Individuals

Posted September 19th, 2016 in Producers, Employers, Individuals
Employers must provide a written notice on an annual basis to any Medicare-eligible individuals who are covered under a group health plan that includes prescription drug coverage. The notice is required to include information as to whether the prescription drug coverage is considered to be creditable. In other words, is the prescription drug coverage at least as good as the standard Medicare Part D plan? 
 
Posted September 6th, 2016 in Producers, Employers, Individuals

The Affordable Care Act (ACA) continues to evolve. Here are 10 changes expected to take effect in 2017. 

Posted August 29th, 2016 in Producers, Employers, Individuals
In 2013 and 2014 the word “exchange” was being used everywhere in the health insurance industry. Now, just a couple of years later, that term isn’t being used as frequently as it was just a couple years prior. Why? For one, the federal government decided the phrase “health insurance marketplace” or “marketplace” was what they would start calling their exchange. The media and general public also seem to associate the word “Obamacare” as being synonymous with the government-run exchanges. Additionally, private exchanges are not experiencing the growth rates that many had projected.
Posted July 28th, 2016 in Producers, Employers, Individuals
There has been a lot of shake up in the recent weeks and months as it relates to health insurance options available in the individual marketplace. UnitedHealthcare (UHC) announced it would only offer individual plan options in three states next year. Humana also announced they would be limiting the number of states it offers individual plans in next year. More recently, three additional CO-OPs in Connecticut, Illinois and Oregon announced their closures by the end of the year.
 
Posted July 7th, 2016 in Producers, Employers, Individuals
It should be pretty clear by now that two of the biggest provisions of the Affordable Care Act (ACA) are the Individual and Employer Mandates. The Individual Mandate requires all Americans to have a health insurance plan or pay a penalty, unless an exemption applies. Factors that may influence the amount of the Individual Mandate penalty include household size and income. The Employer Mandate requires employers with 50 or more employees to offer health insurance coverage to at least 95% of its full-time employees or risk penalties.
Posted June 7th, 2016 in Producers, Employers, Individuals
Telemedicine can generally be defined as a way to provide a broad range of health-related services by phone or through an online platform. Several employers and insurance carriers offer telemedicine services in conjunction with their health plan(s) as a way to provide a cheaper alternative of diagnosing and treating common illnesses, such as the cold or flu. 
 
Posted April 25th, 2016 in Producers, Employers, Individuals
The President of the United States can have a significant impact on the shape and direction of health care, as has been seen with President Obama and the passage of the Affordable Care Act (ACA). The American people will cast their vote for the next President of the United States on November 8, 2016. The future of the health care industry will largely be influenced by the outcome of the election. Here is a very high level summary on how the presidential candidates have suggested they would change the health care industry:
 
Donald Trump
Posted April 4th, 2016 in Producers, Employers, Individuals
H&R Block®, the largest tax services provider in the country, has indicated that so far this year the average penalty paid by those individuals without health insurance in 2015 is $383. The average penalty paid in 2014 was $172, reflecting an increase of $211 from the previous year. The penalties will be steeper in 2016 being the greater of $695 or 2.5% of income.  
 
Posted March 18th, 2016 in Producers, Employers, Individuals
We can categorize health insurance plans in a number of different ways. There are fully-insured and self-insured plans, HMOs and PPOs, high deductibles and low deductibles, and metallic tiers (bronze, silver, gold and platinum) which are used in some market segments. There’s also one other way to categorize health insurance plans, and that’s by their “grandparent” status. The grandparent status determines which Affordable Care Act (ACA) rules a health insurance plan must comply with.
 
Grandfathered Plans 

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