health insurance open enrollment Archives - Page 4 of 5

Preparing For Health Insurance Open Enrollment: Tips To Save Money

The Health Insurance Open Enrollment Period is over. To get the most savings, this year take a deep dive into all the plans available in your area, instead of just renewing your health insurance plan out of habit. If you use the following tips, you might find that there is a plan that covers all your medical needs AND helps you save money.

Find Out if You Qualify for Premium Tax Relief & Cost-Sharing Reductions

Did you know that over 80% of people who enroll in a Marketplace plan receive premium tax credits? Qualification for premium tax credits is based on household income; you can qualify if your household income is at least 100% but no more than 400% of the federal poverty line. If you do qualify for a premium tax credit, you will have the choice to receive the full amount of the credit in advance, so that you can reduce your premiums up front, or you can wait to get the credit when you file your taxes.

If your household income is up to 250% of the federal poverty line, you will be eligible for cost-sharing reductions on copays and coinsurance. In order to receive this benefit, you must be enrolled in a Silver plan; as long as you qualify for this benefit, it will be automatically included as part of your plan.

Consider Your Medical Needs

Do you have a chronic condition that requires ongoing treatment? Medications that you regularly take? Do you have family members with chronic conditions or who need medications? Do you plan on expanding your family? These are just some of the questions you need to ask yourself as you consider your plan for next year. Look closely at your medical expenses from last year, make a list of what you think your needs will be for next year, and figure out how much you can afford to spend on premiums. Remember to also take into account the costs of copays, coinsurance, and deductibles.

Do NOT Automatically Choose the Cheapest Plan

It is always tempting to save money by opting for the cheapest plan available. But this can end up costing you more in the long run, especially if you or a family member ends up having an emergency or becoming ill. Some cheap plans look good on paper, especially since all ACA-approved plans have to cover the 10 essential benefits, but they might have some exclusions in the fine print. Remember that, while all plans cover the 10 essential health benefits, there is no guarantee that a plan will cover any specific service or medication within the 10 categories.

Purchasing a cheap plan might seem like a good way to save money, but in the event that you need coverage for something specific, you could end up spending all the money you thought you were saving on out-of-pocket expenses. Remember, too, that cheap plans tend to have high deductibles, so you will have to pay a lot out-of-pocket before your plan begins to cover your medical expenses.

round blue pills spilling out of prescription bottle on top of hundred dollar bills. — *Save on medication by opting for generic brand or a plan with your medicine on a lower-priced drug formulary tier.*

Save On Medications

Prescription medications are not cheap, especially when you need to regularly purchase medications to treat a chronic condition. To save money, you can opt for generic brand medications, which are usually cheaper. This is because they will generally be in a lower-priced tier in your plan’s drug formulary. Your plan’s formulary will tell you how much you will have to pay for each drug, so as you research plans, make sure to check their drug formularies to see which of your medications might be in a lower-priced tier .

Work With a Reputable Agent

Remember, Open Enrollment is ending soon, so you need to compare plans quickly! The best thing to do at this point is to work with an EZ.Insure agent, who will instantly give you quotes from all available plans in your area. We will show you all of your options, as well as look for any discounts or subsidies you might be eligible for.

Come to EZ and you will work with just one agent who will help guide you to the plan that best suits your medical and financial needs. Our goal is to help you save the most money while getting the most coverage for you and your family’s needs. Do not wait until the last minute and end up settling for a plan that doesn’t fit your needs. To get instant free quotes, simply enter your zip code in the bar above, or to speak to an agent, call 888-350-1890.

Preparing For Health Insurance Open Enrollment: Added Healthcare

Health insurance plans change from year to year. Sometimes prices will change, and coverage will change: some things will no longer be covered, and some benefits will be added to your plan. As you look into plans for next year, you might find some newly added healthcare benefits are now included, like telemedicine, which is now included due to the coronavirus pandemic. Telemedicine is just one of the newly added healthcare benefits to look out for in next year’s plans. The Open Enrollment Period is ending in less than 2 weeks, so now is the time to compare plans if you haven’t already.

Benefits To Look For:

Telemedicine

It always seems to happen during the weekend or when your doctor’s office is closed: you or your child gets sick. You then need to consider going to urgent care or the emergency room. The illness might not warrant an expensive trip to the emergency room, and you might want to avoid going to urgent care because of COVID-19. Luckily, with many new plans, you will not have to go to urgent care when an unexpected illness happens. Starting next year, many plans will give you the option to use telehealth to “see” a doctor 24/7 over the phone or on your tablet or laptop, so that you can get the care you need as soon as possible. Check with different health insurance companies to see if they are offering this benefit.

