Van Doggit

 I've written before about my love of babies (especially since they aren't mine) and what to do when you need to add your new bundle of joy to your health insurance.  It seems as though a lot of people I know have jumped on the baby-bandwagon these days.  What about if a couple is adopting a baby instead?  

This is actually the case for one of my best friends.  She and her husband  have made the decision to adopt their first child instead of having a biological child.  There is alot of information, classes, homestudies, etc. involved with adoption.  It's no surprise that it's easy to forget about adding the new child to your health insurance, whether it be through an employer group health plan or your own individual health insurance plan.  So...how does this work?

In the event of an adoption, your new dependent will be covered as of the date of the adoption or placement for adoption.  The addition must be made within 31 days of this event. The adoptino process can take a while for everything to be legal, but rest assured that you can your new family member effective the date of placement!

 Our health is important to us.  From the time we are babies our parents take us in for series of shots that are recommended for us.  When we got sick, they took us to the doctor and made sure we took our medicine, tucked us, rubbed our tummies and stayed by our side until we got better.  

As we age, the state of our health falls more and more into our own hands.  We make choices that affect our health and we also rely on our health insurance, whether that be with our group health insurance or our individual health insurance here in Nashille, Tennessee; Indianapolis, Indiana or anywhere in the country, to provide us benefits for health services. Prevention is the key.  Under your health insurance plan, you have a wide variety of preventive services that you may utilize and are encouraged to do so.  

Well, what about colonoscopies?  While this test is not as easy or comfortable as going in for your yearly flu shot it is very important!  I frequently get asked if this is something that insurance will cover and if so, how much?  The answer....is yes!  You do have benefits under your health insurance plan for a screening colonoscopy and even better...it's covered 100% when it's billed as a screening colonoscopy!!!  I'm sure  you are all excited about this wonderful news and are now eager to schedule your screening colonoscopy!!

Bernard Health is just like any health insurance broker, right? I can confidently say: Wrong!! Here's why:

Not only do we at Bernard Health help our clients with their group health insurance needs in Nashville, Tennesse; Indianapolis, Indiana; as well as individuals that are eligible for COBRA, looking for an individual health insurance plan,  Medicare beneficiaries seeking help with plan selections or individuals that have confusing medical bills here in Nashville, Tennessee; we also SUPPORT our clients as well.

As a member of the service team on the group health insurance side of Bernard Health, Sara Walton, DeAnna Lax and I dedicate ourselves daily to support the needs of our clients.  Not only can I just say this but our numbers prove it as well.  Thanks to our carefully created and tested system of tracking service related issues and follow ups for our groups, together,we have already support our clients over 2,000 times to date this year.  And just think...the year isn't even over yet!!!  

Questions about State Continuation come up quite a bit.  Ryan McCostlin has discussed it in his blog and I have also written about it as well.  

Health Insurance can be tricky.  There are rules and regulations that employer groups need to follow.  Some are required to be COBRA compliant while others are required to offer their former employees State Continuation.  We at Bernard Health are happy to answer all questions related!!  

Now, what happens if your former employee lives in a different state and you are required to offer them State Continuation?  The answer:  The State Continuation benefits you must offer will need to follow the guidelines of the State that your employee resides.  Let me give you an example:

1. You offer all of your employees a health insurance plan based in Tennessee.
2. Tennessee's State Continuation allows former employees to continue their benefits for an additional 3 months.
3. You have an employee that resides in Colorodo.  
4. Colorodo's State Continuation allows former employees to continue their benefits up to an additional 18 months.  
5. Because your employee resides in Colorodo, they may maintain their State Continuation benefits and remain on your plan for up to 18 months.

 Times are tough and it seems that saving money is on everyone's mind.  Employer groups here in Nashville, Tennessee; Indianapolis, Indiana; Louisville, Kentucky and all over the country are looking to save money on their group health plans.  Many of which are trusting Bernard Health to help them find the plan that best fits their needs.

Not only are our employers looking to save money, but employees are as well.  We find more and more that employees are crunching numbers and talking with their spouses to see what would be best for their families.  This includes health insurance as well.  

A common question that arises is whether or not an employee can drop their spouse from their group health plan if they acquire an individual policy.  The answer is Yes!!  And the answer is No.  Let me break it down:

1. You can drop your spouse off your group plan during open enrollment.  This is the one time a year that employees can make changes to their plan elections.  If you are planning on dropping your spouse, be sure that their individual policy is to be effective on your group plan's renewal date so they will not have any lapse in coverage.  
2. You cannot drop your spouse outside of your group plan's open enrollment. If your health insurance premiums are deducted from your check pre-tax, you cannot drop your spouse due to acquisition of an individual policy in the middle of the year.  This is not considered a qualifying event since this removal is considered voluntary.  In this case, you will have to wait until open enrollment to get your spouse set up with an individual policy and drop them from coverage.

