Health Insurance in Tennessee

My name is Katie Cotnam (or just kt), and I'm Bernard Health's first retail store team member. Originally hailing from the beautiful city of Bend, Oregon (the West Coast is the best coast), I later moved to Montana to attend Carroll College -- a small, liberal arts school set in the valley town of Helena.

After graduation, I embarked on a 6-week solo road trip cross-country. I visited Nashville for the first time, stayed a week, fell in love with the city, drove back West, packed what would fit in my car, and moved to Tennessee. My wanderlust didn't end there, but after zigzagging the U.S. for the past few years -- I'm proud to once again call Nashville my home.

My own experience trying (unsuccessfully) to navigate the healthcare system eventually led me to Bernard Health. I believe in the work we do and feel passionately about helping people make better, more informed choices about their healthcare.

Bernard Health aims to be the world's most trusted advisor when it comes to helping people plan for expected and unexpected healthcare expenses. I'm excited to help achieve this goal. We'll do the legwork, all you have to do is stop in and see us!

Yesterday I met with a woman at the Bernard Health store in Nashville, Tennesee (let's call her Sally). Sally's husband recently left his job with his previous employer, through which his family was insured,  to start his own business. A couple weeks later, Sally received a packet in the mail detailing her family's option to continue receiving their health insurance benefits through COBRA. COBRA provides certain former employees, retirees, spouses, former spouses, and dependent children the right to temporary continuation of health insurance coverage at group health insurance rates. This coverage, however, is only available when coverage is lost due to certain events (e.g. leaving a job), and for a specific amount of time (in this situation, 18 months).

For Sally, the coverage was not the issue -- the issue was the high price of the monthly health insurance premiums. Sally was used to paying only a portion of what she was now being charged due to the fact that her husband's former employer was fitting the rest of the bill. Through COBRA, the premiums for the same health insurance plan would now be closer to 102 percent of the total cost.  Furthermore, there is no longer an employer paying part of the premiums.

That being said, Sally wanted Bernard Health's help in evaluating alternatives -- her family was healthy and she simply felt that they could do better. In fact, after running a complete analysis Sally and her family were able to enroll in a health savings account (HSA) based plan with almost identical out of pocket maximums for nearly $700 per month in savings.
Without sacrificing coverage or increasing her family's financial exposure -- Sally was able to save $8,240/ year.

If you or someone you know recently lost employer sponsored group coverage -- it may be in your best interst to evaluate your healthcare options. Whether you want to replace your COBRA health insurance plan before the coverage expires, or you want help figuring out what to do once it has -- we can help. The first consultation is free and we're always happy to answer questions. It just might save you a small fortune.

Retired healthcare executive Richard Cherrin recently said the Delaware needs a "dramatic, bold, paradigm shift" in the way it provides healthcare to its poorest residents -- those on Medicaid. In a plan laid out during a meeting of the Commission on Medicaid Cost/ Health Care Containment, which he chairs, Cherrin urged moving to "consumer-driven" health savings accounts (HSAs) for Medicaid recipients.

According to the , "state officials are looking for some way to escape the unsustainable trend that now has about 25 percent of Delawareans enrolled in Medicaid, thousands more expected in the next year and the cost of that care tipping toward $1.5 billion for fiscal year 2012."

Cherrin goes on to point out that the average cost of Medicaid, in federal and state money, is approx. $7K per person in his state - and if alternative medical insurance options were available, such as HSAs, that incentivize having something left over each year -- money would be used more efficiently. 

It's too soon to tell just what's in store for Delaware, or whether Health Savings Accounts will part of the plan or not. The commission has a December 15 deadline to submit its recommendations to the governor and legislators -- they'll meet again Nov. 30th.

I ran across an interesting article this afternoon entitled, Traditional Plans Losing Traction, the overall gist is that more and more individuals are moving away from traditional, copay based health insurance plans, and alternatively enrolling in consumer-driven Health Savings Account based health insurance plans .

