Tony Nefouse’s Complete Guide to Group Insurance

Many companies will turn to the internet to search for insurance benefits. Since 1998, we have been helping these businesses obtain group benefits. In the beginning of the internet, very few people would go to the world wide web for insurance information. Today that has all changed, business owners want information at their fingertips. We …

Indiana Group Health Insurance Under ACA

It would be wishful to say that group health insurance under the ACA has stabilized. Comparing it to the Individual market under the ACA, the group is calm. For companies with less than 50 full time employees, or the equivalent under 50, fully insured products are guaranteed issue. This mean there is no underwriting. When employees complete …

Extended Transitional Group Health Policies

Late February 2016, CMS sent out a bulletin for extended transitional policies. The bulletin outlined to extend small group health insurance policies to Dec. 31st 2017.  The former rule was that these policies would be terminated on October 1st, 2017. How does this impact Indiana small group health plans? If you purchased a health plan …

The Death of the Indiana PPO

Preferred Provider Organization  (PPO) A PPO plan is a network of medical providers, who join a network and reduce their fees, in exchange for patients. The insurance Industries used these PPO to give their members access to medical care. Then the Insurance carriers started to develop their own PPO networks. The PPO has been very …

Tax Credit and Filings

The first tax season is behind us and no one knew what was going to happen with tax credits. The Federal Marketplace compared what was reported on the tax credit application and what the individual filed on their tax returns. It was estimated that 45% of the people that purchased health insurance with tax credits, …

2015 Anthem Silver Policy

Benefit Benefit Details Monthly Cost Monthly Cost Includes: Total Monthly Premium Subsidized Premium Non-subsidized ACA Insurer Fee Exchange Fee Reinsurance Fee Deductible(s) $3,500 (Does not apply to Tier 1 and Tier 2 Primary Care Visit to Treat an Injury or Illness You pay $45.00 – not subject to deductible Out of Pocket Max $4,500 (includes deductible) …

What Kind of Coverage Will the Plans Sold Through the Health Insurance Exchanges Include?

The Affordable Care Act (ACA) requires that all health insurance plans sold on state exchanges beginning Jan. 1, 2014 cover ten essential benefits:   Ambulatory patient services Emergency services Hospitalization Maternity and newborn care Mental health and substance use disorder services, including behavioral health treatment Prescription drugs Rehabilitative and habilitative services and devices Laboratory services …

What Are Potential Drawbacks of a High-Deductible Health Plan (HDHP)?

One significant downside to a high-deductible health plan (HDHP) is that you’re responsible for paying everything out-of-pocket until you reach your deductible (which typically ranges from $1,000 to $5,000 on these plans). You’ll pay 100 percent of the cost of prescriptions, doctor visits and emergency room visits. You’ll also pay for the cost of surgeries and out-patient …

What is a High-Deductible Health Plan (HDHP)?

A high-deductible health insurance plan can provide affordable coverage for unexpected major health and medical expenses. Essentially a form of catastrophic insurance, these plans charge a high annual deductible – from $1,000 to $5,000 and higher – in exchange for lower monthly premiums. You’ll have to pay out-of-pocket costs for routine doctor’s office visits or trips to the …