Don't Lose Your Subsidy in 2016

If you received premium subsidy in 2014, please be aware that you need to file IRS form 8962 with
your 2014 taxes.  If you did not file form 8962 you need to file this form by August 31, 2015 or you may lose your premium subsidy in 2016.

Here is the link to form 8962

OTC Nexium Prompts Drug Formulary Changes

NEXIUM® 24HR (esomeprazole 20 mg) became available as an over-the-counter (OTC) 14-day treatment for frequent heartburn in May 2014. As a result, most drug formulary (list of covered drugs) are changing.  The following drugs will be moving (or have moved) to a higher formulary Tier.

• Nexium 
• Esomeprazole 
• Lansoprazole 

King v. Burwell U.S. Supreme Court Ruling: Payment of Premium Subsidies Upheld

Good News! This morning the Supreme Court made an important decision about the Health Insurance Marketplace. Their ruling means that consumers will continue to receive quality affordable health care coverage no matter where they live.

For consumers getting their coverage through the Health Insurance Marketplace, this means that nothing has changed. You will still continue to receive your subsidy. 

If you have any questions please don't hesitate to contact Tiffany or Bud.

You can watch the president’s address here and read the Supreme Court’s ruling here.

Additional information about what the Supreme Court decision means for you can be found online at: HealthCare.gov/Decision. 

Information from:Centers for Medicare & Medicaid Services (CMS)

ACA Requiring Insurance Companies to Collect Social Security Numbers

Beginning this year, health insurers have to send the Internal Revenue Service (IRS) information about health plan members and their insurance coverage, including their Social Security number (or other tax identification number). It’s one of the requirements of the Affordable Care Act (ACA).

The ACA requires that everyone have qualifying insurance, qualify for an exemption, or potentially pay a tax penalty. The IRS will cross-check the information in tax returns against the information health insurers are required to submit for every person they cover. This IRS review will confirm that individuals have the required coverage and don’t have to pay a tax penalty.

Many insurance companies have been phasing out the use of SSNs for member identification. However, with the ACA requirements, health insurers will now be sending letters or otherwise reaching out to plan members asking for that information if they don’t already have it.

Does Your Business Qualify for the Health Care Tax Credit?

As an small employer you may qualify for a health care tax credit.

To qualify for the tax credit, all of the following must apply:

• You have fewer than 25 full-time equivalent (FTE) employees
• Your average employee salary is about $50,000 per year or less
• You pay at least 50% of your full-time employees' premium costs
• You offer coverage to your full-time employees through the SHOP Marketplace

The tax credit is worth up to 50% of your contribution toward your employees' premium costs (up to 35% for tax-exempt employers).

Important Links:

• Calculate your FTE's
• Estimate your tax credit

For more information you can visit Healthcare.gov SHOP overview.

Tiffany Geiger, President

A New Special Enrollment Opportunity

The Centers for Medicare and Medicaid Services (CMS) announced a new Individual Health Insurance Marketplace Special Enrollment Opportunity beginning on March 15 through April 30. This Special Enrollment Opportunity is for individuals and families who did not have health coverage in 2014 and are subject to the fee or "shared responsibility payment" when they file their 2014 taxes. 

Who is Eligible

To be eligible you must meet ALL of the following:

• You must live live in a state that has enrollment through Healthcare.gov. (Ohio is one of these states.)
• Are not currently enrolled in health coverage through Healthcare.gov for 2015 
• Attest that you paid the fee for not having health coverage in 2014 
• Attest that you first became aware of, or understood the implications of, the penalty or shared responsibility payment, after Feb. 15, 2015, when Open Enrollment ended.

What This Means

• You  will have the opportunity to purchase an On-Exchange Individual Health Plan from March 15 through April 30. 
• Enrollments made by the 15th of the month will have coverage effective on the 1st day of the following month. 
• Enrollments made after the 15th of the month will have coverage effective on the 1st day of the second month.

State-based Exchanges (SBE) have the flexibility to determine whether they will establish a similar special enrollment period. Check specific SBE websites for additional information. 

Tiffany Geiger, President 

Important Update Regarding the Anthem Cyber Attack

Notice from Anthem on February 6, 2015

Members who may have been impacted by the cyber attack against us should be aware of scam email campaigns targeting current and former members.  These scams, designed to capture personal information (known as “phishing”) are designed to appear as if they are from a health plan and the emails include a “click here” link for credit monitoring. These emails are NOT from us.

DO NOT click on any links in email.
DO NOT reply to the email or reach out to the senders in any way.
DO NOT supply any information on the website that may open, if you clicked on a link in email.
DO NOT open any attachments that arrive with email.

We are not calling members regarding the cyber attack and are not asking for credit card information or social security numbers over the phone.

This outreach is from scam artists who are trying to trick consumers into sharing personal data. There is no indication that the scam email campaigns are being conducted by those that committed the cyber attack, or that the information accessed in the attack is being used by the scammers.

We will contact current and former members via mail delivered by the U.S. Postal Service about the cyber attack with specific information on how to enroll in credit monitoring. Affected members will receive free credit monitoring and ID protection services.

For more guidance on recognizing scam email, please visit the FTC Website: http://www.consumer.ftc.gov/articles/0003-phishing.

We have created a dedicated website (www.AnthemFacts.com) where everyone can access information such as frequently asked questions and answers.