Monday, March 1, 2010

A New and Unique Insurance Policy For Those Between The Ages of 60 to 64

WPS Bridge65 is designed for people ages 60 to 64, who need health insurance but are not yet eligible for Medicare. The WPS Bridge65 plan includes most of the options available on WPS Individual Preferred and Individual HSA plans, with an important difference: WPS Bridge65 lets you "lock" your rate until age 65.

One Fixed Rate for Up to 5 Years
The WPS Bridge65 rate guarantee helps you more accurately plan for the future. Once you enroll, your monthly premium is guaranteed not to change for up to 5 years, so there's no need to worry about unexpected rate increases.*

Customize Your Plan and Save for the Future
Like our other individual health insurance plans, WPS Bridge65 offers a range of coinsurance and deductible levels, as well as prescription drug options, so that you can build a plan that is right for you. The WPS Bridge65 HSA-qualified plan allows you to save for current and future medical expenses in a tax-free health savings account (HSA). Then, when you become eligible for Medicare, you can even use your HSA balance to pay your Medicare Part B and D premiums.

Do I Qualify?
  • If you are between the ages of 60 and 64, are a U.S. Citizen or resident legal alien, and a Wisconsin resident, you can apply for WPS Bridge65.
  • WPS Bridge65 is an individual health insurance plan. If you are married and your spouse also qualifies for WPS Bridge65, he or she can enroll in WPS Bridge65 on a separate policy.

*Unless you make a benefit change, your eligibility changes, you add/remove dependents, change your address, state and/or federal health insurance mandates require WPS to change your benefits, or WPS discontinues the plan.


For more information regarding a WPS Bridge65 insurance policy please feel free to contact us at (262) 893-3668 or (608) 301-5609 or visit our agency website at http://www.roberthuntinsurance.com

Thursday, February 25, 2010

Medicare Recipients: Beware of Scam Artists Selling Medicare Prescription Drug Coverage

Here are some tips to avoid becoming the victim of a scam artist:

  • Beware of door-to-door salesmen. Agents cannot solicit business at your home without an appointment. Do not let them into your home.
  • Check with your state's insurance department (available through http://www.naic.org/state_web_map.htm) to make sure the salesman is licensed as an agent.
  • Do not give out personal information, such as Social Security, bank account numbers or credit card numbers to anyone you have not verified is a licensed agent. People are not allowed to request such personal information in their marketing activities and cannot ask for payment over the internet.* They must send you a bill. Once you decide to purchase a plan and have verified that the agent is licensed, you may give the agent personal information to assist in enrollment and billing.
  • Verify that the plan is an approved Medicare plan. All of the approved plans are available at http://www.medicare.gov or you can call 1-800-MEDICARE.
  • If you suspect fraud, call the U.S. Department of Health and Human Services Inspector General at 1-800-HHS-TIPS.
  • Contact your local State Health Insurance Assistance Program (contact information available through http://www.medicare.gov/contacts/static/allStateContacts.asp) if you have any questions at all.

To avoid being a victim, verify before you buy.

* If you sign-up for a plan through the Medicare.gov website, you will need to provide your Medicare number.


Friday, February 19, 2010

Michelle's Law Now Applies to Self-Funded Plans

A new federal law, known as Michelle's Law, recently went into effect. This law prohibits a group health plan from terminating a college student's health coverage on the basis of the child taking a medically necessary leave of absence from school or changing to a part-time status.

The leave of absence or reduction in hours must be medically necessary and must beginwhile the student is sufering from a serious illness or injury and would otherwise lose coverage under the plan.

Other requirements exist in order for this provision to apply. The student must have been enrolled in the group plan before the first day of the leave. There must also be a written certification by the student's doctor indicating that the student is suffering from a serious illness or injury that requires the leave or change in enrollment status. The coverage under Michelle's Law must be extended for at least one year; however, coverage may end earlier for certain reasons, such as the student aging out of the plan.

