Open Enrollment Archives - Page 2 of 3

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.

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.

Is There Open Enrollment for Group Health Insurance?

Open enrollment is defined as a period of time when an employee join your group health plan or make changes to their existing policy. If you have a Group Health policy, which you should if your business employs over 50 workers, then any changes outside of a SEP will need to be made during this open enrollment period. Your employees need to be notified so that they do not miss this opportunity.

squares and finger pointing at them — *Open enrollment is the standard period for insurance changes. Do you know the exact dates?*

The unfortunate downside is that if the deadline is missed, then they must wait until next year. However, certain qualifying life events exempt an individual from this rule. You can learn more about that here. <link to SEP article>

For Employees

Open enrollment for the 2019 period will start Friday, November 1, and it will run until Sunday, December 15, 2019.

With your employment-based policy, your staff should receive reminders in the mail, but make sure to either talk to them one-on-one or send them an email yourself.

Health coverage is important, and taking the time to reach out will send a positive message to your employees. They will appreciate your knowledge, guidance, and interest in their well-being.

For Business Owners

You do not have an “open enrollment” period to make changes to your company’s group health policy. You can make changes whenever you’d like.

business owners in their company — *Knowledge is power! Keep in mind important dates when it comes to making policy changes.*

If you want to change your business’ policy, you can (usually) cancel your coverage at any time, but the insurance company prefers to be notified at least 30 days in advance. It would be courteous to let your employees know as well.

For these changes, it’s good to review the pros and cons of joining an HRA or switching to a different policy. Both are valid options, but the choice ultimately falls on what would be best for your company’s future.

Don’t worry about big insurance decisions; EZ.Insure offers solutions. Your agent will answer any questions you have, compare the plans available to you, and even sign you up when you are ready, free of charge. To get started simply enter your zip code in the bar above, or you can speak to an agent by emailing [email protected], or calling 888-998-2027. EZ.Insure makes the entire process simple, easy, and quick.

The Annual Open Enrollment Period Is Almost Over!

The end of the Medicare Annual Enrollment Period is right around the corner. From October 15 through December 7, Medicare beneficiaries have the ability to decide if they like what they have, or if they would like to switch. If you have what you want then great, but if you are not satisfied with it, or looking to save more, it is best to do your research and make a decision soon. After December 7, you will not be able to make any changes, or add a Medicare Supplement or Advantage plan.

*During Medicare Annual Open Enrollment, you have different routes to choose that best fits your needs.*

Review Your Coverage

You will be provided with a handbook for next year’s coverage for Medicare. Take a look at the coverage, prices, and benefits. If you are not happy, or think you may need more benefits, then looking into a Medicare Supplement of Advantage plan is important. You can compare the different plans and see which one will help you the most. But you can only add these plans during the annual enrollment period.

The same goes for your Medicare Advantage or Supplement plans, you will receive an Annual Notice of Change for your plan.

Changes You Can Make

Once you make any change to your current insurance, it will take effect on January 1st. So what can you do during this period? You can:

Join a new Medicare Advantage Plan or Part D Plan
Switch between Original Medicare and Medicare Advantage.
Buy a Medicare Supplement Plan depending on where you live.

Research Your Options

Researching the different plans, and comparing the coverage and prices is a lot of work. You do not want to miss out on a great deal by overlooking or not doing enough research. Overlooking plans will cost you, but we will avoid that from happening. EZ.Insure compares plans of over 20 insurance carriers in your region. We compare all the plans and prices for you within seconds, and provide you with the information so you can choose the best option.

To receive instant quotes, you can enter your zip code in the bar above, or you can contact one of our highly trained agents. You will be given your own personal agent to work with, and not have to worry about jumping around agents. Your advisor will gather information and provide you with all of the plans available to you within your area. No obligation or fee. It is all done at no cost to you. Call 855-220-1144, or email us at [email protected] to get started. Let us take care of you, the research, and the sign up process, for free!

New Medicare Open Enrollment Dates

The Centers for Medicare and Medicaid Services, CMS, has announced that beginning in 2019, there will be a continuous Medicare Open Enrollment Period which will now be January 1- March 31st. During this time, Medicare beneficiaries will be able to to make a one time change of plans.

In 2011, the Affordable Care Act changed the Annual Election Period (AEP) to October 15 through December 7 every year and changed the Open Enrollment Period (OEP) into a Medicare Advantage Disenrollment Period (MADP) which was January 1-February 14. During the Disenrollment Period, you can drop your current Medicare Advantage plan and can return to Medicare and purchase Medicare Supplement. You can purchase Part D plan but only if you drop your Medicare Advantage Prescription Drug Plan, MAPD.

The 21st Century Cure Act that just passed and signed into law is bringing back the Open Enrollment Period dates. During the AEP, beneficiaries can change switch as much as they want but a final decision will be by December 7. The AEP will still during October 15- December 7 every year where beneficiaries can:

Switch from Original Medicare to Medicare Advantage Plan
Switch from Medicare Advantage Plan back to Original Medicare
Change Medicare Advantage Plans
Enroll in a Part D plan
Drop prescription drug coverage
Switch or purchase Medicare Supplement Plan

During the 2019 OEP, January 1-March 31st, beneficiaries can make a one time change to:

Medicare Advantage Prescription Drug Plan to another MAPD
Switch a MAPD to Original Medicare and a Part D
Switch Original Medicare and Part D to a MAPD.
Change Medicare Advantage Plans
Switch from Original Medicare to Medicare Advantage Plan
Switch Medicare Advantage Plan to Original Medicare
Purchase Medicare Supplement Plan when switching to Original Medicare*

*When purchasing a Medicare Supplement Plan during OEP, you will not have guaranteed issue and subject to underwriting.

The AEP can be a hectic time for many Medicare beneficiaries because it falls during the holidays. Some people will wait until the holidays are over to try and change plans and find out they cannot do it until the next AEP in a year. Now, with this new OEP, from January 1-March 31st, beneficiaries can help those that missed the deadline to have another chance to make changes.

Tag: Open Enrollment