Bernard Health Individual

Yesterday I met with a woman at the Bernard Health store in Nashville, Tennesee (let's call her Sally). Sally's husband recently left his job with his previous employer, through which his family was insured,  to start his own business. A couple weeks later, Sally received a packet in the mail detailing her family's option to continue receiving their health insurance benefits through COBRA. COBRA provides certain former employees, retirees, spouses, former spouses, and dependent children the right to temporary continuation of health insurance coverage at group health insurance rates. This coverage, however, is only available when coverage is lost due to certain events (e.g. leaving a job), and for a specific amount of time (in this situation, 18 months).

For Sally, the coverage was not the issue -- the issue was the high price of the monthly health insurance premiums. Sally was used to paying only a portion of what she was now being charged due to the fact that her husband's former employer was fitting the rest of the bill. Through COBRA, the premiums for the same health insurance plan would now be closer to 102 percent of the total cost.  Furthermore, there is no longer an employer paying part of the premiums.

That being said, Sally wanted Bernard Health's help in evaluating alternatives -- her family was healthy and she simply felt that they could do better. In fact, after running a complete analysis Sally and her family were able to enroll in a health savings account (HSA) based plan with almost identical out of pocket maximums for nearly $700 per month in savings.
Without sacrificing coverage or increasing her family's financial exposure -- Sally was able to save $8,240/ year.

If you or someone you know recently lost employer sponsored group coverage -- it may be in your best interst to evaluate your healthcare options. Whether you want to replace your COBRA health insurance plan before the coverage expires, or you want help figuring out what to do once it has -- we can help. The first consultation is free and we're always happy to answer questions. It just might save you a small fortune.

Wow!  I can not tell you how excited I was Sunday when I got my Tennesseean newspaper!  (Yes, I still walk out to my driveway and pick up and read a real newspaper).  I was looking through the Publix sale paper to find some grocery bargains and instead found a prescription bargain!!!!  I saw the words:
 
Well that got my attention!  I have recommended this medication hundreds of times because it is a tried and true $4 generic.  Who knew it would get better?  Wow Publix.... Free Lisinopril, Metformin and free antibiotics... You rock!

While we are on the topic of free medication, do not forget about free diabetic medication at Harris Teeter!


This deal is great for anyone!  HSA health plan or traditional co-pay health insurance, either way free is free!  If you switch from a $4 generic pharmacy to this free offer you can have an extra $48 in your Health Savings Account every year!  Publix and Harris Teeter are both in several locations in Nashville Tennessee.  Our Bernard Health Tennessee group and individual clients should take advantage of these offers.

Most people are accustomed to filing taxes every spring.  Likewise, there is a window each year when Medicare beneficiaries can evaluate their Medicare options and, when appropriate, switch plans.  This window is called the Medicare Annual Enrollment Period.  In 2011, the Annual Enrollment Period runs from October 15 – December 7.  

Though rare, there are times when enrolling in Medicare Part A may not be the best strategy even though the benefits are often free.  If you want to disenroll from Medicare Part A, you can fill out CMS Form 1763 (available by contacting Bernard Health) and mail it to your local Social Security Administration office. 

To disenroll after turning 65, you are required to pay back all of the money you may have received from Social Security as well as any Medicare benefits paid.  You can re-enroll at any time by calling Social Security at 1-800-772-1213 or by visiting your local Social Security Administration office.

If you turn down Medicare Part B when you’re first eligible and don’t have other coverage through an employer, but later decide you want Part B coverage, you can only enroll during from January 1 – March 31 of the following year. 

Your Part B benefits will not be effective until July 1 of that year.  You may also be required to pay a late enrollment penalty of 10% of the current Part B premium for each 12 month period you delayed in enrollment.

 

The list of prescription drugs covered by a Medicare Part D plan can vary from plan to plan.  However, every therapeutic category of prescription drugs will be covered by any one plan.  Medicare Part D plans must cover the following types of drugs: antidepressants, antipsychotics, anticonvulsants, antiretrovirals (AIDS treatment), immunosuppressants, and anticancer.

Within those categories, Medicare Part D plans establish their own lists of approved drugs.  These lists are called formularies.  Most Medicare Part D plan formularies are divided into four or five tiers, and each tier is assigned a different copay amount. 

Some types of prescription drugs are excluded from Medicare Part D.  They include certain types of anti-anxiety and anti-seizure drugs, Barbiturates, Benzodiazepines, prescription vitamins and minerals, and prescription drugs used for anorexia, weight loss or weight gain, fertility, cosmetic purposes or hair growth, and relief of cold symptoms. 

If you don’t join a Medicare drug plan when you are first eligible for Part A, and you go without  prescription drug coverage* for 63 continuous days or more, you may have to pay a late-enrollment penalty to join a plan later.  The penalty amount changes each year, and you will have to pay it for as long as you have Medicare prescription drug coverage.

Now, we realize that no one likes to pay a penalty, but if you find out that you do owe a penalty, know that the penalty for late enrollment in 2012 will be ~$.40 per month for each month that enrollment was delayed.  For example, if you delayed Part D enrollment by 10 months, you would owe an extra ~$4.00 each month, or $48 each year.