Notably, in Indianapolis, Indiana, more than 20,000 state employees have signed on to this type of health insurance plan. It goes on to say, "state officials expect the number to rise further..."

A consumer-driven health plan that works in conjunction with a Health Savings Account (HSA), saves money in premiums while also allowing employees to contribute to the account out of their paychecks before taxes. Employees can use the company HSA to offset the costs for healthcare before their annual deductible is met. "Health savings accounts empower employees to make decisions over their health care. They can choose their doctors, shop for good prices, and question whether procedures are need", says Indiana Gov. Mitch Daniels.

As more and more employers are offering different types of health plans to choose from during annual open enrollment, individuals can become easily overwhelmed with their options.  If you'd like help evaluation the best healthcare strategy for you and your family or would just like to learn more about consumer-driven health plans -- give us a call or check us out online.

I ran across an article this afternoon in the New York Times regarding higher health premiums for employees. The bottom line, more and more companies will push healthcare cost onto their workers as overall costs continue to increase.

According to a new annual study by Aon Hewitt, a large Chicago benefits consultancy -- employees may see health inurance premium increases as high as 11%. That's on top of what had been previously deducted from their paychecks to cover medical insurance premiums.

"The reality is that employers, particularly in this economy, are doing everything they can to get net company levels that they can budget for and afford" -- "Employers are shifting costs to employees to be able to afford to offer benefits", said Jim Winkler, of Aon Hewitt.

One reason noted is that employment trends have left many young adults unemployed, that means fewer healthy workers are paying health insurance premiums while older employees tend to have higher healthcare utilization costs. Mr. Winkler points out, "Companies are not hiring 22-year olds who are healthy to offset the costs of the 58-year-old with diabetes and heart disease".

This data comes from a database of approx. 350 large American employers that spend over $53 billion annually on health insurance benefits -- insuring close to 14.4 million employees and their dependents.

Does this mean that dropping your group coverage and enrolling in a individual health insurance plan to cover you and your family? -- maybe, yes. In some cases, especially if you work for a small employer with an aging employee population, it may be possible for you pay less for individual insurance. For help evaluation your options --  give us a call.

Here at Bernard Health, we're all for Health Savings Account eligible health insurance plans. We love them because they make sense -- not for everybody, but for many, many individuals.

HSAs (health savings accounts) offer lower health insurance premiums when compared to traditional, co-pay based health insurance plans.  They offer flexibility, they reward price shopping, and they offer tax-advantages.  When paired with a a health insurance plan, the result is a consumer-driven health plan, which gives the consumer more direct responsibility for health spending.

Bernard isn't alone is singing the praise of HSAs -- the Kaiser Family Foundation's recent survey of the employer health insurance market found that plans with high deductibles and savings options (HSAs) have been gaining market share rapidly.

• In 2006, only 1-in-25 enrolls were in such a plan
• Today, it's more like 1-in-6

At the end of the day, more and more individuals want a say in the way their money is spent and when it comes to health insurance -- consumer driven health plans offer just that.

I was recently connected with a dad here in Nashville who was looking to reevaluate both his insurance plan and those of his college aged children. First and foremost, he felt he was simply paying too much in premiums. Secondly, he wanted to better understand both his and the kids' policy benefits.

The first thing that struck me during our initial meeting was that everybody had separate policies. At the end of the day, their out-of-pocket maximum totaled $15,000. Knowing that a family policy would drop that out-of-pocket maximum by $5,000 -- the next question became, can we get everybody on to the same plan?

As both kids were under 26 and still attending college, there was no reason that they could not join their dad's plan. The next step was for me to run an analysis and compare quotes.

As it turned out, by first moving the dad's health insurance plan to a health savings account eligible policy -- he was able to save approx.  $150/ month. The next step was to transfer the individual policies held by the kids to their dad's new HSA policy.