Several states have also passed similar laws. Wisconsin has had its own version of Michelle's Law since Wisconsin Act 36 was signed by Governor Jim Doyle in November of 2007. While both laws offered similar language, Wisconsin Act 36 did not cover self-funded employer health plans, also known as ERISA plans, because of preemption by federal law. Enactment of Michelle's Law at the federal level extends this coverage to those ERISA plans.

The new federal law will take effect at renewal time for groups renewing January 1 and later.

Thursday, February 18, 2010

Health Insurance Reform and Wisconsin: The Case for Change

The health care status quo is not an option for our states. If we do nothing, by 2019 the number of uninsured people will grow by more than 30% in 29 states and by at least 10% in every state. The amount of uncompensated care provided will more than double in 45 states. Businesses in 27 states will see their premiums more than double. And fewer people will have coverage through an employer. The time for health insurance reform is now.

Under reform in Wisconsin:

  • 541,000 residents who do not currently have insurance and 320,000 residents who have nongroup insurance could get affordable coverage through the health insurance exchange.
  • 358,000 residents could qualify for premium tax credits to help them purchase health coverage.
  • 871,000 seniors would receive free preventive services.
  • 155,000 seniors would have their brand-name drug costs in the Medicare Part D "doughnut hole" halved.
  • 77,400 small businesses could be helped by a small business tax credit to make premiums more affordable.

Health Insurance Reform Provides Early Relief and Health Security

Proposals implemented in 2010 and 2011 will produce real benefits for:

  • Families: The 5.6 million residents of Wisconsin will benefit as reform:
  1. Ensures consumer protections in the insurance market. Insurance companies will no longer be able to place lifetime limits on the coverage they provide, use of annual limits will be restricted, and they will not be able to arbitrarily drop coverage.
  2. Creates immediate options for people who can't get insurance today. 7% of people in Wisconsin have diabetes, and 26% have high blood pressure - two conditions that insurance companies could use as a reason to deny health insurance coverage. Reform will establish a high-risk pool to enable people who cannot get insurance today to find an affordable plan.
  3. Ensures free preventive services. 33% of Wisconsin residents have not had a colorectal cancer screening, and 21% of women over 50 have not had a mammogram in the past two years. Health insurance reform will insure that people can access preventive services for free through their health plans. It will also invest in a prevention and public health fund to encourage prevention and wellness programs.

Supports health coverage for early retiress. An estimated 71,600 people from Wisconsin have early retiree coverage through their former employers, but early retiree coverage has eroded over time. A reinsurance program would stabilize early retiree coverage and provide premium relief to both early retirees and the workers in the firms that provide their health benefits. This could save families up to $1,200 on premiums.

  • Seniors: Wisconsin's 871,000 Medicare beneficiaries will benefit as reform:
  1. Lowers premiums by reducing Medicare's overpayments to private health plans. All Medicare beneficiaries pay the price of excessive overpayments through higher premiums ~ even the 74% of seniors in Wisconsin who are not enrolled in a Medicare Advantage plan. A typical couple in traditional Medicare will pay nearly $90 in additional Medicare premiums next year to subsidize these private plans. Health insurance reform clamps down on these excessive payments.
  2. Reduces prescription drug spending. Roughly 155,000 Medicare beneficiaries in Wisconsin hit the "doughnut hole," or gap in Medicare Part D drug coverage that can cost some seniors an average of $4,080 per year. Reform legislation will provide a 50% discount for brand-name drugs in this coverage gap.
  3. Covers free preventive services. Currently, seniors in Medicare must pay part of the cost of many preventive services on their own. For a colonoscopy that costs $692, this means that a senior must pay $162.10 ~ a price that can prohibitively expensive. Under reform, a senior will not pay anything for that colonoscopy, or for any other recommended preventive service. A senior will also get free annual wellness visits to his or her provider, with a personalized prevention plan to remain in good health.

  • Small businesses: While small businesses make up 76% of Wisconsin's businesses, only 38% of them offered health coverage benefits in 2008. 77,400 small businesses in Wisconsin could be helped by a small business tax credit proposal that makes premiums more affordable. And these small businesses would be exempt from any employer responsiblity provisions.