If you are interested in looking into individual health insurance policies, your friends at the Bernard Health Retail Store (located at 720 Thompson Lane) here in Nasvhille, Tennessee will be more than happy to help!!  

Its that time of year again.  The days are getting shorter and the weather is getting cooler.  With this comes the buzz of flu season and getting your yearly vaccination.   

Last year, I discussed in a previous blog, how flu vaccinations work with individual health savings account based health plans.  Please take a look here for a friendly reminder of how these vaccinations work with your health plan!  


If ever you  have any questions, the team here at Bernard Health will be happy to help!! 

 I'm daddy's little girl.   It's no secret and I'm not afraid to say it.  In fact, I'm very much proud of that fact!My dad's employer recently switched over to a Health Savings Account based health plan for it's employer group health insurance plan. With this switch came a lot of questions and my dad knew just who to ask:  his little punkin pie...aka...me!!

One of the big questions he had was how much  he could contribute to his health savings account.  So, I told explained to  him that the maximum that could be contributed for family coverage for 2011 is $6,150.  This includes the $1,000 that his employer group contributes to their employee's health savings accounts.  Now, because my dad is over the age of 55 (sorry dad...) he can contribute an additional $1,000 a year as a catch-up contribution.  

In my line of work, I learn something new almost everyday.  While I have been dubbed "The Health Insurance Wikepedia" there's always room for improvement, to learn more and grow. Health insurance, whether it be individual insurance or group health insurance is ever changing. 

It was not too long ago, a very interesting question was brought to my attention:  "Is deportation a qualifying event?"  This required a bit of research on my part to find the answer.  Here is what I found:

Deportation is indeed a qualifying event to make changes to your health insurance elections.  Not only that, but if the dependent that was deported returns to the country, this is yet another qualifying event to make changes to plan elections.  

I found this to be very interesting and thought I would share the wealth when it comes to qualifying events!

Questions, questions, questions!!  That's what I answer everyday here at Bernard Health and I love it.   As I have mentioned before, I work with our group health insurance clients here in Nashville, Tennessee.  

Recently, one of our group health insurance clients asked me about coverage for hearing aids and if they fell under any covered benefits on their health plan.  As it turns out, hearing aids are actually exluded from this groups health plan.  

I did a little research and found that while hearing tests done at a preventive office visit are covered if billed as preventive to the insurance carrier, fittings and hearing aids themselves are not.  However, despite this there is good news!!!  Because this employer group implemented a Health Savings Account based health plan, members of this plan are able to use money in their Health Savings Accounts to pay for hearing aids if they wish.  It's always good to know that you can pay for things like that with tax-free money even though it does not count towards your health insurance deductible!

Major things in life happen.  Many of them happy: a birth of a baby or a marriage, maybe even adoption.  Then there are some that are sad: a death, a divorce, or a spouse losing their job.  Not only are these life changing events, but in the health insurance world, they are also qualifying events.  

When a qualifying event occurs, you as an employee may make changes to your employer sponsored health insurance plan.  This can occur at anytime during the year and you do not have to wait until your employer group's annual open enrollment.  

You may be thinking, "Thanks Amber, but what am I suppose to do if I have a life changing or qualifying event?"  Excellent question!!!  Here is the answer:

You will need to notify your employer or the human resource department of this event.  You will have 30 days to make your change.  For example:  I recently got married on April 27th of this year. Because marriage is a qualifying event, I had 30 days from the date of my marriage to make any changes to my group health insurance benefits in Tennessee.  If you do not make your changes within the 30 day window, you will have to wait until your employer's annual group health insurance open enrollment.  

Tests and surgery can be scary for anyone.  When it comes to health insurance, the main concern is, "Is it covered?"  This is definitely a major concern, but did you know that there is a little more to it than a procedure being covered by the health plan? 

When it comes to health insurance plans, the majority of surgeries and procedures require what is called Prior Authorization.  Basically, what this means, is that the doctor/hospital performing the procedure needs to contact the health insurance carrier prior and obtain authorization before the procedure is done.  These authorizations are put in place to protect the patient from unnecessary tests and procedures.  

When a doctor/hospital participates with a group health insurance plan in Tennessee, the contracted, or participating healthcare professionals MUST obtain a prior authorization.  If they do not, the claim will be denied and the doctor/hospital will have to eat the cost.  The patient will have no responsibility to pay the bill.  

However, when a surgery or procedure is done by a participating provider out-of-state and a prior authorization is not obtained, the patient will be responsible for the full charge.  

