Rates are Going Up and Down at Blue Shield in the 4th quarter.

Decreasing rates for ACA plans: Blue Shield has announced that rates under the Affordable Care Act (ACA) plans will receive a reduction. The reduction for HMO plans will be 1.8% while the reduction for PPO plans will be 7.7% Increasing rates for “Grandmothered plans: On July 7, 2014 Governor Brown signed Senate Bill 1446 (aka. The Grandmothering Law) into effect. This law allows small groups renewing between October 1st – December 1st to keep their current non-ACA plans (Grandmothered plans) in effect for another year. Those opting to keep their non-ACA plans for another year can expect rate increases of 1.2% for HMO plans and 9.9% for PPO plans. What does it all mean and which plans work best for me? • Companies with a younger demographic could see significant savings by switching to ACA plans. The ACA plans rate each employee based on their date of birth therefore a 30 year old employee will pay the rate for a 30 year old. Grandmothered plans have age-banded rates which means that a 30 year old is paying the same as a 39 year old. • Companies with an older demographic may be better holding off with Grandmothered plans for another year for the same reasons that a company with a younger demographic would benefit from switching (due to age-banded rates). • Companies that have many employees with families may also be better off sticking with the Grandmothered plans since the ACA plans will rate each dependent individually. In other words, a family of five that switches to an ACA plan can expect a separate rate for each family member based on...
Should you take advantage of latest Obamacare delay?

Should you take advantage of latest Obamacare delay?

Federal officials announced last Wednesday that Americans can keep health insurance plans that fail to meet the standards of the Affordable Care Act for another two years.  This latest delay allows insurers to renew the old plans as late as October 1, 2016, meaning customers who renew then would be covered for most of 2017.  The option will only be available to people who renewed plans at the end of 2013. New subscribers will not be able to enroll in these plans. Those who are satisfied with their current coverage may take comfort in knowing they can put off shopping for health insurance for a few more years however, this does not necessarily mean that they will be getting a better “deal”.  The old policies were canceled initially because they didn’t meet the higher standards set by the health reform law, which requires that all plans cover maternity care, prescription drugs and mental health, among other benefits. Many people who decide to keep their old plans may find out that they would have to pay higher rates to keep the same coverage.  Even if rates are unchanged, some subscribers may find they need better coverage, since the plans being extended may not cover hospital stays, prescription drugs or other services. Having an educated broker to turn to for guidance in these changing times is proving to be a more valuable commodity than ever. Contact Bedrosian & Associates if you would like a free review of your current medical insurance plan versus the medical insurance plans...

What is Considered Preventive Care?

                                If you have a new health insurance plan or insurance policy beginning January 1, 2014 or after the following preventive services must be covered without your having to pay a copayment or co-insurance or meet your deductible. This applies only when these services are delivered by a network provider.  When making an appointment with your provider for preventive services, it is always good practice to tell them that your visit will be for preventive services as outlined in your health plan.   15 Covered Preventive Services for Adults Abdominal Aortic Aneurysm one-time screening for men of specified ages who have ever smoked Alcohol Misuse screening and counseling Aspirin use for men and women of certain ages Blood Pressure screening for all adults Cholesterol screening for adults of certain ages or at higher risk Colorectal Cancer screening for adults over 50 Depression screening for adults Type 2 Diabetes screening for adults with high blood pressure Diet counseling for adults at higher risk for chronic disease HIV screening for all adults at higher risk Immunization vaccines for adults–doses, recommended ages, and recommended populations vary: Hepatitis A Hepatitis B Herpes Zoster Human Papillomavirus Influenza (Flu Shot) Measles, Mumps, Rubella Meningococcal Pneumococcal Tetanus, Diphtheria, Pertussis Varicella Learn more about immunizations and see the latest vaccine schedules. Obesity screening and counseling for all adults Sexually Transmitted Infection (STI) prevention counseling for adults at higher risk Tobacco Use screening for all adults and cessation interventions for tobacco users Syphilis screening for all adults at higher risk 22 Covered Preventive Services for Women, Including Pregnant Women Anemia screening on a routine basis for...

Healthcare Reform – Commonly Used Terms Defined

  Most of us have been bombarded with information pertaining to the changes that have come with the newly enacted Affordable Care Act (ACA) or as it is commonly referred to, Obamacare.  For many of us, this information can be confusing.  In an effort to assist you better understand your health plan, we have provided definitions to a few of the more commonly used words associated with the new health plans. Adult Children – The Affordable Care Act requires plans and issuers that offer dependent coverage to make the coverage available until a child reaches the age of 26. Both married and unmarried children qualify for this coverage. This rule applies to all plans in the individual market and to new employer plans. It also applies to existing employer plans unless the adult child has another offer of employer-based coverage (such as through his or her job). Beginning in 2014, children up to age 26 can stay on their parent’s employer plan even if they have another offer of coverage through an employer. Essential Health Benefits – Essential health benefits are those that must be included in private health insurance sold in the exchange. The categories of essential health benefits are: a) Ambulatory patient services. b) Emergency services. c) Hospitalization. d) Maternity and newborn care. e) Mental health and substance use disorder services, including behavioral health treatment. f) Prescription drugs. g) Rehabilitative services and devices. h) Laboratory services. i) Preventive and wellness services and chronic disease management. j) Pediatric services, including oral and vision care. Full-Time Employee – The Affordable Care Act defines a “full-time employee” as working 30 or...

5 Things to Know About Deductibles in The Exchange

Having health insurance can lower your costs even when you have to pay out of pocket to meet your deductible. Insurance companies negotiate their rates with providers and you’ll pay that discounted rate. People without insurance pay, on average, twice as much for care. A health insurance deductible is different from other types of deductibles. Unlike auto, renters, or homeowners insurance, where you don’t get services until you pay your deductible, many health insurance plans provide some benefits before you meet the deductible. All medical plans cover preventive care. Screenings, immunizations, and other preventive services are covered without requiring you to pay your deductible. Many health insurance plans also cover other benefits like doctor visits and prescription drugs even if you haven’t met your deductible. In 2014, there usually is a $6,350 maximum for individual out-of-pocket costs for in-network services. The maximum for families is $12,700. Even if you choose a high deductible catastrophic plan, your out-of-pocket costs should not exceed this limit. Over 70% of Marketplace plans have deductibles under $3,000. When you choose a health insurance plan, it’s important to understand what your insurance company covers without requiring you to pay your deductible. Then you can decide whether you want a plan with lower monthly premiums and a higher deductible, or one with a higher monthly premium and a lower...