Author Archives: jtdickerson

Supreme Court upholds health insurance subsidies for Georgia residents

25 Jun , 2015,
jtdickerson
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Great news for Georgia residents who enrolled in health insurance through the Health Insurance Marketplace! The Supreme Court has ruled in favor of preserving tax credits for people who purchased a plan through the federally facilitated marketplace!

Per the AP: “The Supreme Court on Thursday upheld the nationwide tax subsidies under President Barack Obama’s health care overhaul, in a ruling that preserves health insurance for millions of Americans.”

Blue Cross and Blue Shield of Georgia’s parent company proposes to acquire Cigna Corporation

22 Jun , 2015,
jtdickerson
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Per a press release from Anthem last week:

On June 20, 2015, Blue Cross and Blue Shield of Georgia’s parent company announced that it has submitted a non-binding proposal to acquire Cigna Corporation (NYSE: CI) for $184 per share in cash and stock. The proposed combination would create a premiere global health benefits company with critical diversification and scale to lead the transformation of health care delivery for consumers.

As you know, our industry is changing rapidly. Our relationships with brokers, employers, health care providers, managed care companies, and the public are all shifting in this new environment. Combining the complementary strengths of Cigna and our parent company creates a diversified platform that can seize on new opportunities and meaningfully compete across product lines and geographies. The combined company would be more efficient, focused and better able to deliver solutions that simplify health care processes and improve health care quality and affordability.

We are very excited about the opportunities this combination would create, and look forward to sharing more information with you in the future. For now, however, it is important to recognize that our proposal is conditioned on the negotiation of a definitive agreement with Cigna, and there is no guarantee that a transaction will occur.

 

ACA funds new Bainbridge Health clinic

13 May , 2015,
jtdickerson
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According to a recent article, a new Federally Qualified Health Center, funded by a grant from the Affordable Care Act, will be opening in Bainbridge Georgia in late summer 2015. This new primary care facility will be located at 509 Wheat Avenue. This facility is a result of collaboration between Memorial Hospital and Primary Care of Southwest Georgia. According to the article at www.BainbridgeGA.com:

PCSG will serve the broad health needs of Southwest Georgia residents through a family practice model of care. Ann Addison, Ph.D., CEO of PCSG, stated, “The Board of Directors and staff of PCSG are very pleased that we will be able to provide high quality, affordable healthcare services in a beautiful setting made possible by the collaboration between Primary Care of Southwest GA and Memorial Hospital and Manor.” Dr. Addison continued, “We worked closely with Billy Walker, CEO and staff of Memorial Hospital and Manor and Senator Dean Burke while applying for the New Access Point funding . The new practice will help provide local healthcare to those in need.”

Stay tuned to MyGeorgiahealthplan.com for the latest health insurance and Affordable Care Act news for Georgia residents! We are your #1 Georgia Obamacare Agent!

2015 Georgia Health Insurance facts

16 Apr , 2015,
jtdickerson
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Now that the 2015 Affordable Care Act open enrollment has come to a close (though a tax time Special Enrollment Period is open now), we wanted to take a moment to review some of the numbers surrounding the health insurance market in Georgia.

According to ACAsignups.net Georgia enrolled 541,080 individuals through the marketplace in 2015 versus 316,543 individuals enrolled in the 2014 open enrollment season. This means Georgia had 170.93% MORE individuals enroll for 2015 versus 2014!

Although we do not have exact enrollment figures, we do know, that for the 2014 enrollment season, Humana led the state in individual health plan enrollments statewide. Click here to view Humana health plan quotes in Georgia. Per Kaiser Family Foundation “A main goal of the Affordable Care Act (ACA) is to extend health coverage to many of the 47 million nonelderly uninsured individuals across the country, including many of the 1.8 million uninsured Georgians.”

In 2015, Georgia experienced an increase in competition on the health insurance marketplace, resulting in 10 different insurers offering Qualified Health Plans for Georgia residents to choose from. According to a recent article in the Atlanta Journal Constitution: “The Georgia increase in the lowest-cost Silver plan was just 1.8 percent in 2015, rising from $255 to $260 a month. The national average for that plan was $264.”

