Texas Medical Plans https://health-quotes.com Insuring your health Sat, 01 May 2021 07:48:54 +0000 en-US hourly 1 https://wordpress.org/?v=6.7.1 Opportunity for lower premiums with the new COVID-19 relief bill https://health-quotes.com/opportunity-for-lower-premiums-with-the-new-covid-19-relief-bill/ Sat, 01 May 2021 07:48:54 +0000 https://health-quotes.com/?p=1429   The March 2021 COVID-19 relief legislation, the American Rescue Plan Act (ARPA), has improved affordability for millions more Americans and has opened a limited special enrollment period through August […]

The post Opportunity for lower premiums with the new COVID-19 relief bill first appeared on Texas Medical Plans.

]]>

 

The March 2021 COVID-19 relief legislation, the American Rescue Plan Act (ARPA), has improved affordability for millions more Americans and has opened a limited special enrollment period through August 15th. The uninsured can get coverage if they missed the last open enrollment period and for those already covered, they can reconsider their options with increased affordability and lower out of pocket costs on Silver plans.

Here are the highlights of the ARPA that are helping people now.

$0 Silver Plans for enrollees under 150% FPL with lower or $0 deductibles and reduced out-of-pocket expenses.

The income cap has been removed, now all households regardless of income have their costs capped at only 8.5% of income. This can amount to over $10,000 in savings a year for some households that were shut out of subsidies entirely before.

Larger premium subsidies for enrollees – Costs reduced from 9.6% to 8.5% or less

There are more improvements to healthcare through the ARPA that will continue to be rolled out in the coming months. They include COBRA subsidies and greater savings for anyone that has received unemployment benefits in 2021.

If you’d like to understand more about how these changes can benefit you, call us to speak with a licensed insurance advisor today. Don’t attempt to make changes on your own when free professional help is available.

https://www.cms.gov/newsroom/fact-sheets/american-rescue-plan-and-marketplace

https://www.kff.org/health-reform/issue-brief/how-the-american-rescue-plan-act-affects-subsidies-for-marketplace-shoppers-and-people-who-are-uninsured/

https://www.healthsherpa.com/?_agent_id=greg-myers

 

The post Opportunity for lower premiums with the new COVID-19 relief bill first appeared on Texas Medical Plans.

]]>
Limited Special Enrollment Period Announced for 2021 Healthcare Exchanges due to COVID-19 https://health-quotes.com/limited-special-enrollment-period-announced-for-2021-healthcare-exchanges-due-to-covid-19/ Tue, 02 Feb 2021 06:31:59 +0000 https://health-quotes.com/?p=1421 There is a new Special Enrollment Period opening on February 15th for people that need health insurance during the pandemic.  This SEP will be available to all Marketplace eligible consumers across […]

The post Limited Special Enrollment Period Announced for 2021 Healthcare Exchanges due to COVID-19 first appeared on Texas Medical Plans.

]]>
Special Enrollment Period

There is a new Special Enrollment Period opening on February 15th for people that need health insurance during the pandemic.  This SEP will be available to all Marketplace eligible consumers across 36 states including Texas, served by HealthCare.Gov.

This enrollment opportunity will not require a loss of coverage like most SEPs do and there will not be any need to provide documentation of a qualifying event (e.g., loss of a job or birth of a child). Current enrollees can change to any available plan without being limited to their current coverage level.  Benefits will begin the first of the month after plan selection.  This limited period will run through May 15th, 2021.

This is part of a larger effort to restore and strengthen access to health care for Americans through Medicaid, the Affordable Care Act, and expanded availability to women’s healthcare. The Biden administration is expected to spend 50 million dollars in outreach and education for this new limited sign-up period. In addition to the executive orders to improve access to healthcare during the public health emergency (PHE), agencies have been directed to re-examine several policies that undermine the Health Insurance Marketplace, pre-existing conditions related to COVID-19, and more.  We could potentially see changes related to health insurance and a return to Obama-era rules limiting short-term policy durations and more.  Although that kind of change could take months or even years.

Individuals and families in need of health insurance should contact an agent or Healthcare.gov to see if they qualify and to understand their coverage options.

https://www.hhs.gov/about/news/2021/01/28/hhs-announces-marketplace-special-enrollment-period-for-covid-19-public-health-emergency.html 

 

 

The post Limited Special Enrollment Period Announced for 2021 Healthcare Exchanges due to COVID-19 first appeared on Texas Medical Plans.

