Author Archives: jtdickerson

BlueCross BlueShield release framework for market stability

24 May , 2017,
jtdickerson
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As reported by multiple news sources, the BlueCross BlueShield Association recently released a framework for market stability. This press release was in response to the White House seeking a 90 day delay in the House vs. Price lawsuit. The House vs. Price lawsuit appears to be a central issue for insurers planning to participate in the Health Insurance Marketplace for 2018, as this lawsuit may determine the fate of $7 billion in Federal funding for Cost Sharing Reductions (CSRs) – money used to reduce co-pays, deductibles and out-of-pocket amounts for Americans that fall within certain income parameters. As insurance carriers scramble to file rates for 2018, the availability of CSR funding may be a linchpin for actuaries responsible for determining how much insurers will charge for coverage, or whether some insurers will participate at all in the individual health insurance marketplaces. Below are the key points released by the BlueCross Blueshield Association:

-Continued protections for people with pre-existing medical conditions and sustained federal funding to offset the cost of care for the sickest patients.

-More leeway for states to experiment with health insurance benefits, with a basic floor of federal standards.

-Preserving ACA consumer safeguards including no lifetime caps on benefits, no higher premium for women based on gender, and a requirement that insurers spend a minimum of 80 cents of every premium dollar on medical care.

-Penalties such as waiting periods for people who fail to maintain their coverage. Republicans want to repeal the Obama-era tax penalties on uninsured people deemed able to afford coverage.

-Significant federal funding to subsidize premiums and out-of-pocket costs.

BlueEssentials Member Claims Filing Error by Carolinas HealthCare System

6 Apr , 2017,
jtdickerson
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We just received an update from Blue Cross Blue Shield of South Carolina pertaining to a claims issue affecting members who have received treatment at a Carolinas Health Care system provider. As you may recall from our previous blog entry, Carolinas Health Care (CHC) providers were added to the BlueEssentials network earlier this year. Thankfully, it appears that both parties are working diligently to correct the problem!

Scroll down for details!

Claims have been denied in error for BlueEssentials members who received services from a Carolinas HealthCare System (CHS) provider in 2017. These members may have received an Explanation of Benefits (EOB) and/or a bill from CHS showing that a claim or multiple claims were denied for services received from an out-of-network provider. The claim(s) in question were denied because of a claim filing error.

We are working diligently to ensure the claim(s) will be refiled by CHS and processed correctly. Approximately 900 subscribers have been impacted and will receive a letter from us within the next week explaining the circumstances.

If you speak with clients affected by this issue, please encourage them to remain patient as we work with CHS to resolve it as quickly as possible. No action is needed on the part of agents or members. Incorrect bills from CHS and incorrect EOBs from BlueCross BlueShield of South Carolina should be disregarded. If a member received a bill from CHS and has already paid it or has questions about it, the member should call the phone number on the bill.

As a reminder, the 2017 BlueEssentials network includes numerous providers throughout South Carolina, as well as more than 1,600 CHS physicians at more than 300 CHS practice locations in Chesterfield, Lancaster and York counties in South Carolina, and in Anson, Cleveland, Columbus, Gaston, Mecklenburg, Polk, Richmond, Robeson, Rutherford, Scotland and Union counties in North Carolina.

 

SChealthconnector recognized as Top Health Insurance Agent!

10 Jan , 2017,
jtdickerson
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hc_gov_champions_circle_badge

As your #1 South Carolina Obamacare Agent, we are pleased to announce that we recently received the honor of being a member of the Marketplace Circle of Champions! As one of the top South Carolina health insurance brokers, we are proud to be honored in this manner!

Check out the press release below!

If you need help getting enrolled during the 2017 Open Enrollment, just give us a call at 843-882-7062 to schedule an appointment! We are always happy to help!

Check out the press release by clicking here!

 

 

Blue Cross Blue Shield SC premium payment extension!

29 Dec , 2016,
jtdickerson
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Great News!

Premium Payment Deadline Extended to Jan. 13
Blue Cross Blue Shield of South Carolina Members with individual Affordable Care Act (ACA) plans with effective dates of Jan. 1, 2017, have until midnight on Friday, Jan. 13, to pay their first month’s premium. Although the payment deadline is extended, members must pay before they can use their benefits.

