continue to expand and change. By maintaining regular check-ups of your coverage, you can ensure that your health insurance remains a useful tool in maintaining your personal health and well-being — rather than becoming an obstacle to accessing care.

Remember, just as you wouldn’t skip your annual physical, don’t overlook the importance of reviewing your health insurance coverage. If you haven’t yet had a chance to get an insurance check-up, there’s still time. You can revisit your coverage and make changes that will take effect on February 1. But it’s important to reach out for an appointment well before the January 15 deadline.

Now is the time to get a handle on your current and future health insurance needs with a professional who cares about your well-being. “When you call us, you’re going to get a real human that answers the phone, and that real human is going to connect with you and care about you, learn about your family, and figure out what you need,” says Yates.

What’s The Buzz? Have You Heard About ICHRA Plans?

What’s The Buzz? Have You Heard About ICHRA Plans?

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What’s The Buzz? Have You Heard About ICHRA Plans?

“ICHRAs are designed to give employers flexibility when offering a group health plan.”
~ Rebecca Yates, CEO of Ark Insurance Solutions

Individual Coverage Health Reimbursement Arrangements, most commonly known as ICHRA plans, have become increasingly popular in some areas as a flexible alternative to group plans. And since they represent a significant shift in how businesses approach health insurance, they’re worth knowing about.

ICHRA plans are relatively new. First introduced in 2020, they’ve gained some traction among businesses looking for an affordable group health insurance option. But, like anything else, ICHRA plans also come with potential drawbacks. Depending on what state you’re in, how many employees you have, and the overall health of your group, an ICHRA plan might not be the best option for you.

If you’re a business owner looking at alternative health plans like ICHRA, we recommend getting an in-depth analysis with a trusted professional. While they can be particularly advantageous in states like Alaska, they aren’t so much in Utah — the nuance of which we’ll discuss below.

What exactly is an ICHRA plan?

In a nutshell, ICHRA plans allow employers to reimburse their employees for individual health insurance premiums and qualified medical expenses, and the reimbursement is completely tax-free. Rather than selecting and managing a one-size-fits-all group health plan, businesses can provide employees with a predetermined amount of money each month. Employees then use that money to purchase an individual health insurance coverage on the marketplace that best fits their specific needs.

Think of an ICHRA as essentially creating a personal expense account for each employee’s healthcare needs. When employees incur medical expenses or pay their individual insurance premiums, they can submit receipts for reimbursement up to their allowed amount. This arrangement offers a fair amount of flexibility, while still providing the same tax advantages that are typically associated with employer-sponsored health benefits.


Where ICHRAs shine

For some companies, ICHRAs present an attractive option, because they solve some of the most common challenges among business owners in providing adequate health benefits. This kind of control is valuable for growing businesses or those operating across multiple states.

ICHRAs also get rid of the administrative burden of managing a group health plan. No more annual renewal negotiations, plan design decisions, or employee enrollment periods. Instead, companies just have to decide what the employee reimbursement amounts will be and process employee receipts — this is something they should delegate to third-party administrators.

This arrangement can work pretty well for companies that have a diverse workforce spread across several states. Rather than trying to find a single group plan that satisfies everyone, employees can select the coverage that matches their needs. A young, healthy employee might choose a high-deductible plan with lower premiums, while an employee managing a chronic condition might opt for more comprehensive coverage.

“It’s not uncommon for an employer to come to us and say, ‘I have people in 20 states. How do I possibly build a group health plan for them?’ And often ICHRAs are the answer.”

Despite their advantages, ICHRAs aren’t without potential drawbacks. And much of this depends on what state your business and employees are operating in. The success of an ICHRA program directly correlates with the strength of the individual insurance market in your area. So, if you take Utah for instance, the state has a much more affordable group market with excellent benefits, which ICHRA can’t compete with. It’s likely that employees would struggle to find better coverage with their ICHRA allowance. But in Alaska, ICHRA plans often present a more beneficial choice.