If you need help getting enrolled in a Georgia health insurance plan, contact us today!

 

 

 

Get enrolled: Tax time Special Enrollment Period!

Apr , 2015,
jtdickerson
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If you owe a fee with your taxes for not having health coverage in 2014 and don’t yet have Georgia health coverage for 2015, you may still be able to get coverage for 2015.

The Health Insurance Marketplace is providing individuals and families in Georgia who need to pay the fee when they file their 2014 taxes with one last chance to get covered for 2015.

This is too important to put off. If you don’t have coverage for the remainder of 2015 you’ll risk having to pay the fee again next year for the portion of this year that you don’t have coverage. The fee for people who don’t have coverage increases in 2015 to $325 per person or 2% of your household income – whichever is higher.

Get Covered SC health plans

Don’t leave money on the table: Millions of people have already signed up, and 8 out of 10 can find coverage for $100 or less a month with tax credits through the Marketplace. Over 500,00 Georgia residents signed up for 2015 health coverage, don’t get left out!

We hope you take advantage of this extended opportunity to get quality coverage this year.

 

Grady Hospital rejoins BCBS-GA networks!

1 Apr , 2015,
jtdickerson
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Great news for Georgia residents insured through Blue Cross Blue Shield of Georgia! Yesterday, BlueCross BlueShield of Georgia announced that Grady Memorial Hospital has rejoined the BCBS-GA network! And of course, you can click here to see individual health plans offered by BCBS-GA! Keep scrolling for the full press release!

 

Grady Memorial rejoins BCBS-GA network

Grady Memorial rejoins BCBS-GA network!

From BCBS-GA:

We’re pleased to announce that Grady Health System and Blue Cross and Blue Shield of Georgia (BCBSGa) have reached agreement which will give BCBSGa members full in-network access to the clinical services of Grady Health System. As a result of this agreement, effective April 1, 2015, Grady Memorial Hospital will once again join BCBSGa networks as a participating provider.

Grady Health System is one of the largest safety net health systems in the United States. Grady consists of the 953-bed Grady Memorial Hospital, six neighborhood health centers, Crestview Health & Rehabilitation Center, and Children’s Healthcare of Atlanta at Hughes Spalding, which is operated as a Children’s affiliate. For more information about the services offered by Grady, click here.

We take the responsibility for providing our members access to high quality, affordable health care seriously. Because the contracts we negotiate with hospitals and physicians on our clients’ behalf directly impact what they and their employees pay for medical care, our goal is always to provide our members access to high quality health care providers at rates they can afford.

Please join us in sharing this good news with your clients. We have prepared these Frequently Asked Questions to help you address questions from your clients. If you have additional questions, please contact your BCBSGa sales representative.

This article applies to:
Georgia
Small Group, Large Group, and Individual (under 65)

Ambetter Georgia!

25 Oct , 2014,
jtdickerson
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We are pleased to announce that we have recently added Ambetter Georgia by Peach State Health Plan to our portfolio of products offered to residents of Georgia! Ambetter Georgia prides itself as having health insurance plans that offer benefits, programs and support to help you lead a healthy, fulfilling life.

Ambetter Georgia

Ambetter is a great choice for budget conscience shoppers! Click here to compare plans and rates!

Need help getting enrolled in Ambetter? Have questions? Call us at 843-882-7062

Do you need to view Ambetter Georgias Provider Directory? CLICK HERE

New for 2015! We expect Emory University Hospital  to be added as an IN Network provider for Ambetter health plans offered on the marketplace in Georgia!

Are you looking for information about a specific Ambetter Plan?

CLICK HERE to view BRONZE Plans.

CLICK HERE to view SILVER Plans – Most Popular!

CLICK HERE to view GOLD Plans.

Some of the highlights of Ambetter Georgia’s plans include:

Comprehensive Medical Coverage Comprehensive Medical Coverage
Complete medical coverage that meets your medical needs and contains all of the Essential Health Benefits.

