31. March 2018 14:25
by Harry
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Lost Your Job? These Are Your Health Insurance Options

31. March 2018 14:25 by Harry | 0 Comments

Losing a job is one of the worst feelings on the planet, especially if it’s a job you actually enjoyed.

In addition to the feelings of anger, depression, fear, and grief, you’re now saddled with the responsibility of finding new health insurance if your company was the one providing your coverage.

Luckily, you have a number of options available to you after losing job-based coverage that you should begin to explore as quickly as possible, starting with ...

Primary Options For Coverage After a Job Loss

Coverage from Your Spouse or Domestic Partner’s Employer

If your spouse or domestic partner’s insurance plan is open to family members, you may be able to join now that you no longer have insurance through your employer.

Under the Health Insurance Portability and Accountability Act (HIPAA), you have 30 days from the time that your former employer stops paying for your insurance to enroll in your spouse or domestic partner’s plan. This rule stands even if your loss of coverage doesn’t occur during an open enrollment period.

Coverage from the Marketplace

 

Under the Affordable Care Act (ACA), you can enroll in a health plan in the Marketplace during a Special Enrollment Period if you lose your job-based coverage outside of the normal open enrollment period. You may even be eligible for subsidies for reduced premiums and you might qualify for lower out-of-pocket costs.

 

Coverage from the Individual Market

 

If you don’t qualify for a subsidy for reduced premiums from the Marketplace, you can simply sign up for a new plan off of the marketplace through the individual market. Not sure whether or not you’ll qualify for a subsidy? This interactive tool on the Marketplace’s website can help you determine that.

Continuing Current Coverage Through COBRA

 

The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives you the right to remain on the health plan that you had with your former employer. (COBRA does not apply if your employer had fewer than 20 employees, if your employer went out of business or if you were fired for “gross misconduct.”)

If you are eligible for COBRA benefits, you will receive notice from your former employer or the health plan and can enroll within 60 days after receiving the notice.

  • COBRA generally guarantees coverage for 18 months but may be longer depending on your circumstances.
  • Each family member can make a different COBRA election, even if your entire family was once covered under your employer’s health plan. Or, your child(ren) may elect COBRA on your plan and you may find coverage elsewhere.
  • You are responsible for paying the full COBRA premiums, which includes the amount you used to pay while employed, the amount paid by your former employer and an administrative fee. This can make COBRA coverage very expensive.

We recommend exploring the first 3 options above before looking into COBRA coverage as COBRA is likely to be your most expensive option for continuing coverage.

Secondary Options for Coverage After a Job Loss

State-Sponsored Programs

There may be state laws that complement federal COBRA regulations or other consumer protection statutes. They include:

  • Mini-COBRA plans. If you worked for an employer with 20 or fewer employees, your state may have mini-COBRA laws that allow you to obtain the same benefits by paying the full premium (or more in some states).
  • Conversion policies. If you cannot continue coverage with your former policy, your state may require insurers to convert your policy into an individual plan.

Protections Under HIPAA

Under this federal law, at least one insurer must sell you a health plan if you can meet the following conditions:

  • You previously had 18 months of coverage without a break for more than 63 days.
  • The last day of your coverage was through your employment.
  • You do not have a COBRA or mini-COBRA option available.

Trade Adjustment Assistance (TAA) Reauthorization Act and Health Coverage Tax Credit

If you lost your job due to a trade policy (moving your job overseas), you may qualify for 72.5 percent of the cost of your health insurance for up to three years under TAA. 

Medicaid, The Children’s Health Insurance Program (CHIP) or VA Coverage

Medicaid is available for low-income individuals and children, parents with dependent children, permanently disabled individuals or those over 65. Eligibility varies from state to state.

  • Though you may not qualify for full Medicaid benefits, you may be eligible for screenings for breast and cervical cancer or assistance with tuberculosis or sickle cell anemia treatments.
  • Consult your local health department for more information about public coverage options in your area.
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12. November 2017 13:44
by Harry
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3 Reasons You Should Sign up for Health Insurance

12. November 2017 13:44 by Harry | 0 Comments



Early this year, a spike in flu cases was seen across the country. According to the CDC, 104 children died across the country during the 2016-2017 flu season. The CDC doesn’t track how many adults die from influenza each year. To prevent yourself and members of your family from falling ill, being hospitalized, and missing work and school, be sure to get a flu shot. The CDC recommendations for 2017 include getting vaccinated before the end of October. If you’re wondering whether health insurance will cover the injection, the U.S. Department of Health & Human Services (HHS) says your health insurance company is required to cover flu shots without charging a co-payment, but you may need to visit a specific facility.

“Some insurance plans only cover vaccines given by your doctor or at a limited set of locations,” says the HHS.

Here are three more reasons to sign up for health insurance during the 2017 Open Enrollment period.

Accidents Happen

If you get into an accident while driving to or from work, and you don’t have health insurance, you could wind up having to pay a few thousand dollars for an emergency room visit or tens of thousands of dollars for long-term care.

