October 11, 2016
Changes to MyHealthQuoter.com Services
Two things may have caught your attention over the past year regarding Health Reform (aka “Obamacare”)- a reduction of insurance carriers in the marketplace, and high increases in your health insurance premiums. If you feel as though you are paying more for less these days, you are not alone.
There are several culmination factors that have led us to this point in our history: a lack of transparency in health care (the true cost of care), over-utilization of health care amongst the population (by providers and consumers alike), inflation of medical costs *new tehcnology and medicine, mean higher costs) and now, the Affordable Care Act (aka Obamacare); which did not allow the carriers to balance their risk of health to sick policyholders.
As a result, here is what is happening now-
Carriers have been backed into a corner. Medical Loss Ratio (MLR) rules dictate that the carrier must pay 80% of your premium payments to the hospitals, doctors, and pharmaceutical companies. From carrying mostly sick people with high claims and being mandated to provide more benefits, health insurance carriers are left with only two options: trey to stay in the market by limiting hospital and doctor networks, and reducing prescription benefits, or exit the market completely.
Compensation for service is being cut or eliminated. Many remaining carriers, in an effort to stay in the market, have reduced comnpensation to their workforce or eliminated staff, which includes brokers. This comes at a time when the role of an adviser has never been greater. For the vast majority of consumers, their broker helps them navigate the minefield and reduces the number of hours they need to research plans, or learn a carriers’ processes.
What This Means to You-
Just as carriers have made changes to remain in the marketplace for the benefit of their members, we too must also implement changes. Therefor, we have established two levels of service for all current and future clients:
Our Advocates Service includes eight (8) areas of expertise:
- Pre-Authorization Support
- Claims Review and Auditing
- Billing Review and Resolution
- Prescription Saving Review
- Carrier Appeals Management
- Physician and Pharmacy Review
- Marketplace Appeals and Documentation Issues
- Policy Administration (Add, Drop, Reinstatements, etc.)
No matter what service level you choose, we are always available for policy support by calling our office at 614-336-3636. However, if you would like expert help with any of the eight (8) areas noted, we invite you to email: firstname.lastname@example.org for more details. Again, thank you for your trust and for your business- we look forward to serving you in the years ahead!
May 26, 2016
URGENT NEWS: InHealth Mutual Closure
Today the Ohio Department of Insurance notified our office that InHealth Mutual of Ohio has been liquidated. Franklin County Common Pleas Judge Kim Brown granted the Ohio Department of Insurance full authority to operate the company, pay policy holder claims, and control the cash reserve held by the company. Under the order, InHealth policy holders must continue to pay their premiums, and providers must continue to honor their contract for service to InHealth policy holders.
Unfortunately, this affects all of our clients, those with and without subsidy, at InHealth Mutual. However, this is where our office steps in as your advocate. Because the application you completed with our office during Open Enrollment (or a Special Enrollment) is still on file, we are able to quickly move you to new coverage, within the next 60 days, as allowed by this mandate. As mandated, during this transition, all claims will be honored up to $500,000 per insured.
Do to the time-sensitive nature of this issue, ALL INHEALTH MUTUAL CLIENTS should click HERE to select a new plan. Out office will be notified of your selection and a new plan submitted to the Marketplace on your behalf.
June 6, 2016
You may have noticed when setting an appointment that we ask how you prefer to be contacted with important updates. We want to ensure you are receiving updates from our office in the manner desired, so we will reach out via telephone to discuss your preferred contact methods (email, U.S. mail or phone) in June, and to update your file with our office.
May 30, 2016
Spiralight Group and MyHealthQuoter.com will be closed on May 30th, in observance of the Memorial Day holiday. You may submit a help ticket on our webpage for any policy inquiries desired for review, or leave us a voicemail in the office, and we will address your inquiry on our next business day in the office. Thank you!
May 26, 2016
Health Reform: Update regarding reconciling your 2014 subsidy (Advanced Premium Tax Credit)
The Marketplace is working with the Internal Revenue Service (IRS) to confirm consumers have reconciled advanced payments of the premium tax credit (subsidy) they received during plan year 2014. Consumers whom failed to complete reconciliation for 2014 could lose their current plan year subsidy as soon as October 2016, and could be reenrolled in coverage for plan year 2017 without subsidy.
If you have questions about reconciling your 2014 subsidy and confirming if this was completed, please speak with your tax professional. Thank you!
May 24, 2016
2017 IRS Guidelnes for HSA plans
The Treasury Department and Internal Revenue Service (IRS) recently released the 2017 guidelines on the maximum contribution levels for Health Savings Accounts (HSAs) and out-of-pocket spending limits for High Deductible Health Plans (HDHPs) that must be used in conjunction with HSAs. The 2017 requirements are below: