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9.09.2014
Federal Government Signs Web-Broker Entity Agreement With eHealth
MOUNTAIN VIEW, CA--(Jul 31, 2013) - eHealth, Inc. (NASDAQ :EHTH ), the nation's leading online health insurance exchange for individual and family health insurance, today announced that it has reached a written agreement with the U.S. government on key requirements that will set the stage for eHealth to help enroll tax-subsidy-eligible residents of 36 states in qualified health insurance plans under the Affordable Care Act (ACA).
The agreement is between eHealth as a "web-broker entity" (WBE) and the federal government's Centers for Medicare and Medicaid Services (CMS), which supervises the federal government's health insurance, web-based exchange, called the "Federally Facilitated Exchange" or "FFE." Under a specific regulation issued by CMS on March 27, 2012, WBEs such as eHealth, after reaching agreement with CMS or individual states operating their exchanges, are authorized to help enroll tax-subsidy-eligible individuals under the Affordable Care Act.
The FFE agreement just signed by eHealth and CMS allows eHealth to access the Federal electronic data hub, which is necessary for a determination of tax subsidy eligibility and the amount of a subsidy. It also provides for additional strict consumer- and privacy-protective requirements and standards beyond those spelled out in regulations. An additional agreement encompassing the federal requirements for agents and brokers will still need to be signed by eHealth and CMS in order for eHealth to begin enrolling subsidy-eligible individuals into qualified health plans made available by the ACA.
"The agreement announced today is an important step in eHealth's efforts to help deliver on the goals of the Affordable Care Act by giving many Americans the ability to utilize their subsidies when they enroll in quality health insurance at eHealth.com," said Gary Lauer, Chief Executive Officer and Chairman of eHealth, Inc.
"We applaud CMS for embracing public-private partnerships with marketplaces like eHealth to establish a framework for secure, streamlined and cost-free enrollment of tax-subsidy-eligible people," Lauer said.
"We now hope that the 14 States and DC that are working hard to develop their own health insurance exchanges will follow the leadership of the federal government and allow their subsidy-eligible residents the same opportunity that is expected to exist in the 36 other states to utilize resources like eHealth.com for enrollment. This will simply result in more enrollments, which is crucial to the Affordable Care Act's success, and at the same time save the government taxpayer money."
Lauer said that eHealth has offered every one of these states technical assistance to enable eHealth to sign a similar agreement and be ready to take advantage of eHealth and other WBEs to supplement their enrollment capacity.
"If there are technical concerns by individual states," Lauer pointed out, "I am confident we can quickly help resolve them."
The agreement signed by eHealth is with the Centers for Medicare and Medicaid Services (CMS), the federal government agency that is responsible for the management and oversight of the FFE and the Federal electronic data-hub. The data-hub allows the government exchanges to determine tax subsidy eligibility and subsidy amounts. The WBE would receive limited data sufficient to serve as a web-based platform enabling insurance carriers to enroll tax-subsidy-eligible individuals in "qualified health plans," as defined under the Affordable Care Act. All WBEs must abide by strict consumer-protective and privacy and security requirements and standards under the agreement with CMS in order to be allowed to assist the federally facilitated exchanges in enrolling tax-subsidy-eligible individuals.
eHealth has enrolled over 3 million individuals in coverage since it sold the first health insurance policy online in 1998, approximately 40% of whom were uninsured before they came to eHealth.
About eHealth
eHealth, Inc. (NASDAQ : EHTH ) is the parent company of eHealthInsurance, the nation's first and largest private health insurance exchange where individuals, families and small businesses can compare health insurance products from leading insurers side by side and purchase and enroll in coverage online. eHealthInsurance offers thousands of individual, family and small business health plans underwritten by more than 200 of the nation's leading health insurance companies. eHealthInsurance is licensed to sell health insurance in all 50 states and the District of Columbia.
eHealth, Inc. (
eHealth, Inc. also provides powerful online and pharmacy-based tools to help seniors navigate Medicare health insurance options, choose the right plan and enroll in select plans online through its wholly-owned subsidiary, PlanPrescriber.com (www.planprescriber.com) and through its Medicare website www.eHealthMedicare.com.
