open enrollment

Open Enrollment

How to Prepare for Group Health Open Enrollment

‘Tis the season for open enrollment in the world of health insurance! Open enrollment for Medicare 2020 has already begun (October 15th – December 7th, 2019). Additionally, individual open enrollment is underway (November 1st – December 15, 2019). Lastly and most important to this article is the fact that many employers are in the midst of their group health plan open enrollment. Many group plans renew January 1st so it’s a busy time of year for employers, brokers, and insurance carriers.

This article is designed to assist employers in knowing what to focus on during this busy season.

Renewals

The most important thing we need to focus on is the premiums that you pay to the insurance carriers. We know this is a huge expense and we work with you to keep this competitive to what’s available in the marketplace.

Most of the January 1st group health insurance renewals are out. Perhaps your increase is palatable enough to forgo shopping and just renew as is. However, that is more the outlier than the norm. Typically, it’s best to assist us with the necessary data needed in order to shop your policy with the competing carriers in the marketplace. By now, your account managers at BBG have been working hard to gather the necessary data for shopping. These items include:

  • Current Census
  • Average Total Number of Employees (ATNE). This is based on how many total employees you employed each month and dividing by 12. Estimates are used for the remaining months of the year.
  • Names of your employees who are eligible but waive off the plan
    • The reason they are waiving
  • If you are a 51+ group we’ll need what is called an Employer Risk Assessment Form (ERAF)

The above will allow us to obtain street rates in the small group market place and potentially underwritten rates in the 51+ marketplace. Street rates are off the shelf rates that are based on your group’s census alone. They are still subject to underwriting but give us a good benchmark to know if we should pursue underwritten rates

Medical Health Questionnaires (MHQs)

The dreaded MHQs need not be so dreaded anymore! Most insurance carriers prefer to receive electronic MHQs via programs like FormFire. Some carriers now require FormFire MHQs. BBG has dedicated team members who can assist your employees in completing this process. We’ve worked hard this year to streamline the process to allow us to help a larger number of you in a shorter amount of time.

So when are MHQs needed? This answer is different depending upon what market segment you are in…

1-50 Small Groups

If you have 50 and under total employees, FormFire MHQs will be needed to obtain underwritten rates from any competing carriers. However, BBG is all about efficiency so we first obtain street rates to determine if this is even worthy of your time. If we determine that it is then we highly suggest proceeding with FormFire.

The only exception here is when we obtain community rates. Community rates are different from underwritten rates and are typically more expensive than their underwritten counterparts.  We’ve been finding that mostly micro groups and other groups with certain characteristics that may adversely impact underwriting are served best by community rates.

51-99 Mid-Size Groups

If you have between 51-99 total employees some carriers require MHQs to release any underwritten rates. However, there are a few carriers who will release underwritten rates if your renewal is <25% and you’ve completed an ERAF.

100+ Large Groups

Typically MHQs are not needed in the 100+ market segment; although, there are exceptions where MHQs can be helpful. Your account manager will assist to know when this applies to you.

When Not to Shop the Market

There are only two instances when it makes sense to not shop the market. 1.) If you are in the 51-99 market and your incumbent carrier asks for your “no shop” number. A no shop number is an increase you are willing to accept in agreement for not shopping.

In our experience, if a carrier is asking for your “no shop” number, they are willing to play ball and negotiate. If you are not sure what a reasonable no shop number is, talk to your account manager and they can assist you with this. However, you can always be aggressive and ask for a flat increase. What’s the worst they can say? No? If the carrier cannot meet it, we can always shop your policy.

2.) Or if you are in the 1-50 market your incumbent carrier may be able to provide some rate relief in an agreement to not shop your policy. The amount of rate relief available in the small group market is much smaller but if you received a favorable renewal a few points of rate relief may be enough for you to decide to stay put. Your account manager and BBG will let you know if this is a feasible option for your specific group.

Closing Thoughts

At BBG, we are fully aware that the most important work we do is to assist the employers we work for in keeping healthcare costs and the coverage your employees receive competitive to what’s in the marketplace. The most important benchmark number we look at is your average cost per employee per year. This number is found by taking your total costs and dividing by your total employees enrolled in the health plan. We realize your enrollment can fluctuate and by looking at this number we are looking at a comparable number year over year.

Open enrollment is always a busy time of the year but the exercise of shopping, completing FormFire, and allowing BBG to negotiate with the carriers on your behalf is the important work. This work allows you to maintain strong benefits year after year.

 

 

bbg65Plus Certified To Facilitate National Medicare Educational Program

Medicare can be daunting and confusing and quite difficult to grasp.

This is true in the case of existing Medicare beneficiaries as well as their care givers.  And, it’s especially true for those prospective new enrollees who are about to turn 65 and have to deal with trying to understand their Medicare options for the very first time. 

The Medicare Minute was created and sponsored by the Medicare Rights Center to help address and alleviate some of the confusion surrounding Medicare. The program consists of an ongoing series of free monthly educational programs designed to equip people with the knowledge to more clearly understand their Medicare options, to make more informed decisions, and to ultimately utilize their Medicare coverage more effectively. 

Volunteers from across the country with experience in how health benefits work serve as facilitators for the Medicare Minute educational programs.  And, bbg65Plus is now certified and appointed to serve as a Facilitator of the Medicare Minute program. 

The Medicare Minute educational program is available free of charge to employers, organizations, and community groups interested in educating members on the ABC’s (and Part D) of Medicare. And now readers of our blog will be able to read a summary of some of highlights and key tips from those programs in this space each month. 

