The Latest Small-Group Health Plan News

For your Redlands-based small business, of one to one hundred employees, finding the right health plan can be a challenge. Amid so many options, fluctuating circumstances, and things to consider, the choice is often overwhelming. However, with informed guidance and attentive counsel, you and your employees will benefit from the security of a quality health insurance plan. This is where we at Bernardini and Donovan come in. We are here to provide you with expert advice as you make this critical decision for your valued team members. And before you finalize your choices, take note of these health insurance updates.

Latest small group health insurance news:

  1. In the fourth quarter of this year, those who are renewing their policies will notice a rate increase. This is caused by an added component of the Affordable Care Act called the Health Insurance Tax (HIT). Though it was anticipated to be repealed, it is now driving up costs. These price increases vary in severity ranging from three to four percent to 15 percent. As we anticipate this upcoming tax, there are some opportunities to offset these costs with other insurers. Though this option will not exempt you of this tax, it will alleviate it, so it is not so harsh.
  2. Rates seem to fluctuate with every quarter. That’s why in light of these increases, we can look forward to a rumored rate decrease in the first quarter of next year. Take note though that group plans are dependent upon their renewal date. This is the point at which your rate will be fixed for the next 12 months. And so, these changes will not affect your policy if it’s locked into what is called your rate guarantee.
  3. There is a new coverage option, specifically helpful for the small employer who is concerned that they will not have enough participants. The Portfolio Plan does not require any number of participants, making this one of our most competitive options and an excellent choice for small business owners.
  1. As you consider these updates and search for your ideal plan, keep in mind the value of your insurance broker’s customer service. While the price of a health coverage plan will remain the same across the board, the quality of your broker’s service is what really matters. So, look for a provider that will be there when you need them, who will help you care for your employees, and make sure to keep you compliant. These are the most valuable services a broker can provide. And these are what we at Bernardini and Donovan are proud to offer our clients right here in Redlands. If you are in search of a health coverage plan in any capacity, please do not hesitate to reach out. We are prepared to offer our expertise as we assist you in this complex decision-making process.

5 Small Business Health Insurance Pitfalls

Redlands small businesses face several challenges when it comes to employee health insurance. However, this must be made available for the benefit of each employee and the success of your company. Offering health insurance makes your employees more likely to stick around, keeps them happy and healthy, and can even save you money. So, while it may seem like a daunting endeavor, we advise that no matter the size of your company, you consider offering health insurance.

There are a few mistakes when implementing a health care plan for your employees of which to take note. Make sure that you are aware of their threat and of the ways these pitfalls can be avoided. And rest assured that, even when issues arise, there are often simple solutions.

  1. A misunderstanding of eligibility requirements. 
    There are a few things that might keep an individual from partaking in their employer’s health care insurance plan. That’s because a group insurance plan does not automatically prompt eligibility for every employee. Typically, employees are required to work a minimum of 30 hours a week and must fulfill a distinguished waiting period to gain eligibility. This all depends on your state, your insurance provider, and your particular policy. Make sure that upon implementing a new plan, your employees are aware of these requirements.
  2. Miscommunication about the waiting period.  The waiting period indicates the number of consecutive days an employee must work to gain eligibility for the health insurance plan. This number should be decided based on the time you believe is required to discern an employee’s loyalty to the company. And you must communicate this exact amount clearly to your new employees to avoid miscommunication and confusion.
  3. Paperwork mishaps.  Paperwork is something about which we can all commiserate. But despite its world-renowned nuisance, this is the paperwork you cannot overlook. Incomplete or untimely paperwork will cause several complications in your health insurance plan. So make sure that it is submitted with complete accuracy and on time. And be assured that if an employee is terminated, added, or needs to make changes to their coverage, their corresponding paperwork is updated correctly.
  4. Failing to reconcile carrier bills. If an employee is wrongly included or missing from a bill, you face the issue of someone either not receiving coverage or being overcharged. And while these bills are typically accurate, you ought to review them regularly for assurance.
  5. Neglecting to take action when something goes wrong. The Explanation of Benefits or EOB lists the date of service, cost, negotiated discount and deductible accounting and amount for which the patient is responsible. This must coincide with the patient’s medical bills. So if these are mismatched, or demonstrate an issue, be sure to take action immediately. There is often an easy solution to this problem, but it is best solved with urgency.

