when-is-open-enrollment

When is Open Enrollment in Ohio?

Worried about at what time around the year can you sign up for Health Insurance Enrollment? Or do you plan on shifting your healthcare needs? It is important to have a proper understanding of open enrollment to have the coverage you are looking for. You must be looking into the following factors when considering Health Insurance Enrollment in Ohio:

 

  1. What is Open Enrollment?

It is a time to get yourself enrolled in Health Insurance. This time of enrollment comes once a year where individuals can look into organizations offering Health Insurance in Ohio while going for the one that best suits you.

Also, the following alterations have been brought to the Health Insurance Policy as of the year 2021:

  • There will be no penalties if you do not enroll yourself for Health insurance
  • There will no increase in premiums and they will remain the same as of 2020

 

  1. Timeline

The timeline for Open Enrollment in Ohio begins from the 1st of November 2020 and lasts till the 15th of December 2020. This serves as an open opportunity for the following reasons:

  • For the residents of Ohio to get themselves registered
  • Residents to get their existing memberships renewed
  • For the residents looking for an upgraded version or a seemingly different plan for the year ahead

Note: It is important to be noted that the Open Enrollment in Ohio starts earlier for older individuals (65 and old).

 

  1. Who needs enrollment? 

The following individuals should sign up for Open Enrollment:

  • An employee and your company does not provide you with insurance
  • Individuals who are not supported by the government
  • If you are an adult and not fall into your parents Health Insurance Enrollment
  • Someone who has an existing Health Insurance, but it does not match your needs anymore
  • If there is a variance being brought to your budget and you need to renew it

 

  1. How to Apply 

You can apply for Open Enrollment in a variety of ways. Below is a list mentioned for you to consider one of the options available for applying to Open enrollment:

  • Online

You need to get yourself registered to the company/organization you want to enroll in. This will assist you while being time-efficient as well as being at ease since you will not be waiting into ques to get yourself registered or your account activated. 

  • Telephone

It serves as a primary medium where you will be facilitated with a customer representative, looking forward to your queries and concerns while getting everything resolved for you. Also, a customer representative aids in guiding you about the details and full information regarding the application and its procedure.

  • In-person Assistance

You can look up for an individual who will assist you in-person about the enrollment details and its whereabouts. You can search online with your zip codes and you could find a couple of individuals who would be happy to help and let you know about the requirements and necessary documentation. 

  • Paper Application 

This consists of downloading the application and filling out the relevant details manually. Once this is complete, you will be sending it through the mail to the concerned organization or focal person responsible for the Health Insurance Enrollment. 

 

  1. Coverage questions for employees

Once the Open Enrollment starts, employees often have varying concerns as to their Health Insurance Plans. They do not know if to continue with their existing health insurance plan or bring about an adjustment to it. Here’s a checklist of factors to consider that will determine and help you decide about your Open Enrollment for the year ahead:

  • Expanded Coverage

You need to explore what options are available for you. For instance, small business owners as well as employees should take into consideration if options for dental or vision can be a part of expanded health coverage or not. 

  • Number of Dependents

This is where you need to decide and look into the number of dependents you will be having in the following year. You need to consider if you will be adding or removing an individual from your family from the Health Insurance Plan. 

  • Employer Coverage

You need to inquire about the Health Care Open Enrollment from your organization. This is important to assess if your organization will be contributing it to in some way or not.

  • Added coverage

This serves as additional benefits being provided. For instance, incorporating telemedicine or wellness programs that will together be part of the organization’s Health Insurance Plan.

 

  1. How to decide about the right Health Insurance Enrollment?

There are different sorts of Health Insurance Enrollment in Ohio. You need to be decisive while choosing one. This is particularly because you need to understand the requirements and benefits that best suit you or your family as a result. Here’s a checklist that will help you determine as well as evaluate your options while looking for a certain Health Insurance Enrollment:

  • Costs of Plans

This is related to your finance and budget allocation. Cost plans are a way to measure and define the amount you would be spending on Health Insurance. 

