Insurance

Look Backward to Plan Forward | North Carolina Employee Benefits

We have entered Open Enrollment season and that means you and everyone in your office are probably reading through enrollment guides and trying to decipher it all. As you begin your research into which plan to choose or even how much to contribute to your Health Savings Account (HSA), consider evaluating how you used your health plan last year. Looking backward can actually help you plan forward and make the most of your health care dollars for the coming year.

Forbes magazine gives the advice, “Think of Open Enrollment as your time to revisit your benefits to make sure you are taking full advantage of them.” First, look at how often you used health care services this year. Did you go to the doctor a lot? Did you begin a new prescription drug regimen? What procedures did you have done and what are their likelihood of needing to be done again this year? As you evaluate how you used your dollars last year, you can predict how your dollars may be spent next year and choose a plan that accommodates your spending.

Second, don’t assume your insurance coverage will be the same year after year. Your company may change providers or even what services they will cover with the same provider. You may also have better coverage on services and procedures that were previously not eligible for you. If you have choices on which plan to enroll in, make sure you are comparing each plan’s costs for premiums, deductibles, copays, and coinsurance for next year. Don’t make the mistake of choosing a plan based on how it was written in years prior.

Third, make sure you are taking full advantage of your company’s services. For instance, their preventative health benefits. Do they offer discounted gym memberships? What about weight-loss counseling services or surgery? How frequently can you visit the dentist for cleanings or the optometrist? Make sure you know what is covered and that you are using the services provided for you. Check to see if your company gives discounts on health insurance premiums for completing health surveys or wellness programs—even for wearing fitness trackers! Don’t leave money on the table by not being educated on what is offer

Finally, look at your company’s policy choices for life insurance. Taking out a personal life insurance policy can be very costly but ones offered through your office are much more reasonable. Why? You reap the cost benefit of being a part of a group life policy. Again, look at how your family is expected to change this year—are you getting married or having a baby, or even going through a divorce? Consider changing your life insurance coverage to account for these life changes. Forbes says that “people entering or exiting your life is typically a good indicator that you may want to revisit your existing benefits.”

As you make choices for yourself and/or your family this Open Enrollment season, be sure to look at ALL the options available to you. Do your research. Take the time to understand your options—your HR department may even have a tool available to help you estimate the best health care plan for you and your dependents. And remember, looking backward on your past habits and expenses can be an important tool to help you plan forward for next year.

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Short-Term Limited-Duration Insurance – In a Nutshell | North Carolina Benefit Advisors

On August 3, 2018, the Departments of Labor (DOL), Health and Human Services (HHS), and the Treasury (the Departments) published a Final Rule to expand the availability of short-term medical policies. Called short-term, limited-duration insurance (STLDI), the policies are marketed to individuals as an alternative to ACA-compliant plans. Currently a short-term policy is limited to less than three months, but the new rule will allow carriers to issue the policies for longer periods.

What is short-term limited-duration insurance (STLDI)?

Short-term, limited-duration insurance is a specific type of health coverage that is exempt from the ACA’s market reform rules. STLDI policies may exclude entire categories of benefits, such as prescription drugs, maternity, or mental health care, may impose coverage caps, and may reject applicants with pre-existing conditions. STLDI policies offer lower premiums than ACA-compliant plans because they provide less coverage and typically only accept healthy applicants.

Note that STLDI is not minimum essential coverage and does not satisfy the ACA’s individual mandate. The individual mandate (i.e., the requirement for individuals to have some form of minimum essential coverage) expires at the end of 2018, after which persons without adequate health coverage will no longer be exposed to potential IRS tax penalties.

What is the purpose of the new federal rule?

The existing rule defines “short term” as less than three months and limits the policy’s duration by prohibiting renewals that would go beyond the three-month period. The new rule, on the other hand, will allow carriers to issue STLDI policies for an initial term of up to 364 days, and allows extensions or renewals for up a total of 36 months. This is a significant change that is intended to expand access to low-cost limited-coverage options for individuals.

The new federal rule takes effect for STLDI policies issued October 2, 2018, or later. There is a catch, however. Insurance is subject to state insurance laws, and many states appear reluctant to adopt the new rule for policies issued in their state. Some states even prohibit short-term policies under the current federal rule. At last weekend’s National Association of Insurance Commissioners (NAIC) meeting, several state regulators expressed concerns about “junk insurance” or deceptive marketing practices that may lure consumers into purchasing substandard coverage.

Are employers affected by STLDI policies or the new rule?

No.

Employers are not directly affected by STLDI policies. The policies are marketed to individuals, where permitted by state insurance law; they are not group plans.

Some workers may consider STLDI options, or ACA-compliant individual insurance options, as an alternative to their employer’s group plan. In most cases, though, persons who buy individual insurance do so because they do not have access to an employer’s plan. Workers whose employment ends may also consider individual options as an alternative to COBRA.

What’s Next?

Over the coming weeks and months, state insurance regulators and state legislatures are expected to review their existing laws and regulations on short-term, limited-duration insurance and consider whether to adopt changes. Some states likely will choose to implement rules to support the new federal rule, while other states certainly will impose restrictions or continue to prohibit the sale of insurance products they consider to be substandard.

Originally published by www.thinkhr.com

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