Employee BenefitsWhether or not ICHRA is a good idea can also come down to the number of employees your business is supporting. If a large employer with more than 50 employees can’t get enough people to enroll in a group plan, or if that plan is somehow canceled by the carrier, they could potentially use an ICHRA as an affordable option.

“ICHRAs tend to be better for those large employer scenarios where they’re trying to be compliant because now they’re going to get penalized if they’re not offering, but they can’t find a good way to offer,” says Rebecca Yates, CEO of Ark Insurance Solutions. “They can be a good alternative for businesses that have a hard time meeting participation.”

Employee education represents another challenge to the overall effectiveness of an ICHRA plan. Many workers are familiar with traditional group health insurance but they might find the individual market confusing. They’ll need guidance on selecting appropriate coverage, understanding how reimbursements work, and managing their healthcare spending.

Some employees might also miss the simplicity of having their employer choose their health plan. While flexibility can be helpful, it also means employees must take more active roles in their healthcare decisions. This responsibility can feel overwhelming, especially for employees who have never had to shop for health insurance before.

Tax advantages

ICHRA does have its tax advantages, with reimbursements that are tax-deductible for employers and tax-free for employees. This is a significant benefit compared to simply providing extra salary for healthcare expenses. It allows businesses to provide health benefits with the same tax advantages as traditional group coverage but with greater flexibility and often lower administrative costs.

ICHRAs can also help businesses better control their long-term healthcare costs. Unlike traditional group plans, where premium increases are the norm, employers can adjust ICHRA allowances based on their budget and business performance.

“We can have you give a dollar amount to each employee, have it come out with a pre -tax benefit, and then those employees can use that money to buy a plan that works for them in their area.”

Choosing ICHRA

When it comes to implementing an ICHRA plan, you need to carefully plan and provide clear communication and assistance for your employees. This isn’t a decision to enter into lightly, and you shouldn’t do it without a broker. If your business has less than 50 employees and they aren’t making high salaries, it may be smarter to allow them to qualify for federal subsidies through the ACA marketplace instead. Because there are so many caveats to an ICHRA plan, it’s best to get help from a knowledgeable professional.

When choosing an ICHRA plan, businesses need to determine appropriate reimbursement amounts for different employee classes, making sure these amounts give employees the ability to purchase adequate coverage. They also need to establish clear policies surrounding eligible expenses and reimbursement procedures.

“Most brokers are only comfortable with group or individual plans. But at Ark, we’re well-versed in both of these options and can help you find what best fits your business,” says Yates. “It’s important to get an analysis from someone who knows what they’re doing and is established in your area.”

Tax advantagesMaking the decision

Whether an ICHRA makes sense for your business or not depends on a variety of factors, like your workforce demographics, local insurance market conditions, and administrative capabilities. A thorough analysis from Ark will look at your current health benefit costs and challenges, and compare those against projected ICHRA expenses. We consider everything, including the reimbursement amounts and administrative costs of the plan. It’s also important to think about your employees and their preferences. You may want to take into account the overall health of your group and their potential needs when it comes to healthcare. At Ark, we take every factor into consideration.

As healthcare costs continue to rise and workforce needs evolve, ICHRAs represent a new approach to employee health benefits that may be helpful in certain states and/or situations. While they may not be the perfect solution for every business, they present a compelling alternative worth considering.

For businesses struggling with traditional group health insurance or seeking more predictable benefit costs, ICHRAs can be worth looking into. However, they still require careful planning. In the right use cases, ICHRAs can create a win-win situation – providing employees with the health benefits they need while giving employers greater control over their healthcare spending.

Want to see which plans might best fit your needs? Click here to schedule an appointment with an Ark Insurance Solutions agent.
Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.

With a limited time waiver, you can offer a Group Health Insurance Plan for your team at no cost to you

Small Business Owners: With a Limited-Time Waiver, You Can Offer a Group Health Insurance Plan for Your Team at No Cost to You

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With a limited time waiver, you can offer a Group Health Insurance Plan for your team at no cost to you

If you’re a small business owner and you’ve been waiting to offer a group health plan, now might be the perfect time. Until December 15th, the U.S. government has waived the Minimum Participation Rate (MPR) requirement as well as the minimum contribution requirement. This temporary waiver aims to make it easier and more affordable for employers with 2 to 50 employees to get health insurance coverage for their team.

In Utah, the Minimum Participation Rate (MPR) is generally 75%, which means that without this waiver, 75% of your eligible employees would have to enroll in a health insurance plan you are providing for you to offer insurance. But here’s how the waiver helps. Even if you have 50 employees, with the waiver, you would only need two employees who wanted to sign up for health insurance to make it work.

During the rest of the year, employers are required to pay for a certain portion of their employees’ health insurance. During the waiver period, employees can configure the arrangement so that each employee pays 100% of the cost for their own health insurance. So, even if in the past providing health insurance to your employees seemed out of reach, during this special window it might just be possible.

If your company wants to take advantage of this special waiver, it’s important to understand that it takes a few weeks for a health insurance agent or broker to help you explore plans, choose a plan, enroll in the plan, and get all the paperwork signed and accepted by the carrier. Since all paperwork must be signed and accepted by December 15, 2024 (with coverage beginning January 1, 2025), you should book an appointment with an agent now.

Want to see which plans might best fit your needs? Click here to schedule an appointment with an Ark Insurance Solutions agent.

Not Insurance: Health Share Plans Could Leave You Unprotected

Not Insurance: Health Share Plans Could Leave You Unprotected

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Not Insurance: Health Share Plans Could Leave You Unprotected

Health share plans and healthcare sharing ministries (HCSMs) are often marketed as “cost-effective alternatives to traditional health insurance.” However, as some Utahns are finding out, these plans have substantial limitations on coverage and lack the protections that ACA-approved health insurance plans provide.

If you’ve ever researched healthcare plans for yourself or your family, you know firsthand that searching for and comparing plans can be confusing—really confusing. There are so many different plans, pricing tiers, subsidies, and sign-up windows—the whole experience can be overwhelming. If you don’t know how to apply for subsidies made available through the Affordable Care Act (ACA), the cost of coverage can also seem impossible.

During your search for coverage, you may have encountered programs called health share plans or healthcare sharing ministries (HCSMs). These plans appeal to the human desire to be part of a community of people with similar beliefs and values. Members of HCSMs “share a common set of ethical or religious beliefs and share medical expenses among members in accordance with those beliefs.”

A report from the Colorado Division of Insurance found that more than 1.7 million Americans rely on sharing plans and that many of the plans require members to ask for charity care before submitting their bills.

-First Annual Report on Health Care Sharing Plans and Arrangements from Colorado Division of Insurance, May, 12, 2023

Both health share plans and healthcare sharing ministries plans are touted as affordable alternatives to traditional health insurance—and it’s true that monthly premiums are sometimes lower than health insurance plans. However, the reason the premiums are lower is alarming: Health share plans and healthcare sharing ministries plans are not insurance plans. They don’t provide essential coverage and benefits and don’t have to meet the minimum health benefits mandated by the Affordable Care Act.

Unlike regulated insurance companies, health share plans and healthcare sharing ministries are not required by law to pay their members’ claims for medical expenses.

Choosing a health share plan over an ACA-compliant health insurance plan can have profound, negative implications on your access to healthcare. No one plans for a severe illness, injury, or medical emergency, but if you choose a health share plan instead of insurance, there’s a good chance it won’t be covered. If you have a serious illness, it’s also very possible that the cost of your care exceeds the annual limit (the cap on the amount the health share will pay in a single year). There are thousands of documented cases of Americans with health share plans who ended up with a severe illness or injury, only to find themselves up a creek without a paddle.

Let’s dive in and cover a bit more about why you should avoid these plans, and how a health insurance plan through the Health Insurance Marketplace is the better alternative.