Heath care plans vary, but all of them at least partially cover the following:

  • Emergency room visits
  • Outpatient care
  • Inpatient care
  • Lab tests
  • Prescription drugs
  • Rehabilitation services, such as physical therapy and psychiatrist appointments
  • Dental and vision care
  • Pre- and postnatal care
  • Substance abuse rehab
  • Preventive services, such as screenings and vaccinations

In case you’re still on the fence about whether you want to part with a monthly payment, more than half of consumers who signed up for 2016 Affordable Care Act coverage selected a plan with a monthly premium of $100 or less after tax credits. That $100 per month is a lot less than you’ll spend if you’re hospitalized after a car accident and, unfortunately, odds aren’t in your favor. According to the Department of Transportation, someone was injured in an accident every two minutes and eight seconds in 2016. Additionally, the US lost 35,092 people in traffic crashes in 2015, ending a 5-decade trend of declining fatalities with a 7.2% increase in deaths from 2014.

Some Colleges Require Health Insurance

Not only may the federal government charge a penalty for not having health insurance, some universities require students to have their own plan or remain enrolled on their parents’ policy. If you’ll be attending college this year, contact the admissions department to see how this affects you.

It’s the Law

The Affordable Care Act requires everyone to have health insurance. If you don’t, you may pay a penalty come tax time.

Should You Sign up During the 2017/2018 Open Enrollment Period?

Health insurance is a wise investment, but if you can’t afford any of the plans on the Health Care marketplace, contact Freeway. Our friendly, knowledgeable representatives will help you find a plan that fits your budget. 

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29. September 2017 00:45
by Nicki
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Small Businesses Can Get Health Insurance With Lower Participation

29. September 2017 00:45 by Nicki | 0 Comments

One of the lesser-known provisions of the Affordable Care Act (ACA) is an Annual Special Open Enrollment Window that gives you and your business the opportunity to get health coverage for your employees, even if you were turned down in the past.

An Amazing Opportunity

You can enroll in CaliforniaChoice with fewer requirements from 11/15/17 to 12/15/17. You do not have to meet the standard 70% employee participation requirement, nor do you have to contribute the usual 50% of premium for your employees’ health coverage.

This special enrollment period is an excellent way for your employees to get the coverage they want – and need – without increasing the costs to your business.

No Minimum Enrollment, No Minimum Premium Contribution

If you apply during the 11/15/2017 to 12/15/2017 enrollment Window, your employees’ coverage will begin on January 1, 2018.

There’s no minimum enrollment for your group and there’s no minimum contribution required from you for your employees’ premium. If you don’t want to contribute, then you will collect the full premium from each of your participating employees each month and pass it along to CaliforniaChoice.

If you want to contribute, you are able to pay any amount toward their coverage premium; the usual 50% employer contribution does not apply. It’s your choice; you can contribute 5%, 10%, 25%, or more – or you can make zero contribution to your employees’ premium.

There’s no minimum group participation either. (The usual requirement that 70% of your employees enroll does not apply.) So, if you have 10 employees and just two want to enroll, that’s fine. All we ask for is a minimum of one enrolled employee and that CaliforniaChoice be the only health plan offered.

Great Options for Employees

CaliforniaChoice offers your employees a variety of plans from seven different health insurance carriers, so each one is sure to find coverage to match his or her individual or family health care needs. They can select from HMOs, PPOs, HSAs, and other plans from Anthem Blue Cross, Health Net, Kaiser Permanente, Sharp Health Plan, Sutter Health Plus, UnitedHealthcare, and Western Health Advantage.

Qualification

It doesn’t matter how many employees you have, or how many choose to sign up for coverage through CaliforniaChoice during this special enrollment window. This is your once-a-year opportunity to offer health coverage to your employees without worrying about participation guidelines or premium contribution requirements.

Keep in mind, though, if you employ 50 or more full-time and/or full-time equivalent employees, your business is considered an Applicable Large Employer and you required to offer “affordable” health coverage to full-time employees. Continuation of Coverage

If you sign up during this ACA Special Open Enrollment Window, your employees’ coverage will begin January 1 and continue for up to 12 months as long as the premiums are paid. At the end of that time, if you want to keep your CaliforniaChoice coverage, you will need to meet the usual participation and premium contribution requirements at renewal.

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11. September 2017 22:53
by Harry
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Corporate Health Insurance Trends You Need to Know

11. September 2017 22:53 by Harry | 0 Comments

The ever-rising cost of corporate health care is expected to increase by 4.4 percent this year. Couple that with rising pressure from hard-fought efforts to maintain compliance with the federal government’s Affordable Care Act, and some employers have chosen to waive benefits, placing more responsibility onto their employees, who pay more both in premiums and out-of-pocket costs.

According to a survey released yesterday, workers are paying roughly $100 more per month in medical costs than they were three years ago, and can expect to pay 37 percent of the expenses acquired from company health plans this year. That’s an increase from the 34 percent in 2011.

A higher price tag isn’t the only change employees will have to deal with in the near future. The study suggests that employees also will be required to shoulder more of the costs for covering their spouses and dependents. Although today, roughly 70 percent of employers believe offering subsidized insurance for spouses is important, more than half believe it will not be important in 2015 and beyond.