To learn more about the Medicare Minute educational programs and how you can schedule Medicare Minute presentations for your organization, contact Tom Barrett, Medicare Minute Facilitator for bbg65Plus at 866.845.8600 x130 or tbarrett@bbginc.net.

For more information — go here  1 Medicare Minute Overview and here 2 Medicare Minute FAQ

 

Medicare Minute

 

 

 

 

For Medicare Peace of Mind Turn To BBG65Plus

We have some very exciting news to share with you. Earlier this year, with great encouragement from our clients, we launched bbg65Plus.

Thinking about Medicare can be truly daunting. For years our clients have leaned on our knowledge, experience, and hallmark customer service for guidance on what to do and where to start when it comes to all things Medicare.

Now you can also turn to us to find the right coverage. We provide the full range of:

  • Medicare Advantage Plans,
  • Medicare Supplemental or Medigap Plans, and
  • Prescription Drug Plans

We match each person with the plan that’s right for them. And, we simplify the enrollment process making the transition to Medicare smooth and pain-free.

The age 65 and over demographic represents the fastest-growing segment of the U.S. workforce. Today, Medicare plays a much more significant role in the workplace.

Successfully transitioning to Medicare is a big deal that can also be a big cost and coverage win when done the right way. We can help.

Our goal centers on providing Medicare Peace of Mind. We remove the mystery and help you make the right decision about your Medicare coverage.

In launching bbg65Plus, we’re excited to serve the needs of our business clients as well as the Medicare needs of our families, friends, colleagues, and neighbors in the communities where we live and work.

So, for anyone needing assistance and hoping to experience Medicare Peace of Mind, please contact us. We’d love to help.

And, of course, we’d be very grateful if you’d help us spread the word.

(e) 65Plus@bbginc.net; (p) 866.845.8600 x130

65Plus Is The Hottest Labor Market Demographic. Here Are Key 2019 Medicare Costs That Employees And Employers Should Know.

Some say it’s the hottest demographic in the labor market — men and women ditching traditional retirement age to work into their 70s, 80s and sometimes beyond.   According to the Bureau of Labor Statistics the 65 and over crowd will make up the fastest-growing segment of the workforce over the next decade.  With that in mind, over the next few months we’ll be providing key bits of information that employers and employees may find helpful as they navigate the best and most cost effective options for health coverage for the 65Plus workforce and their dependents.

First off, 2019 cost considerations for “traditional Medicare”:

2019 Medicare Costs + Coverage

PART A PREMIUM (Hospital Insurance)
Most people don’t pay a monthly premium for Part A (paid Medicare taxes for more than 39 quarters.  If 39 or fewer quarters worked they’ll pay a premium of up to $437).

PART A DEDUCTIBLE + COINSURANCE
– $1,364 deductible for each benefit period
– Days 1-60: $0 coinsurance for each benefit period
– Days 61-90: $341 coinsurance per day for each benefit period
– Days 91 and beyond: $682 coinsurance per each “lifetime reserve day” after day 90 for each benefit period (up to 60 days over your lifetime)
– Beyond lifetime reserve days: all costs

PART B PREMIUM (Medical Insurance)
The standard Part B amount is $135.50 (or higher depending on your income).

PART B DEDUCTIBLE + COINSURANCE
– $185 deductible per year
– After deductible is met, enrollees typically pay 20% of the Medicare-approved amount for most doctor services, outpatient therapy, and durable medical equipment (DME).

2019 PART B + PART D (Prescription drug coverage) INCOME-RELATED MONTHLY ADJUSTMENT AMOUNT (*IRMAA PREMIUMS)
An additional amount that some individuals whose modified adjusted gross income (MAGI) is above certain thresholds will pay for their monthly Part B and Part D premiums.

  • 2019 Medicare Part B (Medical Insurance) Income Related Adjustments
FILE INDIVIDUAL TAX RETURN FILE JOINT TAX RETURN FILE MARRIED + SEPARATE TAX RETURN MONTHLY PREMIUM IN 2019
$85,000 or less $170,000 or less $85,000 or less $135.50
above $85,000 up to $107,000 above $170,000 up to $214,000 Not applicable $189.60
above $107,000 up to $133,500 above $214,000 up to $267,000 Not applicable $270.90
above $133,500 up to $160,000 above $267,000 up to $320,000 Not applicable $352.20
above $160,000 and less than $500,000 above $320,00 and less than $750,000 above $85,000 and less than $415,000 $433.40
$500,000 or above $750,000 and above $415,000 and above $460.50
  • 2019 Medicare Part D (Prescription drug coverage) Income Related Adjustments
FILE INDIVIDUAL TAX RETURN FILE JOINT TAX RETURN FILE MARRIED + SEPARATE TAX RETURN MONTHLY PREMIUM IN 2019
$85,000 or less $170,000 or less $85,000 or less your plan premium
above $85,000 up to $107,000 above $170,000 up to $214,000 Not applicable $12.40 + your plan premium
above $107,000 up to $133,500 above $214,000 up to $267,000 Not applicable $31.90 + your plan premium
above $133,500 up to $160,000 above $267,000 up to $320,000 Not applicable $61.40 + your plan premium
above $160,000 and less than $500,000 above $320,00 and less than $750,000 above $85,000 and less than $415,000 $70.90 + your plan premium
$500,000 or above $750,000 and above $415,000 and above $77.40 + your plan premium

 

Next Up:  The eligible employee’s three main options when it comes to their employer-sponsored plan and/or Medicare coverage.

 

2019 Medicare_and_You_2019

 

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