Wellmark has filed proposed rate increases of 0 - 8.7% for plan year 2021 on their Pre-Affordable Care Act plans with the Iowa Insurance Division. If policy holders are forced to move to Affordable Care Act plan, Wellmark states the average rate increase is estimated to be 94.2% for their customers.
Grandfathered plans: 0.00% (Originally purchased prior to March 23, 2010)
Grandmothered plans 8.7%
Part of the reason is that the reinsurance taxes embedded in the premiums you paid, were never paid out as reinsurance to offset the increased claims under the ACA. Instead, it was spent elsewhere. Resulting in insurance companies cancelling plans or having massive triple digit premium increases.
Statement from Medica:
We are committed to ensuring our Individual & Family plan (IFB) members have uninterrupted access to the health care and medications they need during these challenging times. We will be communicating to IFB members that if they are having trouble paying their monthly premium, they can reach out to Medica for help.
If you have any questions, please contact Broker Services at 1-866-752-0945
The Coronavirus Aid, Relief, and Economic Security (CARES) Act, signed into law March 27, 2020, contains important updates on the use of health savings accounts (HSAs).
The CARES Act restores the ability to use HSAs, FSAs and HRAs to purchase certain Over-The-Counter drugs and medications that was removed with the Affordable Care Act. These OTC drugs include aspirin and other pain medications, allergy medication, etc., without a doctor's prescription.
For the first time, menstrual care products are considered qualified medical expenses for payment or reimbursement with an Health Savings Accounts, Flex Spending Account or Health Reimbursement Account.
Both provisions for OTC and menstrual products apply to amounts paid or expenses incurred on or after January 1, 2020 and are ongoing without an expiration date.
Wellmark will allow Individual and Small Business policyholders to request a 60-day grace period when making premium payments for due dates between March 17th and June 30th. If circumstances change, they may need to revisit the extensions offered. Wellmark will work with any Mid-size or Large groups on a case-by-case basis to determine appropriate and flexible payment timeframes to ensure premium payments are made as timely as possible.
Individual & Family Plans:
Any member who is unable to pay their premiums due to impacts of COVID-19 should send an email to IndividualBilling@wellmark.com, including their full name and subscriber ID. They need to state that they are unable to pay premiums due to COVID-19. A billing representative will reach out to collect further information and work to ensure benefits remain active.
The group must request the extension. They need to send an email to FullyInsuredBilling@wellmark.com with the Group ID and Group name. Wellmark will also need the name of a contact person at the group and their email address. They need to state in the email they cannot pay due to the effects of COVID-19. They can also call the billing department directly with this information at 800-348-6430.
Congress passed a $2 trillion economic stimulus package by an overwhelming vote in the Senate and the House. President Trump is expected to sign the bill immediately.
Individuals and Businesses: The CARES Act functions largely as an economic stimulus by providing cash payments to individuals below a certain income, providing extra unemployment benefits and allowing self-employed individuals to apply for unemployment. For businesses, aid is provided through emergency grants, forgivable loans and relief for existing loans. These provisions are intended to assist employers to help them stay in business, keep employees on their payroll, and allow them to continue to support employees through employee benefits and health insurance.
Healthcare: The CARES Act also includes $100 billion for hospitals and $150 billion for state and local governments to combat the COVID-19 pandemic. The bill expands coverage beyond what was in last week's Families First bill by requiring health insurers to pay for coronavirus testing beyond those that are FDA-approved, including lab and state-developed tests as well as other tests approved by HHS.
Accessibility for telehealth is also expanded. High-deductible health plans with HSAs may now allow pre-deductible coverage for telehealth and other remote services, as well as allowing the use of HSAs for the purchase of over-the-counter medications without a prescription.
Very limited action was also taken to address surprise medical bills. Under the CARES Act, all health insurance plans would reimburse a COVID-19 test provider at the in-network rate put in place prior to the pandemic. If the provider is out of network, the health plan is to fully reimburse the provider based on the provider's own "cash price," which must be made publicly available while the public health emergency is still declared. Providers that do not post their test price publicly could be fined up to $300 a day.
In response to the current Corona virus (COVID-19) situation, and the requirements / recommendations of both Governor Reynolds and the CDC, the offices of Premier Health Insurance of Iowa will not be open to the public. We feel this is in the best interest of both the clients and staff.
Rest Assured: We are still open and ready to assist you. Please use preference in emailing, faxing to 319-363-3757 or calling our office at 800-383-6590.
At times, we may be working remotely with all calls and contacts still funneling through the office according to the Premier Health Insurance of Iowa contingency plan.
As the world continues to work its way to a solution, we will continue to keep you updated. Please watch our social media posts, or check our Blog for updates.
Good news for those on the lower priced pre-Affordable Care Act plans through Wellmark and United Health Care. Centers For Medicare & Medicaid Services has allowed an extension on these plans until January 1st, 2022 in the state of Iowa until their coverage will be terminated under the Affordable Care Act guidelines.
Premier Health Insurance of Iowa Recognized by the Marketplace / HealthCare.gov and the Centers For Medicare & Medicaid Services: Premier Health Insurance of Iowa & Dan Walterman were recognized by Randy Pate, Deputy Administrator of the Centers for Medicare & Medicaid Services, and the Marketplace / HealthCare.gov for their leading roll in the 2020 ACA Open Enrollment.
Iowa Insurance Division No Longer Allows 3 Month Short Term Plans. In 2015 President Obama limited short-term "annual" plans from 364 days to 90 days. On October 2nd 2018, President Trump extended these plans out to 3 years. In November 2018 the Iowa Insurance Division eliminated all options longer than 3 months. Now they have extended these plans back out to 3 years and have eliminated any options 3 months or less ....well.....at least we're in the right direction this time!