  • Types of Plans

There is a wide variety of plans including HMO, PPO, POS, and EPO, while all offering distinctive requirements and Health Insurance Plans for you. You need to carefully identify which one is the best for you while covering all your needs and requirements.

  • Different Levels

The levels differ greatly in terms of benefits provided to the individual. This means that for each level, there is a different type of Health Insurance being provided. You need to evaluate each of these and then match it to your requirements for assessing the one that is suitable and covers the benefits you are looking for. 

In summation, the above pointers will assist you with the Open Enrollment in Ohio along with its policy and procedures to be followed. It is important to keep each of these factors and consider them while deciding and coming to a solution. 

 

2021-Employee-benefits-planning

How and Why to Start Planning Your 2021 Employee Benefits

Have you ever wondered what keeps you motivated even after working for hours? Did you ever give a thought to how employee benefits bring about a difference outside your work life? If you did not, I believe it’s high time that you do because it notably has a significant impact on you, your family as well as your lifestyle!

Employees of all ages seek security and that too originating from your employer is a plus. In the modern fast-paced world of today, where competitiveness is at its peak, a driving factor to attract and retain individuals like you is by offering Employee Benefits. It portrays the organizations are not only investing in the short-term but the organization, as an employer are looking out and concerned for your future that lies ahead of you as well.

Now let us have a deeper understanding of the much familiar term ‘Employee Benefits’

 

What Are Employee Benefits?

Employee Benefits, also commonly known as fringe benefits are non-financial compensation that is provided to you as part of an employment contract other than your salary. It may be required by law, depending upon the country you currently reside in, or could be also due to a risk that is associated with your job. The purpose of employee benefits is to increase your economic security as an employee.

Below is a check-list of the employee benefits commonly being provided by organizations:

  •       Health Insurance
  •       Disability Insurance
  •       Casual Leaves
  •       Sick Leaves
  •       Vacation Leaves
  •       Retirement Plans
  •       Well-being Program
  •       Tuition Reimbursement
  •       Gym Reimbursement
  •       Loan Contribution
  •       Transportation Facility
  •       Employee discounts
  •       Free lunch

 

Why Are Employee Benefits Important For You

Employee Benefits acts as security. This is where above 70% of the population is willing to settle for their security and wellbeing, even in comparison to high salaries being offered.

Here are some reasons why employee benefits are important to you:

  •       They ensure your security
  •       They ensure to facilitate you will all resources at their disposal
  •       They have a strong impact on your motivation towards your work
  •       They contribute towards increased satisfaction while being at work

Note: If an organization is offering a good salary along with additional benefits, it is the right moment for you to grasp the opportunity before it’s too late!

 

Why Is 2021 Benefits Planning Important?

We are all aware of the global pandemic and the unfortunate events that it brings along. As it continues to wage on, the COVID-19 pandemic has been a wake-up call for all employees to get themselves secured. This is observed as a reflection in the employees being super concerned about the additional benefits and support provided by their employer to help create ease in such tough times.

On this account, all employees need to start focusing on their concerning employee benefits to get themselves secured for any unfortunate causality that could occur as a result.

Here are some common reasons to why you should step ahead into employee benefits planning for the year 2021:

 

Healthcare Coverage

You have probably heard the common phrase ‘Health is Wealth’. Yes, your health is the most important factor and should be your top priority, especially in such times. You need to consider the maximum amount of opportunities from where you could get medical coverage as part of employee benefits.

 

Telehealth facility:

It is an additional sub-category that is on the rise nowadays. Telehealth is where you could get connected to a doctor through a telephonic call or video chat. As the graph for COVID-19 increases, there has been observed an increasing trend toward telehealth services, with over 60% population being dependent on it.

Therefore, it is extremely important to consider the benefits of health coverage in employee benefits planning for the year 2021.

 

Mental Health

A survey in 2020 investigated the after-effects of COVID-19 on employees where there was a significant increase in individuals linking the global pandemic as one of the most stressful times of their lives. This is where employees were not sure about job security where each one of us felt threatened that our organization might be laying us off.

It is hence important, to consider your mental health before even giving a second thought to any of the factors. For this reason, you should start looking into organizations and programs that cater to these in addition to the usual benefits being provided.