*Even if you have prescription drug coverage through your employer, you’ll want to make sure that the prescription benefit counts as “creditable”.  If it doesn’t, be sure to sign up for a Part D plan to avoid a late enrollment penalty! 

Medicare Advantage Plans are health plan options that are part of the Medicare program.  If you join one of these plans, you generally get all of your Medicare-covered healthcare through that plan.  This coverage can include prescription drug coverage.  Medicare Advantage Plans include:

This varies from state to state.  If you are under 65 and receive Medicare benefits due to disability or end-stage renal disease, you may not be able to buy a Medigap plan until you turn 65.  Federal law does not require insurance companies to sell Medigap plans to people under age 65, however, some states require insurance companies to sell you a policy, at certain times, even if you are under age 65. In Tennessee, Medicare beneficiaries who are under 65 are able to enroll in a Medigap Plan as of January 1, 2011.

During the first six months after you turn age 65 and are enrolled in Medicare Part B, you can sign up for a Medigap plan without undergoing medical underwriting. 

When you first qualify for Medicare coverage, it takes time and diligence to evaluate whether to enroll in Medicare Part A, Medicare Part B, or both.  In fact, the Medicare enrollment process can be so frustrating that many Medicare beneficiaries get through the paperwork or online enrollment, wipe their brow, and say, "Boy, I'm glad that's over with."


That's what happened with a recent Bernard Health client (let's call him David).  David first qualified for Medicare in September, 2009 due to a disability. He had some trouble filing paperwork and providing documentation to qualify for Medicare, and by the time he received approval, David was just glad to receive Medicare benefits at all. As a result, he never enrolled in a Medicare Part D plan, Medicare supplement, or Medicare Advantage plan. 

Since 2009, David's prescription drug costs continued to rise.  By the time he called Bernard for help, David was paying over $600 per month for maintenance drugs.  David met with a licensed, non-commissioned Bernard Medicare advisor over the phone.  We collected his information and analyzed all of the options available in his town in Missouri.  The advisor found David a Medicare Advantage plan that saved him over $5,000 annually on Medicare and prescription drug costs! 

If you're confused by your Medicare options, Bernard can help.  Call 615-528-3399 for more information or to schedule a free consultation. 

Bernard Health is just like any health insurance broker, right? I can confidently say: Wrong!! Here's why:

Not only do we at Bernard Health help our clients with their group health insurance needs in Nashville, Tennesse; Indianapolis, Indiana; as well as individuals that are eligible for COBRA, looking for an individual health insurance plan,  Medicare beneficiaries seeking help with plan selections or individuals that have confusing medical bills here in Nashville, Tennessee; we also SUPPORT our clients as well.

As a member of the service team on the group health insurance side of Bernard Health, Sara Walton, DeAnna Lax and I dedicate ourselves daily to support the needs of our clients.  Not only can I just say this but our numbers prove it as well.  Thanks to our carefully created and tested system of tracking service related issues and follow ups for our groups, together,we have already support our clients over 2,000 times to date this year.  And just think...the year isn't even over yet!!!  

It's time to send out the notices to all Medicare-eligible employees of group health plans.  This is an annual requirement for companies that offer group health insurance which should be completed by October 15th.  The Medicare Modernization Act is where this requirement comes from.  The notice is an important part of the employee's decision whether or not to enroll in Medicare Part D.

I was recently asked by a group administrator if their group health insurance prescription drug plan was considered "creditable". Fortunately, their group insurance carrier had tested their plans and sent a reference sheet to help the companies determine this.  This link also provides information for determining if prescription drug coverage is creditable.

The health insurance companies are not the only ones offering information to help.  The Centers for Medicare and Medicaid also provide a wealth of information.  Their website even offers sample notification letters to send to your Medicare-eligible employees.

Bernard Health's Retail Store can also help people who are Medicare-eligible with their options.  The 2012 enrollment season is here, so give us a call at 615-528-3399.  

If you are a small business owner offering group health insurance, regardless of whether you offer a Health Savings Account or traditional Copay-based plan, it's important to understand the minimum participation requirements necessary for group plan eligibility.

Generally speaking, the requirements below serve as an industry standard regarding group health insurance plan participation:

1. A minimum of at least 75% of "net eligible" or 50% of "total eligible" employees take the health plan.
2. "Total eligible" employees are the sum of all eligible employees (Full Time working >30hr/week)
3. "Net eligible" employees are the total eligible employees minus those eligible employees who have credible coverage through elsewhere (i.e. through a spouse, Medicare, Tricare, etc...)  

Why is it important that your company meet these requirements?  

Well, if you don't and the health insurance company audits your census and finds that your group is out of compliance with the plan contract, they have the ability to deny any claims that your employees incurred for the period of time your plan was non-compliant.  Try explaining that one to an employee!

I ran across an article this afternoon in the New York Times regarding higher health premiums for employees. The bottom line, more and more companies will push healthcare cost onto their workers as overall costs continue to increase.