How Do Health Share Plans Work?

Health share plans and healthcare sharing ministries operate on the premise that members of the plan pool their money to cover each other’s medical expenses. Members typically pay a monthly “share” or contribution, and those contributions are used to pay the medical costs of other members who file claims.

Don’t Be Fooled. Health Share Plans Are Not Health Insurance

Some health share options offer free co-pays or coverage for specialty appointments, but when it comes to your health (which is affected by your insurance coverage) it’s important to look farther down the pipeline. Here are some crucial differences between health share plans and health insurance.

  1. Health share plans aren’t regulated: Traditional health insurance plans are regulated by state insurance departments, while health share plans aren’t. Health share plan providers aren’t subject to the same oversight, consumer protections, or legal requirements as health insurance companies. As a result, health shares have fewer guarantees regarding coverage, claims processing, and dispute resolution. Often, these limitations are buried in the fine print. According to the Utah Insurance Department’s own website, when it comes to these plans “Don’t expect coverage for pre-existing conditions, mental health, or other needs.”
  2. Limited coverage: Health share plans impose restrictions on coverage. Pre-existing conditions, preventative care, and medical treatments (like cancer treatment) aren’t fully covered. Coverage varies based on the plan you’re on, and the preferences of the health share’s members.
  3. “Morality” as a litmus test for coverage: Many healthcare sharing ministries have a morality clause that requires members to adhere to specific religious or lifestyle guidelines to qualify for a plan. This often leads to a denial of coverage for conditions that are connected to activity or behaviors the administrators of the plan deem as “immoral.” This often includes treatment of STDs, treatment of alcohol or drug abuse, cirrhosis of the liver, or maternity benefits for anyone who is unmarried and pregnant.
  4. No guarantees: Health share plans operate voluntarily and rely on the willingness of members to contribute to the shared pool of money. There are no guarantees there will be funds to cover all the members’ medical expenses, especially when there is a large-scale healthcare crisis (like COVID-19) or an unexpected financial hardship among members (such as a recession).
  5. No provider network and lack of negotiated pricing: If you do find yourself paying out of pocket for your medical expenses that weren’t covered by a health share plan, there’s another unwelcome surprise waiting for you. Since health share plans don’t have provider networks, you’ll likely be charged full price by the doctors and hospitals, instead of the lower, negotiated rates available to people covered by health insurance. To add insult to injury, some plans require the patient to try to negotiate a lower price for services directly with the doctor or hospital before submitting a claim. Some even have you pay the bill and then request reimbursement.

Real-Life Consequences: A Short Case Study

In 2019, Salt Lake City’s Jennifer Wunderlich received some terrible news. Her daughter was diagnosed with a rare form of cancer and needed to start life-saving treatment immediately. Unfortunately, Jennifer’s family was enrolled in a health share plan, which she believed was the only option her family could afford, based on the perceived cost of health insurance. Jennifer contacted her health share plan, and they informed her they would only cover up to $100,000 of her daughter’s cancer treatment. Since her daughter was going to need almost 18 months of care and Jennifer would not be able to work during that time, it was looking like the Wunderlich family was also headed for financial ruin. Even worse, the health share plan would likely only cover the first few weeks of her daughter’s cancer treatment. The doctors recommended that Jennifer transfer ownership of their family’s home to one of her younger children through a trust. While it’s devastating to hear your child has cancer, learning that your “insurance” won’t cover the cost of treatment is an additional, unfathomable blow to anyone.