]]>
When You Lose Your Job You Only Have 60-Days from that Date to Enroll in Insurance https://health-quotes.com/when-you-lose-your-job-you-only-have-60-days-from-that-date-to-enroll-in-insurance/ Sat, 23 May 2020 05:11:14 +0000 https://health-quotes.com/?p=1399 “An estimated 1.6 million Texans are uninsured after losing their jobs during the coronavirus pandemic, according to a report from the Kaiser Family Foundation, a San Francisco-based health policy think […]

The post When You Lose Your Job You Only Have 60-Days from that Date to Enroll in Insurance first appeared on Texas Medical Plans.

]]>
When You Lose Your Job You Only Have 60-Days from that Date to Enroll in Insurance

“An estimated 1.6 million Texans are uninsured after losing their jobs during the coronavirus pandemic, according to a report from the Kaiser Family Foundation, a San Francisco-based health policy think tank.

About 20 percent, or 328,000 people, qualify for Medicaid. Roughly 55 percent, or 881,000 people, could receive government subsidies for health insurance plans from the Affordable Care Act marketplace.

Across the U.S., an estimated 26.7 million employees lost health insurance benefits as the economic downturn forced companies to lay off workers, according to Kaiser Family Foundation figures.

In Texas, nearly 2 million workers have filed first-time claims for unemployment. Nationwide, more than 36 million jobless claims have been filed since the end of March.” (1)

Remove Your Health Insurance Stress with Help from our Experts

Why go to 10 different insurance websites and fill out quote forms on each site, or talk to 5 different insurance representatives to give them each the same information for a quote, or take the advice from friends that do not specialize in insurance or read through social media recommendations from strangers when an Independent Insurance Advisor can guide you?

Texas Medical Plans reviews all your insurance options for free. We compare Cobra, Medicaid, the Marketplace, Health-Care Ministries, etc. so contact us at (512) 847-3164 or email customerservice@health-quotes.com today.

  • Wu, Gwendolyn. “Report: 1.6 million Texans lost employer-sponsored health insurance”. 19 May 2020. Houston Chronicle. https://www.chron.com/business/bizfeed/amp/Report-1-6-million-Texans-lost-15277790.php. 20 May 2020.

The post When You Lose Your Job You Only Have 60-Days from that Date to Enroll in Insurance first appeared on Texas Medical Plans.

]]>
COVID-19 Scam Alert https://health-quotes.com/covid-19-scam-alert/ Tue, 24 Mar 2020 06:04:36 +0000 https://health-quotes.com/?p=1375 Stay up to date on the latest Coronavirus scams! The Coronavirus outbreak has global attention and is a national emergency in the United States. Since cybercriminals prey on fear, we […]

The post COVID-19 Scam Alert first appeared on Texas Medical Plans.

]]>
Stay up to date on the latest Coronavirus scams! The Coronavirus outbreak has global attention and is a national emergency in the United States. Since cybercriminals prey on fear, we can expect to see more and more COVID-19 scams as the situation progresses.

Scammers may use COVID-19 as an opportunity to steal your identity and commit Medicare fraud. In some cases, they might tell you they’ll send you a Coronavirus test, masks, or other items in exchange for your Medicare number or personal information. Be wary of unsolicited requests for your Medicare number or other personal information.

It’s important to always guard your Medicare card like a credit card and check your Medicare claims summary forms for errors. Only give your Medicare number to participating Medicare pharmacists, primary and specialty care doctors or people you trust to work with Medicare on your behalf. Remember, Medicare will never call you to ask for or check your Medicare number.

More Information

3 types of coronavirus scams to watch out for

  1. Porter, Taryn. “COVID-19 Scam Alerts.” 19 Mar 2020. Cyber Crime Support Network. https://cybercrimesupport.org/covid-19-scam-alerts/. 23 Mar 2020.
  2. Created & distributed by the Centers for Medicare & Medicaid Services and paid for by the U.S. Department of Health and Human Services. “Watch out for Coronavirus scams.” Message to Gregory Myers. 23 Mar 2020. E-mail.

The post COVID-19 Scam Alert first appeared on Texas Medical Plans.