At the end of the day, the family was covered by the same health savings account eligible policy.

This:

• Saved them approx. $5,000 a year in premiums
• Decrease their out-of-pocket maximum by $5,000
• And, reduced their taxable income by $6,150 through the use of the health savings account

So, if you or someone you know wants help reevaluating your current health insurance strategy -- give us a call!

Last week I met with a woman who was turning 65. She came to Bernard Health because she didn't know what to do about her health insurance. She wanted to continue working, liked her current group health insurance plan -- but was under the impression that she had to enroll in Medicare Part A and B because her birthday was right around the corner.

It was a good thing that she came in. As it turns out, as long as an individual or their spouse continues working over the age of 65 -- they can continue having their health insurance coverage through their employer without having to pay a late enrollment penalty for Part B, if they choose to enroll in Medicare at a later date.

In this specific situation, her monthly premiums for her group insurance were less than she would have to pay for Medicare Part B. In addition, she had a health savings account eligible insurance plan that her employer was contributing to on a regular basis. Upon enrollment in Medicare A and B, neither employer or employees can continue to contribute to a health savings account.

Had she not come and simply enrolled in Medicare -- she would have increase her monthly premium costs by almost $116 per month and lost her employer contributions to her HSA. In this situation, MediGuidance was the perfect solution.

I've been asked, by more than one client, with all the constant changes to new healthcare reform -- "will  health savings accounts (HSAs) go away?".  Of course, I can't predict the future, but with the constant healthcare battle being fought in Washington, it's difficult to know what's staying, what's going and really what's even going on.

That being said, Nick Calabrese, VP of CDHP (Consumer-Driven Health Plan) product management at CIGNA Corp. was recently quoted saying, "Unless there's a significant change in any of the legislation, CDHPs (of which HSAs are an example) will remain a viable option post-health care reform. --If you rewind the clock back to before health care reform, there was a concern on our end whether they would be eliminated. But, by and large, they were left untouched".

In fact, enrollment in Consumer-Driven Health Plans like Health Saving Accounts (HSA) is on the rise. According to Anna Turner, product manager at Benefitfocus in Charleston, S.C., "With reform, there's a lot of concern that premiums are going to be increasing as a result of the new benefit requirements. This is continuing to drive the existing momentum".

The bottom-line is that CDHPs like Health Savings Accounts solve a lot the problems we're currently seeing in the insurance world -- they offer lower premiums, more flexibility, rewards for price shopping, and tax-advantages. For now at least, they are here to stay.

This past Monday, the Obama administration issued new health insurance standards that will require health plans for cover all government-approved contraceptives for women, without co-pays or other charges.

To join the already set requirements for guaranteed free coverage for preventive care (ex., annual physicals, well-woman exams, well-child exams, etc.), these new health insurance standards will include breast pumps for nursing mothers, screening for the virus that causes cervical cancer and for diabetes during pregnancy, and counseling on domestic violence -- just to name a few.

Health and Human Services Secretary Kathleen Sebelius acted after a near-unanimous recommendation last month from a panel of experts convened by the Institute of Medicine, which advises the government. Sebelius was quoted saying, "These historic guidelines are based on science and existing literature and will help ensure women get the preventive health benefits they need".

Don't expect any changes just yet, these new standards aren't set to take effect until January 2013 for health insurance plans that operate on the basis of a calendar year. More information on the services to be covered can be found here.

A former Bernard Health client recently asked the question, "What happens to my family health insurance policy after my wife and I get a divorce?" After a little research, I learned that when it comes to individual health insurance, family polices can only include the following combinations of policy holders: married couples, married couples with children, or single parents/ legal guardians with children. That being said, once a couple becomes legally divorced they have 30 days to divide the policy without going back through medical underwriting.

