by rmckenzie | Mar 12, 2014 | Anthem, Blue Shield of CA, Covered CA, Health Insurance, Health Net, Individual Benefits, Kaiser, L.A. Care, SHARP |
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...
by Ryan | Mar 4, 2014 | Group Benefits, Health Insurance, Health Net |
Bedrosian & Associates, your employee benefit specialists, want to share the following Health Net updates with you since these are the most commonly asked questions we have received. What you need to know about Health Net Underwriting: Mix and match all HMO and PPO plans, regardless of metal tiers Groups of 1 to 5 eligible employees are required to have 70% participation with Health Net, and groups with 6 to 50 eligible employees are required to have 50% participation with Health Net. Same applies if the group is writing alongside Kaiser. Newly Established Groups of 1 to 5 enrollees must qualify through 50% of prior calendar quarter test to be considered eligible for coverage. Groups of 6 or more enrollees must be in business for at least 6 weeks to be eligible for coverage. All plans can be wrapped Groups currently in PEO arrangement are eligible for Health Net Small Business Group coverage. We can use the PEO payroll or PEO DE9C to establish their eligibility for coverage. Owner only or Husband and Wife groups must have at least 1 non-owner, non-spouse W2 full time employee for at least 50% of the prior calendar quarter to be considered for coverage. No carve out groups No 1099s No seasonal/temporary/substitute employees Groups that leave Health Net previously no longer have to wait 12 months to return to Health Net NETWORKS – Everything you need to know about Health Net Networks All new 2014 Small Group HMO plans use WholeCare HMO network. Sutter, Health, Brown and Toland and Alta Bates Medical Group are excluded from the WholeCare HMO network. PPO is FULL NETWORK. It is inclusive of Sutter Health (i.e. Palo Alto Medical Foundation, Mills...
by rmckenzie | Feb 28, 2014 | Anthem, Blue Shield of CA, Covered CA, Group Benefits, Health Insurance, Health Net, Kaiser, L.A. Care, SHARP |
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...
by rmckenzie | Feb 19, 2014 | Anthem, Blue Shield of CA, Covered CA, Health Insurance, Health Net, Kaiser, News |
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...