  • States: State budgets will be relieved from rising health care costs as reform:
  1. Reduces state employee premiums. Coverage would immediately be expaned to the uninsured, decreasing the amount of uncompensated care costs that gets shifted to the premiums of state employees. For states that provide early retiree health benefits to their state employees, a reinsurance program would provide premium relief of up to $1,200 per family policy per year for all employees.
  2. Reduces uncompensated care. Right now, providers in Wisconsin lose $876 million in uncompensated care each year, which states subsidize at least in part. Instead, under reform, uncompensated care would begin to be reduced immediately as more uninsured people gain coverage.

Health Insurance Reform Provides Stability, Security, and Choice.

  • Provides relief from rising healh care costs.
  1. Ends the "hidden tax". The $876 million spent on uncompensated care in Wisconsin often gets passed along to families in the form of a hidden premium "tax". By expanding coverage to the uninsured, health insurance reform will eliminate this burden on people who already have insurance.
  2. Provides premium tax credits. Without reform, individuals and families in Wisconsin will spend increasing amounts of money out-of-pocket to cover premiums, deductibles, and co-payments, from $7.0 billion today to up to $12.1 billion in 2019. Through health insurance reform, 358,000 Wisconsin residents could be eligible for premium credits to ease the burden of these high costs.
  • Promotes health insurance portability and choice. Health insurance reform establishes a health insurance exchange that will provide individuals with a wide variety of choices and ensure that they will always have coverage, whether they change jobs, lose a job, move or get sick.
  1. Currently 541,000 residents of Wisconsin do not have health insurance, and if nothing is done, by 2019 this population could swell to 738,000. The exchange will help the uninsured to obtain needed coverage and will also help the 320,000 Wisconsin residents who currently purchase insurance in the individual insurance market to get quality coverage at an affordable price.

  • Supports long-term home and community based services: It is estimated that 65% of those who are 65 today will spend some time at home in need of long-term care services, which typically cost almost $18,000 per year. This means that 408,000 older residents of Wisconsin who are aged 55 to 64 will need home health services after they turn 65 ~ services that are not always covered by Medicare, Medicaid, or private health insurance.
  1. Health insurance reform will create a new voluntary long-term care services insurance program, which will provide a cash benefit to help seniors and people with disabilities obtain services and supports that will enable them to remain in their homes and communities.
  2. Reform will encourage states to expand their home and community based services through Medicaid by providing enhanced funding, and will create a program to provide community support services for disabled Medicaid enrolles who would otherwise need to be in a nursing home. These programs could help improve care for many of the 140,000 disabled Medicaid beneficiaries in Wisconsin.

Health Insurance Reform Improves Quality and Reforms the Delivery System.

  • Reduces preventable readmissions. The current health care system does not place enough emphasis on improving quality of care. For example, nearly 20% of Medicare patients who are discharged from the hospital end up being readmitted within 30 days. For Wisconsin, that's 42,900 readmissions each year which could potentially be prevented with improved care coordination. Health insurance reform will invest in innovations in primary care and will provide financial incentives to hospitals to better coordinate care at discharge to avoid preventable readmissions.
  • Lessens Paperwork. Physicians spend on average about 140 hours and $68,000 a year just dealing with health insurance bureaucracy. For the 17,311 in Wisconsin, this adds up to 2.4 million hours and $1.2 billion in costs. By simplifying and standardizing paperwork and computerizing medical records, doctors will be able to focus on caring for their patients instead of dealing with bureaucracy.
  • Incentivizes primary care. Roughly 7,000 doctors in Wisconsin practice primary care and would qualify for a new 5-10% payment bonus under health insurance reform.
  • Invests in the health care workforce. Approximately 607,000 people, or 11% of Wisconsin's population, cannot access a primary care provider due to shortages in their communities. Health insurance reform will expand and improve programs to increase the number of health care providers, including doctors, nurses, and dentists, especially in rural and other undeserved areas.