Fitness Benefits

Want to get fit but don’t have the money to invest in a gym membership? Some 0health insurance companies will be offering fitness benefits as part of their plans. These benefits include incentives to get healthier, like paying a certain percentage of your gym membership’s monthly fees. Take control of your wellness, and feel happier and healthier, by taking advantage of this added healthcare benefit!

Chronic Condition Management

Unfortunately, many Americans are dealing with some kind of chronic condition, such as respiratory disease, diabetes, or heart disease. The ongoing treatment for these conditions can become very expensive, because they require constant monitoring and medication. All health plans currently sold on the Marketplace cover chronic care management, but some are limited in what they cover. In general, most plans have some type of coverage for doctor visits, lab tests, prescriptions, preventive care, behavioral health services, rehabilitation services (including physical therapy) and hospital care related to your chronic condition.

Luckily, as of January 1st, some health insurance companies will be expanding benefits for ongoing management of chronic conditions. With some plans, you will be given your own care manager who will work with you to coordinate care and help you manage your condition.

Travel Coverage

Although it doesn’t seem like we will be doing much traveling anytime soon due to the pandemic, the time will come when we will start going on vacations and business trips again, and you might find that you need medical coverage for your trips. Your current plan probably requires you to purchase additional medical coverage before you travel, which most likely costs an arm and a leg. But many health insurance plans will begin to offer travel coverage to members at no extra cost next year. This type of coverage will include:

Medical emergency services: You will receive coverage for medical care such as medical referrals, emergency medical evacuation, prescriptions and more.
Travel emergency services: This will help with things such as lost luggage/documents, and will offer legal and interpreter referrals, as well as care of minor children and pets when experiencing a travel emergency.

Price Estimation Tool

Starting next year, some companies will offer a price estimation tool that will help you budget better for the year. This tool will provide estimates of the price of medical procedures, surgeries, and prescription drugs. It will show you how much in-network healthcare providers charge for services and medications based on your specific plan.

If you are interested in receiving all of these benefits, some of them, or even just one of them, then it is best to compare plans. It can be time consuming and confusing to figure out which plan will offer these benefits, and will also meet your financial needs. EZ.Insure offers free guidance in figuring it all out. We make the process easier by comparing all available plans in your area in minutes. We will compare plans and find one that includes the added benefits you might want/need, but is still in your budget. To get free instant quotes in minutes, simply enter your zip code in the bar above, or to speak to an agent, call 888-350-1890.

Signed Up For A Plan & Regretting It? Let EZ Find You A New Plan

Buyer’s remorse- it happens to the best of us. It can even happen to you after you sign up for a health insurance plan. Now that Open Enrollment has ended and you have signed up for a plan, have you reviewed it and come to the conclusion that you don’t really like it? Maybe you felt rushed or pressured into buying a plan before Open Enrollment ended; whatever the case, know that you don’t have to stick with that plan. EZ.Insure can help you change plans if you live in one of the states that has an extended Open Enrollment. If you don’t live in one of these states, we can help find you another option.

Extended Open Enrollment Periods

The Open Enrollment Period (OEP) is from November 1 to December 15, but some states have an extended OEP. These states are:

California– Nov. 1, 2020 to Jan. 31, 2021
Colorado- Nov. 1, 2020 to Jan. 15, 2021
D.C.- Nov. 1, 2020 to Jan. 31, 2021
Massachusetts– Nov. 1, 2020 to Jan. 23, 2021
Nevada- Nov. 1, 2020 to Jan. 15, 2021
New Jersey- Nov. 1, 2020 to Jan. 31, 2021
New York– Nov. 1, 2020 to Jan. 31, 2021

During this time, one of our licensed agents can help you change plans. We will review all available plans in your area, compare quotes and coverage, and find a plan that meets all of your needs – and we won’t make you feel rushed to choose!

Special Enrollment Qualifying Events

When it comes to health insurance plans, you have two options: a private plan or a Marketplace plan. Private plans, like Marketplace plans, meet all the requirements of the ACA, such as including pre-existing conditions and providing free preventive care. Also like Marketplace plans, private health insurance plans have to be purchased during the Open Enrollment Period, unless you qualify for a Special Enrollment Period (SEP).

two rings on the ends of a paper with the word divorce on the paper and a rip in the middle — *Getting divorced is considered a qualifying life event for a Special Enrollment Period.*

To qualify for a SEP, you must experience a qualifying life event. These events include:

Getting married
Having a baby, adopting a child or placing a child up for adoption or into foster care
Moving
Becoming a U.S. citizen
Leaving incarceration
Losing other health coverage due to job loss, divorce, or aging out of a parent’s plan
Losing eligibility for Medicaid or the Children’s Health Insurance Program (CHIP)
Change in income or household status that affects eligibility for premium tax credits or cost-sharing subsidies
Becoming a member of a Native American tribe

If you have experienced one of these events, speak to an EZ.Insure agent about finding a new plan.

