happy family on couch browsing health insurance options on tablet

Getting the Most out of Open Enrollment

With 2020 Open Enrollment period in full swing, families across the country are reviewing their current insurance coverages and seeing what other options may be available to them. Below are a few tips to help you navigate the process.

  1. Learn the Language

Insurance jargon may be enough to make some people’s heads spin but learning just a few key terms could help you pick the best health coverage for you and your family. To make it easy, here are a few words we feel you should know:

  • ACA-compliant” refers to plans that follow all the guidelines and regulations in the Affordable Care Act. These plans are only available during the annual Open Enrollment period or through a Special enrollment period, if you have a qualifying event.
  • Non-ACA plans” also known as short term health plans do not adhere to all of the Affordable Care Act’s guidelines and regulations.
  • Deductible” the amount of money you must pay out of pocket before your insurance kicks in
  • Premium” the amount you pay to your insurance company every month
  • In-network” refers to a provider that has a contract with your insurance provider
  • Out-of-network” refers to a provider that does not have a contract with your insurance provider
  1. Think of the Future

No one can predict the future, but you may be able to take an educated guess as to what the next 12 months could hold. Thinking about the coming year could help you determine how much coverage is right for you and your family. Have you had any health issues in the past year? Are you taking any medications? By examining your current health status and concerns you may be able to narrow down your health insurance plan options.

  1. Utilize Your Resources

Did you know as a benefit of your AOA membership, you have access to our team of licensed Benefits Counselors? Our Benefits Counselors are experts in their field and are standing by to help you navigate the Open Enrollment process and find the best health insurance for you and your family’s needs.

We’ve been providing health insurance answers and guidance for over 30 years. Be sure to visit the AOA Insurance Marketplace for access to appointment scheduling services, webinar replays, and other informational resources designed to help make the Open Enrollment process as quick and easy as possible.

  1. Know Your Deadlines

Like last year, the annual individual health insurance Open Enrollment period began on November 1 and will run until December 15. For those who enroll in one of these ACA-compliant plans, you can expect an effective date of January 1.

Non-ACA plans typically do not follow the ACA open enrollment period dates and are available in most states year-round.

Ready to make your decision? Visit https://osteopathic.memberbenefits.com/health-insurance/ today to secure ACA-compliant coverage for you and your family in 2020.

2020 Open Enrollment Webinar invite

Upcoming 2020 Individual Health Insurance Open Enrollment Webinar

Join us for a free webinar on Tuesday, October 29 from 12:00pm-12:30pm EDT, where we’ll review the upcoming 2020 Individual Health Insurance Open Enrollment period and cover topics such as important dates, preparation tips, industry updates, and more! Reserve your spot by registering today. Can’t make it to the webinar? Register anyway and we’ll send you a link to the video replay later that day.

professional woman on phone outside smiling

Knowing Your Options Outside of Open Enrollment

While the annual Open Enrollment period focuses on ACA-compliant individual major medical insurance, there are still other forms of insurance available for potential enrollees.

Knowing Your Options

According to healthinsurance.org, “ACA-compliant coverage refers to a major medical health insurance policy that conforms to the regulations set forth in the Affordable Care Act (Obamacare)…This means they must include coverage for the ten essential benefits with no lifetime or annual benefit maximums, and must adhere to the consumer protections built into the law.”

Unless you qualify for a special enrollment period, you cannot receive ACA-compliant individual health insurance coverage outside of the annual Open Enrollment Period, which typically runs from November 1st until December 15th of each year.

If you missed out on Open Enrollment but still need individual health insurance, you still have a few options available:

  1. COBRA

According to the U.S. Department of Labor, “The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances such as voluntary or involuntary job loss, reduction in the hours worked, transition between jobs, death, divorce, and other life events. Qualified individuals may be required to pay the entire premium for coverage up to 102 percent of the cost to the plan.”