There are certain life changes aka "qualifying events" that allow individuals to make health insurance changes without reapplying or going through the medical underwriting process. Some examples of "qualifying events" include:

• Change in legal marital status, including marriage, death of a spouse, divorce, legal separation and annulment
• Change in the number of dependents, including birth, death, and adoption
• Change in employment status
• A dependent ceasing to satisfy eligibility requirements, including age, student status, etc.

In the case of divorce, the family policy can be divided simply by notifying the insurance company and in some cases filling out a change form. If the divorce is set to happen in the future, but has not legally occurred -- the policy can be split as early as the following month. However, if the divorce has already happened the division of the policy must occur within 30 days of the event. Proof of divorce decree may be required as well. 

If you or someone you know is going through a life change, be it divorce, marriage, child birth, or career change, it would be in their best interest to contact their insurance carrier sooner than later. Of course, you can always call Bernard Health and we'll help you through the entire process and make sure you have the right policy to begin with!

Upon turing 65, most individuals enroll in both Medicare Part A and Medicare Part B benefits. If you started receiving Social Security Benefits early, or enroll online, by phone, or at your local Social Security office -- you will automatically be enrolled in Part A and B with an effective date the 1st day of the month you were born.

Example:
You've been receiving your Social Security benefits since age 62.5 and are turning 65 August 8 of this year. If you do not do anything, you should receive a Medicare card in the mail with a Part A and Part effective date of 8/1/2011.

In most cases, there is nothing wrong with enrolling in A and B -- however, for some individuals, delaying Medicare B would be beneficial. If you are insured through you or your spouse's employer because you or your spouse plans to continuing working past the age of 65 -- having Part B may be unnecessary. In most cases, you can save at least $115.40 per month in Part B premiums by opting out. When the time comes that you or your spouse decides to retire, you can opt back in/ enroll in Part B without facing late enrollment penalties.

The best thing you can do to determine what your best healthcare strategy is upon turning 65 is make an appointment with one of Bernard Health's licensed, non-commissioned advisors. Medicare open enrollment is right around the corner and if you have Medicare questions, want to evaluate your Medicare insurance options, or just want to better understand your current individual or group insurance benefits -- so give us a call today!

If you have the kind of health insurance plan that allows you to open a health savings account, you probably already know how much you're allowed to contribute -- tax-free,  every year. In 2011, individual account holders are allowed to contribute up to $3,050 to their individual HSA to help pay for eligible medical expenses.  Families can contribute up to $6,150. This is all pretty straight forward unless your situation changes mid-year.

The other day, I was working with a woman named Carrie whose son recently got a new job that offered group health insurance coverage in Tennessee. Up to this point, Carrie had been fully funding the family's health savings account at $6,150 -- but after August she becomes the only person on the plan.  Her husband is enrolling in Medicare, and her son is turning 27. Therefore, her maximum contribution amount drops to $3,050. So how much can Carrie contribute and therefore write off her taxes for the year 2011?

The answer is pretty simple -- you pro-rate for the number of months you have each type of plan like so....

1. 7/12 x $6,150 = $3,587.50
   a. 7/12 = January through August

2. 5/12 x $3,050 = $1,270.80
   b. 5/12 = August through December

3. $3,587.50 + $1,270.80 = $4,858.30

Therefore in this specific situation, Carrie can contribute as much as $4,858.30 to her health savings account. So if you have  regarding benefits, contributions, medical bills or you simply want someone to explain your current policy to you -- Bernard Health can help. 

A few weeks ago I had a meeting with a client, we'll call her Lynn. She was young, happy, healthy, and completely certain that I wasn't going to be able to help her. Lynn is 29, has a full-time job and owns her own home, but had been uninsured for almost a decade because someone once scared her into believing she was uninsurable -- putting her entire financial future at risk.

After meeting with Lynn and learning more about her medical history, I was shocked that she had been told "not to bother" and that even if she applied "she'd never be covered".  Just like most people, she was occasionally sick, but no where close to uninsurable. The fact of the matter is that with a new federal plan called the Pre-existing Condition Insurance Plan, everyone is insurable -- one way or another.

