Payment Deadlines Extended

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Due to the growth in their plans and high call volumes,  the University of Utah Health Plans and SelectHealth are extending their payment deadline to January 12  ( U of U) and January 15 for individuals with a January 1 effective date. 

Select HealthU of U Health Plans

Select Health to enforce CMS Guidelines

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Select Health will be enforcing the CMS guidelines for the Special Enrollment Periods (SEP) for marriages as of September 1, 2017. The CMS guidelines states that at least one of the applicants has had one day of coverage in the past 60 days, at a minimum. Proof of both the marriage and prior coverage is required to process a SEP application.

Changes to Preventive Lab Services also in effect as of January 1, 2017.

The following lab procedures are covered under the adult medical benefit when billed with a covered diagnosis codes:

  • Basic Metabolic Panel
  • Comprehensive Metabolic Panel
  • General Health Panel
  • Thyroid
  • Urinalysis

 

Questions? Please give us a call.

Doctor in black tie with stethoscope studio shot

 

 

Employee microchipping, invasion of privacy or just efficient?

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Similar to microchipping your pets, you may have heard that a company in Wisconsin is offering microchip implants to their employees. The majority of their employees have already agreed to inject the implant into their finger, exchanging convenience for privacy.

The implants are programmed to allow accesses to certain company functions, like entrance into secure company offices and IT networks. The RFID microchips communicate using electromagnetic fields and can be read at a distance of six inches.

Privacy advocates are concerned that this procedure is yet another way to intrude on our privacy. Smart phones have already stripped us of some privacies, apps can now collect data from your phone and broadcast your information. Do you find it unsettling when your phone knows exactly where you are, or Google knows your interest based on your search history?

Arguments against microchipping humans, are vast. What may originate as a matter of convenience can turn into monitoring a person’s habits on an entirely different level. They may even evolve to monitor productivity or lifestyle habits.

What say you?

 

Report shows ACA marketplaces experienced most profitable first quarter yet

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According to a new analysis by the Kaiser Family Foundation, health insurers who participated in the Affordable Care Act marketplace earned an average of $300 per member in the first part of 2017.

This figure is more than double than this time period for the previous three years.

The figures presented to do not account for administrative costs, however, the increases still show that the marketplaces are becoming more profitable for private companies selling plans on the exchanges.

According to Cynthia Cox, a researcher at the Kaiser Family Foundation who worked on the analysis, the current profitability seems to come from increased premiums and steady cost which also suggests the markets are becoming more stable.

These increases were partially due to insurance companies underestimating the cost to cover people in the marketplace, many were sicker than expected and seeking insurance. Additionally, costs have been stable over the past few years, indicating that healthy people were not driven out of the marketplace. Insurers have set premiums high enough for them to profit but not so high that healthier customers left the market, allowing the market to achieve stability.

Source: Kaiser Family Foundation

Important information if you have Aetna or CoventryOne insurance.

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Recently, Aetna notified our brokerage of some important changes that will be taking place this year. Essentially, if you are currently covered individually by Aetna or CoventryOne, your coverage ends December 31, 2017.

“As a result of financial risk and an uncertain outlook for the Individual marketplace, Aetna (including Coventry)  has decided that we will no longer offer individual health products in the following states AR, AZ, CT, FL, GA, IL, KS, KY, LA, ME, MI, MO, NC, OH, PA, SC, TN, TX, UT, and WV for 2018.

Your clients’ existing coverage in these states will continue until their policy period ends onDecember 31, 2017. They will not be able to renew their plan when their policy term ends.

The 2018 Open Enrollment Period runs from November 1 through December 15, 2017; however your clients will have a Special Enrollment Period. They must select a plan from another carrier no later than December 31, 2017 to ensure there is no gap in coverage on January 1, 2018.”

 

Source: Aetna and CoventryOne individual and families

 

2018 Health Savings Accounts Limits Are Set

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The IRS recently published the inflation adjusted limits for the 2018 Health Savings Accounts (HSA). Deposits made to an HSA are tax free; contributions grow within the account tax free; and distributions are tax free as long as the money is used for out-of-pocket health care expenses, including deductibles.

