Indiana Hospitals Rank #8 as Most Expensive in the Country

A recent study by the Rand Corporation ( Hoosiers Pay More Than Three Times the Medicare Reimbursement Rate for Health Care The Rand study, conducted from 2020 to 2022, is a comprehensive analysis of medical claims data from a diverse population of privately insured individuals and hospitals across the United States. This study’s findings, which […]

GLP-1s will no longer be available through Caremark Mail Service

CVS Caremark is a pharmacy benefit manager (PBM) and a third-party administrator of prescription drug programs. PBMs are primarily responsible for processing and paying prescription drug claims, negotiating discounts and rebates with drug manufacturers, and managing pharmacy networks for health insurance plans, employers, and government programs. CVS Caremark has over 100 million members who utilize […]

Navigating The Death of an Employee

Managing grief in any setting is a profoundly personal experience that doesn’t follow a set timeline or pattern. As an owner/HR/manager, supporting your team through a loss can be challenging but crucial for maintaining a healthy and compassionate work environment. Here’s a comprehensive guide on what to expect and how to navigate the grieving process […]

New Digital Insurance Cards

As we enter 2024, the health insurance and employee benefits industries are transitioning to digital ID cards. Traditional ID cards will be a thing of the past. The Insurance companies are adopting digital ID cards for several reasons, including: Cost Reduction: Producing physical ID cards involves printing, packaging, and mailing expenses. Convenience for Customers: Digital […]

Primary Care Physician Shortages

Primary care physician shortage is a significant concern in Indiana and the entire country. The average wait for an onsite appointment with a physician is 26 days, and that is in metropolitan areas. If you live in a rural community, it could be months. Several factors contribute to this shortage of Primary Care Doctors. Aging […]

Filing Medical Insurance Claims

The medical claims submission processed has changed over the years with technology but the steps to ensure your claim is processed accurately and promptly have not. Here’s a guide on how to fill medical insurance claims: Understand Your Policy: Familiarize yourself with your health insurance policy to understand what is covered, exclusions, and any copayments, […]

Nefouse & Associates Scope of Services

As a benefit consultant we advise businesses on designing, implementing, and managing employee benefits packages. These benefits can include health, dental, vision, life, disability insurance, and other perks that contribute to employees’ overall compensation and well-being. 1.) Needs Analysis: Assessment: Understanding the unique needs and demographics of the client’s workforce. 2.) Plan Design: Customization: Designing […]

Open Enrollment for Employees

Open enrollment for employees

Open enrollment typically refers to the period when individuals can enroll and change their employee benefits. As an employee, determining when your open enrollment period starts and ends is the first and most important thing. The 2nd is what platform will be used for completing the open enrollment for employees. Most companies will use a […]

Humana Leaves the Group Health Insurance Market

Affordable Care Act (ACA)

Humana, based in Louisville, Kentucky, announced in March that it would exit the employer-sponsored group health insurance market in Indiana and Kentucky. Most Humana group health business was in Flordia, Texas, Georgia, and Kentucky. They also had businesses in Ohio, Tennessee, Illinois, Missouri, Louisiana, Wisconsin, Indiana, Michigan, and Arizona. It’s been reported they have about […]

Indiana Multiple-Employer Welfare Arrangements (MEWA)

Multiple-Employer Welfare Arrangements (MEWA) are a type of health and welfare benefit plan allowing multiple employers to pool their resources together to offer their employees health insurance and other welfare benefits. MEWAs are typically established by associations or organizations representing a group of employers with a common interest, such as belonging to the same industry […]