You helped our daughter, Rebecca, find health insurance. We went to Europe and wanted to be sure she got what she needed, so we suggested she contact you. Thanks for doing a great job – again! – Emily K.

What is Telehealth, Tele-Medicine, Virtual Medicine? It is a service offered by the insurance carriers that became available on January 1 2016.

Brian and Kayla walk you through how a groups policy is renewed here at ComPro.

With all of the tools available online, it may seem like you can handle health insurance on your own. So, why should you use a health insurance agent?

Brian, I need some advice. My drywall business is losing employees to the competition because they offer employee benefits and I don’t. I’ve got to fix this. Can you find something that I can afford?

Health insurance is the most requested employee benefit, and a quality plan can help retain & attract good employees. That said, it can be an expensive undertaking for a business. With our experience and knowledge we can design a plan that offers valuable benefits to your employees while maintaining affordability for the employer. Don’t continue to lose good employees because you think you can’t afford health insurance!

This is a growing issue with the low unemployment rate that Nebraska is currently experiencing.

Kayla, I’m confused. Are the Summary Plan Description and the Summary of Benefits of Coverage the same thing? What are the requirements for an employer?

A Summary Plan Description (SPD) and Summary of Benefits of Coverage (SBC) are different documents required by the ACA. The SBC is a document intended to help people understand their health coverage and compare plans. The SBC must be provided to all eligible employees. The SPD is the main vehicle for an employer to communicate plan rights and obligations to participants and beneficiaries. The SPD must be provided to all enrolled employees.

Kayla, one of our employees has a big problem. The insurance plan is NOT paying for her ambulance fees because it is out-of-network. Can you help?

An out-of-network provider has the right to charge you the full-billed amount instead of accepting the discounted rate that in-network providers accept. However, we will negotiate with the ambulance provider and ask them to accept a lesser amount than the full charge, even accepting payment for the in-network rate as payment in full. Give us a call and we will help you through this process.

Brian, I’m expanding my business to a new state and will have salespeople based there. How will their health insurance be handled?

Typically your plan will extend to employees in other states using a wrap around network. Provider networks are usually reginal but the wrap around network can provide nationwide coverage. Check your ID card for network information or call Kayla. Your Plan may offer a national or regional network.

I went to my doctor’s appointment and I need to pick up a new prescription but I don’t have my new insurance card, what do I do?

This is not an unusual situation for doctors offices and pharmacies to deal with at the beginning of the year. Call ComPro we will help you get the information that is necessary for you to go ahead and get your medical services taken care of.

My health plan includes benefits for Pediatric Dental so I should cancel my children off of my employer’s dental insurance policy?

Closely check into the benefits for your health plan’s Pediatric Dental coverage before you cancel the dental insurance. Most health plans don’t cover any pediatric dental benefits until the health plan’s medical deductible is met. You will likely get much better benefits through the dental insurance policy, at least until you meet the deductible on your health insurance.

Is it better for me to keep my pre-ACA plan than switch to a plan that complies with the ACA?

ACA plans are not always more expensive.  Even though they include benefits like maternity coverage and pediatric dental, those plan designs and rates should be considered.  The ACA compliant plans can be less expensive for groups that have an older population or high claims experience.

Can our new employee keep their current individual policy instead of going on our group health plan?

The employee can keep their individual policy but there may be consequences depending on the policy type.  If the employee receives premium tax credits and the group policy meets the affordability test they are no longer eligible to receive the premium tax credits and will be responsible for the full premium amount of the individual policy.  If the employee does not receive premium tax credits they are free to keep the existing policy without negative consequence.

Instead of providing group health insurance can I just pay for my employee’s individual policies?

Under IRS Notice 2013-54 these arrangements are considered an employer payment plan and do not satisfy the reforms under the ACA.  Such arrangement can subject the employer to an excise tax of $100 per employee per day.   The IRS issued Notice 2015-17which provided transitional relief from the penalties, through June 30, 2015, for small employers that had continued to offer such plans.  With the expiration of the transitional relief the penalties are now in effect.  Please refer to your tax preparer for additional information.

My child just got married, so do I need to remove her from my health insurance at work?

Children can stay on their parent’s policy through age 26 regardless of school status, marriage, employment status or financial dependence on parents.

Are there any first dollar benefits on my high deductible health plan?

All policies include first dollar Preventive Care benefits, which means FREE to you. As long as the visit is billed as Preventive by the physician’s office and falls within the approved category you will have no charge.

I’m currently on my wife’s plan but their premium is going up significantly next month.  Can I join my employer’s plan now?

An increase in premium is not a qualifying event.  That employee will have to wait for Open Enrollment.

Compensation Programs Inc.