Hurricane Harvey Donations

We know many of our clients are thinking about, or already have, many donations to help the Hurricane Harvey relief effort. For those who want to make a donation, the following are links to some reputable charities that are using the donations to go directly toward the relief effort. Please do consider making a donation to the following:

American Red Cross

Houston Food Bank

Greater Houston Community Fund

And if you want to make a donation for the furry victims of the Hurricane, please consider the following.

SPCA of Texas

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Preparing for Open Enrollment

Overview

Open Enrollment tends to be one of the more stressful times of the year for many of our clients. Whether you have to navigate group or individual open enrollment, you will have important decisions to make concerning your health and financial future for the next year. Managing those decisions can certainly be stressful, which is why we’re here to help. Providing advice and attempting to streamline the process are just some of the services we provide. With a little preparation, we can help make this year’s open enrollment the smoothest yet.

What You Can Do

As your prepare for open enrollment, one of the best things you can do is to plan ahead. If you have an individual policy, take some time to go over how well your health plan has been serving you. Consider your finances and health history when reviewing your plan. This is also an excellent time to contact us with any questions you might have about plan changes, availability, or any other questions you have. We are happy to go over plans with you.

If you are administering a group plan, preparation for open enrollment is even more important. Preparing to answer your employees’ questions, updating records, soliciting employee input, and analyzing you benefit offerings. It is helpful if you have can provide us with a list of eligible employees. We can then compare our list to yours, and fix any discrepancies. Knowing who is eligible can go a long way to making the process easier. If you are planning on changing carriers or plans, it is important to notify your employees of that change. While the law does not require you to do so, it is a good practice so as to minimize confusion. New providers mean new networks, and a possibly a new drug formulary. It is important that your employees know about these changes in advance, so they can make informed elections.

What We Do For You

As open enrollment approaches, there are several things that we can do for you. If you are interested in looking at different carriers, let us know. We can see if there are available plans that may be less expensive. Let us know what your goals are, and how your current benefits have been working for you. If you’re satisfied, we can make sure your renewal is seamless. If you want to look elsewhere, let us know! Once we have that information, we can work on tailoring a quote that addresses your needs.

Another way in which we can help streamline open enrollment is to provide communications to your employees. These communications not only serve as a reminder to your employees about the benefits you provide, but also help them to make informed choices about their open enrollment elections. We can provide these communications either digitally or via mail. Further, we can include forms to allow the employee to make elections and get them back to us directly for processing.

Finally, if you are thinking about adding new benefits, let us know! We can provide you with quotes from different carriers, to get your the best price for your benefits. Adding benefits to your offering can go a long way to helping your employee retention rate. If you’re interested in adding these benefits, please contact us at 612-492-9320, and we will be happy to start the quoting process.

 

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Physical vs. Office Visits

Overview:

One of the most important ways to minimize your health care costs is to be knowledgeable about your visits to the doctor. Most visits usually fall under two different types: physical or office. What is the difference between physical vs. office visits, and how do they work? Physical visits remain one of the most important ways to keep costs down. The sooner your doctor discovers a potential issue, the sooner they can treat it. That also increases the likelihood that the treatment will be less expensive than if you delay treatment. Insurance considers these visits preventative. An office visit, in contrast, is a visit when you visit your doctor for a specific symptom or concern. Treatment received at an office visit is usually not preventative, and so you will be responsible for some of the costs, depending on what all your insurance covers.

Physical vs. Office Visits:

A physical visit is your routine annual check up. The ACA mandates that these visits are free once a year. The physical’s purpose is to discover health problems before they become serious. A physical does not include tests or treatment. If you don’t want to pay anything out of pocket for a physical, you should speak to your doctor about only performing screenings that insurance considers preventative. If you don’t, your doctor may run extra tests that insurance does not cover as preventative.

An office visit, in contrast, is when you visit the doctor for treatment of specific issue. These are the visits you schedule when you don’t feel well. During these visits, the doctor provides their opinion and treatment plan, and you are responsible to pay for the service. That payment usually takes the form of a copay or a payment toward your annual deductible. If you have already met your deductible during the year, your insurance may cover most if not all of the fee.

