Special Enrollment Period Allows Small Businesses to Easily Qualify for Group Benefits

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.


Important Dates for 2016 Medicare Annual Election Period

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.

BCBSAZ 2016 Individual/Family Plan Renewal

August 27, 2015

bcbsaz logo

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:

  1. 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.


Client Annual Reviews

July 23, 2015


The lazy days of summer are a great opportunity to sit down and review your insurance policies, coverage, and retirement plan.

L&A Services, Inc. performs this service for each client at no charge on a regular basis, and you may hear from a representative soon to check your schedule for the purpose of setting this important appointment. The appointment is at your convenience, either in person or over the telephone.  We will be looking to update your individual profile along with any life changes that may have occurred.

We will review your policies and coverages to determine whether you are over-insured, under-insured, need to make changes or are at risk in any other areas that need protection.  We will also let you know about new rules, laws, programs, and important dates to remember that apply to your benefits.  We have found people who have this done regularly are more satisfied with their insurance, feel more secure, and enjoy a greater peace of mind knowing their insurance matters are in order and up-to-date.

For your appointment with our agent, please have your policy documents handy, including retirement savings information.  Also be sure to write down any specific questions you want to ask & goals you would like to accomplish.

Please take advantage of this valuable time.  We look forward to seeing you soon.

Aetna 2015 Plan Updates – Arizona

October 15, 2014

Aetna Logo

In October Aetna will be mailing out letters to members outlining options for 2015 and informing them that some plans are being terminated at the end of 2014.

Most members will be automatically enrolled into a new plan.  But others are being informed that their coverage will be ending December 31, 2014.

This includes pre-ACA plans as well as those who purchased ACA compliant plans both “ON” and “OFF” the exchanges.

In most cases, Aetna will automatically renew members into a 2015 plan. The letter will include information about the plan benefits and premium. If the member likes the new plan, they need to do nothing.

In some situations, Aetna will recommend a plan but will not be able to auto‐enroll the member. These members will need to submit a 2015 application when open enrollment begins on November 15.

Members always have the option to decide not to take the recommended plan, whether Aetna automatically enrolls them or not.

L&A Services will help these members understand their options, including shopping on the public exchange.

HealthNet Update for 2015

October 9, 2014

HealthNet Logo

HealthNet of Arizona, Inc. (HealthNet) is streamlining their Individual & Family Plan HMO portfolio for 2015 with fewer plans.

In 2014, Health Net offered more than one HealthNet CommunityCare HMO health plan in each of the metal tiers: Platinum, Gold, Silver, and Bronze.  We are expecting this to change for 2015.

Automatically, members who enrolled directly with Health Net (i.e., off the marketplace) will be moved to similar plans.  If you like the new plan, you don’t have to do anything to keep it.

However, your agent, L&A Services, Inc. is available to assist you in choosing a new plan for 2015 if you would like to explore your options.

Members who enrolled via the Marketplace are asked to go back to HealthCare.gov during Open Enrollment and actively choose the plan they want for 2015. Don’t forget you need your broker’s name (Benjamin Rosky) and National Producer Number (6747133) to ensure proper service.

Contacting the Marketplace is also necessary for members who qualify for tax credits to get the right amount for 2015.

Member Notifications

90-day plan closure notices to members mailed October 2, 2014.

NOTE:  Regulatory approval is still pending for 2015 plans. Once approved, plan information details will be communicated here.  Until then, Health Net does not have any plan information to release.

Donut Hole Fix for Medicare Beneficiaries

November 2, 2012

Seniors are concerned that in the next 2 months they may fall into their ‘donut hole’, if they have not already.  While in the ‘donut hole’, out-of-pocket costs for prescription drugs increase for Medicare beneficiaries.   As a solution to this common problem, we have found a way to significantly reduce these costs during this time.

Accepted at thousands of pharmacies, the Arizona Rx Card is a complimentary prescription card that has saved hundreds of dollars in prescription costs for our clients, relatives and friends on Medicare.  We would like to see others use this card to save hundreds more!

Not only does the free card reduce prescription costs up to 78%, the Medication Pricing Guide also allows patients to ‘shop around’ for the best price on the drugs they need based on where they live.  Check your prescriptions here and you will find major price differences between one pharmacy and another.  You must use the Arizona Rx Card to receive the special pricing, and you can download as many as you need on this website.

The Medicare drug plan ‘donut hole’ is scheduled to close entirely by 2020.  Until then, we must find other ways to help our medical dollars stretch further, particularly for those high cost prescription drugs.  We believe this card is one solid solution you and your family members can use right away.

If you have any questions about this card,  please contact L & A Services, Inc at 602-996-6010.