Humana’s Pull out of Indiana
Humana’s individual health insurance division is exiting the Indiana market for 2016. Humana had offered health insurance coverage for individuals and families off the exchange. They were utilizing their PPO Network Humana/choicecare which was a national network. This plan resembled a pre Affordable Care Act product than a post. They had one of the best […]
Small Group Health Insurance rates for 2016
The health insurance companies that offer small group plans, have had their rates for 2016 approved. The definition of small group is about to change for Indiana. Currently, small group is a company with less than 50 full time employees. For 2016, this number is going to change to less than 99 employees. This is […]
Large Group 6055 & 6056 Reporting
Under the Affordable Care Act reporting obligations for large employers, is about to get complex. There are 2 new sections of the IRS code that every controller, accountant, broker, & insurance company are trying to understand. 6055 & 6056 In my own words, I will try to explain what the codes are and why they are […]
Anthem Buying Cigna
Anthem is buying Cigna for $48 Billion! This buyout would create the largest health insurance company in the US. It’s estimated that Anthem would then cover over 53 million belly buttons. Currently, Anthem is the 2nd biggest insurer and Cigna is the 4th biggest. This buy out creates less competition for the consumer, business, or medical […]
Obamacare Shovels Another $122M to Indiana Insurers
The Affordable Care Act recently sent $122.4 million to health insurers in Indiana to help Hoosiers pay for their large medical bills. The Indianapolis Business Journal wrote an article discussing this in which I was interviewed for. Read more about my thoughts on this action by visiting the IBJ website. -Tony Nefouse
2016 Individual Health Insurance rate Submission
The individual health insurance companies have submitted their 2016 rates for Indiana. Each health insurance company must submit a very detailed rate submission to the department of Insurance (IDOI). The IDOI then reviews the submission and then approve the filling if the math behind the submission makes sense. Making sense of the filling can be […]
Supreme Court Ruling on King v. Burwell
The Supreme Court ruled 6-3 in favor of keeping the tax credits for states without a state based exchange. This is a huge win for the Affordable Care Act. This was viewed by some as the last big battle of the ACA. When you read the actual ruling, the court points out that the term […]
Breast Cancer Susceptibility testing Under the ACA
The Departments of Treasury, Labor and HHS released clarification on preventive care requirements under the Affordable Care Act. Specifically they addressed personal history as it relates to routine breast cancer susceptibility gene (BRCA) testing. We should see all of the health insurance policies that are ACA compliant cover this type of test as preventive care. […]
Anthem Network Expansion!
St. Vincent’s and Anthem have come to an agreement for Anthem’s individual health insurance network. This is a large expansion of the Pathway X HMO/POS network. Now all Anthem individual policy holders both on and off the exchange will have access to utilize St. Vincent’s medical services. Learn more here When the Affordable Care Act […]
UnitedHealthcare Individual Health Insurance Billing Issues
UnitedHealthcare/UnitedHealth Life/ Allsavers have had major billing issues on their individual lines of coverage. If you make a payment and it is not allocated to your account, that’s when problems begin. It’s almost like the payment stays in limbo. Automatic Bank Drafts are being drafted but are not posting to the account. In some situations, we are […]