Posts Tagged ‘deductibles’
Tuesday, January 24th, 2012
Anthem Blue Cross policyholders who remained on grandfathered plans (those administered by the Department of Managed Health Care rather than the Department of Insurance) faced an unexpected surprise. Along with increased premiums, their plan benefits changed as well. Co pays, deductibles, and out of pocket maximum amounts all increased as a result of these changes. Anthem said this was a necessary move to keep up with increasing health costs, but policyholders had enough, and Consumer Watchdog stepped in. The lawsuit that has been filed states that Anthem used “bait and switch” tactics, leaving “consumers are left with no certainty about what they will have to pay and what coverage they’ll receive.” Many customers who had met their deductible earlier in the year were surprised to receive bills from their providers stating that they had not yet reached their portion of medical expenses, though the patient was under the impression they had.
The lawsuit serves to protect the 100,000 policyholders who have experienced what they feel is a misrepresentation of plan coverage. Company spokespeople from Anthem state that there is no violation of state laws and regulators were made fully aware of the proposed plan changes. Consumer Watchdog stated that even though these state regulators were aware of the plan changes, they in no way received a stamp of approval to move ahead with them. Per Jerry Flanagan, staff attorney at Consumer Watchdog, “Basically, higher deductibles mean you’re paying more for less health care. It’s a change to the essential definition of a plan.”
While it is understandable that changes need to be made to policies from time to time, it is important that these changes be presented in a clear and concise manner. This will help to avoid confusion and allow members to make necessary adjustments ahead of time.
Permanent link to this post (300 words, estimated 1:12 mins reading time)
Tags: deductibles, health insurance, individual health, premiums
Posted in Federal, General, Laws, Resources, State, Tools | No Comments »
Thursday, November 10th, 2011
A surprising number of employees make vital errors during their company’s open enrollment process, often resulting in unexpected out of pocket costs. By not understanding deductibles, coinsurance, or premiums amounts responsible out their own pockets, many find out too late that they have made an error and must wait until their next anniversary date to make a change. Some of the most common mistakes are not knowing what benefits they have, not clearly understanding costs for the coverage chosen (for themselves and their dependents), and not taking advantage of pre-tax premiums and/or flexible spending plans, and not electing ancillary benefits (i.e. dental and vision), all by not taking advantage of face to face interaction prior to enrolling or renewing their benefits.
As your agency, we will assist you in every step of your open enrollment process, whether you are the employer or employee. We will walk you through the plan options, explain out of pocket exposure, and break down your monthly portions for you and your family members before you enroll, ensuring that you are on the best plan for your needs. Our enrollment meetings are not only a great way to get to get to know us, it also guarantees your complete understanding of your company’s benefits.
Permanent link to this post (209 words, estimated 50 secs reading time)
Tags: deductibles, group health, health plan, health savings accounts, premiums
Posted in Employees, Employers, Group | No Comments »
Monday, July 11th, 2011
As baby boomers begin to reach the age of Medicare eligibility, the program designed to cover senior’s health care faces an overwhelming addition of new enrollees. In fact, this year sees 7,000 new beneficiaries per day. Over the next 20 years 70 million are expected to be eligible for benefits, as compared with 45.2 million in 2008. As the aged population grows almost as quickly as the cost of medical care and pharmaceuticals, fears are growing that the Medicare system will become insolvent for many, even though they have paid into the system for their entire work lives.
This is a preview of
Medicare Faces Insolvency As Baby Boomers Enter System
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Tags: deductibles, health insurance, medicare, medicare supplement, medigap
Posted in Resources, Seniors, Tools | No Comments »
Thursday, January 13th, 2011
According to studies done in 2010, High Deductible Health Plans increased significantly in both the group and individual markets. Many found that taking on higher out of pocket plans greatly reduced their premiums, while not affecting first dollar benefits, such as preventive care or doctor office visits. It was shown that individual enrollment in HDHP’s increased from 39% in 2007 to 51% in 2010. Numbers were similar when reviewing group enrollment in HDHP’s. It is believed that as more information is provided to potential enrollees of HDHP’s regarding the benefits of adding on a health savings account, more people wanted to take advantage of the tax benefits as well. Overall, many feel that these plans gave them more control over their health care needs and costs as a whole.
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High Deductible Health Plans and HSA’s Growing in both Group & Individual Markets
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Tags: deductibles, health care costs, health plan, health savings accounts
Posted in Employees, Employers, Family, Individual, Resources | No Comments »
Thursday, October 21st, 2010
Many small business owners are now facing the tough decision as to whether they should grandfather their plans, or make necessary changes to bring down their costs. There are pros and cons to both sides, and the decision should not be a rushed one. Therefore, we want to provide some guidance tools to help you make the right choice.
With the recent rate increases there may be a desire or need to choose a higher deductible plan with lower rates.