]]>
HDHPs Can Pay Benefits for Coronavirus disease (COVID-19) Without a Deductible https://health-quotes.com/hdhps-can-pay-benefits-for-coronavirus-disease-covid-19-without-a-deductible/ Fri, 13 Mar 2020 05:11:45 +0000 https://health-quotes.com/?p=1370 On March 11, 2020, the IRS issued Notice 2020-15 to advise that high deductible health plans (HDHPs) can pay for COVID-19 testing and treatment before plan deductibles have been met, […]

The post HDHPs Can Pay Benefits for Coronavirus disease (COVID-19) Without a Deductible first appeared on Texas Medical Plans.

]]>
On March 11, 2020, the IRS issued Notice 2020-15 to advise that high deductible health plans (HDHPs) can pay for COVID-19 testing and treatment before plan deductibles have been met, without jeopardizing their status. According to the IRS, this also means that individuals with HDHPs that cover these costs may continue to contribute to their health savings accounts (HSAs).

The IRS also noted that any COVID-19 vaccination costs count as preventive care and can be paid for by an HDHP without cost sharing.

To qualify as an HDHP, a health plan cannot pay medical expenses (other than preventive care) until the annual minimum deductible has been reached. IRS Notice 2020-15 provides an exception to this general rule to remove financial barriers that might otherwise delay testing for and treatment of COVID-19.

Click here for more information.

The post HDHPs Can Pay Benefits for Coronavirus disease (COVID-19) Without a Deductible first appeared on Texas Medical Plans.

]]>
You are Vulnerable to Surprise Health Care Billing Regardless of the New Texas Legislation https://health-quotes.com/you-are-vulnerable-to-surprise-health-care-billing-regardless-of-the-new-texas-legislation/ Thu, 22 Aug 2019 16:07:28 +0000 https://health-quotes.com/?p=1342 Millions of Texans will remain unprotected from surprise medical bills despite state lawmakers this year passing one of the nation’s most aggressive pieces of legislation to curb such bills. Senate […]

The post You are Vulnerable to Surprise Health Care Billing Regardless of the New Texas Legislation first appeared on Texas Medical Plans.

]]>
Millions of Texans will remain unprotected from surprise medical bills despite state lawmakers this year passing one of the nation’s most aggressive pieces of legislation to curb such bills.

Senate Bill 1264, signed into law in June and effective Jan. 1, stops patients from being blindsided by exorbitant medical bills for emergency services, services provided at in-network hospitals and other facilities, and for lab work.

But the new state law only protects about a third of the 14 million Texans who are vulnerable to surprise medical bills because it only applies to those who have insurance regulated by the Texas Department of Insurance — usually teachers, state employees, those who work for small businesses and individuals who buy their own insurance.

Roughly 9 million Texans, mostly those with employer-funded insurance plans that are regulated by the federal government, are not covered by the law.

“Consumers are rightly frustrated at the fact they chose an in-network facility or an in-network provider and receive a bill that is hundreds of dollars more than it would have been. We’re trying to fix this bait and switch,” said Stacey Pogue, senior policy analyst with the Austin-based, progressive Center for Public Policy Priorities.

Surprise medical bills are usually high-dollar charges for medical services that patients didn’t know were outside of their health insurance network. They happen most often in emergency situations and with anesthesiologists and ambulance rides. A combination of factors are to blame for surprise bills, including the growing cost of health care and breakdowns in negotiations between insurers and physicians.

With state lawmakers exhausting almost all avenues to solve the issue, patient advocates are pushing Congress to pass bills that would hold patients harmless for surprise medical bills in emergency and nonemergency situations.

“I worry primarily about those who work for big employers … for Dell or any other big electronic manufacturers in Austin,” said Ken Janda, a Houston-based health consultant and professor at Rice University. “That is why the activity in Washington is so important, because that will fix the other big piece of the puzzle.”

Out-of-network charges

Christine Sederquist, a Leander resident who also serves on the City Council, received more than $4,000 in anesthesia bills after her 12-year-old son’s appendix suddenly burst while on a summer trip to California three years ago. Even though the hospital was in-network and UnitedHealthcare covered the surgery, the insurance company told Sederquist anesthesia was not a covered benefit and she would have to prove why it should be covered.

Sederquist provided the American-Statesman with copies of a claim statement from UnitedHealthcare.

After months of going back and forth with the insurance company and with the help of the human resources department at her husband’s job, the charges finally were reduced.

Because Sederquist’s insurance plan through her husband’s employer, Electronic Arts, isn’t regulated by the Texas Department of Insurance, her family is susceptible to another surprise bill.