Get fit for $50

Employers are looking to make proactive changes, too. Incentive health programs is a method many companies are implementing in order to improve the overall health of their workers, and therefore, decrease visits to the doctor’s office, clinic or hospital.

In increasing numbers, companies are offering an array of wellness activities to the workforce, such as boot camps and weight-loss competitions. Oftentimes, cash is the ultimate prize; on average, employees who complete all available programs could be $50 richer.

Retired and uninsured

Another serious issue facing employees – especially those considering retiring before age 65 – is the possibility that they may not have insurance coverage upon retirement. Public exchanges may become the sole option for pre-65 retirees as a reported 66 percent of companies are likely to eliminate access to coverage.

Where do we go from here?

According to the survey, only 25 percent of companies were confident they’d be providing current benefits to workers by 2024. Employers and employees need to start planning now for what’s to come. With rapid change taking place on a daily basis, “later” could mean “tomorrow,” so action planning should start today. For employees, perhaps that just means educating yourself on these trends and options, while for employers, it could mean a reconfiguration of your benefits strategy.

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6. September 2017 17:31
by John
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11 Things You Should Know About Cobra Health Insurance

6. September 2017 17:31 by John | 0 Comments

What you don't know about COBRA could come back to bite you.

If you've lost or left a job and have employer-sponsored health insurance, you'll likely be offered something called COBRA. This extends your employer-sponsored health insurance for a period that typically lasts 18 months.

Here are 11 things you should know about COBRA coverage:

1. What is COBRA?

COBRA is a federal law designed to let you pay to keep you and your family on your employer-sponsored health insurance for a limited time after your employment ends or you otherwise lose coverage.

2. What does COBRA stand for?

COBRA is an acronym for the Consolidated Omnibus Budget Reconciliation Act, the federal law that also amended ERISA to enable temporary health insurance for people who have lost or left their jobs. The law took effect in 1985.

3. Who is eligible for COBRA?

People who qualify for COBRA include employees who have voluntarily or involuntary lost their jobs, had their work hours reduced, are transitioning between jobs, or have experienced a life-changing event such as a death or divorce. This coverage is available to covered employees, their spouses, their former spouses, and their dependent children. Each year, about 3 million individuals and families use COBRA benefits.

4. How will you learn about your COBRA eligibility?

You'll receive a letter from the employer or the health insurer outlining your COBRA benefits.

HR director at Seattle-based real estate developer Geonerco Management, warns that the six-to eight-page letter can be difficult to understand “because it contains all manner of mandatory government language." If you're having trouble deciphering that language, contact the employer's HR department or the insurer.

5. Which employers are required to offer COBRA?

Generally, COBRA requires that group health plans sponsored by employers with at least 20 employees (in the previous year) must offer employees and their families the opportunity to temporarily extend their health insurance in circumstances like the ones outlined above. State and local government agencies also fall under the COBRA umbrella. Some states have COBRA-type laws that apply to employers with fewer than 20 employees.

6. Which employers are not affected by COBRA?

The law does not apply to health insurance plans sponsored by the federal government, churches, and certain church-related groups. However, federal employees are covered by a law similar to COBRA.

7. How much does COBRA cost?

The cost depends on how much insurance coverage you received from your previous employer. If you decide to accept COBRA coverage, you'll pay up to 102 percent of the insurance premiums, including the portion that your employer used to pay. In 2012, the average COBRA premiums for a family plan totaled $15,745, plus the 2 percent fee.

For some, the steep increase in financial responsibility that accompanies a COBRA plan is not always realistic—especially when unemployed. The Affordable Care Act marketplace offers alternative coverage options that can be “a lot cheaper, particularly with tax credits,” says Ivan Williams.

8. What sort of benefits will you get under COBRA?

Once you choose COBRA coverage, you retain the same rights as an employee who remains with the employer sponsoring the insurance, Szymanski says. “That means that you must go through open enrollment, which may change insurance companies, benefits offered, pricing and coverage," he says.

9. What are some alternatives to COBRA?

If you reject COBRA coverage, your health coverage options include your spouse's health insurance plan, the federal government's health insurance marketplace, your state's health insurance marketplace, the government-backed Medicaid program, or a short term medical policy designed for gaps in health coverage. These alternatives may or may not cost less than COBRA coverage, so it pays to weigh all of your options.

One option that Szymanski doesn't recommend: skipping health insurance altogether. “Electing to go uninsured is almost always a very unwise decision, with lots of potentially catastrophic downsides and very little upside," he says.

10. What if you change your mind and decide you want COBRA?

If you are entitled to elect COBRA coverage, you must be given an election period of at least 60 days. If you decline COBRA coverage during the normal 60-day decision period, you must be allowed to rescind your coverage waiver. However, you must reverse your decision during that period, and your final decision will become permanent after the 60-day window closes.

11. What happens if you miss a COBRA payment?

Szymanski cautions that you must pay premiums (usually via monthly checks sent by regular mail) in a timely manner (often a grace period of 30 days) or your coverage will be canceled.

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