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2018 Medicare Open Enrollement is Here

2018 Medicare Open Enrollement is Here

 


Get Medicare Quote          

2018 Medicare Open Enrollement is Here

We are certified and appointed to sell senior plans from Empire Blue Cross, AARP United Healthcare, Humana and Aetna to help people in New York currently enrolled in Medicare or those who are aging in to Medicare (turning 65) with a wide variety of options. Some of these are Medicare Advantage (HMO, PPO), supplement plans and Part “D” prescription plans (PDP,s).

There are also some special enrollment periods (SEP) available to individuals under certain conditions. The Annual Enrollment Period (AEP) for Medicare is October 15 to December 7 this year. Those currently on Medicare can shop around and switch their plans at this time. The initial enrollment period (IEP) of 7 months. This is from 3 months prior to your 65th birthday, the month of your birthday and the 3 months following your birth month.
It is wise to contact an expert to help you find the coverage that best suits you during these enrollment periods. You can call or email us at any time for comprehensive, “no pressure” advise.

Resource:

Download a Copy of 2017 Medicare and You.

2013 Medicare Costs

Medicare Supplement Plans

Medicare Advantage 

Medicare Advantage vs. Supplement Plans

Getting Extra Help with Medicare Expenses

Medicare FAQ

Dates to Remember

October 1

You can start getting plan information for 2018 premiums and benefits.

October 15 — December 7

This is the Annual Election Period (AEP). During this time, you can make changes to your existing Medicare health or prescription drug plan or select a new plan for 2018.

January 1 — February 14

This is the Medicare Advantage Disenrollment Period. During this time, you can prospectively disenroll from your Medicare Advantage (MA) plan and return to Original Medicare.

If you are turning 65:

– If you aren’t getting Social Security (for instance, because you are still working), you will need to sign up for Medicare benefits. You should contact Social Security three months before you turn age 65.
– You can enroll in a Medicare plan starting three months before the month of your 65th birthday, the month of your birthday, and for up to three months after your 65th birthday, for a total period of seven months.

Learn more aboiut your Medicare Supplement options.Please contact us at info@medicalsolutionscorp.com or (855)667-4621. 

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Health Exchange Marketplace Top Ten List

Health Exchange Marketplace Top Ten List

HIX TOP 10

Health Exchange Marketplace Top Ten List

The Health Exchange  also known as The Health Marketplace or Obamacare Exchanges are  set to open in less than 12 hours.  Are you ready or aye you like most asking What is an Exchange?  Starting Oct 1 you can enroll until March 31, 2014, though you’ll generally need to sign up by Dec. 15 of this year, to be covered as of Jan. 1. You can find your state’s marketplace at healthcare.gov.  The prices for the marketplace plans are likely to be similar to those sold privately. A plan that is also available on the exchange  may be eligible for subsidies.  Heres an easy top 10  list of what you need to know.

10. Locate your State Exchange

Look up your state’s exchange here  and Healthcare.gov.  Some states are running their own exchange, others are running it through the federal government see www.healthcare.gov.  For NY Tri-State the sites are:

NYS –  http://info.nystateofhealth.ny.gov       See rates here

NJ – https://www.healthcare.gov/how-do-i-choose-marketplace-insurance

CT – https://www.accesshealthct.com  See rates here

9. Individual Mandate Penalty

For 2014, the annual penalty is $95 or 1% of your income, whichever is greater. The penalty will increase over the first three years. Coverage can include employer-provided insurance, individual health insurance, Medicare or Medicaid.

Health Insurance Individual Penalty for Not Having Insurance
Pay the greater of the two amounts
Year Percentage of Income Set Dollar Amount
2014 1% $95 & $285/family max
2015 2% $325 & $975/family max
2016 2.5% $695 & $2,085/family max

8.  Individual Subsidies

Individuals who do not have affordable minimum essential coverage from their employer will be eligible for tax credit subsidies for their health insurance purchase on a state exchange if their income is below 400 percent of federal poverty level.

If you make under $45,960 or your family makes under $94,200, you could get a real break on health insurance costs More low-income people will also be eligible for free coverage under Medicaid For those eligible, the subsidies will cap the amount you pay for your exchange policy at between 2% and 9.5% of your income (on a sliding scale, based on your income). To find out how much you would pay, estimate your income for this year and plug it into any health subsidy calculator. You can also see estimate subsidies with these “health subsidy charts”.