Member Incentive Program
Earn reward dollars just by staying proactive about your health. For 2015, every Ambetter member will receive a My Health Pays card. Ambetter rewards your healthy choices through the My Health Pays incentive program. Earn up to $125 on your My Health Pays card for:

• Completing your online Health Risk Assessment ($50)
• Getting your Annual Wellness Exam ($50)
• Getting your annual flu shot ($25)

Use your card to pay for out-of-pocket costs such
as copays, deductibles or monthly premium payments.

24/7 Nurse Line
Call and talk to a medical professional about your immediate health needs—at any time.

Prescription Coverage
Extensive Prescription Coverage. Get coverage for your medical prescriptions.

Optional Adult Dental Coverage
Coverage for services such as teeth cleanings, screenings and exams.

Integrated Care Management
Get well and stay well with preventive care and whole health services.

Optional Adult Vision Coverage
Coverage for services such as eye exams and prescription eyewear.

 

Ambetter has a very competitive price in many Georgia markets, including the following towns, cities and counties: Barrow, Chatahoochee, Clarke county / Athens, Elbert, Muskogee, Fayette, Fulton, Greene, Harris, Henry, Jackson, MAdison, MArion, Muscogee county / Columbus, Oconee, Spalding and Talbot county.

 

Ambetter in the News:

Peach State Health Plan receives approval to participate in Georgia Health insurance Marketplace“Ambetter” to provide affordable, quality health insurance plan alternatives to Georgians.

ATLANTA, Sept. 26, 2013 /PRNewswire/ — Peach State Health Plan (Peach State) announced today that it has received approval from the Georgia Department of Insurance and the Centers for Medicare and Medicaid Services (CMS) to participate in the Georgia Health Insurance Marketplace, where it will offer a line of products branded as “Ambetter from Peach State Health Plan.”

“Participating in Georgia’s health insurance marketplace is a natural progression to expand upon the affordable health solutions Peach State has offered to low-income individuals in Georgia,” said Patrick Healy, president and CEO of Peach State. “Our marketplace offerings will be under the product name Ambetter, a name that exemplifies our commitment to providing access to quality, integrated healthcare for individuals, while helping transform the communities in which they live, work and raise families.”

Ambetter health insurance plans are designed to deliver high quality, locally-based healthcare services to its members. With outreach programs focused on preventative care, members achieve healthier outcomes. Ambetter partners with Georgia-based health care providers and utilizes medical management and call center staff based in Georgia, contributing to the local economy.

With the implementation of the Affordable Care Act, health insurance marketplaces, or health exchanges, will offer consumers a place to shop, compare and select an affordable health plan.  Consumers can compare and purchase Ambetter products during the initial Open Enrollment period beginning October 1, 2013, through March 31, 2014, at www.ambetterhealth.com.

Peach State has been providing healthcare services to Medicaid members in Georgia since 2006.

 

Georgia Special Enrollment Periods

3 Oct , 2014,
jtdickerson
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Georgia Special Enrollment Periods

Special Enrollment Periods let Georgia residents enroll in a plan on the health insurance marketplace outside of open enrollment. A Special Enrollment Period occurs when you have a “Qualifying Life Event” or QLE. Examples of QLE’s include events that involve a change in family status (for example, marriage adoption or birth of a child), moving to a new address or loss of other health coverage.

The video below gives a great overview of Special Enrollment Period rules, feel free to leave a comment if you need help qualifying for a Special Enrollment Period.

If you need help with Georgia Special Enrollment Periods, just drop us a line using the contact info at the bottom of the page.

You can read the entirety of the latest CMS Georgia Special Enrollment Period guidance by clicking HERE.

 

Georgia Special Enrollment Period

Giving birth or adopting a child may qualify you for a Special Enrollment Period.