“On the face of it, you can see how ridiculous it is,” Sederquist said. “Of course, a 12-year-old getting his appendix out needs anesthesia, and, of course, you can’t check to see if somebody is in-network. It should be a no-brainer to anybody that has to be covered. When you’re … trying to get everything back to normal, you shouldn’t receive notices and bills that just shock you.”

Texas has some of the nation’s highest rates of out-of-network charges associated with hospital stays and emergency visits that could lead to surprise bills, according to a 2017 Kaiser Family Foundation analysis of claims from large employer insurance plans. More than a quarter of hospital stays in Texas led to an out-of-network charge, tying the state with Kansas for the third-highest rate nationally. Thirty-eight percent of emergency visits in Texas led to an out-of-network charge, the highest rate among all states.

The number of requests to the Texas Department of Insurance for help with surprise medical bills has grown each year since the agency started offering the service in 2009, totaling 9,843 through fiscal 2018. With a month left in fiscal 2019, the agency has received 7,701 more requests for help with surprise medical bills.

“You have this whole breakdown in contracting between insurance companies and physicians groups, and there’s plenty of blame to go around, but what always happens is that consumers get trapped in the middle with a surprise medical bill,” said Blake Hutson with AARP Texas, which has been advocating for legislation to eliminate surprise billing.

Sharing blame

A contributing factor to the high rates: Patients often assumes if they choose a hospital covered by their health insurance, the doctors at the hospital also will be covered. But state law restricts hospitals from directly employing physicians, so a hospital being in the health plan’s network has no bearing on a doctor being in the network.

Doctors are left out of network for a few other reasons.

Some physicians have joined large practices, and, in some cases, those practices have adopted business models in which they prefer to be outside the network of health plans’ covered providers so they can charge higher fees to patients, Hutson said. Meanwhile, insurance companies prohibit in-network physicians from charging additional fees to patients.

“Essentially, a physician could be getting their full bill charges if they are out-of-network, which would be more than a negotiated rate with an insurance company if they were in-network,” Hutson said.

David Fleeger, an Austin physician and president of the Texas Medical Association, said there are only a handful of physicians in Texas who prefer to be out-of-network so they can charge exorbitant fees to patients.

Fleeger said that insurance companies intentionally limit the number of doctors in their network.

“Those rates are so low that the physician can’t actually run their business profitably. They can’t pay their overhead let alone make a margin that will be their salary, so they have to reject that offer and they’re therefore out of network,” Fleeger said.

Health insurance company executives said that they’re forced to limit the number of doctors in their networks or doctors would negotiate higher rates, putting more costs on patients.

They also said insurance networks aren’t as strongly tied to surprise billing as doctors make it seem. A 2016 Commonwealth Fund study of large and smaller insurance networks showed a 3 percentage point difference in the rate of surprise billing.

“If it were a network adequacy problem, then research would show that surprise billing was different by the network and it would also be a problem across the board,” said Jamie Dudensing, CEO of the Texas Association of Health Plans. She added that the bulk of surprise billing happens in three service areas: anesthesia, hospital emergency rooms and free-standing emergency rooms.

Hutson said free-standing emergency rooms, which are not affiliated with hospitals, have contributed to the problem in Texas. About 200 free-standing emergency rooms have cropped up in Texas since the state started licensing them in 2009 as a means to lower hospital emergency room wait times and fill a need left by rural hospital closures.

Lawmakers, patient advocates and insurance companies have accused free-standing emergency room operators of being opaque about their prices and insurance plans they accept.

State legislation passed this year requires free-standing emergency room operators to disclose to patients the average cost and fees for a treatment and which health plans consider their facilities in-network.

Rhonda Sandel, board president of the Texas Association of Freestanding Emergency Centers, said in a statement that insurance companies are more to blame for surprise billing.

“Over recent years, insurance corporations in Texas and elsewhere have systematically worked to erode the rights of people seeking medical care, particularly emergency care,” Sandel said. “Providers of care refer to surprise billing by its truer name — surprise undercoverage, the result of insurers selling junk health plans to unsuspecting consumers.”

Legislative limitations

Over the last decade, Texas lawmakers have targeted surprise medical billing, adopting among the stiffest regulations in the country, unusual for a Republican-dominated state. Other states that have approved comprehensive legislation are Washington, Colorado and New Mexico.

In 2009, then-state Rep. Kelly Hancock, a North Texas Republican, authored a bill, passed into law, that allowed people with state-regulated insurance plans to pursue reducing surprise bills through Texas Department of Insurance’s mediation service. As state senator, he filed bills in 2015 and 2017 that expanded the service.