Short-Term Plans

If your state does not offer an extended Open Enrollment Period, and you have not experienced a qualifying life event that would qualify you for a Special Enrollment Period, you still have options. For example, you can look into a short-term health insurance plan. Not only are these plans affordable, but their coverage is flexible. Short-term plans can be sold year round and can cover you for up to a year, which will provide you with at least some health insurance until the next Open Enrollment Period. Or, if you are happy with your short-term plan, you can re-apply for another short-term plan. Although these plans are not required to cover the 10 essential health benefits that ACA plans are required to, they are good options for those who are looking for convenient and affordable coverage.

Catastrophic Plans

If you are under 30 and qualify for a hardship exemption, then you can sign up for a catastrophic plan at any time. Hardship exemption means that due to financial hardship or other hardships, such as the death of a family member, you are unable to afford health insurance coverage. Many people are unaware that these plans are an option. These plans:

Cover all the essential benefits defined by the ACA
Have high deductibles
Cover at least 3 primary care visits per year before the deductible is met (copays can apply for these visits, but part of the cost will be paid by the insurance company, even if you haven’t met your deductible).

Some hardship exemptions include:

Homelessness
Bankruptcy
Domestic violence
Death of a close relative
Utility services being shut off
Eviction
Home foreclosure
A fire or other natural- or human-caused disaster that results in substantial property damage

Beat Buyer’s Remorse

Purchasing a health insurance plan that you later regret is not the end of the world. You still have options. If you live in one of the states with an extended deadline, great! You can purchase a Marketplace plan or private health insurance plan through one of our agents. If you do not live somewhere that has an extended Open Enrollment Period, then consider a short-term plan or a catastrophic health plan. You do not have to stick with the plan you currently have and continue to pay monthly premiums for a plan that doesn’t meet your needs, or is too expensive.

Your best bet? Speak to an EZ agent! Our agents are highly trained in the health insurance industry and work with the top-rated companies in the nation. To see all of your options and find out how to save money, simply enter your zip code in the bar above. We will provide you with free instant quotes within minutes. Or to speak directly with an agent, call 888-350-1890.

Preparing For Health Insurance Open Enrollment: Employer Checklist for Open Enrollment

Open Enrollment for health insurance has begun. This period gives employers and employees the opportunity to change their benefit options, and many companies use this time to review their employees’ health insurance plans to see if they can find ways to save money or improve coverage. The opportunity for business owners to save money during Open Enrollment is especially important this year because the coronavirus has hit many companies hard financially. Now is the time to speak to an EZ agent to see if you should renew your current plan or switch to a more affordable plan that offers just as many benefits.

As you review your options, you also have to be aware of any legal changes affecting the design and administration of your current plan or any other plan you choose. Go through the following checklist, share it with your employees, and use it to help you choose your plan for the coming year.

change written on many freen arrow signs pointing in different directions. — *Healthcare plans change every year, including the price and coverage, so you need to be aware to be better prepared.*

Plan Design Changes

Healthcare plans and the rules surrounding them change every year. The cost of your plan may go up, so you need to be aware of changes to your costs. But you also need to be aware of changes to certain limits in your plan. Some changes to know for 2021 include:

Affordable Care Act (ACA) affordability standard– The affordability percentage for 2021 is 9.83%. Employer-sponsored coverage for next year’s plan will be considered affordable under the employer shared responsibility rule if the employee’s required contribution for self-only coverage does not exceed 9.83% of the employee’s household income for the tax year.
Out-of-pocket maximum– The annual out-of-pocket maximum limit for 2021 is $8,550 for self-only coverage and $17,100 for family coverage.
FSA contribution limit: This has not been announced yet, so watch for IRS guidance on the FSA contribution limit for the 2021 plan year.
High deductible health plan (HDHP) and health savings account (HSA) rules for 2021:
- HSA contribution limits: $3,600 for individuals and $7,200 for families
- HDHP minimum deductible: $1,400 for individuals and $2,800 for families
- HDHP out-of-pocket-maximum: $7,000 for individuals and $14,000 for families

Make sure to confirm that your plan’s out-of-pocket maximum complies with the ACA’s limits for next year. If you offer a HDHP, make sure that the plan’s deductible and out-of-pocket maximum are also in compliance with next year’s rules. Remember to communicate these changes to your employees.

