November 4, 2015
If all Meritus policies terminate 12/31/15 and if Meritus does not offer renew or offer new policies in 2016, as we are being led to believe by the AZ Dept. of Insurance, then the loss of individual Meritus coverage is a Qualifying Life Event which will allow individual policyholders to submit an application to another carrier until 12/31 for a 1/1/16 effective date in order to avoid a lapse in coverage.
After 12/15 a paper application must be submitted.
Online applications for 1/1/16 are only accepted up until 12/15.
November 2, 2015
The following important press release comes from the Arizona Department of Insurance
Meritus Health Placed Under Supervision
Two Arizona health insurance companies have been placed under supervision by the Arizona Director of Insurance, Andy Tobin. Director Tobin filed an Order for Supervision on October 30, 2015, to place Meritus Health Partners and Meritus Mutual Health Partners into supervision. Meritus declined to consent to the Order for Supervision. The Meritus companies’ ability to write new policies or renew existing policies is suspended. The Centers for Medicare and Medicaid Services has removed the Meritus plans from the Marketplace. Director Tobin, appointed as Supervisor under Arizona law, will oversee the two companies.
Under Supervision, both Meritus companies will honor their individual and group health insurance plans through the end of 2015. As part of the Order for Supervision, Meritus may not issue new policies or renew existing policies. Current Meritus policyholders should seek new coverage for 2016 when Open Enrollment begins November 1, 2015. An affected policyholder may contact the Marketplace to inquire about a Special Enrollment Period, if the policyholder needs more time to select a non-Meritus plan. Currently, there are expected to be eight companies on the Exchange in Arizona representing roughly 120 individual plans, and three companies offering approximately 15 small group plans. There are additional plans available off the Marketplace, as well.
Click HERE for the entire press release.
October 14, 2015
Maricopa County, AZ ~ Blue Cross® Blue Shield® of AZ (BCBSAZ) has announced the Statewide PPO network will be discontinued at the end of 2015 for all Non-Grandfathered Individual & Family plans. In Maricopa County, BCBSAZ will offer two exclusive HMO networks only, Alliance and Select.
Although open enrollment doesn’t begin until November 1st this year, there are a few things you can do to prepare if you are one of the many members required to make a new plan selection for 2016:
- Check the new networks to find out which network has the doctors you desire, if any.
- If you do not find your desired doctors on either the Select or Alliance network, you will want to check available networks from other insurance companies.
- If you purchased your insurance directly from BCBSAZ, your agent can help you make a plan change with them now.
- If you purchased your insurance on the Marketplace, you can reapply here (After November 1st)
Auto-renewal WILL NOT be available for all plans, which means some members will be required to select a new health plan by December 15th to avoid a lapse in coverage. You can view the 2016 plan options with BCBSAZ here.
If you travel out of state on a regular basis, you will most likely want to select a carrier and plan with a PPO network.
L & A Services is prepared and certified to assist with 2016 health plan selections and enrollment on or off the federal marketplace under National Producer Number 6747133.
October 14, 2015
Are you a business owner with less than 50 full-time equivalent W-2 employees?
The ACA has a little-known special open enrollment period from November 15 to December 15 where insurance companies must relax their rules…they cannot enforce any participation or contribution requirements. This makes it possible for smaller employers to get group health insurance, even with only one participant.
The effective date for these policies will be January 1, 2016. All employee and employer paperwork must be received by the carrier by December 15. Standard community rates apply.
In addition, there are also tax credits available based on the size of your business and average employee income.
Another option for employers who have employees in good health is called a Level-Funding Option. If you know which employees are going to enroll, providing employee health history can give you additional ways to save money on employee benefits. This is available any time of year for employers with at least 10 participating employees.
For all your premium savings options, request a quote and/or contact L & A Services ASAP for one-on-one assistance throughout the entire process. We are certified to assist with shopping and selecting a plan, securing the coverage, and applying for any tax credits you may be eligible for. Since this is a busy time of year for health insurance companies, the earlier you begin the smoother the process will be.
October 14, 2015
Obamacare is great for small businesses with less than 50 employees who have a history of large health claims. But what if the business is made up of healthy workers?
Since health history can’t be considered under the Affordable Care Act (ACA), insurance carriers must offer all employees the same premium with the only adjustments being for age, tobacco use and family size. This can often mean employers with the healthiest employees are paying the same premiums as employers with an unhealthy employee population.
For this reason, we are recommending employers who offer health insurance to at least 10 employees take a look at Level–Funding. With Level-Funding plans, a portion of the premium is set aside for the purpose of covering employee health claims, rather than paying the higher fully-insured premiums per employee. Coupled with a stop-loss policy, small companies are then protected from higher than expected losses from claims. If employee claims are less than anticipated during a plan year, a refund check is issued to the employer.
These plans are not subject to the same ACA “community rating” and other requirements, but they have many of the same benefits, and offer the same look and feel of a traditional health insurance plan. Level-funded plans give the employer more flexibility, allowing the plan design to provide an even greater benefit to the employees at a much lower cost than traditional fully-insured health plans.
These plans are not for every employer. Contact L & A Services for professional guidance and to obtain a quote.
October 14, 2015
Open Enrollment & Your Key to ‘White Glove’ Service
November 1st marks the first day individuals and families can review options & make health insurance selections for 2016. While 2016 plan details and premiums have not yet been released (we expect to have this information by November 1st), here are four(4) important “to-do’s” for you to prepare in advance:
- Stay informed: Sign up for L & A’s blog– this includes the most current news on insurance changes that may impact you.
- Look up your doctor– Provider networks are changing every year. As more limited networks emerge, it’s important to always verify the available plans and networks in which the doctor participates.
- Look up or call your pharmacy to make sure they will continue to accept your insurance plan.
- See if you qualify for health insurance tax credits,based on your anticipated 2016 income.
For 2016, many health plans must be replaced by December 15th for a January 1st effective date. It is important to schedule an appointment with us to review your options and guide you to the right plan for next year.
Next, check our availability for a personal appointment for 2016 Health Insurance Open Enrollment. December 15 is the deadline but we encourage you NOT to wait. The end of the Open Enrollment period is very busy so to ensure we are able to provide the individual attention you deserve, L&A Services is encouraging each of you to take this opportunity to schedule your appointment in advance. Review the November calendar then call or email us directly at (602) 996-6010 or firstname.lastname@example.org.
September 2, 2015
The Centers for Medicare and Medicaid Services (CMS) has declared the 2016 Medicare Annual Election Period
It’s hard to believe, but yes, the Medicare Annual Election Period is just around the corner again! This applies to anyone who is currently enrolled in Medicare.
The Medicare Annual Election period runs from October 15th, 2015 through December 7th, 2015 this year. This is the time of year when changes can be made to your Advantage or Supplemental plan. All elections made during this time period will be effective January 1st, 2016.
If you are happy with the plan you have, simply do nothing. If you want to consider other options for the 2016 plan year, please keep reading.
If you are on a Medicare Advantage plan (MAPD) For 2016, there will be a 45-day Annual Disenrollment Period from January 1st through February 14th, during which time you may unenroll once from a Medicare Advantage plan to enroll in Original Medicare, Part C (Supplement), AND a Part D (Drug) plan. You can no longer make changes between MAPD plans during this time.
At L&A Services we will continue to serve the needs of Medicare beneficiaries which has been our tradition since 1985. We value you, our client, and invite you to contact our office at your earliest convenience so that we can schedule an appointment at a time good for you.