It is possible that you can have both a physical and an office visit at the same time. If you go in for your physical, but your doctor treats you for a medical issue, you will be billed for both services. Insurance will cover the preventative aspects of the physical, and you will be charged for the office portion of the visit.

Out-of-Pocket Expenses:

Even though your insurance will cover the costs of your physical, you may be responsible for a small copay. You will ultimately be responsible for any services that your insurance will not cover. The best way to reduce your out-of-pocket expenses then is twofold. First you should schedule a physical visit once a year. This will help to catch small problems before they become big ones. Second, you should speak with your provider about what they cover. Some plans limit the number of office visits, tests, or physicals you can receive per year. You can also check with them before you visit the doctor to make sure that your service will be covered. If you know what services you need, having the insurance company give you an estimate is a great way to manage your out-of-pocket costs and create a plan.

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Senate ACA Replacement: The BCRA

Overview

On June 22nd, Republicans in the Senate released their plan to repeal and replace the ACA. This proposal is called the Better Care Reconciliation ACT (BCRA). The BCRA, as it currently stands, keeps several provisions of the ACA. The BCRA is the response to the House’s bill, the AHCA, which we wrote about here. Ultimately, the BCRA is a budget reconciliation bill, and so it cannot repeal the ACA in full. What it can do, is to make changes to the ACA’s tax credits and federal spending dedicated to the ACA. As with the AHCA, the Senate has not voted on the bill yet, and so there is still time to make changes. However, based on what the Senate has released, here’s what we know so far.

What’s New?

First, the BCRA seeks to remove the employer and individual mandates. Like the AHCA, the BCRA  cannot repeal these mandates. However, it does reduce the penalty imposed for violating the mandates to zero. This means that, even though the mandates remain, there is no penalty for disregarding them.

The BCRA would also eliminate a provision in the AHCA to allow insurance carriers to add a 30% late enrollment charge for those seeking to enroll outside of enrollment periods. Further, the BCRA seeks to replace the ACA’s insurance subsidies with tax-credits. These tax credits are designed as an incentive to enroll in coverage by helping to partially fund the purchase of insurance.

State waivers are another important aspect of the the new bill. In response to the House’s AHCA, which allowed States to apply to waive essential health benefits (provisions that all plans must include), the BCRA eliminates that option. Instead, the new bill expands Section 1332 of the ACA. This section allows States to change what they consider essential health benefits. These changes must meet the basic protections of the ACA. The BCRA lowers the standards for reasons that a state can apply for a waiver. This means that states can fundamentally change what is considered an essential health benefits in their state.

Finally, there are also important changes to HSA’s in the bill. Currently, the IRS sets a yearly limit on how much a participant can contribute to an HSA. Under the BCRA, the contribution limit, starting in 2018, would be the maximum out-of-pocket the law allows. In this case, that would be $6,550 for those with an individual plan, and $13,100 for those with family coverage.

What Stays the Same?

Under the BCRA, many provisions of the ACA would remain intact. Importantly, individuals under the age of 26 will continue to have the option of coverage under their parents’ plan. Further, the ACA’s requirement that pre-existing conditions be covered will still be in place. The prohibition of lifetime and yearly annual limits for essential health benefits has also stayed. Finally, the clauses requiring guaranteed availability and renewability, along with non-discrimination rules and the prohibition against health status underwriting remain in place.

As we talked about earlier, the individual and employer mandates are also still in place, although due to the lack of penalty for violating these provisions, the BCRA renders them effectively void.

Conclusion

The BCRA is the next step in the Republicans’ attempt to fulfill their promise to repeal and replace the ACA. Because the Senate has not voted on the BCRA, it is not law. Once they vote, there are still more steps. First, the Senate will have to send the bill to the House, which could make further changes. Then, it would come back to the Senate for a final vote. Finally, the President would sign it into law.

For the time being, the ACA is still the law. We’ll be watching to see what changes are made, if any, and keep you up to date as the bill moves along. As always, if you have questions about the BCRA, the AHCA, or the ACA, please reach out to us. You can reach us via email at info@morganplan.com, or by phone at 612-492-9320.

 

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