While these issues may pose significant setbacks to your business, choosing a local Redlands broker like Bernardini and Donovan will help alleviate their severity and prevalence. We are prepared to assist your choice in plans and to provide exceptional customer services as it is administered.

Health insurance is a vital aspect of one’s well being. It assures that upon unforeseen medical circumstances, an individual will be financially covered. This confidence, as one faces inevitable unknowns, is crucial to living well and happily. So, as a small business owner, be sure to provide insurance to your employees for their peace of mind and the benefit of your company. Please do not hesitate to reach out to us today for a simplified and seamless experience.

Single Payer Healthcare Cons

Single Payer Healthcare Cons

Part 2

If you have not read our previous blog, please see part 1 to read more about the logistics of single payer healthcare. As stated previously, in an ideal world everyone would love to see every person receive the health care that they need at no cost to them. But to play this idea out in the real world, there are some very real concerns that we have. Some of the cons to single payer healthcare are:

Contributes to Drug Abuse –

Because health care is available to all, it also means that there is more access to prescription drugs which is the fastest growing avenue for substance abuse. There are also many that will abuse the system because they do not see the value. They will go to the doctor any time that they feel a slight itch or discomfort. This wastes doctor’s time and makes more severe cases need to wait even longer for care.

Less Benefit –

One of the ways to pay for this type of healthcare is to impose new taxes. Taxes like these can come out of your income and be bases upon the level of what you are bringing home. For those that make more money that means that they are paying more but will receive no extra benefits.

Less innovation –

Because everyone is getting paid the same rate there are less financial incentives to create, research and develop new treatments or new technologies. This can come at a big cost to us as this lowers the quality of care, not only for Americans but for the world we are are forerunners in many innovative practices.

Health Insurance still needed –

For families that have unique health issuescertain care that they will need will not be covered under this system. That means that they will still be in need of health insurance to cover the costs of the additional services that they require but are not included under a single payer health system.

These are just a handful of issues that can come up with single payer healthcare. As California continues to look at SB 562 we will need to answer these concerns otherwise we will end up with a very broken system.

Single Payer Healthcare Cons

Single Payer Healthcare Cons

Part 1

While many people would love to see universal health care become a reality, but there are Single Payer Healthcare Cons. It would mean that thousands of people would receive their health care free of charge, but many issues come up when you start to look seriously at universal and single payer health care. Where it may be easy to talk about healthcare as a human right, it becomes a very different issue when you realize that enabling one person to receive a resource means that another person is obligated to provide the same. Universal healthcare is not a new problem, and it has been debated and discussed for years. Here are a few reasons that this concept has continued to be so hotly debated:

Cost –

As much as we like to hear the word “free” attached to health care, the cost of health care doesn’t suddenly change with a new system. There is no such thing as a free lunch. There will be additional taxes, and no one has given a firm number of how the rest of the cost will be covered. Proponents say that a single payer system will save us money, but no one has come up with a firm dollar for dollar plan that shows this. It is all theoretical and up in the air.

Increased size of government –

For this system to work the government has to oversee all the funds and make sure that it is going to the appropriate places. This can slow down the process considerably. It also puts all the doctors, nurses and health care providers as government workers.

Wait Times –

In countries that have moved to single payer health care, there have been long waits to receive care. If you need to get a medical procedure, some governments suggest that the wait time will be around four and a half months. Where many people have said, they have waited up to eight months before they could receive the treatment they needed.

For more cons of Single Payer Healthcare see part 2 of this blog.

Single Payer Healthcare

Single Payer Healthcare

Single Payer Healthcare is a system in which all medical treatments and health care coverage are paid for by a single organization. In most cases, this single organization is a federal government. A single payer healthcare system does not, however, speak to who receives this treatment. Universal healthcare is a system in which every individual receives health care coverage. These two systems go hand in hand as Universal healthcare is not possible without a single payer health care system in place. Under a single payer healthcare, most services rendered come from private facilities rather than government-led facilities.