The agency’s mediation service has saved Texas patients more than $46 million in out-of-pocket health care costs since 2015, when the agency began tracking this data.

Even so, most Texans don’t know about it, Hancock said.

When Hancock was charged with a surprise bill of more than $1,000 last year for therapy services related to a shoulder injury, he decided to put his legislation to work. He went through the agency’s mediation process and although his bill was lowered, he found the process too cumbersome for the regular Texan, so he proposed SB 1264.

“I wanted to personally experience the way everybody else does, and so that’s the reason I did it and what prompted me to say, ‘We can do better than this,'” Hancock said. “We can take the patient out of this, which is what we did.”

Under SB 1264, a patient never receives a surprise bill, and it’s up to the provider to ask for arbitration from the Texas Department of Insurance to resolve the cost differences between insurer and provider.

A bill authored this year by Sen. Larry Taylor, R-Friendswood, adds another layer of protection that applies to all insured Texans. The legislation prohibits the failure to pay a surprise medical bill from hurting one’s credit report. Although patient advocates say the legislation essentially removes the main ramification for not paying a surprise medical bill, it doesn’t prevent patients from receiving a bill.

Hancock understands the limits to his legislation and had authored another bill this past session to allow nonstate-regulated insurance plans to opt into the Texas Department of Insurance’s mediation services. It passed the Senate but died in the House.

He plans on pitching it again next session.

Ambulance bills

SB 1264 also does not protect against surprise ambulance bills nor would the bills being considered in Congress. Ambulance charges are among the most common surprise medical bills because they often are not covered fully by insurance.

Jaime Lee, who has state-regulated insurance as a part of her job at the Texas Realtor Association, was charged $1,700 for two ambulance rides last year, charges she wasn’t expecting. She provided the Statesman with copies of two bills.

Minutes after her son was born at St. David’s South Austin Medical Center, doctors noticed parts of his body weren’t receiving oxygenated blood. Within hours, the baby was in an ambulance on his way to the neonatal intensive care unit at St. David’s Medical Center 8 miles away. To have another medical team double-check his condition, the baby was then taken three days later by ambulance to Dell Children’s Medical Center.

Lee’s son eventually received surgery to repair two holes in his aorta and is fully recovered. Lee and her husband ended up dipping into their savings to pay thousands of dollars in medical bills associated with the delivery and her son’s surgery. The couple would have had to pay more if not for a patient advocate, a benefit offered by her job, who was able to negotiate with the insurance company and providers for lower bills — except those from the ambulance company.

“We had no say in that decision. These are life-and-death, critical situations … you’re not thinking about the billing or if this is going to cost more over that,” Lee said. “I almost feel like we were done a disservice. Our baby got excellent nursing and medical care, and it’s just the fallout after the fact.”

Julie Chang. “Texas legislature’s fix to surprise health care bills still leaves millions vulnerable.” Austin American Statesman (TNS), DallasNews powered by Dallas Morning News, August 19, 2019, https://www.dallasnews.com/business/health-care/2019/08/19/texas-legislatures-fix-surprise-health-care-bills-still-leaves-millions-vulnerable). Accessed August 21, 2019.

Rules and regulations surrounding health insurance will be a hot topic for the foreseeable future. Our insurance team at Texas Medical Plans is leading the insurance industry with our 35 years of experience. We are experts in the insurance field and we ready to help you. An insurance advocate on your side has never been more important than it is NOW.

Our clients are matched with the best insurance benefits at the best price based on their needs or the needs of their company’s employees. We don’t stop there though . . . we service your insurance policy for as long as you have it; resolving any issues, answering your questions, facilitating communication with the insurance carrier, so you don’t have to, and our insurance agents are here to assist you with medical claims. Don’t waste another minute trying to figure out your insurance, how your insurance works, where you can get care using your insurance, while trying to stay current with the constant changes that affect insurance and your care; CALL US at (512) 847-3164 TODAY. Texas Medical Plans Advisors are standing by to take your call now.

The post You are Vulnerable to Surprise Health Care Billing Regardless of the New Texas Legislation first appeared on Texas Medical Plans.