7.  Small Business Subsidy – SHOP Exchange

A key change is that the small business health care tax credits will only be available ONLY through the SHOP Exchange marketplace in 2014. Small businesses with 25 or fewer employees who receive less than $50,000 a year in wages may be eligible for tax credits if they purchase the plan through the SHOP marketplace. These credits will cover up to 50% of the employer’s cost (35% for non-profits) for the first two years of coverage. Click here to read more about the small business health care tax credits.

6. Your income

not your assets, such as your house, stocks or retirement accounts – will count toward determining whether you can get tax credits. When you buy your plan, you estimate your income for next year, and your tax credit is based on that estimate. The next year, your tax returns will be checked by the IRS and compared against your estimate.

5.  Pre-Existing Conditions Eliminated

Your insurer generally can’t drop you, as long as you keep up with your insurance premiums and don’t lie on your application. Generally, people will be able to enroll in or change plans once a year during the annual open enrollment period. This first year, open enrollment on the exchanges will run for six months, from Oct. 1 through March of next year. But in subsequent years the time period will be shorter, running from October 15 to December 7.

4. Essential Health Benefits Covered

Each plan covers 10 “essential health benefits,” which include prescription drugs, emergency and hospital care, doctor visits, maternity and mental health services, rehabilitation and lab services, among others. In addition, recommended preventive services, such as mammograms, must be covered without any out-of-pocket costs to you.  More info here.

3. Ninety-Day Maximum Waiting Period

Group health plans and health insurance issuers may not impose waiting periods of more than ninety days before coverage becomes effective. This also applies to grandfathered plans.

2. Annual or Lifetime Limits

Group health plans, including grandfathered plans, may no longer include more than restricted annual or any lifetime dollar limits on essential health benefits for participants. Limits may exist in and after 2014 for non-essential benefits.

1. Not Everyone is Eligible

  • Immigrants who are in the country illegally will be barred from buying insurance on the exchanges.  However, legal immigrants are permitted to use the marketplaces and may qualify for subsidies if their income is no more than 400 percent of the federal poverty level (about $46,000 for an individual and $94,200 for a family of four).
  •  members of certain religious groups and Native American tribes
  • incarcerated individuals
  • people whose incomes are so low they don’t have to file taxes (currently $9,500 for individuals and $19,000 for married couples)

Conclusion:

There has been a lot of news about individual Obamacare provisions getting delayed – Obamacare Employer mandate Delayed. Some people may assume that means the health law is being slowly dismantled, or put off for an additional several years. .The Affordable Care Act is an extremely complicated law with a lot of moving parts, but ultimately, the biggest provisions are still moving forward. There will likely be more hiccups along the way. As the enrollment period opens for Obamacare’s new exchanges, industry experts predict there will probably be other issues that need to be ironed out — but that doesn’t mean the whole law is collapsing

Still confused?

Don’t be.  These are the common questions that we are working through with our clients daily.  Am I better off going SHOP Exchange vs. Individual  for my business?  Am I better off going off  Exchanges or onto Private Exchanges?  Whats my minimum employer contribution?  Do I have to cover employee and dependents? Is dental and vision included?  What happens to my Healthy NY when it shuts down Jan 1, 2014? What employer notices must I be posting?

Please contact our team at Millennium Medical Solutions Corp if you have additional questions regarding  how SHOP Exchanges and Individual Exchanges can benefit you     Stay tuned  to our site for updates as more information gets released.   Sign up for latest news updates.

Looking for Affordable Health Insurance? You can use this SINGLE PAGE form to get affordable health insurance quotes outside exchange and save money. If you are above 64 years, then use this link to Get FREE Medicare quotes from the most trusted carriers.

