Essential Health Benefits For Indiana

  The Essential Health Benefits have been released by the federal government. This dictates that Insurers must cover 10 broad categories of care. This includes maternity services, doctor and medical services, mental health and substance abuse, and prescription drugs. Why is this important? All individual and small group will be effected by this ruling. This […]

Dropping Group Health Benefits?

Health care reform is bringing new options for small and mid size group plans. Not just here locally, but for the entire country. One of the benefits of having a group health plan, is being able to offer guaranteed issue to employees.  This is where the group health plan will accept you, no matter what […]

HHS Delays Basic Health Plan

Kaiser has reported that HHS will delay the “Basic” Health plan until 2015.  The “basic” health plan was to help people that are making 2 times federal poverty level.  This plan is to be designed with very little cost to insured both from a claims and premium standpoint. The other advantage to this plan is if […]

UnitedHealthCare Pharmacy Migration

UnitedHealthCare will be consolidating and managing its pharmacy benefit program in house through OptiumRX. Currently the pharmacy benefit manager has be Medco. UHC will begin migrating members starting in early 2013. They have invested more than $200 million in developing OptumRX. UHC starting using OptumRX back in 2009, when it moved Medicare Part D member […]

Qualified Health Plan (QHP)

Next year all health insurance plans must meet the essential health benefits to be considered a Qualified Health Plan (QHP) These requirements are base on: If the plan is offered inside or outside the exchange IF the plan is fully insured  or a self funded plan Premiums for Individual and small groups will no longer […]

Group Health Insurance

In 2013, we should see the final implantation of health care reform. The final stage should open an additional markets and strategies for group health insurance. In 2014, group health insurance will no longer have medical underwriting. This is call guaranteed issue. No longer will an employee have to complete application and answer medical questions. […]

5 Things A Small Business Needs to Know about Health Insurance Reform

Insurance companies are held accountable. The insurance company must spend at least 80% of the premium collected on medical care.  If they don’t, then a rebate check will be issued to the group. Insurance companies are health accountable for large rate increase. Insurance companies must publicly justify any rate increase over 10%. Tax Credits for […]

Status Of Health Insurance

As we enter 2013, there are huge changes on the horizon for health insurance locally and the rest of country.   Here are few of the bullet points of what health care reform is suppose to put into place.   •             Administrative simplification begins •             Annual fee on medical device sales begins •             Deduction for expenses allocations to […]

$63 Fee Hidden in PPACA Regulations

It turns out that everyone that has a health insurance policy will have to pay an additional $63 a year. This $63 is to help fund the health insurance industries risk for in 2014. If you have an individual, small group, large group or self funded plan you have to pay. In 2014, the individual […]

Community Ratings For Small Group Health Insurance

In 2014, we are going to see a major transformation of the small group health insurance market. One of the biggest changes is the community ratings. No longer will a small group premium be based on medical conditions. This means most will groups will have similar pricing. Right now small groups in the area are medical […]