Forward-Looking Statements
This press release contains statements that are forward-looking statements as defined within the Private Securities Litigation Reform Act of 1995. These include statements regarding eHealth's expectation that it will gain the ability to help enroll tax-subsidy eligible residents of 36 states in qualified health plans, the availability of the electronic data hub and the use of web-based brokers to enroll individuals through government-run health insurance exchanges, the utilization of resources like eHealth resulting in more enrollment and government savings, resolution of state exchange technical concerns and WBE receipt of data sufficient to enroll tax-subsidy eligible individuals in qualified health plans. These forward-looking statements are inherently subject to various risks and uncertainties that could cause actual results to differ materially from the statements made, including permission from state and federal governments to operate as a WBE, eHealth's readiness to act as a WBE and the government's readiness to permit enrollment from WBEs, eHealth's ability to comply with the terms of its WBE related agreements and with laws and regulations related to acting as a WBE, the terms of additional agreements relating to eHealth acting as a WBE, technical difficulties and integration issues in connection with the implementation of WBE capability to enroll individuals in qualified health plans and the effectiveness of eHealth in enrolling individuals into qualified health plans. Other risks and uncertainties that can affect actual results are included under the captions "Risk Factors" and "Management's Discussion and Analysis of Financial Condition and Results of Operations" in our Annual Report on Form 10-K for the year ended December 31, 2012 and our most recent Quarterly Report on Form 10-Q, which are on file with the SEC and are available on the investor relations page of the Company's website at http://www.ehealthinsurance.com and on the Securities and Exchange Commission's website at www.sec.gov. All information provided in this press release is as of the date of this press release, and we undertake no duty to update this information unless required by law.
This press release contains statements that are forward-looking statements as defined within the Private Securities Litigation Reform Act of 1995. These include statements regarding eHealth's expectation that it will gain the ability to help enroll tax-subsidy eligible residents of 36 states in qualified health plans, the availability of the electronic data hub and the use of web-based brokers to enroll individuals through government-run health insurance exchanges, the utilization of resources like eHealth resulting in more enrollment and government savings, resolution of state exchange technical concerns and WBE receipt of data sufficient to enroll tax-subsidy eligible individuals in qualified health plans. These forward-looking statements are inherently subject to various risks and uncertainties that could cause actual results to differ materially from the statements made, including permission from state and federal governments to operate as a WBE, eHealth's readiness to act as a WBE and the government's readiness to permit enrollment from WBEs, eHealth's ability to comply with the terms of its WBE related agreements and with laws and regulations related to acting as a WBE, the terms of additional agreements relating to eHealth acting as a WBE, technical difficulties and integration issues in connection with the implementation of WBE capability to enroll individuals in qualified health plans and the effectiveness of eHealth in enrolling individuals into qualified health plans. Other risks and uncertainties that can affect actual results are included under the captions "Risk Factors" and "Management's Discussion and Analysis of Financial Condition and Results of Operations" in our Annual Report on Form 10-K for the year ended December 31, 2012 and our most recent Quarterly Report on Form 10-Q, which are on file with the SEC and are available on the investor relations page of the Company's website at http://www.ehealthinsurance.com and on the Securities and Exchange Commission's website at www.sec.gov. All information provided in this press release is as of the date of this press release, and we undertake no duty to update this information unless required by law.
9.05.2014
Top Honeymoon Destinations, From Bronze to Platinum Budgets
By Micaela Jimenez on July 15th, 2014
Filed: Advice, Health and Wellness
“Good seasons start with good beginnings.” – Sparky Anderson
Summer is here! ‘Tis the season of renewal and fine weather – and, last but not least, weddings.
For the soon-to-be newlyweds out there, here are a few medal-winning destinations for your honeymoon, inspired by the qualifying life plan metal levels, of course!
Did you know the average honeymoon last year cost between $2,000 and $15,000? What a range! Just like health plans, honeymoon prices can be pretty intimidating.
Here’s our list of honeymoon destinations to consider this year by medal levels:
- Platinum: Italy, $7,000
Italy is the perfect destination for a couple that shares a love for art, history, and food. Not only does it have a reputation for being one of the most romantic places in the world, its passionate culture will suck you into moving back your flight an extra week.
- Pro Tip: During your two week stay in Italy, I would recommend hitting three major cities including Rome, Florence and the Almafi Coast. You won’t regret strolling through Rome also known as the “eternal city”, dancing in Tuscany, or wine tasting on the coast of this honeymoon destination.
- Gold: Mexico, $4200
Cancun is one of the most popular honeymoon destinations in the world, and is perfect for a couple who wants to both relax and venture depending on their mood.
- Pro Tip: I would recommend an all-inclusive resort in Cancun to save you time and money. All-inclusive resorts not only give you a relative amount of privacy and seclusion, but also give you that option to get away anytime. I’d recommend venturing outside the resort to see the ancient ruins in Tulum, or spending a day venturing through the rainforest.
- Silver: Maui $3800
Maui is a perfect destination for couples who are looking to have a very intimate outing with absolutely no worries. Most resorts in Maui offer honeymoon packages that will provide you with the classic image of honeymoons, such as consistent rose pedals, couple activities, and privacy.
- Pro Tip: I would recommend Maui to a couple who took on a big wedding and are looking to stay away from the social scene. The islands breathtaking sunsets, tropical scenery and the positive Hawaiian culture is a perfect way to keep the spark going in your new marriage.
- Bronze: Napa, CA Range: $1000-$3,000
Who says staying local is overrated? Napa Valley has emerged into a popular honeymoon destination as it holds a stunning scenic landscape, world-class restaurants, and more importantly is a home to over 400 wineries. What’s a honeymoon without wine, right?