Deadline Extended!!!!

16 Dec , 2016,
jtdickerson
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Because of extraordinary demand at HealthCare.gov and the Marketplace Call Center, the deadline to sign up for January 1st coverage has been extended until 11:59 p.m. PST on Monday, December 19th.

Rite Aid to Join BlueEssentialsSM Advanced Choice Pharmacy NetworkTM on Jan. 1

9 Dec , 2016,
jtdickerson
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Great news from BlueCross Blueshield of South Carolina regarding the pharmacy network for members who are covered by an ACA individual health plan purchased on or off the health insurance marketplace! From the release:

 

Good news! Rite Aid will join the Advanced Choice Pharmacy Network effective Jan. 1, 2017. The Advanced Choice Pharmacy Network is used by all individual Affordable Care Act (ACA) BlueEssentials plan members.

Please note that Rite Aid was not expected to be in network for 2017, so some marketing materials (including the 2017 BlueEssentials product brochure) list them as out of network.

As always, we encourage agents and members to visit our website for the most up-to-date pharmacy listings. Rite Aid will be included on our website pharmacy listing beginning Jan. 1, 2017.

Carolinas HealthCare System Joins BlueEssentials Network (BCBS-SC)

16 Nov , 2016,
jtdickerson
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Great news for South Carolina residents with individual health plans along the SC/NC border!

In case you were unaware, effective Jan. 1, 2017, BCBS-SC BlueEssentials products will only have emergency and urgent out-of-area benefits. This presents difficulties for clients near the northern NC/SC border along the I-77 corridor.

However, we are pleased to announce that effective Jan. 1, 2017, BlueEssentials members will have full access for covered services at Carolinas HealthCare System (CHS) hospitals and providers.

The agreement includes access to more than 1,600 physicians at more than 300 practice locations in Chesterfield, Lancaster and York counties in South Carolina, and in Anson, Cleveland, Columbus, Gaston, Mecklenburg, Polk, Richmond, Robeson, Rutherford, Scotland and Union counties in North Carolina.

Carolina Healthcare Systems is listed on the BlueEssentials Hospital and Doctor Finder on the BCBS-SC website here.

Need help shopping for a new plan in South Carolina? We can help! Call us today at 843-882-7062. Or view all SC plans by clicking here.

One tip that can help South Carolina residents save BIG on health insurance!

19 Oct , 2016,
jtdickerson
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As 2017 draws near, many South Carolina residents are receiving notice that their health insurance plans are changing and their premiums are rising! As a broker helping South Carolina families for over 13 years, we have developed many strategies to help clients maximize their healthcare dollars.

One particular strategy we employ with many clients is the use of tax advantaged savings accounts to maximize tax credits to reduce premiums. Sound complicated? It’s really not, and many people can take advantage of this simple tax code to maximize their healthcare dollars – and best of all, it’s an easy and effective way to save money! Tax credits are available for any plan (except Catastrophic) for those with a household income under 400 percent of the FPL. However, choosing the CORRECT plan, may give you additional tax benefits and savings! Scroll down to read more….

Premium tax credit ACA APTC

This chart shows who may qualify for savings!

 

 

 

 

 

Let’s take a look at a couple of examples:

The first is a longtime client family of 5 – let’s call them the Smith’s for the sake of discussion. Mr. and Mrs. Smith are both 39 years old, with three children ages 10, 7, and 5. For 2016, the Smith’s estimated their household income to be just a bit above $120,000, and want to spend as little as possible on health insurance premiums. If you were to go to the health insurance marketplace (CLICK HERE for our marketplace quote engine), you would see that in 2016, a family of 5 making $120,000 would not qualify for premium tax credits. The least expensive plan for the Smith’s (who live in Charleston county) would be a Blue Option Bronze 6500 – at a cost of about $949 per month!