  1. Qualifying Life Event (QLE)

There are certain life circumstances called Qualifying Life Events (QLEs) that can qualify you for a special enrollment period. Special enrollment periods allow you to obtain ACA-compliant health coverage outside of the annual Open Enrollment period for you and your eligible dependents. The most common QLEs pertain to:

  • Loss of health coverage
  • Changes in household
  • Changes in residence

If you find yourself matching any of the above circumstances or feel your unique circumstance should qualify you for a special enrollment period, please contact us and our team will help guide you in the right direction based on your individual needs.

  1. Non-ACA Compliant plans

Non-ACA compliant plans, also referred to as short-term medical plans, have recently become more appealing to a growing number of people due to their lower rates. According to the Henry J Kaiser Family Foundation, “Late last year (2017), President Trump issued an executive order directing the Secretary of Health and Human Services to take steps to expand the availability of short-term health insurance policies, and a proposed regulation to increase the maximum coverage term under such policies was published in February.”

So, what separates the ACA-compliant health plans from the ones that are not? One of the biggest factors being the ACA’s ten essential health benefits. Non-ACA compliant plans do not need to adhere to the numerous rules and regulations laid out in the Affordable Care Act.

mother with breast cancer smiling and hugging her young daughter

What You Should Know: Home Breast Cancer DNA Tests

In March of this year, ancestry DNA testing giant, 23andMe, announced that they would begin testing user DNA for Breast Cancer genes, more specifically identified as the BRCA1 and BRCA2 genes. While technically able to test for these genes for years, it wasn’t until this past March that the FDA officially signed off on it, therefore, making the 23andMe at-home DNA test, the first FDA-approved direct-to-consumer test to evaluate one’s potential risk for cancer.

What Can Your DNA Reveal

The test is offered as an add-on to 23andMe’s standard ancestry report for a total of $199 and is delivered alongside a variety of other reports designed to tell you if you possess certain genetic markers which may suggest a predisposition to things such as:

  • Macular Degeneration
  • Lung and/or Liver Disease
  • Celiac Disease
  • Hemochromatosis
  • Hereditary Thrombophilia
  • Alzheimer’s Disease
  • Parkinson’s, and many more
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Young People Discussing Group Insurance Benefits with an agent

3 Benefits of Group Health Insurance For Employers

Group health insurance is usually provided by an employer and can cover just the employee or even the employee’s spouse and children.

Not providing group health coverage could be a major misstep for some companies regardless of size, as there are a number of benefits to providing Group Health Insurance coverage.

1. Lower Costs Than Individual Plans

There is no question that the term health care reform has been a hot-button topic and on the lips of nearly every politician regardless of political party over the course of the past 10 years. In light of the Affordable Care Act (ACA), it has now become more affordable to purchase Group Health Insurance than for your employees to purchase health insurance individually.

Level-funding insurance plan options have been growing in popularity over the past number years. Level-funded plans are ERISA compliant and may offer more flexibility for employers with virtually no risk and offered by several reputable insurance carriers with a nationwide network of hospitals and physicians to choose from.

What has many employers especially excited about these plans is the opportunity for 10%-15% in lower premium costs and the Return of Premium potential. Unlike other policies on the market, with level-funded options, if your employees don’t rack up a large number of claims throughout the year, your company may have a substantial amount of money (originally paid in premiums) returned.

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Last Chance to Enroll

Last Chance to Enroll in Individual Health Insurance for 2017

Don’t wait until it’s too late to get your individual health coverage for 2017. Open Enrollment for Individual Health Insurance ends on January 31st. If you haven’t enrolled in a plan by this date, you may be stuck with your current coverage or no coverage for the remainder of the year unless you have a qualifying life event. Schedule an appointment with a licensed benefits counselor or start shopping today to make sure you are covered.

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Tips for Fighting The Flu in the Workplace

The flu can be a big disruption for business. Employees who are sick may need to take time off to recover and may not be as productive when it comes to getting work done. In addition, symptoms such as coughing, sneezing, and fever can spread germs to healthy employees.

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