In the end, Bernard Health signed Lynn up for a health savings account (HSA). Not only was she accepted by the insurance company without any restrictions on her coverage, but we found her the best benefits in Nashville for a price well below what she expected to pay.

So if you have ever been told "not to bother" or that you are simply "uninsurable", Bernard Health can . When it comes to medical insurance options, there's a lot of misinformation out there.  Bernard is here to answer your questions whether they be about individual HSA's, medical insurance,  COBRA, Medicare, or medical bills.

If you missed the story on Yahoo -- that's OK, I'll fill you in. Last week Bernard Health officially announced our expansion into Kentucky! This means not only will Bernard continue to serve employers in Tennessee and Indiana -- but through out Kentucky too.

The talented Tony Holland, formerly of Holland Income Tax, has joined our team and is leading the charge in Louisville. He'll be working to help Kentucky employers save up to 40% on their health insurance plans through the use of health savings accounts.

Company wide, Bernard Health has a proven track record -- producing an average first-year Health Savings Account voluntary enrollment rate of over 80%. This is in comparison to the industry average of approximately 7%. So if you have questions about group insurance in Kentucky and want to learn more about health savings accounts -- Tony's your guy!

Welcome to the team Tony, Kentucky is lucky to have you!

I recently had a family come into the Bernard Health store with a tough situation.  Their 2 year old son, Jake, had been on TennCare (Tennessee's version of Medicaid) essentially since birth, but the family recently received a letter saying his health insurance through TennCare was being canceled.

Jake was born with Down syndrome, and when he was born, hospital staff recommended to his parents that they enroll Jake in TennCare, even though at the time he and his family had group health insurance coverage through Jake's dad's employer. At that point, Jake's diagnosis was enough to qualify him for TennCare coverage at no cost to his parents. The rest of the family continued to be covered by Jake's dad's group health plan.

Now Jake and his parents had options, but with every option came pros and cons:

• Enroll Jake in the family's current group plan -- the entire group could incur higher premiums in the future due to increased utilization of the healthcare.
• Enroll Jake in a Guaranteed Issue Policy -- have high premiums, high out-of-pocket costs, no prescription coverage.
• Enroll Jake in CoverKids -- rates were affordable, but this required that Jake go uninsured for 90 days before he could qualify for coverage.
• Enroll Jake in the federal government's Pre-Existing Condition Plan -- this was a good option as well, if not for the fact that Jake would have had to have gone uninsured for 6 months before qualifying for coverage. 
• Enroll in an individual policy - Since private child-only policies are no longer available in Tennessee, this option would require one of Jake's parents to drop his/her group health insurance coverage and apply along with Jake.  Because of Jake's pre-existing condigion, premiums would be 300% higher. 

Through Bernard Health's product InsurAdvise, Jake and his parent's didn't have to make this choice alone or without all the facts. After running a thorough analysis and presenting all the different options available to Jake -- we were able to come up with a solution that best fit their specific needs.

If you find yourself in a similar situation -- where making the right choice is important to you and yours, give us a call and let us help. When it comes to health insurance, Medicare, and understanding medical bills -- sometimes it's just too complicated to go at it alone.

This past Wednesday marked the one year anniversary of the landmark Affordable Care Act. A year ago, the president called the legislation's passage "a testament to the historic leadership -- and uncommon courage -- of the men and women of the United States Congress". For those pro-overhaul, it's a celebration, for others a thorn in the side.

No matter how you've felt about all the changes that have come to individual health insurance, Medicare, health savings accounts, and health insurance carrier regulations through the passing of this act -- there were chances to voice opinions on both sides. One example included a donut hole bake sale in Colorado in response to the help seniors received in paying for prescription drugs. In fact, supporters this week had scheduled so many events they had to create a entire spreadsheet to keep it all straight.