 

How To Start Planning Your 2021 Employee Benefits

Planning employee benefits has become essential in the world of today. Having the right employee benefits will give you a distinct advantage in addition to other facilities provided by either your organization or the law of your state itself.

Take into consideration the following steps while planning on your 2021 employee benefits:

 

Prioritize what’s benefits are important to you

As an employee, it is important to evaluate what matters to you. You should be the one deciding what is important, what is relevant, and what is it that will facilitate you in the longer-run as well. Until and unless, you do not have a goal or determination inside of you, it will be far impossible to benefit both, you and your dependents as a result.

 

Differentiate between required benefits and optional benefits

While organizations are increasingly providing employee benefits, it is important to focus on what is best suitable for you. You, as an employee, should be decisive and have the ability as well as a skillset to differentiate between what is necessary and what is not.

Often some startups offer small business benefits since they are not enough financially stable to offer you a range of benefits. For instance, small business benefits could include flextime, telecommuting, paid time off, or even well-being programs. For some, the above would be required benefits where in comparison some employees might have it on their optional benefits list.

Hence, now once provided with both options, you are free to select the one that fulfills your needs and requirements.

 

Dig Deeper into your budget constraints

Having a focused and realistic idea of your budget will aid in understanding and utilization of the benefits important to you and your family. It will provide you with a holistic overview of the employee benefits to plan on while also knowing the ones you can compromise on.

In summation, 2021 is almost here with a roaring start, that links back to employees making decisions about their benefits program and the option available. Where continued unemployment is at its peak, employees should wholeheartedly dedicate a great deal of time settling themselves for a brighter future!

Contact Claimlinx today to schedule a benefits consultation.

 

 

covid-19-health-insurance-options

What to do if you lost your health insurance during COVID-19

It is no secret that COVID-19 has had catastrophic effects on the lives of people as well as entire economies around the world. Many people have found their lives upended due to the pandemic. People have lost their jobs and homes, and many cannot see a secure future in sight. 

Similarly, in counties and states across America, the social and economical conditions of governments and citizens seem to be worsening since no one can determine for certain when this worldwide pandemic will wane.

Unemployment has reached record heights 

As a result of COVID-19, many businesses, regardless of their size, have been forced o reduce, cease, or entirely shut down their operations. Subsequently, as many as 47 million people, according to the officials of the Federal Reserve, have filed for unemployment. This means that not only have millions of people around the country lost their jobs, but many who depended on employers for health insurance have also, unfortunately, lost health insurance coverage

Are you a victim of the devastating socio-economic effects of COVID-19?

If you have landed on this article, it is likely that you, like many other Americans, have fallen victim to this tsunami of unemployment, and you are unsure of what the future holds for you. Undoubtedly, your mind is perhaps racing with questions about how to make up for lost health insurance coverage that has resulted from you losing your jobs. Maybe you are looking into what kind of health insurance options are available for you, and you want to know how you can register for these facilities. Or still yet, maybe you want to know if you are eligible for a special and specific type of help that you can benefit from in these bleak times.

To make this process easier for you and save you some time and worry, we have taken to compile a list of all the possible options you can avail of to get some semblance of stability and security for the future back into your life. 

So what are your options?

The following comprehensive contains all the likely options that you can select from. These include COBRA coverage or coverage under the Affordable Care Act (ACA), as well as some other, more specific alternatives. So read on for a quick rundown of COBRA and ACA coverage, and some guidelines as to how you can find the plan that best works for your exact needs:

COBRA Coverage

Say you have lost your job due to large scale layoffs that took place in the organization you worked for, but the organization itself is still continuing operations. Under such circumstances, you may be eligible to extend your health insurance coverage on account of an employer-sponsored plan, regulated by federal law, which more commonly is referred to as COBRA. COBRA coverage makes it possible for you to fund your health insurance coverage from your own pocket under the same plan that you had when you were an employee for the business; for a period of about 18 months. 

However, the catch with COBRA coverage is that it can be a bit costly for you. This is because, in the time that you were employed, you were funding your health insurance coverage with little more than a percentage of your total monthly premium, while the rest was taken care of by your employer. With COBRA coverage, on the other hand, you are solely responsible for paying the entire premium on your own. 