Providers do know that they need to obtain the authorizations.  You can ask your provider if they've obtained authorization and even ask for the authorization code or number to keep for your records.  If there is ever any question, feel free to ask!!!  

A few months ago, Ryan explained how to exercise your right to Tennessee State Continuation Benefits when you leave an employer that has fewer than 20 employees. We know that State Continuation lasts up to 3 months in Tennessee, but what happens in the event of pregnacy or divorce?  Do the same rules apply?  Yes and no.  The procedure to exercise your rights remain the same but there are a few differences.

Pregnancy:

• If a member (employee or dependent) is pregnant at the time her health coverage would otherwise terminate under the group health insurance plan (for any reason other than replacement of group coverage), she may continue health insurance coverage through such plan for a period up to 6 months after pregnancy ends. Coverage continuation will cease if the member:
  • Does not pay the premium
  • Becomes eligible for another group health plan (or)
  • Becomes entitled to Medicare

Divorce:

• In the state of Tennessee, the ex-spouse will be eligible for State Continuation of health insurance benefits on the date of divorce.
• If the former spouse chooses to enroll in State Continuation, he or she can remain on the health plan for up to 15 months.
• He or she will be responsible for paying the monthly premium to the employer for health coverage.
• Once the divorce is final, the spouse will be removed from the employee's group health insurance plan and enrolled in individual coverage.

If either of these situations applies to you, stop in to see the team at the Bernard Health retail store over on Thompson Lane here in Nashville, Tennessee.  A licensed, independent, non-commissioned health insurance advisor will be happy to sit down with you and go over your options to find the best means of continuing your health insurance coverage that is best for you.  

At Bernard Health, we are dedicated to helping our clients with their group health insurance plans, and we're committed to supporting their employees when it comes to using the health plan.  Not only are we dedicated to helping our clients, but we are also dedicated to helping each other internally.  

We have a very diverse and talented team, each bringing added value to Bernard Health.  While some members of our team are located here Nashville, Tenneessee at our retail store or world headquarters, we also have team members in Indianapolis, Indiana and Louisville, Kentucky.  Sometimes we don't have all the answers and need to lean on another team member for a little help.  This was the case just the other day.  

A few questions came up regarding pregnancy:  Is pregnancy a qualifying event? Can an expectant mother be added to a health plan as a dependent when she finds out about the pregnancy?  What about if she isn't married to the father? Qualifying events can be a bit tricky and this is something I deal with almost every day.  Because of this, my teammate asked me for my thoughts.  This was my response:

In regards to pregnancy and adding the expectant mother to the policy:

You work hard to make the money, and regardless of what your occupation is, you should be proud of your efforts and time.  If you're like most people who have group health insurance in Tennesee, open enrollment is coming up for your employer's group health plan, and it's time to make your yearly elections.  

For Bernard Health group health insurance clients, employee meetings are conducted so everyone at the company is aware of their benefits package.  Some companies contribute tax advantaged money each year into Health Savings Accounts for employees.  Did you know that you can contribute tax free dollars into your company HSA as well?  

You may be thinking, "That's great and all, but I need all the money I can take home out of my paycheck!  I can't have extra money taken out!"  That's an excellent point!  Let's stop and think about your possible situation for a minute:

1. You consider yourself a pretty healthy individual.  You maybe get a sick once a year but other than that you only see the doctor for your yearly physical.
2. Your doctor may be monitoring you for high cholesterol or perhaps a thyroid issue.
3. Because of this you take prescriptions every month.
4. You already know that $30 or $80 a month will be spent out of your paycheck for these medications.

Now let's think about this when it comes to contributing to your Health Savings Account (HSA):

1. You already know that you'll be spending money on medications each month.
2. Why not save money on taxes and put the money you are already spending into your HSA?  The savings can be quite significant!!
3. If you're in the 15% tax bracket, we're talking around 22% in tax savings!!!  That adds up!  
4. You're spending the money anyway, why not save on taxes?

While whether you contribute to your Health Savings Account is a personal decision, just like making your elections during open enrollment for your employer's group health insurance plan, I encourage everyone to stop and think about contributing to your HSA. The savings are right there, and you just have to be proactive about making them work for you! 

 

It's February and we are all hoping for some warm weather! While we long for warmer weather, I hate to admit but there is a downside: Allergies.  Growing up, I suffered from year-round allergies.  I never had a break from the running nose, itchy eyes, sinus pain; misery. 

When I moved to Nashville, Tennessee to work for Bernard Health, it wasn't until after I moved that I was told about the horrible allergens here.  Uh-oh!!  Thankfully, in my case, it appears that I have finally grown out of my miserable allergies and only feel the effects once in a while, rather than daily. It seems only fair.  My childhood was spent with a box of tissues by my side at all times.  Now in adulthood, I can actually go outside and breathe.

