Statewide PPO Plans Discontinued for Individual / Families in 2016

October 14, 2015

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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:

  1. Check the new networks to find out which network has the doctors you desire, if any.
  2. 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.
  3. If you purchased your insurance directly from BCBSAZ, your agent can help you make a plan change with them now.
  4. 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.


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?

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 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.


New Health Insurance Option for Small Businesses

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?

Great Idea!

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 LevelFunding.   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.


2016 Health Insurance Checklist

October 14, 2015

Open Enrollment & Your Key to ‘White Glove’ Service

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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:

  1. Stay informed: Sign up for L & A’s blog– this includes the most current news on insurance changes that may impact you.
  2. 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.
  3. Look up or call your pharmacy to make sure they will continue to accept your insurance plan.
  4. 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 ben@lnaservices.com.


Important Dates for 2016 Medicare Annual Election Period

September 2, 2015

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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 Announces Oct 2015 Rates for Individual Grandfathered Health Plans

July 28, 2015

Blue Cross Blue Shield of Arizona (BCBSAZ) recently mailed individual grandfathered renewal letters.  Individual members with Suite A grandfathered plans with October 2015 renewal dates will be the first to receive their letters and renewal information.

The rate increase for these plans will be 18.5% (average, not including age adjustments.)  Some affected members will be able to increase their deductible within their product to help mitigate the rate increase, however they cannot move to a different grandfathered plan. BCBSAZ is discontinuing the BluePreferred Original individual product effective December 31, 2015.

For Members with Plans Continuing in 2016

Though they will have the option to renew their current plan, some members may consider switching to a non-grandfathered individual plan. Before doing so, they should be aware of the benefits grandfathered plans offer.  Grandfathered plans provide access to a large network of providers, out-of-state coverage, and, in most cases, lower monthly premiums than those found with a non-grandfathered plans.

For Members with Plans Scheduled to be Discontinued

Members enrolled in BluePreferred Original can stay in their plans until December 31, 2015. While this only affects a small number of members, these members must select a new plan by December 15th to ensure a January 1, 2016 effective date.

All Affordable Care Act compliant plans renew on January 1st.  This year, open enrollment for every individual begins on November 1st, and ends on January 31st. Watch for more information on renewal communications, including those to members enrolled in grandmothered and non-grandfathered plans, coming soon.

If you have any questions or help considering your options, please contact your insurance broker, L & A Services at 602-996-6010.


Supreme Court Rules on ‘OBAMACARE’

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.