Coverage under the Affordable Care Act

The other alternative to the COBRA coverage is the option of purchasing an individual or group health insurance plan for your family on your own. This can be done under the rules laid out by the Affordable Care Act (ACA). 

In the case of the affordable care act, you will usually be required to wait for the enrollment period each year that opens up in the fall so that you can sign a new health insurance plan. However, in the case of lost health insurance coverage that was covered by your employer, your case will be considered a “qualifying life event” which will allow for a 60-day window to enroll.

To see what fits you best, you can shop around for group health insurance for your family or individual health insurance coverage using an insurance marketplace run by your state government. In addition to the state-run marketplace, you can look up your options on an online marketplace, or you can hire the services of an insurance broker to help your compare plans directly from insurance companies and find the perfect plan for you or your family. 

If you are going to be going it alone and conducting the research into health insurance plans and providers on your own, maybe the following tips can be of some help to you  

  • Compare health insurance plans on the market- this will help you make sure you find the best plan to not only fit your exact needs but also not exceed your budgetary allowances. As mentioned above, you can enlist the services of insurance brokers or insurance brokerage agencies 
  • Look for plans that provide coverage for your prescriptions and preferred doctors- when selecting a plan, make sure it covers the doctors you would like to continue seeing and that will cover the drugs you need to manage a condition or illness you or a member of your family has
  • Check if you are eligible for government subsidies to help make coverage affordable– if your annual household income is below a certain level, you may qualify for subsidies that can help you new plan be more affordable for you
  • If you’re under age 30, consider a “catastrophic” plan– these are health insurance plans that will cover most of the basic benefits of other ACA plans. Moreover, these plans are slightly more affordable. The only downsides to these plans are that they have higher deductibles attached to them and you cannot avail of help for government subsidies to make them more affordable.  

As there seems to be no end to this economic and public health crisis, now is a time as good as any to make sure your health and future are secured. If you find that you do not qualify for either of the options we have mentioned in this article, look into Medicaid, for which you might be eligible if you check some specific boxes. To get more details on Medicaid and whether you qualify for Medicaid, you can contact the Department of Insurance in your state.

self-funded-merp

Advantages of Having a Self-Funded MERP

As a result of millions of people all around the world losing their jobs and subsequently their insurance due to the current public health crisis caused by COVID-19, which is also the case in the US, an alternative of health insurance that has come to the forefront is what is known as Medical Expense Reimbursement Plans or more easily referred to as MERP.

Predominantly, MERP has become very popular amongst employers lately. This is mainly because with MERP, organizations have the leeway to provide tax-free money, as opposed to providing conventional benefits such as group insurance. This entails the employees of the organization having the discretion to buy whatever product or service pertaining to health care as they prefer, which may also include health insurance for themselves. The employer, then, is responsible to reimburse their employees up to the allowance they have been given. 

To help you grasp the concept of what MERP exactly is, how they work, and what are the advantages associated with them, this article contains a breakdown of all the necessary details. 

Shall we begin?

What exactly is a MERP?

To start off, the term MERP stands for Medical Expense Reimbursement Plan. This is any sort of insurance plan that requires businesses and employers to reimburse their employees for the medical expenses that they or a dependant of their paid for out of their own pocket. When executed properly, a MERP will allow employees to be reimbursed for the entire medical expense, entirely free of any taxes.  

How do MERPs Work?

A MERP is any plan that allows businesses to give their employees without any taxes applied to the amount. The money that is given by the employer can only be used to pay off any medical expenses that an employee paid for out of their own pockets. The process of a MERP typically involves five main steps:

Step 1: Your employer will determine the allowance amounts- this means the set amount of monthly allowance that is allowed for each employee; should the medical expenses of an employee exceed the allowance limit, the employer will only be liable to reimburse the employee for the allowance that was predetermined. 

Step 2: As the employee, you will have to purchase your own health insurance plan- meaning you will have the discretion to choose whatever health care products best serve your needs and requirements. This purchase, however, will be paid for from your own pocket for the time being. 

