Indiana Chamber MEWA: SIHO Replaces Anthem
The Indiana Chamber of Commerce MEWA (Multiple Employer Welfare Arrangement) is undergoing a major transition. Anthem Blue Cross Blue Shield will no longer be the carrier, and SIHO Insurance Services will take over beginning October 1, 2025. Every few years, the Indiana Chamber puts the MEWA contract out for bid via a request for proposal. […]
New Employer Leverage for Indiana Group Health Insurance Costs
Whether you have five employees or 5,000, every employer has felt the pressure of rising Indiana Group Health Insurance costs. But now you have a new advantage with House Enrolled Act 1004, a state law that empowers you to demand transparency, control costs, and renegotiate what you’re paying for healthcare. At Nefouse & Associates, we […]
Indiana Hospitals Rank #8 as Most Expensive in the Country
A recent study by the Rand Corporation (https://www.rand.org/pubs/research_reports/RRA1144-2.html) 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 […]
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 […]
Open Enrollment for 2022 Health Insurance Coverage
Who can apply? Residents of Indiana under age 65. When can I apply? November 1, 2021, through January 15, 2021. If you experience a qualifying life event after January 15, you may still be able to apply. When does my coverage start? For those who apply from November 1, 2021, through December 15, 2021, coverage […]
Medicare Part D Creditable or non-Creditable Notices
What is the purpose of the notice? Insured employees use this information to make an informed decision on when to enroll in Part D Prescription drug coverage. Who should be notified? Employees and dependents who are eligible for Medicare and enrolled in the group-sponsored prescription drug coverage. When are the notices due? October 15, 2021 […]
Surprise Medical Billing Fix
The surprise Medical Billing fix has been included in the Covid-19 relief deal, which would protect patients from receiving large medical bills from out of network providers. The bill calls for patients to be held harmless in emergencies where they have no control over where they receive medical services, especially when it comes to ambulance […]
COVID-19 & Health Insurance
The health insurance industry has been responding as fast as they can to the treatment of COVID-19. This started as a health crisis and has now turned into a financial crisis. The health insurance industry has made multiple changes concerning COVID-19. Testing With most health insurance companies, there is not member cost for being tested […]