Luckily, Jennifer was friends with Rebecca Yates, CEO and Founder of Ark Insurance Solutions, a Salt Lake City-based health insurance brokerage. Based on Jennifer’s family income, Yates was able to sign her up for an affordable health insurance plan through the Health Insurance Marketplace. With subsidies, the health insurance plan was only $16 a month, substantially more affordable than the $450 per month Wunderlich was paying on her health share plan. The new coverage (which was actual health insurance) covered the cancer treatment, and her daughter received the life-saving healthcare she needed. Here’s what Jennifer had to say about the experience:

“Rebecca was able to find a plan that gave us the coverage we needed because we knew this would cost upwards of one million dollars. She was able to lay it out for us, and let us know what would be the best option. It changed everything. We had to go to have proton beam radiation done, which isn’t offered in Utah. So we were able to go to MD Anderson Cancer Center in Houston, and we spent the summer there while [my daughter] had her treatments and underwent other surgeries. We wouldn’t have been able to afford that had we not had insurance coverage. So it literally saved her life.”

Prioritize Your Health With Real Insurance

The significant risks and limitations of health share plans can negatively impact your access to health care. Having good health insurance coverage is critical to getting the best care. The good news is that quality health insurance can actually be affordable when sourced through the Health Insurance Marketplace, which offers subsidies and pricing tiers based on your income.

Since health insurance brokers’ fees are paid by the insurance carriers, you can get the help of a health insurance broker or agent at no additional cost. This empowers you with a professional who can advocate for you, evaluate your coverage needs, and help you find the plan that best suits your family’s budget.

Want to learn more about what type of quality health insurance coverage you can qualify for? Ark Insurance Solutions can help. Let’s talk!
Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.

SelectHealth-HolyCross

Select Health announces a major change to covered hospitals in 2024: Holy Cross Hospital-Davis will not be a part of the Select Health Value Network

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SelectHealth-HolyCross

Select Health has announced that due to a breakdown in negotiations over “establishing fair and reasonable rates that ensure affordable insurance premiums” Holy Cross Hospital – Davis will not participate in the Select Health Value Network after December 31, 2023.

Additionally, Holy Cross Hospital-Davis will no longer participate in the Select Health Med, Select Health Care, and Select Health FEHB networks unless an agreement is reached by the end of the year.

According to Select Health, what this means for customers with affected plans is that after January 1, 2024, “Holy Cross Hospital-Davis will be considered out-of-network, and any services received at this facility may be denied or covered at a lesser benefit.”

If you’re an individual, family, or employer with Select Health, the company is encouraging you to find a new in-network facility to replace Holy Cross Hospital-Davis before January 1, 2024.

Select Health has offered the following guidance:

  • For all other questions, please contact Member Services at 800-538-5038 weekdays, from 7:00 a.m. to 8:00 p.m., and Saturdays from 9:00 a.m. to 2:00 p.m. TTY users call 711. Member Services can help find an in-network hospital, such as:
    • Intermountain McKay-Dee Hospital in Ogden, UT
    • Intermountain Layton Hospital in Layton, UT
    • Intermountain LDS Hospital in Salt Lake City, UT
Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.
Ark Founder and CEO Rebecca Yates Believes All Copays Should Count

Critical Moment for Utahns With Chronic Illnesses: S.B. 184, the Legislation Needed to Stop Unfair Copay Accumulator Policies, Heads to the Business and Labor Committee

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Ark Founder and CEO Rebecca Yates reported Friday from the Utah State Capitol that S.B. 184 – Prescription Cost Amendments, was assigned to the Business and Labor committee in the house. That means it’s crucial to reach out to your representative to ask them to please support this important legislation.

Under current law, insurance companies are permitted to use copay accumulator adjustment policies to exclude copay payments/assistance provided by non-profits and pharmaceutical companies, so that these payments do not count towards a patient’s deductible or out-of-pocket-maximum. This leads to skyrocketing medical bills, and in some cases, patients not being able to afford needed medication.

Yates added, “Trying to address the cost of pharmaceuticals by adding financial burdens to our disabled communities is not only illogical, but also immoral. If they want to fix the cost of care and medications, they need to do it directly, not by trying to recoup it on the backs of those already burdened with poor health.”

Sen. Curt Bramble, R-Provo, is the chief sponsor of S.B. 184 – Prescription Cost Amendments, which would require an insurer to calculate any amounts paid on behalf of an individual towards the individual’s cost sharing requirement, and would require a pharmacy benefit manager to calculate any amounts paid on behalf of an individual towards the individual’s cost sharing requirement.