Step 3: You will be required to provide proof of purchase- once you have made the purchase for your preferred health care products, you will be asked to provide documentation recording that a medical expense was incurrent. This document could be anything from a receipt to an explanation of benefits. However, regardless of the type of document, there should be three key pieces of information present in the document, including the date of the purchase, a description of the health care product or service that was purchased, and your name.  

Step 4: Once the document has been submitted, it will be put under review by your employer- this is done so that the employers can make sure that the amount of allowance is not exceeded, the type of product or service purchase qualifies to be reimbursed for under MERP and that all the important information is present. If the documentation is missing anything, you may be asked to submit additional records.

Step 5: You will be reimbursed by your Employer- after reviewing to make sure all information is present and valid and everything else is in, your employer will pay you up to the amount that was required by your predetermined allowance. 

What are the various types of MERPs?

Before this point in the article, we have discussed a MERP as an umbrella term for any plan under section 105 that dictates that the employer reimburse their employees for the medical expenses paid for out of their own pockets. In this following section, we will take a deeper dive into MERP and take a look at the various types of MERPs that exist out there. 

The following are a few of the most commonly used variations of MERPs:

Stand-alone MERP

A stand-alone MERP, otherwise also known as a stand-alone HRA, refers to any plan that is provided for by the employer where they reimburse employees for health insurance policies that have been purchase for their individual selves. These are MERPs that only cover personal medical expenses as opposed to group health insurance. This way, employers can offer their employees amazing benefits without having to raise their own costs and dealing with the intricacies of insurance.  

A MERP that covers group health insurance

This type of MERP that is coupled with a group plan is also referred to as group coverage HRAs, Deductible HRAs, or Group HRA. This is where employers bundle a MERP with group health plans that typically come with high deductibles. In this variation of MERP, the employer will increase the deductible to an even higher amount on the group health plan. Then, you as the employee will be paid in the difference between the deductible and your allowance. This provides an effective avenue for employers to insure a part of their group plan through dollars before the taxes on them are paid, which allows for huge savings without compromise on the coverage being provided. 

MERPs that exclusively cover Vision and Dental expenses

Even in the case of MERPs, there are only certain types of medical expenses that qualify the employee to receive reimbursement. This type of MERP comes in handy if your employer wants to cover you for your vision and dental expenses without having to purchase expensive insurance plans. 

The Advantages of Self-Funded MERPs

Employees get choice and flexibility 

With MERPs, employees have the discretion to choose whatever health care products meet their needs the best so that the plans can be tailored to requirements and no coverage goes unused.

The company stands to gain financial benefits

Unlike in the case of fully-funded insurance plans where the employer will have to pay the entire premium, in MERPs, they are only required to pay for the expenses that were incurred without incurring any sunk costs.

Employees make better health care decisions

When employees are required to pay for their medical expenses out of their own pockets initially, and they are restricted to a set amount of allowance, they are better prone to learning how to make better and more informed decisions about their health and the health products they purchase.

Special enrollment period requirements

Qualification for a Special Enrollment Period

A Special Enrollment Period allows you to select medical insurance beyond the yearly Open Enrollment Period, or during Open Enrollment for a previous insurance beginning date. You must meet any of the following criteria to be eligible for a Special Enrollment Period through the Health Insurance Marketplace

Ineligibility for health insurance

You (or any of your family members) lost qualifying health insurance (or “least basic coverage”). A few instances regarding being eligible for coverage are:

  • Insurance by the means of an occupation, or by someone else’s work. In this situation, you are also qualified for obtaining assistance to pay for medical coverage as your office is no longer paying you for the coverage or it is not regarded as qualifying insurance any longer.
  • Medicaid or Children’s Health Insurance Program inclusion 
  • Medicare.
  • It also includes all the insurances whether a single or group that end within the current year. 
  • Coverage is given through the health plan of your parents (in case you are included in it) When you are at the age of 26, you can no longer avail the insurance that comes within the parent’s health plan and you become eligible for the Special Enrollment Period. 