- Pro Tip: Honeymoons are about romance, and there are many beautiful places to stay in Napa Valley such as the Napa Valley Lodge or the famous Auberge du Soleil. A weekend in the wine country could be your perfect escape. Napa would be a high recommendation to couples who do not want to travel out of the country and would consider themselves “foodies”.
Do any of these locations make you want to rethink your honeymoon plans, or inspire you to go on another vacation all together? Remember, decisions become more difficult when you settle for researching last minute, so let’s remember to spring forward, and tag summer before it burns us.
9.02.2014
How to Get Health Insurance Outside the Open Enrollment Window
Published
August 26, 2014 | FOXBusiness
The
first open enrollment season of the Affordable Care Act has come and gone and
the next one doesn’t start until Nov. 15, but that doesn’t mean uninsured
individuals can’t get coverage until then.
“Under the Affordable Care Act, people who experience certain life changes may be eligible to enroll in a new health plan before the next open enrollment period begins,” says Michael Mahoney, senior vice president, consumer marketing at GoHealth www.gohealthinsurance.com. “Those who qualify for a special enrollment period generally have 60 days from the qualifying event to shop for coverage. “Here’s what health insurance experts recommend knowing about what qualifies as a “life change” to gain coverage outside of the designated open enrollment period.
“Under the Affordable Care Act, people who experience certain life changes may be eligible to enroll in a new health plan before the next open enrollment period begins,” says Michael Mahoney, senior vice president, consumer marketing at GoHealth www.gohealthinsurance.com. “Those who qualify for a special enrollment period generally have 60 days from the qualifying event to shop for coverage. “Here’s what health insurance experts recommend knowing about what qualifies as a “life change” to gain coverage outside of the designated open enrollment period.
What
Doesn’t Work
The ACA’s open enrollment periods were designed to prevent people from only signing up for care when they need it. The limit protects health insurance companies, but it can hurt consumers if they find a better or cheaper plan outside the season. “Finding a new one that saves you $600 is not a qualifying reason,” says Kevin Luss, owner of Luss Group. “Even if they are going to save money, they got to stay in it or lose coverage.”Letting an insurance policy lapse also doesn’t count as a qualifying event, he adds. Neither is a doctor dropping out of network.
People (at least two) are still able to bind together to purchase group insurance, but the ACA has made it a little restrictive. A husband and wife can’t be the only ones making up a group of two, and thus can’t get new insurance outside of open enrollment that way. The health care reform “really restricted things a little bit,” says Luss.
The ACA’s open enrollment periods were designed to prevent people from only signing up for care when they need it. The limit protects health insurance companies, but it can hurt consumers if they find a better or cheaper plan outside the season. “Finding a new one that saves you $600 is not a qualifying reason,” says Kevin Luss, owner of Luss Group. “Even if they are going to save money, they got to stay in it or lose coverage.”Letting an insurance policy lapse also doesn’t count as a qualifying event, he adds. Neither is a doctor dropping out of network.
People (at least two) are still able to bind together to purchase group insurance, but the ACA has made it a little restrictive. A husband and wife can’t be the only ones making up a group of two, and thus can’t get new insurance outside of open enrollment that way. The health care reform “really restricted things a little bit,” says Luss.
What
Does Get an Exception
While
restrictions abound, there are many qualifying events that allow consumer to
pick up coverage outside of the enrollment period. Some events include, getting
married or divorced, a permanent move to a new coverage area, the birth or
adoption of a child, change in income or no longer being covered by a parents’
health insurance.Experts
warn being prepared to show proof of the event.“A
lot of the carriers require documentation,” says Carrie Mclean, director of
customer care at eHealthInsurance www.ehealthinsurance.com.
“For example, if you have a loss of employer coverage, a lot of carriers want
to see a termination letter from your employer.”
Even
if the carrier doesn’t require documentation, lying to get a new plan or
coverage is not a good idea. According to Mcclean, if an insurer has been
paying claims and asks for proof of the life event, lack of documentation
allows the company to refuse to pay the medical bills.Some
of the lesser-known life events that will get you qualified include, being
released from jail, gaining citizenship or becoming a member of an Indian
tribe. According
to Luss, if a consumer gets bad advice from an insurance agent during open
enrollment, the professional can write a letter to the provider taking the
blame. “It’s really at the discretion of the carrier,” says Luss.
If all else fails, there’s always the option of taking out short-term insurance, says Mahoney.“Short-term plans provide a viable solution if you experience a gap in coverage between now and the next open enrollment period in November,” says Mahoney. “Without insurance, a trip to the emergency room could cost thousands of dollars, but a short-term plan can significantly offset those costs.”
If all else fails, there’s always the option of taking out short-term insurance, says Mahoney.“Short-term plans provide a viable solution if you experience a gap in coverage between now and the next open enrollment period in November,” says Mahoney. “Without insurance, a trip to the emergency room could cost thousands of dollars, but a short-term plan can significantly offset those costs.”
Check out securinglifetoday.com, to learn more about health insurance and to shop and compare rates. Now partnered with eHealth.com
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