What Are Your Options During Open Enrollment:

open enrollment

Insurance EnrollmentTis the season for giving thanks, festive gatherings, and open enrollment! This is the time in which you have the option to either make changes to your health insurance plan or to switch it out with a new one. So, as we approach 2020, be sure to evaluate your healthcare needs, your coverage plan, and your available options.

When is Open Enrollment?

The period in which open enrollment takes place depends on how you get your insurance. For Medicare recipients, open enrollment spans October 15th to December 7th. Individual plan enrollment extends between November 1st to January 31st. However, if you’d like for you plan to be effective on January 1st, you must enroll by December 15th. Medicare begins from October 15th until December 7th. And if your employer covers you, this period varies and depends on your company.

If you are covered by the Affordable Care Act (ACA), open enrollment is dependent on your state. So if you live in California, this period spans from November 1st until January 31st. Finally, if you are eligible and would like to opt for Medicare or the Children’s Health Insurance Program, you can enroll at any time of the year. See if you qualify for either of these programs here. 

Your Health Insurance Options During Open Enrollment: 

  1. Renew your current policy if needed. You have the option to keep your current health insurance if you are satisfied with your coverage. In this case, you may not need to do anything during open enrollment. However, be sure to look out for any changes to your policy. In the case of modifications, consider how they might affect your particular coverage needs. And if you find that you do require change, open enrollment is the ideal time to do so.
  2. Buy an individual plan. You can do this through a marketplace or via an individual policy provider. If you decide to sign up on the marketplace exchange in California, you must qualify for the tax subsidies that will assist in paying for your premiums. Your family size and income determine your eligibility for this.
  3. Make changes to an employer-based group plan. Most people are insured through their employers. In this case, open enrollment will not affect you. That’s because this season will only pertain to the government-run marketplaces and the Affordable Care Act plans. However, you will need to sign up or renew your coverage during the particular time in which your company has its own open enrollment. Each company will have its own specified renewal dates. Your responsibility at this time is dependent on the policies of your employer. Some will automatically renew your coverage every year, while others will ask you to sign up each time. Also, keep in mind that employer health care providers change with some consistency, so make sure you know what you’ll receive with each change.
  4. Change your medicare plan. If you’d like to opt for different coverage within your medicare plan, do so during open enrollment (from October 15th to December 7th for medicare.) The open enrollment period that is specific to government-run marketplaces will not affect you.
  5. If you are not satisfied with the health coverage plan you initially selected, there is one more opportunity for you to make changes to your plan.  This comes during the year’s final open enrollment, happening January 1st until March 31st.

Open enrollment and all things insurance are a common source of holiday headaches. But don’t let the complicated slew of options get you down this season. For all of your insurance inquiries and needs, do not hesitate to call on us at Bernardini and Donovan. We are experts in health care coverage and are here to care for you and your family. Reach out today!

New California Health Insurance Mandates

California health insurance

For the most part, the Affordable Care Act, or Obamacare, has remained intact since President Trump’s election. However, in 2019, congress repealed what Trump found most troublesome about the plan. As a part of a major tax bill, the enforcement of individual mandates was eliminated in January of this year. Prior to this, individuals who were not covered by health insurance were subjected to a tax penalty of $695 per adult or 2.5 percent of their household income, whichever was higher. This was enforced with several exemptions to address the unique circumstances of each individual.

health insurance

However, California is among the handful of states that have passed legislation to reissue this individual mandate. And in 2020, its residents will be required to obtain qualified health insurance or face a tax penalty. But this time, it will look a bit different than that wish was issued on a federal level.

The penalty for uninsured Californians will remain the same. But if it goes unpaid, other assets of yours, like your home, will be targeted. So, as a Redlands, California local, it is vital that this fee does not go overlooked.

What are your options? 

Not only to avoid this fee, but for your general well-being and good health, be sure to purchase an insurance plan. We advise that you do so for you and your dependants as we approach 2020 and the season of open enrollment. And to simplify your process, be sure to contact us at Bernardini and Donovan for expert assistance in choosing the best plan for your needs.

Amid ever-changing legislature, your health insurance decisions may simultaneously fluctuate. That’s why, for your group and individual plans, and all of your coverage inquiries, we at Bernardini and Donovan are here for you. We are prepared to meet your specific needs with a plan that’s right for your Redlands-based business. Call on us today! 

5 Small Business Health Insurance Pitfalls

small business health insurance

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.

California health insurance
  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.

Values of Bernardini & Donovan

Values of B&D

Values of Bernardini & Donovan

At Bernardini and Donovan, we love serving our clients and partners. And we are dedicated to providing you,  your families, and your businesses with insurance services. We do this by following a dedicated set of values which directs our communication and service.

Helpfulness

We are here to help you. We understand that your health is vital and that many of you need good health insurance to help the cost associated with preventative care as well as care whenever illness or injuries occur. That’s why we want to do everything we can to help you. If you are tired of trying to figure out health care on your own, we are here to answer your questions and walk alongside you to ensure that you get the health insurance that you need.

Knowledgeable

Our health insurance market has been flooded with change over the last few years. To the point that many people cannot keep up. We know that it’s hard to keep up in a niche market, so that is why we do it for you. As you have questions about new policy, your best options for your business or when you are starting Medicare; we are here to give you the most up to date information.

Trustworthy  

Webster’s dictionary defines trust as the “assured reliance on the character, ability, strength, or truth of someone or something.” We strive to continue to be above board, up front and honest with all of our clients. We seek to communicate effectively and promptly especially when deadlines are so final with health insurance. And we hope to build lasting relationships with our clients. This isn’t a single transaction, but a desire to see you turn to us for any of your health insurance needs.

We want you to succeed and do everything we can to make the health insurance process as easy as possible. Please contact us today if you have questions about your health insurance.

Did you know… about the 80/20 rule?

80/20 Rule

Did you know… about the 80/20 rule?

We realize that many people may have health care but don’t know how the systems work or what their premiums are going to each month. We understand that life is busy and that you may not have all the time in the world to research and learn an argumentatively complex system of health care insurance and providers. So we thought that we would start a new series of posts focused on “Did you know…” With this blog, we will be looking at the 80/20 rule.

 

Did you know… that health insurance companies are required to spend a mandated amount on your healthcare? Insurance Companies are mandated to $.85 of every dollar on your Health Care.

 

This 80/20 rule is also referred to as Medical Loss Provision Ratio in the Affordable Care Act. The rule states for 80% of premiums collected must be spent on health care or on improving actions for the person. The other 20% can go to administrative needs of the medical insurance company such as marketing or other financial needs. These numbers specifically apply to individual and small group markets. If you are part of a large group market, then the numbers change to 85% and 15% of healthcare and administrative needs respectively. The thought process with this rule is to ensure greater transparency within insurance companies so we can truly see where the money is going. If an insurance company does not spend the 80 to 85% of premiums toward healthcare, then they are required to provide a rebate for the portion that was not spent. This rebate looks at the entire corporation and their spending and not just on one individual’s health care expenditures. Are you someone who has received this kind of rebate in the past? If so you know that the rebates usually come in the form of a check to the individual, are applied as a credit to their account or are reflected in the rates of the following year of insurance. Or if you are part of a small or large group then the rebate is given to your employer who passes it along to their employees. We hope that this “Did you know” blog was helpful. If you have any more questions about the Medical Loss Provision Ratio, please feel free to call and ask us.