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.
August 27, 2015
This week, Blue Cross Blue Shield of AZ (BCBSAZ) unveiled their new proposed plan and premium information for individuals and families in 2016.
There are many changes, and many customers will be required to take action to avoid losing coverage at the end of the year. We are prepared to assist these customers with this process as early as September 9th.
Although BCBSAZ will be sending written notification to all affected members in the coming months, we wanted to provide the information in advance to help better prepare these customers for this year’s renewal.
These are the most important changes to know for 2016:
- Metal level plans (Platinum, Gold, Silver, Bronze) are considered ACA-compliant plans, since these were plans purchased and effective from January 2014 to now.
- In 2015, these plans included three networks: Statewide PPO, Alliance HMO, and Select HMO. For 2016, BCBSAZ will only offer the two HMO networks in Maricopa County…the Statewide PPO plan is being deleted. If you have an ACA-compliant plan with the Statewide PPO network, either purchased through the federal marketplace or directly from BCBSAZ, you MUST select a new plan by December 15th to avoid losing coverage on January 1st. Customers living in all other counties will have access to the Statewide PPO network, as well as another regional network. Note: the HMO plans do NOT require a primary care physician assignment, NOR do they require a referral to see a specialist. However, it is important to check the list to make sure desired doctors participate in the network or else they are not covered.
- The BlueEssential & Copay Complete plans have been deleted, so these customers will need to move to a new plan, as well.
- For customers on a plan with either the Alliance or Select network, BCBSAZ will automatically enroll in the next closest available plan available for 2016. This does not preclude you from changing your plan during open enrollment (November 1 – January 31), so contact our office if alternative choices are desired.
- BCBSAZ ACA-compliant plans experienced an average rate increase of 21.4%.
2. Grandmothered Plans are those plans purchased and effective between 2010-2013, and will include the word ‘Plus’ in the name of the plan.
- All of these plans are being renewed without any changes to benefits or to the PPO network.
- The average rate increase on these plans is 21.2%, however, the new rate will be guaranteed until April 30, 2017. This will lock in the rates for a full 16 months.
- Despite the increase, these plans continue to offer greater premium savings over the ACA-compliant plans. Most customers in these plans will want to keep what they have.
- Nothing is required to keep these plans, but customers still have the ability to either 1) change the deductible to lower the premium, or 2) consider moving to an ACA-plan during open enrollment (November 1 – January 31) if desired. If a member moves away from a Grandmothered plan, they cannot get it back later. We are able to assist with customers with this evaluation.
- BCBSAZ will be sending a letter to each affected customer on October 12th.
3. New Dental Plan
- BCBSAZ is now offering their group BluePreferred Dental plans to individuals and families.
- Contact our office if interested in private PPO dental coverage from BCBSAZ
We suspect there will be many changes in 2016 from all of our carrier partners. We know there will be many questions, and we are here to answer them. Please keep in mind that this is an extremely high-volume time of the year, so time is of the essence…the sooner you take action, the smoother the process will go for you.
Thank you to all 266 of our individual BCBSAZ customers. We look forward to serving you during this time of change.
June 25, 2015
June 25, 2015
Last night, a key provision of the Affordable Care Act (ACA) was upheld by a 6-3 Supreme Court vote which rules that federal subsidies for private health insurance plans remain available in all states, including states where consumers use the Federally Facilitated Marketplace (FFM) to obtain subsidies. You can read the full decision here.
This includes the state of Arizona; your health care coverage remains unaffected and any subsidy you are receiving will continue, as long as you continue to meet the current eligibility requirements of the law.
L&A Services will continue to focus on serving clients to help make good decisions on coverage for care in our ever changing US health care system.