What is Single Payer Healthcare?

The idea behind single-payer health care is that every citizen would receive all medical services such as hospital care, doctor visits, preventative care, mental health services, dental, vision, prescription drug, reproductive health care and medical supply costs without the expense of these services coming directly from their pocket. That they would be paid for by a single payer or for lack of better words, the federal government. The idea is that patients would have a free choice who their doctor would be as well as doctors having autonomy of their patient’s care.

Of course, in an ideal world, this seems like an excellent program. In fact, you’ll find many people who can only speak of how great this program would be. They claim that this type of system costs less because there is no competition in this not for profit structure and an enormous amount of money is not wasted on administrative expenses. There is minimal paperwork for health care workers to do allowing them to focus more on the patient. And this system cuts out insurance companies which allow people to deal directly with their doctors instead of a third party to help pay for the services rendered. The also say that similar to the VA; we would see a decrease in prescription drug costs because the government would be a single buyer allowing them to purchase in bulk, getting a reduced price. Many would disagree with these statements as well. To find out more about their stance, see our next blog post.

What to consider prior to buying health insurance for you and your family

As the time comes for open enrollment or to renew your health insurance, here are some helpful hints to look at before your purchase a plan.

Look before you renew
As the landscape for health insurance continues to change it is important that you make sure that your fully check out your options before opting to renew. Not only do the options available in your plan change from year to year but your personal circumstances change. You may have moved, found a new job, or had a child and all of these can change what you need from your provider. Also, if your plan is being replaced make sure you fully look over what it is being replaced with so you are not surprised later down the road and find that what you need is not covered.

Doctors and prescriptions, oh my…
You will want to make sure that your preferred doctor accepts that coverage before you enroll. And going to a doctor outside of your coverage can cost you substantially more that going in your plan. Also, you will want to know what your prescription medication is going to cost you. Most companies will assign medications to a different level or tier so that between different companies the medication you need may be covered but it may be on a different tier and therefore would cost you much more.

Consult an insurance broker
When the Affordable Care Act come into effect its purpose was to let people comparison shop relatively easily for different health care options. However, the health care market is wide and varied and you can very easily not see a special savings or find out that what you need is not covered when it is too late. Health Insurance brokers are working hard to stay ahead of the changes in the law, know all the different nuances of plans being offered and want to help you find your best fit. Contact us at Bernardini & Donovan and let us help you look beyond the bare essentials to finding a package that fits you and your family perfectly.

Taxpayers Covering Majority of California’s Health Care.

Most people assume that our healthcare systems are paid for through private funds. Those private funds coming from health insurance premiums or from employer based coverage. However, a recent study shows that in California, that is just not the case. In fact about 71% of all funds paying for California’s healthcare comes from public funds, meaning California’s taxpayers are paying for a majority of the state’s health coverage. In 2016 it is estimated that $367 billion will be spent on health care. With these numbers that means that roughly around $260 billion will come from taxpayer money.

But California seems to be a unique case. When looking at the country as a whole, it was estimated that only 45% of the $3 trillion spent on health care comes from public funds. So what has made California stand out so much from the national average? Well there are a few factors to look at. One is that the national average is estimated to be much lower than what is actually being used. The American Journal of Public Health estimates that a more accurate picture of national spending is around 65% of public funds are put towards health care. The second aspect is that California does have some unique cases. UCLA’s study on California’s expenditures states that “health spending through county public health expenditures, new Affordable Care Act subsidies and tax subsidies for employer-based health insurance drives the proportion of care paid for by the public well beyond the CMS estimate” California also has had a larger expansion of Medi-Cal coverage showing around ⅓ of the state’s population is covered through this low income program.

What does this mean for you? Researchers are now beginning to question what it would look like to have a single payer health care system because we are already leaning towards that end of the spectrum as it stands. But we will have to wait and see how things continue to change with our aging generations and shifting political systems.