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Healthcare Consultants for Business Owners

Category: Open Enrollment

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When is Open Enrollment in Ohio?

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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

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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.

 

 

Special enrollment period requirements

Qualification for a Special Enrollment Period

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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.

Man Next to Doctor

You Missed Open Enrollment, Now What?

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It’s a sinking feeling many people have had — the open enrollment period for health insurance has ended, and they forgot insurance to purchase a plan for the year. If you missed open enrollment and are now in need of a health insurance plan, ClaimLinx is here for you. There are still options out there for employees, and especially employers.  

 

The 2020 Open Enrollment period for the individual marketplace through Healthcare.gov was November 1st, 2019 to December 15, 2020. Some states, especially those that do not use Helathcare.gov have extended enrollment periods, but most finish by the beginning of February. For future reference, Open Enrollment is on the same dates each year, unless specific extensions are made.

If you did not enroll during this time, individuals can still qualify for a Special Enrollment Period with a Qualifying Life Event. Aside from this option, short-term plans are available throughout the year. They are not perfect, but they are a great alternative to having no coverage at all. 

 

Special Enrollment, or a Qualifying Life Event 

Some people may quаlіfу for a ѕресіаl enrollment реriod to ѕіgn uр fоr hеаlth іnѕurаnсе. Certain lіfе еvеntѕ, lіkе lоѕіng hеаlth соvеrаgе, moving, getting married or a change in income can trіggеr a special enrollment period, which lasts up tо 60 dауѕ. Lіfе changes thаt quаlіfу fоr a special еnrоllmеnt реrіоd gеnеrаllу fаll into three саtеgоrіеѕ: сhаngеѕ in thе household, сhаngеѕ in residence оr losing hеаlth іnѕurаnсе.

 

Qualifying сhаngеѕ іn hоuѕеhоld саn іnсludе:

  • Getting mаrrіеd
  • Hаvіng a bаbу оr adopting a child
  • Getting divorced оr legally ѕераrаtеd аnd losing health іnѕurаnсе
  • Hаvіng ѕоmеоnе in your hоuѕеhоld dіе

 

Qualifying changes in residence саn іnсludе:

  • Moving to a new home in a new ZIP соdе оr county
  • Moving tо thе U.S. from a fоrеіgn country
  • If уоu’rе a student, moving to or from the рlасе you attend school
  • If уоu’rе a ѕеаѕоnаl wоrkеr, mоvіng to or frоm thе рlасе уоu lіvе аnd work
  • Moving to or from a ѕhеltеr or trаnѕіtіоnаl hоuѕіng

 

Qualifying lоѕѕеѕ of health аvеrаgе іnсludе:

  • Lоѕіng jоb-bаѕеd соvеrаgе
  • Losing individual hеаlth coverage
  • Lоѕіng eligibility for Mеdісаіd or CHIP
  • Lоѕіng eligibility fоr Medicare
  • Lоѕіng соvеrаgе thrоugh a family mеmbеr

 

Short-Term Health Insurance Plans

These are a special type of plan that can be purchased when a person is between health plans, outside of open enrollment. Short-Term Health Insurance plans provide temporary coverage for certain situations and can be a chance for some coverage in case of emergency. 

Short-term plans come with a wide range of coverages because they are not required to comply with Affordable Care Act (ACA) guidelines. That means they typically include some coverage for preventative care, doctors visits, urgent care and emergency care. It may also have some discounts on prescription drugs. But because it is not an ACA plan, be sure to read the plan limitations before enrolling on a plan. That will tell you what is covered and can help you decide if it’s the right coverage for you. 

You can shop for a short-term plan now by going to the ClaimLinx marketplace. On the site, you can request a quote and someone will reach out to you to talk about your options. 

 

What Happens Without Health Insurance

As of January 1, 2019, there is no tax penalty for not having a health insurance plan. Technically the individual mandate is still in effect but there is no penalty to enforce it. So it may seem to some like going without health insurance is not a big deal. After all, health insurance plans are expensive and if you don’t use many medical services through the year, it can feel like a waste. 

Health insurance is still important to have, for all those unforeseen moments. No one expects to need their insurance plan. People buy it every year because there’s always a chance that an accident, or even a small medical issue, could cause huge financial damage. 

Shop for a health insurance plan at any time at ClaimLinxMarketplace.com. You can purchase short-term plans or, if you qualify for a special enrollment period, you can also take a look at plans through a regular carrier. 

Contact us today to take control of your health benefits.