 

Georgia Platinum Plan

Oct , 2014,
jtdickerson
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Have you seen the 2014 Georgia Platinum Plans? I have heard many Georgia residents ask why they cannot seem to find a Platinum Plan to enroll in. YES, there are Georgia Platinum Plans available for purchase on the marketplace, however, these plans are only available in certain counties within Georgia for 2014. For example, residents in Savannah; Chatham County to be exact, residents can enroll in the Humana National Preferred Platinum 1000/1500 Plan on the health insurance marketplace in 2014. However, Georgia Platinum plans are available in nearly every county in 2014 if you are willing to purchase a health plan OFF EXCHANGE . For 2015, however, we expect Georgia residents to have a high quality PPO based Georgia Platinum plan available ON the marketplace/exchange in every county!

CLICK HERE TO SEARCH FOR GEORGIA PLATINUM PLANS!

What is a Georgia Platinum Plan?

Platinum plans, as defined by the Affordable Care Act (ACA, or as some say, “Obamacare”) are health insurance plans that have an actuarial value of 90%.  In general, Platinum plans have higher monthly premiums, but lower out of pocket costs. For this reason, Georgia Platinum plans are more suited to people who expect to go to the doctor often, have regular monthly prescriptions, or expect to have other substantial medical expenditures throughout the year.

Georgia Platinum Plans

Need help finding a Georgia Platinum Plan? We can help!

Off-Exchange/Marketplace Health Plans

Off exchange plans are plans that are offered outside of the Federal Health Insurance Marketplace.  These plans, starting January 1, 2014, must comply with all of the laws that apply to health plans offered on the Federal Exchange/Marketplace at www.healthcare.gov. Just like plans on the marketplace, qualified health plans purchased outside of the federal marketplace must still cover the 10 essential health benefits as defined by the healthcare reform law. The biggest difference to YOU, the consumer? Anyone who purchases an off-exchange plan cannot qualify for Federal subsidies to offset health insurance premiums. Generally, most Georgia individuals and families making between 100% and 400% of the Federal Poverty level may be eligible for premium assistance through the Federal Exchange. I personally believe, that in certain unique situations, some Georgia residents who are eligible for a subsidy, may be better off forgoing the subsidy and buying an off exchange policy. Of course, diligent planning and research must be conducted before making a decision to forego purchasing a marketplace plan. In addition, many off-marketplace plans use more robust provider networks than those found in marketplace plans. Recently, newspapers near Georgia such as the Post & Courier and The State Newspaper published articles about the limited networks for many health plans available on the Federal health insurance marketplace. This is why we recommend working with an experienced Georgia Obamacare agent to be sure that you choose the plan that best suits YOUR unique needs.

 Who offers Georgia Platinum Plans?

Of course, as a full service Health Insurance Agency we offer Georgia Platinum plans through through both Humana & Assurant Health. Assurant Health currently offers 2 Georgia Platinum Plans: CoreMed Platinum 1 and CoreMed Platinum 2. Each of these plans allows the enrollee to select either the Coventry Healthcare network, the CIGNA PPO Network or the Aetna Signature Administrators Network. For benefit summaries for each of the two Georgia Platinum Plans available from Assurant, click the links below:

Assurant Platinum 1                                                                     Assurant Platinum 2

Who is Assurant? Great question. Assurant traces its roots to the founding of the LaCrosse Mutual Aid Association established in LaCrosse, Wisconsin in 1892, formed to provide consumers with disability insurance. Assurant Health now provides quality health care insurance products to customers with an emphasis on individuals who need coverage but are not part of a larger group plan. With a 120-year legacy, the business offers affordable health care products including major medical, supplemental and fixed-benefit plans for individuals, families and small employers. Financial ratings information for Assurant’s various companies can be viewed HERE.

In addition to Assurant, Humana offers Platinum plans on the marketplace in limited areas, as well as off-marketplace. CLICK HERE to learn more about Georgia platinum plans offered by Humana.

Who should consider a Georgia Platinum Plan?