 

Addition in members of the family

  • Those who are married recently 
  • Became a new parent, became a guardian for an adopted child, or put a youngster for child support.
  • Turned into a dependent because of kid care or other request of the court.

In case you picked up or turned into a dependent because of matrimony, one spouse should be eligible for health inclusion for at least one day out of the 60 days preceding the union. It is not necessary if the life partner: 

  • Had been living in another country or a United States region for at least one day out of the 60 days before the marriage. 
  • Is an individual from a governmentally perceived clan; or an investor in Alaska Native Corporation. 
  • Was living in the area that did not have the facility of getting qualifying health coverage for at least one day more than 60 days before their qualifying health insurance enrollment date.  

Change of residence

You (or anybody in your family) changed their residence and accessed new Marketplace health plans. The movement that makes you eligible for a Special Enrollment Period include: 

  • Residing in another home having another ZIP code or district 
  • Acquiring a residence in the United States from a different nation or the United States region 
  • Changing to or from the spot you go to take education 
  • Moving to or from the spot of your occasional work 
  • Moving to or from a haven or other temporary lodging 

Change in qualification for coverage 

You (or anybody in your family unit): 

  • Fulfill any of the following criteria that make new to coverage enrollment 
  • Newly eligible for help paying for inclusion. 
  • Newly unqualified for help paying for inclusion. 
  • Qualified for an alternate measure of help paying for cash-based costs, similar to copayments. 
  • Become recently qualified for inclusion since you have acquired residence or state.
  • Become recently qualified for inclusion subsequent to being delivered from imprisonment (confinement, prison, or jail). 
  • Acquire or keep up status as an individual from a governmentally perceived clan or an Alaska Native Claim Settlement Act (ANCSA) Corporation investor (a position that allows you change designs one time every month, and allows your wards to take a crack at or make a change in plans with you). 
  • Become recently qualified for help paying for inclusion since you relocated to an alternate state or potentially went through an adjustment in pay and you were beforehand both of these: 
  • Unqualified for Medicaid inclusion since you reside in an express that hasn’t extended Medicaid. 
  • Unqualified for help paying for inclusion because your family unit salary was underneath 100 percent of the Federal Poverty Level (FPL). Circumstance Details 

Mistake in Enlisting or plan 

You (or anybody in your family): 

Couldn’t get the plan registered or got registered into a wrong plan due to the following reasons

  • Misinformation, deception, unfortunate behavior, or inaction of somebody working in an office for getting a health plan to enable you to select (like an insurance agency, Navigator, guaranteed application guide, specialist, or representative). 
  • A technical error
  • Misquoted information (like advantage or cost-sharing data) you had when you picked your health plan. 
  • Can challenge that your Marketplace plan disregarded a significant clause of its agreement. 

Other circumstances 

You (or anybody in your family unit): 

  • Applied for Medicaid or Children’s Health Insurance Program (CHIP) inclusion during the Marketplace Open Enrollment Period, or after a passing occasion, and your state Medicaid or CHIP office decided you (or anybody in your family unit) weren’t qualified after Open Enrollment finished, or over 60 days had gone since the enrollment date.  
  • If you are a sufferer of domestic abuse and are willing to enlist separately from your partner and remove all the dependencies.
  • Submitted documents mentioned by the Marketplace to prove that you are qualified, however, your coverage had just finished. 
  • Are under 100 percent of the Federal Poverty Level (FPL), presented documents to demonstrate that you have qualified immigration status, and you could/t get enrolled as you were waiting for your documents are verified by the concerned authorities.
  • Are an AmeriCorps administration employee, whether you are just about to start your service or have just ended it.
  • Can show you had an outstanding condition that was a hurdle in joining up with inclusion, such as being weakened or a survivor of a cataclysmic event during an Open Enrollment Period or another Special Enrollment Period qualifying occasion. 
  • Have newly acquired ingress to an independent insurance Health Reimbursement Account (HRA), or a qualified small employer health reimbursement arrangement (QSEHRA) is being provided.

Hopefully, now you must have got enough information about the circumstances under which you are eligible for the special enrollment period for the health plan so keep the following information in mind and make necessary arrangements for getting the health coverage now if you missed during the due course of time.