Notices To Pass On To Employees

You should provide certain benefits notices to your employees during the Open Enrollment Period. Benefit notices that you should review and provide to your employees include:

Summary of Benefits and Coverage– The ACA requires healthcare plans and health insurance issuers to provide a summary of benefits and coverage to enrollees. This has to be given to your employees who enroll or re-enroll during Open Enrollment.
Summary Plan Description (SPD)– Plan administrators have to provide a SPD to new participants within 90 days after plan coverage begins. In addition, any changes that are made to the plan should be communicated to employees in an updated SPD booklet.
COBRA General Notice– Group health plan administrators have to provide an initial COBRA notice to new participants and certain dependents within 90 days after plan coverage begins. It can be included in the SPD.
Grandfathered Plan Notice– If you have a grandfathered plan, then make sure that you provide any information about the plan’s status and any changes to the plan.
Children’s Health Insurance Program (CHIP) Notice– Group health plans that cover residents in a state that provides assistance subsidies under a Medicaid plan or CHIP have to send an annual notice about the available assistance to all employees residing in that state.
Notice of Patient Protections– This notice needs to be provided if you are offering non-grandfathered group health plans that require designation of a participating primary care provider. If a non-grandfathered plan requires participants to designate a participating primary care provider, the plan or issuer must provide a notice.
Individual coverage HRA (ICHRA)– This applies to employers who sponsor ICHRAs for specific classes of employees, or all employees. You must provide the written notice to each participant at least 90 days before the beginning of each plan year.
HIPAA Privacy Notice– Employers with self-insured health plans are required to maintain and provide their own Privacy Notices. Special rules apply for fully insured plans. Under these rules, the health insurance issuer, and not the health plan itself, is primarily responsible for the Privacy Notice.
Wellness Program Notices- There are 2 notices that you will need to provide employees if you offer a workplace wellness program:
- HIPAA Wellness Program Notice– HIPAA imposes a notice requirement on health-contingent wellness programs that are offered under group health plans. Health-contingent wellness plans require individuals to satisfy standards related to health factors (for example, not smoking) in order to obtain rewards.
- Americans with Disabilities Act (ADA) Wellness Program Notice– Employers with 15 or more employees are subject to the ADA. Wellness programs that include health-related questions or medical exams must comply with the ADA’s requirements, including an employee notice requirement.

shopping cart with money held in a paperclip inside of it. — *Comparing plans with an EZ agent can help you save hundreds of dollars a year!*

Finding An Affordable Plan

Whether you are considering renewing your current group plan, or finding a new plan or insurance company to work with, you will have to do some researching and comparing. There are hundreds of group insurance plans to compare in order to find the one that best suits you and your employees. By combing through these plans, you will be able to save hundreds, and maybe even thousands of dollars a year! The first step in figuring out what kind of plan to look for is to conduct an employee health survey.

Next, you should speak to an EZ agent. It can be time consuming to sit down and compare plans, and with Open Enrollment coming to an end soon, the whole process can become overwhelming. Running a business means that you have a lot on your plate, so let EZ.Insure do all the work for you. You can speak to one of our agents free of charge. They will ask you questions regarding your budget and employees, and will then begin comparing quotes. EZ will present you with the best option that will offer the most benefits and savings. To get instant quotes, simply enter your zip code in the bar above, or to speak directly to a licensed agent, call 888-998-2027.

Preparing For Health Insurance Open Enrollment: 2021 ACA Premium Rates

Open Enrollment begins on November 1, and the 2021 premium rates for ACA plans have now been announced. Rates will be increasing slightly, because insurance companies have had to shoulder the costs of the free coronavirus testing and treatments mandated by Congress. This no-cost testing and treatment has left insurers with a $103 billion dollar bill. The rate increase may not be very large for some, though, because of the medical loss ratio rebate that will be incorporated into their premiums next year. If you’re looking for a new plan, or want to change plans, we’ve broken down what your costs could look like, and how you can still find affordable health insurance that fits your budget and coverage needs.

The ACA Premium Increase

black chalkboard with two white lines forming a line graph, with a red line going upwards in the graph. — *ACA premium rates are increasing slightly for some, while others might see a 20-50% increase.*

The average cost of ACA premiums is increasing by only a few percentage points, with very few states experiencing a decrease. The increase will vary depending on the state, and will also be affected by whether each individual insurer has met the legal standard of spending 80% of revenue on direct medical care. If they have not met the standard over the last three years, then they must issue medical loss ratio rebates back to the policyholders. Many are doing this by putting the rebates towards premiums for next year to help keep them from spiking too much.