I realize this is not the case for everyone.  As a child I had to undergo allergy testing.  It certainly was not pleasant to have my back covered with allergens followed by being scratched with needle on every single drop of allergen placed on my back.  Not to mention the 12 injections of allergens I received in my forearm.  Although, unpleasant, I am very thankful I had this done.  Based on my test results (I was allergic to everything...even cardboard), my doctor was able to prescribe allergy shots, which I received every week for the next 7 years.  Completely worth it, in my opinion.

So, how does this work when it comes to a Health Savings Account based health insurance plan?  Excellent question! Let me break it down:

1. Allergy testing is subject to the deductible as with all other services that are not considered wellcare under a Health Savings Account based health insurance plan.  
2. Once the deductible is met, services are paid up to100% or whatever is stipulated by the coinsurance in the health plan design.
3. Testing is typically conducted in an allergist's office.  It is very rare that a physician will tell you what the cost of the office visit will be, but it will be subject to the deductible. 
4. If you're wondering what allergy testing may cost in your area, check out our partner healthcarebluebook.com.  If you have an HSA in Nashville, Tennessee, your allergy testing will likely cost around $12. 

If ever there is a question regarding the health benefits in your group health insurance plan or your individual health plan here in Nashville, up in Indianapolis, Indiana or where you may be, it never hurts to ask a question!  If you'd like help evaluating your options, you can visit our Bernard Health retail store at 720 Thompson Lane, next to Vanderbilt Health 100 Oaks.  It's your health and your health insurance benefits, and you are entitled to be informed.  

When it comes to group health insurance, whether it be here in Nashville, Tennessee; Indianapolis, Indiana; Louisville, Kentucky or wherever; some things never change.  One of those things is the monthly premium bill.  Another, employee terminations.  It's never pleasant when an employee leaves or is terminated, but it happens.  When it does happen, that employee needs to be removed from the group health plan.  

Now, what happens when an employee is terminated when it comes to the monthly premium bill?  Great question!!!  A few things can happen and it all depends on when the termination is processed:

1. Group Health Insurance bills are automatically generated each month.  Usually this happens in the middle of the month and sometimes, depending on the effective date of the plan, it happens at the end of the month.
2. If an employee is terminated and the health plan is notified before the bill automatically runs, the group will see a credit on their bill, depending on their policy for termination eligibility.  An example:  Eligibility is lost on the date of termination or eligibility is lost at the end of the month in which termination took place.
3. Terminations also occur after the monthly bill has generated.  This is where it gets confusing.
4. The employee will still be on the next months' bill since the health plan was not notified of the change until after the bill ran.

If I haven't confused you enough, you may be thinking, "Okay, Amber.  My terminated employee is on my bill...now what do I do?"  Well, I will be happy to tell you!


I know it may seem a little unfair to pay a bill that has a terminated employee, but trust me, it will all work out and the employer group will be credited.  As always, if there is any bit of confusion when the bill comes in, it never, ever hurts to ask a question.  

2011....WOW!!!  2010 was an incredible year, professionally and personally.  I definitely cannot complain.  

Bernard Health in Nashville, Tennessee and Indianapolis, Indiana had a great year!  We earned the trust of many new group health insurance clients, which allowed us to implement, service and renew their group health insurance plans.  I've truly enjoyed talking with with employees and answering their health insurance questions and can't wait for more!

I hope everyone had a wonderful and safe Thanksgiving weekend!!!  I went up to visit my family in Michigan for the holiday and it was great to see my family and friends.  It was funny on Thanksgiving day my uncles were asking me about Health Savings Account based health plans since their company is switching over to a full replacement at the end of the year.  What's even funnier, they work for an insurance company themselves!   

Wow, can't believe it's almost December already!  The end of the year is coming up quick!  I have to say that I am really looking forward to what 2011 will bring.  We've got great things going on at Bernard Health and on a personal note, it looks like I will be have a busy 2011 as well!!!!  

Bernard Health has clients all over the country, not just here in Nashville, Tennessee.  We help clients with their health insurance and health savings account based plans in many different states, coast to coast.  

Some of you may have seen Bernie, our beloved Saint Bernard mascot hanging out on the walking bridge before Titans games or perhaps outside our retail store at 720 Thompson Lane in Nashville, Tennessee.  Did you know that Bernie travels a bit as well?  Just this past weekend, Bernie took a quick trip to Myrtle Beach, South Carolina!  He was hanging out at the House of Blues and ended up on stage!!!  Check it out!