By helping the Smith’s select a Tax Qualified High Deductible Health Plan (HDHP), however, we cut the monthly premium cost down to $861 per month, an approximate annual savings of $1,080!  How did we do this? By max funding a Qualified Health Savings Account, the Smith’s were able to reduce their household income to $113,250 which qualified them for a tax credit of approximately $90 per month or $1,080 per year!

Think this strategy won’t work for you? Check out a few other examples:

Age 40, single, living in Charleston County earning $36,000 can save $300 in premium by funding a Qualified Health Savings Account!

The savings are even bigger for South Carolina residents over 50! A 60 year earning $48,000 in 2016 would not qualify for tax credits, HOWEVER, a simple contribution of just $1000 into a Health Savings account could result in a $2,820 annual savings!

Sound too good to be true? It’s not! Check out the chart above to see income thresholds for tax credits.

Contributions to Health Savings Accounts reduce taxable income – and your taxable income (Modified Adjusted Gross Income, to be exact) is what the health insurance marketplace uses to determine your tax credit eligibility. This article from Forbes from 2011 discusses the basics of how people use HSA contributions to reduce taxable income.

With premiums increasing sharply for 2017, even more South Carolina residents will be eligible for tax credits – be sure you are saving as much money as possible – and be an educated consumer!

Have questions or want to schedule a consultation? Call us today at 843-882-7062, mention the SChealthconnector article and request an appointment with Josh. I will personally spend up to an hour per appointment, via screenshare, to explain your options and help complete your 2017 health insurance enrollment. And of course, as brokers, we are paid directly by the health insurer so our services are always free. You CANNOT be charged more for working with a broker!

 

 

 

 

SChealthconnector.org, American Eagle Insurance Agency and affiliates do not provide tax, legal or accounting advice. This material has been prepared for informational purposes only, and is not intended to provide, and should not be relied on for, tax, legal or accounting advice. You should consult your own tax, legal and accounting advisors before engaging in any transaction.

Privacy Policy

11 Oct , 2016,
jtdickerson
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This website is operated by SCHealthconnector.org and is not the Health Insurance Marketplace website. In offering this website, SCHealthconnector.org is required to comply with all applicable federal laws, including the standards established under 45 CFR 155.220(c) and (d) and standards established under 45 CFR 155.260 to protect the privacy and security of personally identifiable information. This website may not display all data on Qualified Health Plans being offered in your state through the Health Insurance Marketplace website. To see all available data on Qualified Health Plan options in your state, go to the Health Insurance Marketplace website at HealthCare.gov.

Breaking News: MUSC in network for marketplace plans!

4 Oct , 2016,
jtdickerson
one comments

Great news for South Carolina residents enrolled in a BlueCross Blueshield or Bluechoice marketplace health plan! According to an internal memo, and this article by the Charleston Post & Courier, BlueCross BlueShield of South Carolina (BCBS-SC) and the Medical University of South Carolina (MUSC) have reached an agreement to include MUSC in network effective October 1st, 2016.

2015 South Carolina ACA marketplace rates

Open enrollment for 2017 SC Health Plans begins November 1, 2016!

Per the release:

Medical University of South Carolina health services are now available to more BlueCross® BlueShield® of South Carolina members as the organizations reached agreement for participation in the health plan’s individual exchange and BlueChoice® HealthPlan Medicaid networks. The organizations have a longstanding contract for commercial members.
Specifically, the newly signed contracts are for Affordable Care Act (ACA) plan offerings (healthcare.gov exchange and private exchange) BlueEssentials and Blue Option, and BlueChoice HealthPlan Medicaid. The terms of the contracts became effective Oct. 1, 2016.

The agreement includes all MUSC facilities and providers, thus providing access to MUSC specialty services not found in other facilities throughout the state.

“We are pleased that MUSC Health and BlueCross were able to work together on an agreement that works for both organizations, but most importantly, keeps South Carolina’s citizens connected to the health care expertise they need to live better, healthier lives,” said Patrick J. Cawley, M.D., MUSC Health chief executive officer and MUSC vice president of Health Affairs.

Scott Graves, president of the BlueCross division, said, “We are pleased to add MUSC to our provider network. Increased access and greater choice adds value for our members.”

Credit to the MUSC Office Communications & Marketing for details!