On the other-hand, one pro-repeal group created their own version of NCAA basketball tournament bracket's of problems caused by the law. Their "Sorry Sixteen" included the requirement for most Americans to have health insurance starting in 2014.

All I have to say about the Affordable Care Act's first birthday is that it's been an one heck of a year. Oh, and Happy Birthday!

One of the big changes that came out of the new Healthcare Reform has to do with kids. Due to these new laws, children under the age of 19 can no longer be declined or ridered when on a parent's health insurance plan -- they can however be rated up and in some cases that can be as much as 300%.

The good news is obvious -- all children are now insurable. The bad news is that their health insurance options may still be limited due to high premiums and unfortunately, a general lack of knowledge. Most parents simply don't know that there are options. In fact, health-policy experts predicted that the new insurance pools for high-risk patients would attract so many expensive enrollees that funding would be quickly exhausted. The reality, enrollment is low -- we're currently running at just 6% of expectation.

Outside of under-utilization, another unintended consequence of the new Healthcare Reform Law is that the provision to prevent insurers from denying coverage to children with pre-existing health conditions prompted carriers all over the country to stop selling child-only policies altogether.

So, what about the kids? Even though most parents have never heard of these plans -- but there are options.

1. Pre-Existing Condition Insurance Plan (PCIP):
This plan makes health insurance available to people (including children) who have had a problem getting insurance due to a pre-existing condition. PCIP covers a broad range of health benefits, including primary and specialty care, hospital care, and prescription drugs. It doesn't charge higher premiums based on medical conditions and does not base eligibility on income.

2. Guaranteed Issue (GI):
If you or your child has lost health coverage through TennCare, your employer is dropping its employee medical insurance plan, you've changed jobs and your new company does not offer health insurance, you're are about to exhaust your COBRA coverage or your job has been transferred overseas and you have a child with a pre-existing condition -- a GI might be the right fit. This type of plan might be available without a waiting period for pre-existing condition or a benefit exclusion rider.

3. CoverKids:
CoverKids provides free, comprehensive health coverage for qualifying Tennessee children 19 or young.

4. TennCare:
TennCare is the State of Tennessee's Medicaid program that provides health insurance options for 1.2 million Tennesseans. The State of Tennessee and the federal government share the cost of providing healthcare for those who qualify.

When it comes to keeping kids healthy, parents have options. All four choices listed have different eligibility requirements and vary in price and coverage -- simply put, when it comes to finding medical insurance in Tennessee, nothing is one size fits all. If you have a child with a pre-existing condition that has been without insurance for any reason, you can contact a licensed, independent, and non-comissioned health insurance advisor at Bernard Health by calling 615-528-3399. 

I just read a pretty refreshing article entitled, For A Price, The Doctor Will See You Anytime. The basic gist of this article is this: bypass the health insurance system entirely and not only will you save money, you'll get healthier patients.

Apparently, a growing number of primary care physicians have decided that by working around health insurance as we know it, doctors can save money on administrative overhead and spend more time with fewer patients by changing the way they do business. The idea -- charge patients by the month.

I ran across an article recently that gave readers tips for shopping for health insurance after healthcare reform.  Seven tips were given to help health insurance shoppers today, and tip #5 "Take another look at HSAs if you want a good deal".  Pretty interesting, right!? That's what we at Bernard Health have been saying since 2006.

HSA eligible health plans often have lower monthly premiums than the traditional, copay based plans most people are used to.  With new healthcare reform legislation, all individual or family health insurance plans, including HSA-eligible plans, are required to provide coverage for an array of preventive care for medical services at no out-of-pocket cost to you. It's a win-win. You keep your HSA dollars for other, more costly medical services and you save money in premiums to fund that account.

If you want to learn more about money saving insurance options like Health Savings Accounts, call us at 615.528.3399 to set up an appointment. We promise to save you time, you'll leave with peace of mind, and more likely than not -- we'll save you money.