Resource:

Click Above
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Federal government health care site: www.healthcare.gov

Kaiser Health Reform Subsidy Calculator:http://healthreform.kff.org/subsidycalculator.aspx

[contact-form][contact-field label=’Name’ type=’name’ required=’1’/][contact-field label=’Email’ type=’email’ required=’1’/][contact-field label=’Website’ type=’url’/][contact-field label=’Comment’ type=’textarea’ required=’1’/][/contact-form]

 

 

 

Health Exchange Notification Due Oct 1

Health Exchange Notification Due Oct 1

HIX Employee deadline

Health Exchange Notification Due Oct 1  – Employers Must Distribute Required Exchange Notice

If your organization hasn’t done so already, you have until October 1 to inform employees about their option to enroll in a public health exchange under theAffordable Care Act.

Notice Must Be Provided to Current and New Employees. Following a delay in the original effective date, employers will need to comply with the new requirement to provide each employee a written notice with information about a Health Insurance Exchange (also known as a Marketplace) beginning this Fall.

Employers are required to provide the written notice to each current employee not later than October 1, 2013, and to each new employee at the time of hiring (within 14 days of the employee’s start date) beginning October 1, 2013. Two model notices are available from the U.S. Department of Labor:

Model Notice for Employers Who Offer a Health Plan
Model Notice for Employers Who Do Not Offer a Health Plan

Employers must provide the notice to each employee regardless of plan enrollment status (if applicable) or of part-time or full-time status. Employers are not required to provide a separate notice to dependents or other individuals who are or may become eligible for coverage under the plan but who are not employees.

The notice may be provided by first-class mail, or, alternatively, it may be provided electronically if certain requirements are met. More information on the notice requirement is available from the U.S. Department of Labor.

IMPORTANT: The model notice contains an optional section about employer-sponsored coverage details. The model notice is three pages long and contains an optional section on page three (questions 13 though 16).  An employer is in no way obligated to provide the optional information requested on the model notice.  Also, an employer may modify the notice as long as the end result corresponds to the overall basic content guidelines.  However, the employer should carefully weigh the value of providing additional information about the cost and value of the employee’s group health plan options.

Technically, the law does not impose any fines for failing to provide the notices. However, the Affordable Care Act is  intertwined with other laws (this particular provision is embedded in the FLSA in a new section, 8A), so it is considered a good idea to comply to avoid possible legal complications.

Who Must Receive the Notices?

Notices must be given to all employees, whether or not they work full time, and regardless of whether they are currently receiving health benefits. The October 1 deadline is to give these notices to all employees. After October 1, the notices must be given to new hires within two weeks of coming on board.

The notices must “be provided in writing in a manner calculated to be understood by the average employee,” says the Department of Labor (DOL) in Technical Release 2013-02. They can also be provided via e-mail, but only to employees for whom accessing e-mail is “an “integral part of the employee’s duties” and who can access the system easily.

Which Employers Must Send the Notices?

The notice requirement must be met by employers that must comply with theFair Labor Standards Act (FLSA). In general, the FLSA applies to employers with one or more employees who are engaged in, or produce goods for, interstate commerce. For most firms, a test of not less than $500,000 in annual dollar volume of business applies.

The FLSA also specifically covers the following: hospitals; institutions primarily engaged in the care of the sick, the aged, mentally ill, or disabled who reside on the premises; schools for children who are mentally or physically disabled or gifted; preschools, elementary and secondary schools, and institutions of higher education; as well as federal, state and local government agencies.

Model Notices

The DOL has issued a pair of model notices you can use. One is for employers which currently offer health benefits and another for those which do not. On Part B of the forms, you will see information the employees will need if they plan to purchase coverage on the exchange, assuming they are eligible.

The Part B information would allow employees who apply to their state’s exchange (or the federal version, if no state-run exchange exists) to complete a required questionnaire to determine their eligibility for the program.

The model notice for employers that do currently offer health coverage features a lot of slots for information about your health plan in Part B. Since the law doesn’t actually require you to provide the information, and because some of the information may be hard to dig up employers may decide to disregard some or all of Part B, especially if the information is uncertain or likely to change, employers to be “cautious about volunteering too much information.”

Ask us about our Online Notification Tool developed by our payroll partner.   Be sure to visit our section on Health Care Reform for information on other notices required to be provided and to download additional model notices available for employers and group health plans.

 

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    Obamacare Simplified Using Youtoon

    Obamacare Simplified Using Youtoon

    Obamacare Simplified Using Youtoon by Kaiser is just what the Doctor ordered.  With less than 60 days to go to the October 1, 2013  Health Exchanges Open Enrollment Period  what better way to ease the confusion than a 7 minute cartoon?

    CMS maintains the HealthCare.gov website, and this is where individuals can find more information on health insurance exchanges, the enrollment for which begins on October 1, 2013. Depending on which state individuals reside in, one may be able to enroll in an exchange plan, or may be directed to their state’s own exchange enrollment site. Employers can also use this site to learn about the Small Business Health Options Program (SHOP) which can help them provide coverage for employees.

    Several resources have been made available to help people weed through the information and to make you aware of what requirements and deadlines apply to you. The Kaiser Family Foundation (KFF) brought some levity to the topic by creating an animated video explaining the upcoming changes in health coverage under the ACA.  Narrated by Charlie Gibson, “The YouToons Get Ready for Obamacare,” explains what is and isn’t changing under the law and is posted on the KFF site, along with other resources on the topic. KFF President, Drew Altman, was quoted as saying, ’[t]his cartoon is meant to demystify a complex law and explain what it means for you, whether you support or oppose Obamacare.”

    Obamacare Simplified Using Youtoon

    Resource:

    Our HealthCare Reform Resource

    NYS Approves Health Insurance Exchange Rates

    Health Exchange FAQ
    Click Above

    Federal government health care site: www.healthcare.gov

    Kaiser Health Reform Subsidy Calculator:http://healthreform.kff.org/subsidycalculator.aspx

    For a comparison and additional questions  on which  Exchange – Individual or  SHOP Exchanges is right for you  please contact our team at Millennium Medical Solutions Corp.   Stay tuned for updates as more information gets released. We’re inside of 45 days until exchanges open, and information will be coming quickly in the next few months.  Sign up for latest news updates.

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      Interfaith Hospital Planning Shutdown

      Interfaith Hospital Planning Shutdown

      Bedford Stuyvescent Hospital Closing

      Interfaith Hospital Planning Shutdown. The Bedford Stuyvescent Hospital entered bankruptcy court this week to approve its closing and send layoff warning notices to its 1,544 employees. Pending court and state approval, on Aug. 12 the hospital will end inpatient admissions and divert ambulances to other hospitals. Elective surgeries will end Aug. 19, the emergency department will shut Sept. 11, and all patients will be transferred from the hospital by Sept. 12. Outpatient programs will end Oct. 12 and detoxification and rehabilitation programs Nov. 11.

      The bankruptcy court hearing for Interfaith is August 15. The hospital services 175,000 people  with closest hospital in this predominantly minority community is about two and a half miles away.

      The threatened closing of another Brooklyn hospital, Long Island College Hospital in Cobble Hill, has become an issue in the mayoral campaign. The  506-bed  hospital — which it said to be losing $4 million was taken over by Downstate   in 2011, inheriting a $170 million debt. The Hospital’s location is very sought after and will likely be purchased by developers.  Developers are coveting LICH’s $1 billion in prime brownstone Brooklyn waterfront buildings.

      See our original blog story Interfaith Hospital Files Bankruptcy, Dec 7, 2012.

      Stellaris Hospitals Break Up

      Stellaris Hospitals Break Up

       

      4 Hospitals seek to cut Stellaris ties

      Stellaris Hospitals Break Up.

      Breaking Westchester Health Care News: As reported in The Journal News earlier. A Stellaris Hospitals Break Up is planned; Phelps, Lawrence, Northern Westchester and White Plains may form new alliances.  Stellaris had been in the news in recent years with down to the wite negotiations with Empire Blue Cross Empire & Stellaris Reach Pact effective 8/1/10.

      A Stellaris Hospitals Break Up is not surprising.  This is viewed as possible strategic move for acquisition form larger local hospitals or even national chains such as Cardinal Health or HCA. Insurers have also purchaszed recenlty medical groups,see UnitedHealthcare Buying Medical Groups?  Will it our market allow an Insurer to purchase a Hospital?

       

      4 hospitals seek to cut Stellaris ties

      By Jane Lerner

      Four hospitals in Westchester County want to cut ties with their parent organization — a move that could signal their interest in forming new consolidations and alliances with other health-care facilities.

      Phelps Memorial Hospital Center in Sleepy Hollow, Lawrence Hospital Center in Bronxville, Northern Westchester Hospital in Mount Kisco and White Plains Hospital are seeking to leave the Stellaris Health Network.