Anyone who visits the doctor often, takes many prescriptions, or otherwise has high anticipated medical costs. Our analysis indicates that Georgia residents under the age of 50 may see the most value in a Georgia Platinum plan in 2014. In our analysis, many residents with high medical costs were better off paying higher Platinum plan premiums in exchange for much lower out of pocket costs. Please contact us today to help determine if you may be a good candidate for a Georgia Platinum plan. We can HELP!

Update – 10/28/2013

We really enjoyed this article from the New York Times, especially as it relates to Georgia Platinum plans :

WITH so much attention being paid to the troubled debut of the Obama administration’s health insurance exchanges, another alternative has largely gone unnoticed: unless you live in Washington, D.C., or Vermont, you can also buy insurance outside the exchanges — by going directly to insurance brokers, agents or company Web sites. Read More Here

Update – 11/12/2013

Platinum plans are 2nd most popular plans on the Kentucky Health Insurance Marketplace!

Young female with pricey tastes: Kentucky Obamacare numbers

If Obamacare data were a horse race, Kentucky would be leading the pack.
Kentucky has released in-depth, demographically detailed information about enrollments in its state-run Obamacare marketplace, setting a high bar for federal authorities to beat when they finally release their own enrollment data from HealthCare.gov later this week for the first time. Read More…

Georgia newborn health insurance coverage

2 Oct , 2014,
jtdickerson
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Georgia newborn insurance coverage

Georgia newborn health insurance coverage

We can help find insurance coverage for your newborn child!

Over the course of the last few months, we have received many inquiries from clients wanting to know when a Georgia newborn can get insurance coverage through the health insurance marketplace. As many people may be aware, most marketplace enrollments are effective the 1st day of the month following the date of enrollment.

However, for newborn children in Georgia who need insurance coverage, a Special Enrollment Period or SEP is available that will provide coverage effective on the date of birth! This is great news for new parents worried about the hassle of getting a newly born child insured.

What is a a Special Enrollment Period? A special enrollment period is when you have a qualifying life event that allows you to enroll in coverage on or off of the marketplace, outside of open enrollment. Of course, giving birth to a child is one of the many life events that would qualify you for a Special Enrollment Period.

Below is the specific guidance, directly from CMS, that details how Special Enrollment Periods for Georgia newborn insurance coverage work:

Per 45 CFR §155.420, Special Enrollment Periods (SEPs) constitute periods outside the initial or annual
open enrollment when a QI may enroll in a QHP and QDP or a QI can elect to change a current QHP and
QDP selection as a result of a triggering event, such as birth/adoption, relocation, death, or loss of MEC.
It is the responsibility of the FFMs to determine whether a QI meets eligibility requirements for a SEP.
The FFMs determine eligibility for SEPs, which are described by regulation at 45 CFR §155.420(d). In the
individual market FFMs, Special Enrollment Periods generally last 60 days from the triggering event, per
45 CFR §155.420(c). In SHOPs, including FF-SHOPs, Special Enrollment Periods generally last 30 days
from the triggering event, although there are two exceptions, when an enrollee loses Medicaid or CHIP
coverage and when an enrollee becomes eligible for Medicaid or CHIP coverage For the Medicaid and
CHIP exceptions the SEP is 60 days. The start date of an SEP is based on the date of the triggering event.
Although certain SEPs adhere to the standard effective dates described earlier in section 1.2, there are
exceptions to this rule. For example, for birth, adoption, placement for adoption, or placement in foster
care, coverage is retroactive to the date of birth, adoption, placement for adoption, or placement in
foster care.

Georgia Newborn Health Insurance Coverage enrollment example:

Example : An enrollee contacts the Marketplace on 04/25/2014 to inform the Marketplace of the birth of
twins on 04/01/2014. The Marketplace does a redetermination of the enrollment group. The Marketplace sends
an 834 change transaction to the selected Qualified Health Plan adding the newborn children with a coverage
effective date 04/01/2014.

Do you need help with Georgia newborn insurance coverage?

Of course, if all of this sounds complicated, please call (843.882.7062) or email us directly. or leave a comment. We can HELP!