Unfortunately, the bill does have opponents who are lobbying against it. S.B. 184 will likely be voted on by Tuesday, 2/28, so it’s important to reach out now to one of the representatives on the Business and Labor Committee:

Rep. A. Cory Maloy (R), Chair (Lehi)
corymaloy@le.utah.gov
801-477-0019

Rep. Stephen L. Whyte (R), Vice Chair (Mapleton)
swhyte@le.utah.gov
385-271-8435

Rep. Carl R. Albrecht (R) (Richfield)
carlalbrecht@le.utah.gov
435-979-6578

Rep. Brady Brammer (R) (Pleasant Grove)
bbrammer@le.utah.gov
801-538-1029

Rep. Walt Brooks (R) (St. George)
wbrooks@le.utah.gov
435-817-3530

Rep. Jefferson S. Burton (R) (Spanish Fork)
jburton@le.utah.gov
385-225-0575

Rep. James A. Dunnigan (R)
jdunnigan@le.utah.gov
801-538-1029

Rep. Jon Hawkins (R) (Pleasant Grove)
jhawkins@le.utah.gov
801-368-2534

Rep. Brian S. King (D) (Salt Lake City)
briansking@le.utah.gov
801-560-0769

Rep. Ashlee Matthews (D) (SLC)
amatthews@le.utah.gov
385-264-2024

Rep. Calvin R. Musselman (R) (West Haven)
cmusselman@le.utah.gov
801-941-6188

Rep. Thomas W. Peterson (R) (Brigham City)
tpeterson@le.utah.gov
435-720-3516

Rep. Mike Schultz (R) (Hooper)
mikeschultz@le.utah.gov
801-859-7713

Rep. Norman K Thurston (R) (Provo)
normthurston@le.utah.gov
801-477-5348

Rep. Ryan D. Wilcox (R) (North Ogden)
ryanwilcox@le.utah.gov
385-600-3306

Additional info

Below is an excellent op-ed authored by Jami Curtis that was included in Utah Policy today on this topic.

https://utahpolicy.com/opinion/66635-guest-opinion-end-predatory-copay-accumulator-programs-to-help-people-like-me

Have You Received A Notice That You Will Be Losing Medicaid?

Have You Received A Notice That You Will Be Losing Medicaid?

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Have You Received A Notice That You Will Be Losing Medicaid?

If you were eligible for and enrolled in Medicaid as part of the “Families First Coronavirus Response Act” (FFCRA), you may soon receive–or have already received– notification of a discontinuation of coverage. Ark Insurance is here to help you understand those changes and make sure that you and your family will continue to receive healthcare coverage.

Congress passed legislation during the COVID-19 pandemic to guarantee that people would have access to health insurance and other benefits while the nation was in a state of public health emergency (PHE). This provided continuous coverage for those enrolled in the Children’s Health Insurance Program (CHIP) and Medicaid, even if their eligibility changed. Continuous Medicaid coverage will end on March 31, 2023, and individuals who have received Medicaid coverage will go through state-run procedures to reevaluate their eligibility. It is known as “Medicaid Unwinding” to describe this procedure. Who is affected by the upcoming “Medicaid Unwinding”? It is anticipated that 15 million people will lose their Medicaid coverage as states continue to review the eligibility of Medicaid members, including about 8 million who are deemed ineligible and about 7 million due to administrative churn. Approximately 2.7 million of these people will be eligible for employer-sponsored health plans.

If you’ve received a notice that your Medicaid coverage will be discontinued, be sure to reach out to Ark Insurance Solutions right away. At Ark Insurance Solutions, we’ll help you find affordable health insurance plans to make sure you stay covered.

Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.
Ark Insurance Founder and CEO Rebecca Yates testifies at Utah Senate Hearing

Ark’s Rebecca Yates Testified Today Before Utah Senate Committee About the Negative Impact of Copay Accumulator Adjustment Policies

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Today at the Utah State Capitol, Ark Founder and CEO Rebecca Yates testified before the Utah Senate Business and Labor Committee about the negative impacts of copay accumulator adjustment policies. These policies can lead to skyrocketing medical bills, and in some cases, patients not being able to afford needed medication. The use of these policies often result in copay assistance provided by non-profits and pharmaceutical companies not counting towards a patient’s deductible or out-of-pocket-maximum.

In her testimony, Yates told the Senate Committee:

“Section 1557 in the ACA describes that you are not allowed by benefit design to discriminate on the basis of disability. You’ve heard today (in previous testimony) that this does directly discriminate against people that are disabled. It is discouraging their treatments and therefore is against ACA Law. It is also not in compliance with the actual federal register release which is what they’re using to implement it. Under 45 CFR 156.130, it actually does say that they are not allowed to implement a copay accumulator if there is not a generic available. You’ve heard testimony today that there are not generics available for this. They are already in violation of federal law in multiple ways, and we need to stop it at the state level.”

Sen. Curt Bramble, R-Provo, is the chief sponsor of S.B. 184 – Prescription Cost Amendments, which would require an insurer to calculate any amounts paid on behalf of an individual towards the individual’s cost sharing requirement, and would require a pharmacy benefit manager to calculate any amounts paid on behalf of an individual towards the individual’s cost sharing requirement.

The Senate Committee gave the bill a favorable recommendation by unanimous vote today. The bill will now proceed to the full Senate.

Ark Founder and CEO Rebecca Yates Believes All Copays Should Count

Ark Founder and CEO Rebecca Yates Advocates at the Capitol for All Copays Count Coalition

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Ark Founder and CEO Rebecca Yates Believes All Copays Should Count

Last Friday, January 20th, Ark Founder and CEO Rebecca Yates met with lawmakers and concerned Utah parents at the Utah State Capitol to address the affordability of life-saving medications for chronically ill patients. At issue is the rising use of copay accumulator adjustment policies by insurance companies, which results in co-pay assistance provided by non-profits and pharmaceutical companies not counting towards a patient’s deductible or out-of-pocket-maximum. This leads to skyrocketing medical bills, and in some cases, patients not being able to afford needed medication.

Along with the Utah All Copays Count Coalition, Yates met with Sen. Curt Bramble, R-Provo, who will sponsor a bill this session eliminating copay assistance adjustment policies. Read more here.

Once the bill has been assigned a number, we encourage all concerned Utahns to voice support for it. More details coming soon…

Bill sponsor Sen. Curtis S. Bramble
Bill sponsor Sen. Curtis S. Bramble
Bill sponsor Sen. Curtis S. Bramble
Rebecca Yates with Jen Hepworth, whose daughter, Penny, 9, has cystic fibrosis
Rebecca Yates with Jen Hepworth, whose daughter, Penny, 9, has cystic fibrosis
Friday, January 20, 2023 at the Utah State Capitol
Friday, January 20, 2023 at the Utah State Capitol
Great news on access to Telehealth & Long-Term Care!

Great news on access to Telehealth & Long-Term Care!

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Great news on access to Telehealth & Long-Term Care!

Congress recently passed a $1.7 trillion omnibus package which includes two provisions regarding telehealth and long-term care. The package allows individuals to use existing retirement accounts to pay up to $2,500 each for long-term insurance without a 10% early withdraw penalty tax.

In addition, they have included a two-year extension of telehealth-related “regulatory flexibilities”, known as the CARES Act, that were put in place during the pandemic and were set to expire at the end of 2022.

A bipartisan deal regarding the Medicaid policy that increased funding and preventing states from removing people from Medicaid was given a new end date of April 1, 2023. This change will impact close to 85 million people enrolled in Medicaid.

Substance abuse prevention and expanding access to mental health treatment was also included with a $1.5 billion in state grants.

Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.