According to a new annual study by Aon Hewitt, a large Chicago benefits consultancy -- employees may see health inurance premium increases as high as 11%. That's on top of what had been previously deducted from their paychecks to cover medical insurance premiums.

"The reality is that employers, particularly in this economy, are doing everything they can to get net company levels that they can budget for and afford" -- "Employers are shifting costs to employees to be able to afford to offer benefits", said Jim Winkler, of Aon Hewitt.

One reason noted is that employment trends have left many young adults unemployed, that means fewer healthy workers are paying health insurance premiums while older employees tend to have higher healthcare utilization costs. Mr. Winkler points out, "Companies are not hiring 22-year olds who are healthy to offset the costs of the 58-year-old with diabetes and heart disease".

This data comes from a database of approx. 350 large American employers that spend over $53 billion annually on health insurance benefits -- insuring close to 14.4 million employees and their dependents.

Does this mean that dropping your group coverage and enrolling in a individual health insurance plan to cover you and your family? -- maybe, yes. In some cases, especially if you work for a small employer with an aging employee population, it may be possible for you pay less for individual insurance. For help evaluation your options --  give us a call.

Here at Bernard Health, we're all for Health Savings Account eligible health insurance plans. We love them because they make sense -- not for everybody, but for many, many individuals.

HSAs (health savings accounts) offer lower health insurance premiums when compared to traditional, co-pay based health insurance plans.  They offer flexibility, they reward price shopping, and they offer tax-advantages.  When paired with a a health insurance plan, the result is a consumer-driven health plan, which gives the consumer more direct responsibility for health spending.

Bernard isn't alone is singing the praise of HSAs -- the Kaiser Family Foundation's recent survey of the employer health insurance market found that plans with high deductibles and savings options (HSAs) have been gaining market share rapidly.

• In 2006, only 1-in-25 enrolls were in such a plan
• Today, it's more like 1-in-6

At the end of the day, more and more individuals want a say in the way their money is spent and when it comes to health insurance -- consumer driven health plans offer just that.

Hello readers!  I'm pleased to annouce that yours truely has been annouced as a finalist in this years NEXT Awards as Healthcare Start-Up of the Year.  We are so excited here at Bernard Health just to be named a finalist.

The NEXT Awards are put on each year by the Nashville Chamber of Commerce to recognize Middle Tennessee individuals and companies making a significant impact on the local community.  There will be three finalists and one winner in each category.  

Our fingers are crossed and will keep you updated on the outcome next week.  Thank you all of you who support Bernard Health, we are so appreciative and thankful!

Questions about State Continuation come up quite a bit.  Ryan McCostlin has discussed it in his blog and I have also written about it as well.  

Health Insurance can be tricky.  There are rules and regulations that employer groups need to follow.  Some are required to be COBRA compliant while others are required to offer their former employees State Continuation.  We at Bernard Health are happy to answer all questions related!!  

Now, what happens if your former employee lives in a different state and you are required to offer them State Continuation?  The answer:  The State Continuation benefits you must offer will need to follow the guidelines of the State that your employee resides.  Let me give you an example:

1. You offer all of your employees a health insurance plan based in Tennessee.
2. Tennessee's State Continuation allows former employees to continue their benefits for an additional 3 months.
3. You have an employee that resides in Colorodo.  
4. Colorodo's State Continuation allows former employees to continue their benefits up to an additional 18 months.  
5. Because your employee resides in Colorodo, they may maintain their State Continuation benefits and remain on your plan for up to 18 months.

If your Health Savings Account currently has a $0 balance, this might be good news for you!!  Recently I had a question about HSA monthly bank fees.  They wanted to know what happens if their balance is $0 and they have already contributed the maximum for the year.

In this particular situation, the bank that holds the account said:

1. If the HSA account balance is $0, most banks won't charge a monthly fee.
2. In other words, the monthly fee will not cause the account to go negative.
3. After 16 months of inactivity, the bank will close the account. 

So, if you don't have any money in your Health Savings Account and cannot contribute any more for the rest of the year, you should be alright until January. However, please check with your bank to be sure.

If you don't currently have an HSA eligible Health Plan with an HSA account, give Bernard Health a call at 615-278-9665.  We specialize in health plans with Health Savings Accounts for individuals and employer groups, and we'd be glad to help. 

This past Tuesday, Bernard Health held it's first ever seminar at the Hilton Garden Inn here in Nashville, Tennessee.  The event showcased speakers Roy Ramthun, former Healthcare Advisor to President George W. Bush, and Sam Shallenberger, CFO of RJ Young Company. 

The event started at 8am with a plated breakfast for guests and then the seminar started as Roy Ramthun shared a few White House stories before getting into the nitty gritty of how Health Savings Accounts work and how they are beneficial for companies of all sizes and individuals.

Next, Sam Shallenberger had the crowd laughing with a few jokes and shared a compeling case study about his company and their first and second year savings after switching employees to a HSA based insurance plan.

What a great event for Bernard Health!  We are all so thankful and appreciative to all of you who attended.  We look forward to many more events!