      “Stellaris and its member hospitals made this decision after a lengthy strategic review that evaluated a variety of alternatives to respond to a dynamic and ever more challenging health-care environment,” Stellaris said in a statement.

      The state Department of Health has to approve any change in ownership of a hospital. Requests from the four hospitals to “dis-establish” Stellaris as “active parent and co-operator” were filed with the state last week.

      Leaving Stellaris will enable each hospital to seek new partners.

      “By becoming independent, each hospital can move forward in the direction that each feels is best for its community,” said Arthur Nizza, who is on his way out as president and chief executive officer of Stellaris.

      All four hospitals declined to comment.

      As the parent organization of the four hospitals, Armonk-based Stellaris handled their negotiations with commercial insurance companies, purchasing and information technologies.

      Stellaris will continue to provide IT support and some other services to the hospitals. But once they leave the network, they will be able to seek new partners to increase their bargaining power and share services and expenses.

      Numerous hospital consolidations and mergers are taking place nationwide.

      “I think in time — not immediately — the idea of a freestanding community hospital is going to be passe,” said Kevin Dahill, president of the Northern Metropolitan Hospital Association, an industry group.

      Sound Shore Medical Center in New Rochelle and its Mount Vernon Hospital are seeking to merge with Montefiore Medical Center in the Bronx once the Westchester County institutions emerge from Bankruptcy Court. In New York City, Mount Sinai Medical Center and Continuum Health Partners, a network that includes Beth Israel and two St. Luke’s-Roosevelt campuses, agreed last week to merge.

      “Hospitals are doing what they have to do to position their organizations,” Dahill said.

      Stellaris was formed in 1996 as an alliance between White Plains and Northern Westchester hospitals. In 1997, Phelps and Lawrence joined and, in 2000, the company formed an emergency medical service to provide paramedic service to part of Westchester.

      Nizza will become CEO of St. Francis Hospital and Health Centers in Poughkeepsie next month. Sharon Lucian, who has been with Stellaris since 1999 and is vice president and chief financial officer, will replace him.

       

      Health Care News

      Click Above for Latest News

      NYS Approves Health Insurance Exchange Rates

      NYS Approves Health Insurance Exchange Rates

      Health Insurance Exchange

      NYS Approves Health Insurance Exchange Rates.

      Governor Cuomo announced  yesterday that New York’s Health Benefits Exchange have been approved . Additionally, the New York Times yesterday published an article highlighting that the rates in the individual market that will be offered in 2014 are at least 50 percent lower than they are now.  The article link and Governor’s office press release are included below.

      5 things we now know about the NYS Exchanges:

      • Importantly,  Insurers must still confirm that they will be in either the individual exchange and/ or shop exchange
      • The rates approved yesterday are subject to final certification of the insurers’ participation in the exchange.
      • Many of the networks used on the Exchange appear to be smaller than the group rated.
      • Some new insurers have eneter the marketplace such as OSCAR and Freelancers.  While a few such as EmblemHealth have taken a wait and see approach.
      •  Additionally,  NYS  individual market rate will drop significantly in 2014 but they have been historically always the highest.  An individual/Direct Pay  HMO is approximately $1,000-$1,200/month. They are still approximately 18% highest.

      The Department of Financial Services (DFS) has approved  New York’s Health Health Insurance Exchange  rates for 17 insurers seeking to offer coverage including eight new entrants into the market that do not currently offer commercial health insurance plans.  Please click the following links for the Governor’s Press Release and the Individual and Small Group rates.

      Governor’s Press Release

      NYS Approved 2014 Exchange Rates

      The following companies had health insurance plan rates for the health benefits exchange approved today by DFS. The rates approved today are subject to final certification of the insurers’ participation in the exchange.

      • Aetna
      • Affinity Health Plan, Inc.

