News

Select Health to enforce CMS Guidelines

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?

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

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