Losing health insurance coverage mid-year? 3 options for consumers

Posted by Alex Tolbert on Mon, Aug 13, 2018 @ 10:08

What to do if you lose coverage

Losing health insurance coverage mid-year can happen for a variety of reasons. Whether you have had a recent job change, a move or a change in your household resulting in a loss of coverage, this transition can lead to anxiety for consumers.


What are consumers supposed to do if they lose coverage in the middle of the year? Fortunately, the reasons described above, among others, are considered “qualifying events,” which means you can sign up for health coverage on the Affordable Care Act marketplaces at any time of the year after experiencing them.

However, the marketplace isn’t your only option. There are other options for health coverage, and which one you choose will depend on a few different factors, including your health status, how long you expect to need new coverage and your income.

Below is an outline of these options and how consumers can think about them.

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Tags: healthcare, The Tennessean, healthcare costs, surprise medical bills

How to handle employee absences outside of FMLA

Posted by Emily Kubis on Fri, Aug 10, 2018 @ 09:08

What to do when FMLA doesn't apply

When it comes to personal or medical employee absences, the Family and Medical Leave Act provides a standard set of requirements for employers with over 50 employees.

But there are cases where FMLA does not apply. If you have less than 50 employees, or the employee has not worked for the company the required amount of time for FMLA eligibility—1,250 work hours or 12 months of active employment—how do you handle employee leave?

The process will vary based on the specific circumstances at your organization, as there isn’t a “one-size-fits-all” approach when FMLA doesn’t apply. But in general, here are two scenarios—one where the employee has Short-Term Disability coverage, and one without Short-Term Disability coverage.

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Tags: group benefits, group plan, broker, BernieHR, FMLA

The pros and cons of a PEO

Posted by Emily Kubis on Wed, Aug 08, 2018 @ 11:08

Five things to consider

Are you considering using a Professional Employer Organization (PEO) at your business? Businesses can partner with a PEO to outsource a variety of administrative tasks, including HR, payroll, health insurance and more.

When partnering with a PEO, the organization effectively becomes the employer of record of your employees. There are some pros and cons associated with this arrangement. Here are five things to consider about PEOs.

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Tags: group benefits, group plan, broker, Professional Employer Organization, PEO

Strategies to keep pharmaceutical costs down as a self-insured employer

Posted by Chase Ballard on Tue, Aug 07, 2018 @ 06:08

You’re likely spending too much on your employees' prescriptions

As a self-insured employer, you have a lot of control over how you spend money on your employee’s prescriptions. Unfortunately, most employers are not aware of all the tactics that are available to help them mitigate these prices.

Prescription spending is the fastest growing healthcare cost, and these costs likely make up a good portion of your annual healthcare spend. Fortunately, there are a few available strategies that will help you and your employees find the cheapest available options:

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Tags: pharmacy, employer digest, pharmacy costs, employee benefits

Three things employers should know about the new HSA bills

Posted by Emily Kubis on Mon, Aug 06, 2018 @ 09:08

New bills could expand qualified expenses and contribution limits

In July, the House of Representatives passed two new bills affecting Health Savings Accounts. The new bills could expand the list of qualified medical expenditures, as well as nearly double contribution limits.

With adoption of high-deductible health plans still on the rise, the new regulations would expand the opportunity for employers to maximize the value of their benefits plans and support employees in opening accounts.

Here’s what employers should know about the new bill:

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Tags: HSAs, health savings accounts, employers, health insurance small employers, employer digest

Group health premiums going up? Consider self-funding

Posted by Emily Kubis on Fri, Aug 03, 2018 @ 10:08

Getting a big rate increase? 

If you are receiving a big rate increase on next year’s group health plan, it may be time to consider a different funding strategy. With healthcare costs continuing to rise, there are only so many solutions for reducing the financial pressure on employers and employees through a fully-insured insurance plan.

If you’ve raised deductibles, helped employees with HSAs, implemented wellness programs – and are still seeing double digit premium increases, you may want to pursue a self-funded health plan.

First, what is self-funding, or self-insuring?

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Tags: group benefits, group plan, broker, self-funded, self-insurance, stop-loss coverage

Tennesseans have more health insurance marketplace options, but will consumers sign up?

Posted by Alex Tolbert on Wed, Aug 01, 2018 @ 09:08

Insurers re-entering Tennessee market

Next year, Tennessee consumers will have more options for coverage through the Affordable Care Act (ACA) marketplaces, as carriers reverse the trend of previous years and re-enter or expand in the state’s individual market.

Right now, five different insurance carriers have filed with the state to sell individual health plans in 2019. This is the most carriers selling in Tennessee’s individual market since 2016.

However, it is possible that fewer Tennesseans will enroll in this kind of coverage. Below, we’ll look at new options for Tennesseans and some factors to consider about marketplace plans versus other options.

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Tags: healthcare, The Tennessean, healthcare costs, surprise medical bills

How a defined contribution health plan can help you save

Posted by Chase Ballard on Tue, Jul 31, 2018 @ 06:07

Combat rising health plan expenses with a defined contribution plan

You’ve heard it before; the cost of group health plans are on the rise. You’ve probably experienced the effects of these cost increases within your own company. Here’s how a defined contribution health plan could help you regain control over your healthcare spend.

For decades, most employers have been approaching rising costs in one of two ways:

  1. To change the plan design by introducing higher deductibles, copays, or out of pocket maximums.
  2. To increase employee payroll deductions.

This may be an appropriate way to address cost increases of two to three percent, but it could cause serious issues when your plan see’s a cost increase of fifteen-plus percent as many have in recent years.

Let’s say this years health plan costs $500 per employee per month. You, the employer, are telling your employees that you are picking up 80 percent of that expense, leaving $100 per month for your employees.

Now, let’s say the cost of your plan increases by twenty percent to $600 per employee per month (PEPM) next year. The cost to you, the employer, would rise by that same twenty percent meaning next years plan would cost you $480.

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Tags: group plan, employer digest, employee benefits

How much does Medicare cost?

Posted by Emily Kubis on Mon, Jul 30, 2018 @ 10:07

Most retirees aren’t planning ahead for healthcare costs

There is sometimes a misconception that when you turn 65, you just “go on Medicare,” and your healthcare is paid for throughout retirement.

This is actually not the case. First, there are at least 18 different Medicare strategies consumers can choose from. Second, there are expenses associated with Medicare, in particular, premiums for Medicare Part B and prescription drug costs.

Part B premiums range from $134 per month to $428.60 per month in 2018, depending on income.

Other costs to consider are the costs of supplemental Medicare policies, drug plans, or Medicare Advantage plans.

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Tags: Bernard Health, retirement, healthcare costs, financial planner, financial advisors, healthcare extension, medicare costs

Are AHPs a good fit for my organization?

Posted by Emily Kubis on Fri, Jul 27, 2018 @ 09:07

New plans could save employers money, but might not be right for every group

New regulations released by the Trump administration means more employers can form Association Health Plans (AHPs) to offer health coverage to employees. By allowing employers to band together to offer health coverage, AHPs allow smaller employers to take advantage of economies of scale.

The new rules mean any employers in the same industry or region, as well as sole proprietors, can now form or join an association and offer an AHP. Because these plans don’t have to offer the same set of benefits as other health plans, this can represent cost-savings for many employers.

However, this strategy isn’t necessarily right for every small business. How do you know if an AHP is right for your organization? Here are a few questions to ask.

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Tags: group benefits, group plan, offer health insurance, broker, small group market, association health plans, AHPs

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