Dan Walterman interviewed by Adam Sullivan of The Gazette concerning the new 3-year short term limited duration plans offered by President Trump to combat the extreme costs of the Affordable Care Act plans for those who do not qualify for tax credit subsidies. It is interesting that the Kaiser Family Foundation's estimates the lowest priced Silver plan in Iowa is $211 for an individual and $746 for a family of 4. The reality is the lowest priced Affordable Care Act plan for a 45 year old individual is $642 and $1964 for a family.
The Iowa Insurance Division has approved National General to offer the new 3 year short-term limited duration plans. These plans provide a much lower price than the Affordable Care Act plans for those who do not qualify for a tax credit subsidy. A variety of plans are offered, including copay plans and more catastrophic deductible plans. Contact us for quotes and plan information.
I think we can all agree that health care providers should be required to provide the cost of their services and procedures to patients. When we purchase a gallon of milk at the store we know the price. Why can't we receive the price of what a hospital charges until we receive our actual bill? Anyone who has ever tried to inquire about the pricing of a specific procedure knows the run-around one receives between the hospital and insurance companies. Luckily for the consumer, this is about to end. Federal regulations that were finalized November 15th 2019 will require hospitals to make public their prices starting in 2021.
Several healthcare reform proposals being considered would significantly change the way that Iowans receive their health insurance. One of these proposals - Medicare for All - would eliminate private insurance and create a healthcare system fully run by the government. Now, a proposal called the Medicare "public option" is being discussed as an alternative. But this proposal would also have far reaching impacts - and according to a new study, would drive out most of the private plans we know today.
Not only would the public option change the Medicare system as we understand it, the proposal would create government-run plans acting alongside the existing private marketplace. A study by FTI Consulting and the Partnership for America's Healthcare Future further explains:
The public option would create government healthcare plans, which individuals can buy into. These plans would mostly likely be set up with artificial prices determined by the government, forming a "two-tier" system. Because government payments pay providers much lower than private plans, the public option would "crowd out" private coverage and eventually lead to a one-size-fits-all system - just like Medicare for All but on a longer timeline, reducing consumer choice and decreasing quality of care.
The study found that by 2050, Iowa could end up being one of over 30 states to likely lose all private insurance plans. When examining the changes in our healthcare system, it's important to look at the long-term impacts of your own plan.
Centers for Medicare and Medicaid Services has announced the opportunity for certain states to offer additional wellness benefits for those enrolled in Affordable Care Act Plans.
Once again Premier Health Insurance of Iowa has qualified for the Healthcare. gov / Marketplace Circle of Champions by assisting consumers in lowering their health insurance premiums through available tax credits and subsidies.
Listen to an Interview with Jeff Stein of KXEL concerning Medicare-For-All, public option, rising health care costs, and the new 3 year plans available in October.
Iowa Insurance Commissioner states "ACA individual health insurance market has become unaffordable..." All new lower priced 3 year Non-ACA plans with essential benefits will be offered! Contact us for more info!
Iowa has been the center of attention when it comes to healthcare reform. Many proposals, including Medicare for All, a public option, or a Medicare buy-in would drastically change the way our healthcare system works. Not only do many Iowans rely on private or employer health plans, but Iowa also has a low Medicare reimbursement rate that serves as a continued challenge within the state.
A new study covered by the Cedar Rapids Gazette highlights the impact of what one of these one-size-fits-all proposals would look like in Iowa. A public option proposal has been touted as an alternative to single-payer health care, but new challenges would arise within Iowa's healthcare system.
The Partnership for America's Healthcare Future published this study completed by Navigant, which determined that 52 of Iowa's 90 rural hospitals will be at a "high risk of closure" under a public option plan.
Wellmark Blue Cross and Blue Shield has requested a 0% rate increase for the Pre-Affordable Care Act Grandfathered plans. Unfortunately, the Affordable Care Act longer no allows these plans to be purchased. However, those one them experience substantially lower premiums compared to the Affordable Care Act plans when not receiving a tax-credit subsidy. Please be aware, that these plans may still have an age based rate increase.
No, that was not a typo. Medica has filed for an average 11% decrease in their 2020 ACA premiums.
The IRS has allowed additional preventative care benefits for HSA participants to be covered without requiring them to meet a deductible.
Wellmark has filed a proposed January 1st 2020 rate increase with the Iowa Insurance Division due to additional Affordable Care Act taxes, more significant health conditions, and increased prescription use.
A public hearing has been scheduled for Wellmark's requested rate increase on their Pre-Affordable Care Act plans.
Drug prices are skyrocketing and there is a complete lack of transparency within the industry. This creates high costs to consumers, increases health insurance premiums and finger pointing in every direction. Congress has passed the Patient Right to Know Drug Prices Act and the Know the Lowest Price Act to help combat these high prices. In addition, President Trump is proposing an executive order to create medical transparency and remove the industry's secret negotiations and pricing. We encourage everyone to watch the video below to see how drug pricing actually occurs.
As many of you know, these have been not only a great way to reduce premiums by 50 - 75% of Affordable Care Act plans, but also a hot political debate. President Obama limited them to only 3 months. President Trump extended them to 36 months contingent upon state approval. The state of Iowa allowed 12 month plans for a short time, then limited them back down to 3 months. However, Iowa has now agreed to 36 month plans, and allow them to offer better coverage as well. There are several insurance companies that have filed to offer these plans in Iowa. We are currently waiting for the Iowa Department of Insurance to approve them.
Once eliminated by the Affordable Care Act, these plans allow for employers to provide tax-free reimbursement to employees for health insurance premiums and other health care expenses. US Departments of Health & Human Services, Labor & Treasury issued a new policy allowing for HRAs once again. We will keep you informed of the final rules. For more information "View Here"