- If you increase the deductibles, coinsurance, or maximum out of pocket exposure, your new plan will be subjected all changes in the recently passed healthcare reform act.
This is a preview of
Should You Grandfather Your Group Plan?
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Tags: added benefits, Coinsurance, deductibles, group health, health care reform, preventative care, Universal Health Care
Posted in Employers, Federal, Government Run Health Plan, Group, Laws | No Comments »
Friday, September 24th, 2010
What does it mean to lose “grandfathered status”? This may or may not be a concern to you. In a nutshell, this means is your plan will now have to comply with all regulations mandated by health care reform. One of the most important things to know is that along with guarantee issue coverage for all applicants, premium ratios cannot exceed 3:1. Currently, most carriers implement rate variations every 4 years — i.e. 30-34, 35-39, and so on and so on. With the reduction of rate brackets (from 8 to 3), one can only imagine that premiums for younger clients will be much higher than they currently are in order to meet this requirement.
Tags: deductibles, health care reform, health insurance, preventative care, Universal Health Care
Posted in Federal, General, Government Run Health Plan, Laws, Resources, Tools | No Comments »
Monday, August 30th, 2010
One outstanding declaration in President Obama’s health care reform plan is the promise people who like their current health plan will have the option to keep it. How will this work? The plan is to grandfather in policies in order to “protect the ability of individuals and businesses to keep their current plan while providing important consumer protections that give Americans – rather than insurance companies – control over their health care”, per the U.S. Department of Health and Human Services, Labor and Treasury. Also, “The new regulation also provides stability and flexibility to insurers and businesses that offer health insurance coverage as the nation transitions to a more competitive marketplace in 2014 when businesses and consumers will have more affordable choices through exchanges”*.
This is a preview of
Rules Governing Grandfathered Health Plans
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Tags: Coinsurance, deductibles, group health, health care reform, Universal Health Care
Posted in Employees, Employers, Federal, Government Run Health Plan, Group, Laws | No Comments »
Monday, November 16th, 2009
Anthem Blue Cross has discontinued some of their PPO Share (maternity) plans in California, and although you may keep your current coverage, you may find the rates higher than you anticipated. In this case, new plans have been designed to offer comparable coverage with lower premiums. For instance, those individuals and families on the PPO Share 2500 or 1500 may want to consider moving to a less expensive plan, such as the PPO Share 3500. These plans will balance the escalating costs of maternity coverage with higher deductibles and out of pocket maximums. You will still have the comfort of knowing that your coverage is in place should you need it, and continue using your current doctors and hospitals. Also, moving to a new plan will not always require medical review, making the process even easier.
As your agent, we also suggest reviewing options for those family members who do not need maternity coverage, and consider separate plans for your family members. You’ll find that this can often reduce your overall premiums, as you are no longer paying for coverage you don’t need.
Permanent link to this post (186 words, estimated 45 secs reading time)
Tags: Coinsurance, deductibles, heath insurance, maternity
Posted in Family, Individual, Resources | No Comments »
Monday, October 12th, 2009
Many carriers have released information that they will be covering the H1N1 virus (swine flu) vaccine and all administrative costs associated with obtaining the vaccine. Although focus will start with clients at most risk, all members will be ultimately covered. The two anti-viral medications, Tamiflu and Relenza, both offered in a generic formula as well, will be covered under the Tier 1 benefit, which ensures the lowest copayment for members to get their medications.
Companies that have agreed to this thus far are Blue Shield of California, Aetna, and BCBS IL, with more carriers joining in every day. Please contact us or check your insurance companies website to see how they will help you to protect yourself and your family members.
Note:
It is important to understand that these benefits are subject to the vaccine’s availability. The CDC is working with local health departments to ensure the following targeted priority populations receive the vaccine first:
1. Pregnant women
2. People who live with or care for children younger than 6 months of age
3. Healthcare and emergency medical services personnel
4. Persons between the ages of 6 months through 24 years
5. People ages 25 through 64 years who have chronic health disorders or compromised immune systems.
Permanent link to this post (209 words, estimated 50 secs reading time)
Tags: Coinsurance, deductibles, preventative care, wellness
Posted in General, Resources, Tools | No Comments »
Friday, June 5th, 2009
We all know how confusing insurance terminology can be. Here is a short list of the most commonly used terms to help you better understand the fine print on your policy:
HMO: refers to Health Maintenance Organization. HMO’s provides comprehensive health care by network physicians to those in a particular geographic area. With an HMO, you need to access care through a designated Primary Care Physician.
PPO: Preferred Provider Organization. PPO plan members receive full coverage by using doctors and hospitals within the PPO network, or they can pay more to go outside of the network for care.
Tags: Coinsurance, deductibles, HMO plan, ppo, ppo plan
Posted in General, Resources | No Comments »