        NYS Approves Health Insurance Exchange Rates

        The cheapest you’ll pay for individual health insurance in NY

      • American Progressive Life & Health Insurance Company of New York
      • Capital District Physicians Health Plan, Inc.
      • Health Insurance Plan of Greater New York
      • Empire BlueCross BlueShield
      • Excellus
      • Fidelis Care
      • Freelancers Co-Op
      • Healthfirst New York
      • HealthNow New York, Inc.
      • Independent Health
      • MetroPlus Health Plan
      • MVP Health Plan, Inc.
      • North Shore LIJ
      • Oscar Health Insurance Co.
      • United Healthcare

      If you have additional questions regarding  how SHOP Exchanges and Individual Exchanges can benefit you  please contact our team at Millennium Medical Solutions Corp.   Stay tuned for updates as more information gets released. We’re inside of 75 days until exchanges open, and information will be coming quickly in the next few months.  Sign up for latest news updates.

      Resource:

      Health Exchange FAQ

      Click Above

      Federal government health care site: www.healthcare.gov

      Kaiser Health Reform Subsidy Calculator:http://healthreform.kff.org/subsidycalculator.aspx

      [contact-form][contact-field label=’Name’ type=’name’ required=’1’/][contact-field label=’Email’ type=’email’ required=’1’/][contact-field label=’Website’ type=’url’/][contact-field label=’Comment’ type=’textarea’ required=’1’/][/contact-form]

       

       

      Obamacare Employer Mandate Delayed, More Guidance

      Obamacare Employer Mandate Delayed, More Guidance

      Employer Shared responsibility Mandate Delayed

      In an unexpected announcement pre-July 4th the big news was Obamacare Employer Mandate Delayed with penalties under the Affordable Care Act (ACA) until 2015.  The mandate also known as the “Employer Shared Responsibility” requires employers with 50 or more FTEs to offer affordable health insurance coverage to their workers or face financial penalties for not doing so.  Those penalties would originally have been applied beginning in 2014.

      There has been a follow up guidance issued last week July 9th by the IRS.  According to the IRS, the delay will give employers more time to prepare for the change in how health insurance is provided and will also give the Obama Administration time to simplify the insurance-related reporting requirements that employers face. This transition relief appears to come with “no strings attached.”  Although the IRS guidance encourages employers to voluntarily comply with the employer mandate and maintain or expand health care coverage in 2014, the IRS will not impose penalties for a failure to do so.

      Although the IRS guidance encourages employers to voluntarily comply with the employer mandate and maintain or expand health care coverage in 2014, the IRS will not impose penalties for a failure to do so.Notably, the guidance issued on July 9th also does not require employers to make “good faith” efforts to comply. As a result of this transition year, employers will have the option of deciding to what extent (if any) they will continue efforts to comply with the employer mandate during 2014.

      Employers who intended to rely on one of the transition rules previously announced for 2014 should keep in mind that the latest IRS guidance does not provide special transition rules for 2015. Other group health plan requuirements still apply as discussed in our prior blog Essential Health Benefits Not Delayed.

      This means that for plan years beginning on and after January 1, 2014, all group health plans must:

      •  Eliminate all pre-existing condition exclusions (regardless of age);
      • revised Summary of Benefits and Coverage templates;
      •  Essential Health Benefits Not Delayed; and
      •  Eliminate waiting periods of longer than 90 days.
      • Maximum Cost Sharing Deductible to $2,000/individual ($4,000/family); limit in-network out-of-pocket maximums to $6,350/individual ($12,700/family)

      • Individual Mandate Still Applies. individuals will still be required to obtain health care coverage or pay a penalty for each month they do not have coverage, beginning January 1, 2014
      • Exchanges (Marketplaces) Open for Enrollment October 1, 2013.

        The IRS notice makes it clear that individuals who enroll in coverage on the marketplaces will continue to be eligible for a premium tax credit if their household income is within a specified range and they are not eligible for other minimum essential coverage.

      • Employers Must Send Notice of Exchanges (Marketplaces) Before October 1, 2013.  These notices must be sent to current employees by October 1, 2013.  Then, beginning October 1, 2013, employers must send this notice to new hires within 14 days of their start date.
      • New taxes still apply – Patient Centered Outcomes Research Institute (PCORI) excise taxes and transitional reinsurance program fees;HRA/HSA/FSA clients also pay a monthly $1/employee tax.

      We will continue to monitor ACA developments and will provide you relevant updated information when available.  In the meantime, please visit to view past blogs and Legislative Alerts at https://medicalsolutionscorp.com/feed. 

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