]]>
2020 Employer Mandate Details – Marks a Decrease from the Previous Year. https://health-quotes.com/2020-employer-mandate-details-marks-a-decrease-from-the-previous-year/ Thu, 08 Aug 2019 03:41:15 +0000 https://health-quotes.com/?p=1327 The Internal Revenue Service recently released Revenue Procedure 2019-29 which included details on the affordability percentage related to the Employer Shared Responsibility (“pay or play”) provisions of the Affordable Care Act (ACA), […]

The post 2020 Employer Mandate Details – Marks a Decrease from the Previous Year. first appeared on Texas Medical Plans.

]]>
The Internal Revenue Service recently released Revenue Procedure 2019-29 which included details on the affordability percentage related to the Employer Shared Responsibility (“pay or play”) provisions of the Affordable Care Act (ACA), also known as the Employer Mandate. In 2020, applicable large employers (ALE)—generally those who have 50 or more full-time employees (including full-time equivalent employees)—may be subject to a penalty if they do not offer affordable coverage that provides minimum value to their full-time employees and their dependents. An ALE will be considered to offer affordable coverage to its full-time employees if the cost of coverage is 9.78% or less of the employee’s household income. This is a decrease from the 2019 affordability percentage which is currently set at 9.86%.

Given that employers are unlikely to know an employee’s household income, they may use a number of safe harbors to determine affordability, including W-2 method, monthly rate of pay method, and the federal poverty level method.

Additionally, earlier this year the Department of Health and Human Services (HHS) released the 2020 Notice of Benefit and Payment Parameters. This is a ruling that is issued each year which addresses changes to the ACA, including inflation adjustments.

The inflation adjustment percentage that is utilized for the Employer Mandate implies the penalty under Code Section 4980H(a), sometimes referred to as the failure to offer penalty, will be increased to $2,570 multiplied by the number of full-time employees in excess of 30 (assuming at least one full-time employee receives a subsidy on the Exchange). In 2019, the failure to offer penalty is $2,500 multiplied by the number of full-time employees in excess of 30 (assuming at least one full-time employee receives a subsidy on the Exchange).

Assuming an ALE meets the offer requirements but coverage is either unaffordable or does not provide minimum value, the inflation adjustment percentage that is utilized for the Employer Mandate implies the penalty under Code Section 4980H(b) will be increased to $3,860 for each full-time employee who receives subsidized coverage on the Exchange. This is an increase from $3,750 in 2019.

The penalties under the Employer Mandate started at $2,000 under Code Section 4980H(a) and $3,000 under 4980H(b). The affordability percentage started at 9.5%. Each year these numbers are adjusted with the penalties increasing and the affordability percentage changing upwards or downwards.

Aguirre, Christina M. with Flexible Benefit Service Corporation “Re 2020 Employer Mandate Details” Message to Courtney Mecklenburg. 7 August 2019. E-Mail.

Rules and regulations surrounding health insurance will be a hot topic for the foreseeable future. Our insurance team at Texas Medical Plans is leading the insurance industry with our 35+ years of experience. We are experts in the insurance field and we ready to help you. An insurance advocate on your side has never been more important than it is NOW.

Our clients are matched with the best insurance benefits at the best price based on their needs or the needs of their company’s employees. Don’t waste another minute trying to figure out your insurance, how your insurance works, where you can get care using your insurance, while trying to stay current with the constant changes that affect insurance and your care; CALL US at (512) 847-3164 TODAY. Texas Medical Plans Advisors are standing by to take your call now.

The post 2020 Employer Mandate Details – Marks a Decrease from the Previous Year. first appeared on Texas Medical Plans.

]]>
EEO-1 Component 2 Online Filing System Now Open https://health-quotes.com/eeo-1-component-2-online-filing-system-now-open/ Wed, 17 Jul 2019 06:48:41 +0000 https://health-quotes.com/?p=1323 Employers Must Submit 2017 and 2018 Data by Sept. 30 The Equal Employment Opportunity Commission (EEOC) has announced that the online filing system for EEO-1 Component 2 data is available […]

The post EEO-1 Component 2 Online Filing System Now Open first appeared on Texas Medical Plans.

]]>
Employers Must Submit 2017 and 2018 Data by Sept. 30

The Equal Employment Opportunity Commission (EEOC) has announced that the online filing system for EEO-1 Component 2 data is available as of July 15, 2019, when system login information will also be sent to employers via regular mail and email.