Despite projections of slight increases, some policyholders have been posting letters from their insurance carriers on Twitter that say their premiums will increase anywhere from 20 to 48%! In addition, according to one study, commercial insurers like Blue Cross Blue Shield, Aetna, Cigna, and Oscar Health could increase premiums anywhere from 4% to 40%.

So far, the highest increase for individual health plans has been proposed by Oscar Health in New York at 19.1%. For small group plans (employer-sponsored plans), Oscar Health also has the highest proposed increase of 29.1%, followed by Emblem at 20.9%.

More Affordable Options

Now that Open Enrollment is approaching, you should reassess your current insurance plan, if you have one (and if you don’t, now is the time to start looking!) It’s possible that different insurers have expanded into your state or county, and you might have more options available to you than you did before. Take advantage of this time and consider all of your options!

Because premiums vary by state or region, it is important to get some help determining what the increases to your premiums could look like. You should also get help finding the best plans available in your area. The best way to do this is by speaking with an EZ agent. Our agents are trained in your region and work with the top-rated companies in the country, so they have quick and easy access to all plans in your area. They will go over your medical and financial needs, and then compare all plans, including their coverage, premiums, deductibles, and other costs of each plan. We will help find an affordable plan, and maybe even lower your health insurance cost!

To compare plans in your area for free, enter your zip code in the bar above, or to speak to one of our highly trained, licensed agents, call 888-350-1890.

Renewing Your Health Insurance? Here Are Some Helpful Tips

It’s easy to simply purchase a health insurance plan, get comfortable with it, and not review it at the end of your year-long policy period. But if you automatically renew your plan and don’t look at other options, you could be missing out on savings, or a plan that provides more coverage. When you receive a “renewal notice” from your health insurance company, you should read through it carefully in order to decide if your current plan is still right for you.

It can be stressful to research and compare plans, which is why EZ.Insure was created. We want the best for our customers, so we provide you with a dedicated EZ.Insure agent who will go over your current plan, its price, and its coverage. We’ll then compare it to all other plans in your area so you can decide whether you should sign up for a better plan or renew your current one.

november 1st on a calendar in red with a red thumbtack on it — *You can renew your health insurance plan, or change it, during open enrollment Nov 1-Dec 15.*

When Can You Renew?

In general, you can only renew your health insurance plan during Open Enrollment. But if you have employer-based insurance, then your enrollment period might be at a different time, so make sure to check with your employer. Open Enrollment is November 1st through December 15th.

There are two ways that you can renew a plan:

Active renewal – you personally cancel the policy that you had and pick a new one.
Passive renewal – your health insurance company automatically re-enrolls you into the same plan for the coming year.

What You Need To Review

When you receive a renewal notice, you should go over the following things to make sure that your plan still suits your needs:

Premium– Your monthly payment for your health insurance plan.
Deductible– The amount you pay before your health insurance company starts paying for services.
Copay- how much you pay for each doctor visit, hospital visit, prescription medication, and specialist visit.
Coinsurance– the percentage of costs you have to pay after meeting your deductible.
Out-of-pocket maximum– The maximum amount of money you will have to pay out-of-pocket for covered healthcare services in a given year.
Your Current Network- the doctors, pharmacies, and specialists that are covered by your plan
Some health plans will offer a gym membership stipend.

Other Benefits To Review

Check to see if other benefits have been added to your plan, if benefits that you want are not covered, or if other plans might have benefits that you want included for free. Some of the benefits to look for include:

Gym discounts
Covered annual physical exam
Weight loss programs
Discounts on glasses and contact lenses

Change In Status

When deciding whether to renew your plan or find a new one, you should also consider whether you’ve had a change in income, or if your family has grown or has become smaller. Adding or removing dependents can change the cost of your plan and its coverage, so you might find that your current plan is more expensive, or that it is going to provide less coverage.

Although it is easy to sit back and let your health insurance plan renew, you should take a closer look at your plan and how it will change in the coming year. You don’t want any surprises, like to find out that your doctor is no longer in your network, you have less coverage, or your deductible went up, etc. Any of those things could end up costing you a lot of money.

If it feels like a lot of work to go over your current plan and research new ones, don’t worry: EZ will help you. We will compare all of the plans available to you, as well as go over all of your financial and medical needs. We’ll make sure that your current plan has the coverage you need, and if it doesn’t, we’ll find you a great new one! If you allow us to help you, you could end up saving hundreds of dollars a year. And remember, our services are always provided at no cost to you. To start comparing quotes, simply enter your zip code in the bar above or to speak directly to one of our agents call 888-350-1890.

Tag: health insurance open enrollment