Insurance carriers change the drugs covered year to year, and it is important to know which are covered and which aren’t. All insurance carriers are required to provide a drug formulary (drug list) where you can find out just how a specific drug is covered by your insurance plan. We’ll give you the option to …
There are three elements to qualifying for COBRA benefits. COBRA establishes specific criteria for plans, qualified beneficiaries, and qualifying events: Plan Coverage – Group health plans for employers with 20 or more employees on more than 50 percent of its typical business days in the previous calendar year are subject to COBRA. Both full and part-time …
1095-A and 1095-B are tax forms that may be used to file your taxes concerning your health coverage. When applying for health insurance you were asked to estimate your income and based on that estimation you may have been offered a subsidy. Those who received a subsidy and got their plan from the marketplace will receive …
A drug formulary is a specific list of all prescriptions drugs covered by an insurance carrier. These lists vary from carrier to carrier and year to year, therefore what was covered last year or by a different carrier may not be covered this year or with this company. When receiving a new prescription it is …
COBRA stands for The Consolidated Omnibus Budget Reconciliation Act. COBRA gives workers and their families who lose their group health benefits the right to choose to continue the coverage provided by their group health plan for a limited period of time and under certain circumstances such as voluntary or involuntary job loss, reduction in the …
The Affordable Care Act allows young adults to stay on their parents’ health care plan until age 26. Before the President signed this landmark Act into law, many health plans and issuers could and did in fact remove young adults from their parents’ policies because of their age, leaving many college graduates and others with …
The Affordable Care Act mandates that person who can afford a health plan but chooses not to purchase one must pay a penalty known as the individual shared responsibility payment. You will owe the fee for any month that you and your dependents are without minimum essential coverage mandated by the ACA and is paid …
All newly purchased individual and small group policies are required to be ACA-compliant, regardless of whether they are sold on or off-exchange. This has been the case since January 1, 2014. (Employees may still enroll in existing small-group plans that were in effect before 2014, but if a small business purchases a new plan in …
If it’s a serious injury, heart attack, major burn or gunshot wound, it’s probably safe to say you should head straight to the nearest hospital’s emergency entrance. Some hospital systems are also starting to build stand-alone emergency centers. They act just like the hospital ER and cost the same, but are located in suburban areas. When …
An Explanation of Benefits (EOB) Statement is a notification provided to members when a healthcare benefits claim is processed by your insurance company. The EOB outlines the expenses submitted by the provider and shows how the claim was processed. In most cases, an EOB will be mailed to you after a claim has been finalized. …
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