EEO-1 filers must submit Component 2 data (on compensation and hours worked) for calendar years 2017 and 2018 by Sept. 30, 2019. The web page for the filing system has been updated with employer FAQs and links to additional employer resources, such as a sample pay data collection form, an instruction booklet for filers, and a user’s guide. The EEOC has also set up a help desk, which may be reached at eeoccompdata@norc.org or 877-324-6214.

The EEO-1 filing requirement generally applies to private employers with 100 or more employees and certain federal contractors.

The post EEO-1 Component 2 Online Filing System Now Open first appeared on Texas Medical Plans.

]]>
4 Annoying Insurance Scams to Dodge https://health-quotes.com/4-annoying-insurance-scams-to-dodge/ Thu, 04 Jul 2019 06:07:54 +0000 https://health-quotes.com/?p=1316 When it comes to getting the best deal for your insurance, you really need to pay attention to the details. We are seeing this occurring with more frequency year after […]

The post 4 Annoying Insurance Scams to Dodge first appeared on Texas Medical Plans.

]]>
When it comes to getting the best deal for your insurance, you really need to pay attention to the details.

We are seeing this occurring with more frequency year after year. “Cheap health insurance” or “no exam life insurance” scams are common. Buyer Beware! You could end up with a SCAM insurance policy that will not cover you when you need it the most.

How do we know? We encounter the scams too! We approach the scam head on, asking the insurance questions that scams dance around and nail them for what they are, lies. Here is what you need to know:

Common Insurance Scams

Insurance scams can come from an actual insurance agent or a fake agent. These individuals may offer you insurance at extremely low rates or insurance you do not want or need in order to inflate their commissions.

  1. The Robo-Call Scam

    You’re sitting at home when your phone rings. When you answer, it’s a voice asking if you like your insurance policy. Then they start explaining that you can get insurance for a cheaper price. They go over all the “wonderful benefits” and give you a great price, but the price is “only good right now”, so you need to sign up. Oh yea, and they are quick to say that you have _____ amount of time to change your mind and cancel to get a full refund. Now all they need you to do is provide your personal information.We are sure you already know this, but just in case, if someone calls you and wants your personal information, you should always hang up!
  2. The Fake Agent

    You are looking for cheap health insurance or cheap life insurance on the internet, and you come across an agent’s ad for ultra-cheap insurance. You click on the ad, and it takes you to the insurance agent’s website where you blindly apply for the coverage and agree to pay a certain amount each month for that coverage. If the agent is fake, your premiums are going directly into his or her pocket, and you won’t know it’s fake until you call to make a claim.
  3. The Unethical Insurance Agent

    Many insurance agents are professional and ethical, but a few insurance agents are not. These agents tell you all the benefits of the insurance policy they want you to buy, but they skip the limitations of the policy. They can be very convincing and pushy. It is important that you insist on having the contract agreement or the summary of benefits document that outlines exactly what is covered emailed or mailed to you to review before signing up.
  4. The Ultra-Cheap Insurance Policy

    If a health insurance policy sounds amazingly good, you should be extremely skeptical. If it is a legitimate policy, it may not meet your state’s minimum requirements, which could leave you underinsured and drowning in medical bills.If you come across any of these scenarios, you should immediately screen the calls or block the phone numbers and report them. Reporting the incident flags the number so that they can be investigated, taken out of business and potentially criminally prosecuted.

How To Avoid Insurance Scams

Avoiding insurance scams involves being vigilant and refusing to provide your information to someone who you did not call. You should also only view insurance policies from reputable insurance carriers.

  • Never provide information to an unsolicited caller– If a company or person calls you, never provide your personal information, especially if you are not actively shopping for health insurance or life insurance.
  • Be wary of clicking on online insurance ads– The advertisement may look legitimate, but you are better off locating the insurance company and agent via an Internet search rather than clicking on the ad.
  • Research the agent– Even if the agent does work for the stated insurance company, he or she may not be ethical. Always research the company and the specific agent before purchasing a policy.
  • Research the insurance company– If you’ve never heard of the insurance company, it’s best to do your research to find out if they are licensed and legally allowed to operate within your state. You can accomplish this by looking on your state’s insurance department’s website.
  • Never agree to purchase super cheap insurance– If the cost of the insurance policy is 90 percent below average, there’s a good chance the policy is either fake or doesn’t cover what you think it covers. Always read the details of the policy.

Getting a New Policy from a Reputable Insurance Company

Rather than going to 15 different insurance websites and filling out quote forms on each site, we recommend using a local insurance agency. When you do business with a local insurance agency you will have the assurance knowing that your insurance needs are handled in a ethical and legal manner.