Here are the new limits:

  • Individual accounts rise to $3,450 (from 2017’s $3,400)
  • Family coverage rises to $6,900 (from 2017’s from $6,700)
  • Maximum out-of-pocket figures are also up: for single coverage to $6,650 (from 2017’s $6,550) and for family coverage to $13,300 (from 2017’s $13,100)

 

Source: IRS

Small business owners are voicing their opinions on the President’s ideas to repeal and replace the Affordable Care Act.

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When 1,000 small business owners were recently survived, 53.1 percent are against the health care bill passed by the House, while only 13 percent support it.

An impartial position of 34 percent was reported while a large majority of 60.4 percent do not think the bill would have a negative effect on their small business. Almost all agreed at 92.5 percent that insurance companies should provide coverage to people with pre-existing conditions.

At 72 percent, most small business owners agreed that expanding access to health care is most important over reducing taxes and decreasing the federal debt.

 

Sources: BenefitsPro.com, Fit Small Business

Understanding Mini-Medical Plans

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Many industries or small sized employer groups utilize a mini-medical plan, such as restaurants, hotels, maid services, catering services, etc. These limited benefit plans pay for covered services at an affordable premium for both the employees and the employers. But keep in mind, they cost less, so they cover less, and most likely will not protect you from a bankruptcy situation for any catastrophic medical care.

Mini-medical plans provide a basic level of coverage for people who do not have access to a major medical plan or traditional coverage.

Some large employers have a class of employees who are ineligible for their companies traditional health insurance plan for a variety of reasons. For instance, they may be only seasonal or part-time employees. Being able to offer them a mini-medical plan helps to boast employee moral and increases retention.

Mini-medical plans are not meant to replace major medical plans, but to fill a specific niche and provide some medical coverage for those who may not qualify otherwise.

 

Long-term care insurance, should you have it?

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Becoming chronically ill due to a cognitive impairment, or if you’re unable to perform at least two activities of daily living without substantial assistance, qualifies a person for long-term care. Having insurance that covers long-term care would help pay for the care you need. Depending on the level of care that is required, that care may be provided in a nursing home, an alternate care facility, or even your own home.

In addition to helping pay the costs of long-term care, long-term care insurance may help to provide these additional benefits:

  • Protect your savings and other assets
  • Preserve your independence
  • Avoid government dependence

If you’re unable to pay for long-term care when you or even a loved one needs it, odds are you will need to spend down, or liquidate, your assets to become eligible for Medicaid to pay the costs of the care required. That is a sad reality if you do not have the coverage when you need it.

Another option is purchasing a long-term care rider on your life insurance. This option provides care before the client requires long-term health due to age but instead provides coverage become impaired due to an accident or illness.

 

Five Factors that can Affect Your Premium

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Did you know there are five factors that can affect how much your health plan’s monthly premium under the health care law? However, individual states can limit how much these factors come into play.

These five factors are:

 

  • Age: Premiums can be up to 3 times higher for older people than for younger people.
  • Location: Where you live has a big effect on your premiums. Differences in competition, state and local rules, and cost of living are the reasons why.
  • Tobacco use: Insurers can charge tobacco users up to 50% more than those who don’t use tobacco.
  • Individual vs. family enrollment: Insurers can charge more for a plan that also covers a spouse and/or dependents.
  • Plan category: Bronze, Silver, Gold, Platinum, and Catastrophic. The categories are based on how you and the plan share costs. Bronze plans usually have lower monthly premiums and higher out-of-pocket costs when you get care. Platinum plans usually have the highest premiums and lowest out-of-pocket costs.

 

In addition, insurance companies may offer more benefits, which could also affect costs. Furthermore, insurance companies can not charge women and men different prices for the same plan, nor can they take your current medical history or health into account when, otherwise known as pre-existing conditions.