Time to review the Insurance Benefits and Processes?

With the economic shutdown from COVID-19, is this a time review insurance benefits and processes? Every business is different, and COVID has impacted every industry, which may lead some employers to re-address their benefits and procedures. Process & Procedures: Employee education on Insurance Benefits has been changing the last five years, to a more digital …

Executive Order to Reveal Health Care Pricing

On 6/24/19, the President of the United States issues an executive order requiring Hospitals and Insurance companies to reveal what they are charging or paying for services. The idea is to make health care cost transparent, which then would lead to consumerism and then medical providers reducing costs to attract more patients. Primarily pressuring the …

Jan. 1st 2019 Small Group Rates Delayed

Small Group Rates Delayed  Every year the health insurance companies of Indiana have to submit their rates and plan designs for approval through the Indiana Department of Insurance. In the past, this filing would be submitted for review and approval in the month of May.  The filing for 2019 small group fully insured policies was …

Indiana Recovers Medicaid Tax Under the ACA

Indiana was one of six states to file a lawsuit against the Affordable Care Act’s health insurance provider fee (HIPF) for State Medicaid plans. The U.S. District Judge ruled in favor of the plaintiffs, Texas, Indiana, Kansas, Louisiana, Wisconsin & Nebraska’s that the government must pay back $840 Million in Obamacare fees. What is the …

What to Expect in 2019 for Small Group Health Insurance

All the health insurance companies that want to participate in Indiana’s small group health insurance has submitted rates & plan designs to the Indiana Department of Insurance for review. These filling are for fully insured groups with less than 50 employees. As always, it’s going to be an interesting year under the rules and regulations …

Trump Admin. Releases Final Rule on Short-Term Health Insurance

Short Term Health Insurance Final Rule 36 months of coverage Short-term health insurance is a policy that is very similar to pre-affordable care act coverage.  The plan does not cover preexisting conditions and requires underwriting.  If your accepted, the cost is 50%-60% less than an ACA product. These plans are also using traditional PPO networks, …

Administration Decision to Reinstate Risk Adjustment Payments

It was reported that the Trump administration has reinstated the risk adjustment program of the affordable care act. The risk adjustment program redistributes funds from carriers with lower risk members to plan with higher risk member.  The reason this was witten in the ACA was to protect against adverse selection in the marketplace by spreading …

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 …