To compare insurance rates from top companies in your area contact us at (512) 847-3164 or email customerservice@health-quotes.com. Texas Medical Plans has been serving our Texas friends and neighbors for over 35 years.

We hope you found this article helpful. If you’d like to see more articles like this, please follow us on Instagram, Facebook, Twitter, and LinkedIn.

 

The post 4 Annoying Insurance Scams to Dodge first appeared on Texas Medical Plans.

]]>
Never A Dull Moment When It Comes To The Affordable Care Act (ACA) https://health-quotes.com/never-a-dull-moment-when-it-comes-to-the-affordable-care-act-aca/ Wed, 10 Apr 2019 06:31:53 +0000 https://health-quotes.com/?p=1110 Never A Dull Moment When It Comes To The Affordable Care Act (ACA) Constitutionality of the ACA Last year, a federal judge in Texas ruled that the ACA was now […]

The post Never A Dull Moment When It Comes To The Affordable Care Act (ACA) first appeared on Texas Medical Plans.

]]>
Never A Dull Moment When It Comes To The Affordable Care Act (ACA)


Constitutionality of the ACA

Last year, a federal judge in Texas ruled that the ACA was now unconstitutional because there is no more Individual Mandate penalty.

The judge found that all portions of the ACA are now void. That ruling has been appealed and is currently under review by the U.S. Court of Appeals for the 5th Circuit in New Orleans.

In response to the Texas ruling, The Trump administration had initially taken the position that only some parts of the ACA had to be repealed (those most closely linked to the Individual Mandate) while other parts of the law could stand. In a new filing by the Justice Department last week, the administration now says the Texas judge’s decision should be affirmed and all parts of the ACA should be invalidated. If the ACA were to be ruled unconstitutional, there is no replacement plan currently in place.

Association Health Plans

Last year, the Department of Labor (DOL) finalized new rules which relaxed regulations pertaining to association health plans (AHPs). The rules made it easier for self-employed persons and small businesses to join forces when purchasing health insurance plans. Under the new rules, AHPs are regulated similarly to large group health plans which are exempt from some ACA market reforms, including the requirement to cover all ten essential health benefits. Because AHPs don’t have to follow all the ACA market reforms, premiums are generally lower.

The legality of the new AHP rules were challenged by proponents of the ACA, and a federal judge ruled in their favor. The judge indicated that the new AHP rules are “clearly an end-run around the ACA.” A spokeswoman for the Justice Department indicated the Trump administration disagreed with the court’s decision. The administration can seek a stay and appeal the decision. This would allow the AHP rules to remain in force while an appeal is heard. The DOL could also revisit the rule and issue a different version of the previously finalized rules. It’s unclear at this point how the Trump administration will proceed.

Grandmothered Plans

Health plans in the individual and small group markets that were issued after March 23, 2010 and prior to January 1, 2014 are commonly referred to as grandmothered plans. Grandmothered plans were supposed to be terminated in 2014 because they failed to satisfy all of the ACA’ s market reforms, but the federal government has temporarily allowed these plans to continue. In an announcement, the Department of Health and Human Services (HHS) has indicated grandmothered plans can continue to be renewed for plan years beginning on or before October 1, 2020, provided the plans end by December 31, 2020. Absent this announcement, these plans were set to expire at the end of 2019. It should be noted that this extension is an option for states and carriers, not a requirement.

Aguirre, Christina M. with Flexible Benefit Service Corporation “Re: There’s never a dull Moment when it comes to the Affodable Care Act (ACA).” Message to Courtney Mecklenburg. 1 April 2019. E-Mail.

Rules and regulations surrounding health insurance will be a hot topic for the foreseeable future. Our insurance agency, Texas Medical Plans, has mastered the health insurance industry in the 30+ year we have been in business. We are experts in the insurance field and we ready to help you. An insurance advocate on your side has never been more important than it is NOW.

Our clients are matched with the best insurance benefits at the best price based on their needs. Don’t waste another minute trying to figure out your insurance, how your insurance works, where you can get care using your insurance, while trying to stay current with the constant changes that affect insurance and your care; CALL US at (512) 847-3164 TODAY. Texas Medical Plans Advisors are standing by to take your call now.

 

The post Never A Dull Moment When It Comes To The Affordable Care Act (ACA) first appeared on Texas Medical Plans.

]]>