Changes in the Senior Medicare Market
Also, COBRA & HIPAA Compliance

Alan Benoy Insurance Services - (559) 734-4288

October 2011   |
The Times
They Are

Whether or not you like the song, the truth is, you and/or someone you know will be affected by the following change: the health coverage for a vast number of Californians over the age of 65 will be affected in 2012. This unanticipated change will leave many seniors feeling stranded... and upset. So, what  happened? Basically, some very popular and affordable coverage options (Medicare Advantage plans with a Part D Prescription drug plan - aka MAPD plans) will end on Dec. 31, 2011, for thousands of senior citizens in many areas of California. These folks will be forced to do one of the following: (1) remain on straight Medicare (Parts A and B), with or without a Part D Prescription Drug plan (PDP); (2) enroll in a Medicare Supplement plan (again, with or without a PDP), that they may not be able to afford; or, (3) find another Medicare Advantage plan in their area (if one is available to them).   

There is a HUGE difference between a Medicare Advantage plan and a Medicare Supplement plan. Let me be clear, Medicare Supplement plans ARE NOT going away. Many seniors purchase a Medicare Supplement with a separate PDP. Why? Because this may very well be the best coverage available to them for their situation. They pay a premium every month for their Medicare Supplement plan, but, if they've chosen the F plan, they've virtually eliminated the majority of other out-of-pocket medical charges for themselves. This brings people peace of mind, which is worth its weight in gold to many. PDP plans are a whole different subject, so we'll leave that to you and your agent to figure out what's best for you. 

So, what do you do now? ACT! If you or someone you love is currently on a Medicare Advantage plan that's being discontinued, you must make a decision soon (prior to Dec. 7, 2011 for Annual Open Enrollment) or you may be left with Medicare alone (Parts A & B; i.e. "straight Medicare") in 2012. Talk to your insurance agent about an affordable Medicare Supplement and stand-alone PDP plans in your area. If you choose to not enroll in a PDP plan, there will likely be penalties when you decide to join one in the future, unless you have other creditable coverage, such as group coverage with creditable coverage. You and/or your loved one may decide that straight Medicare is the only affordable option for you. However, if there is ANY way to enroll in a Medicare Supplement plan, or some other Medicare Advantage plan, I strongly advise that you consider it. If you do, you can most likely maintain your standard of care, and keep medical costs at a manageable level. 

One facet of my job is to keep you abreast of the changes, whether you or I like them or not!
Feature of the Month: 
COBRA & HIPAA Compliance Survival 93-page compliance booklet. Simply, a basic description of the laws and compliance responsibilities of the employer. (For guidance only; not intended to provide legal, accounting or professional service for COBRA compliance)
  • Continuation of Group Health Coverage Required During Pregnancy Leave, beg. Jan 1, 2012 - SB 299
  • Should Medicare Eligibility Age Rise to 67?
  • The Broccoli Case - Can the government force us to buy health insurance, any more than they can make us buy broccoli?
  • Maternity Coverage - Mandated - All Individual Health Policies Must Include Coverage for All Insured - SB 222, beg. July 1, 2012
  • How Long Can We Avoid Long-Term Care?
  • COBRA & HIPAA Compliance Survival
  • Small Business Tax Credit Calculator
  • Keeping Up with the HCR Law - Facts to Keep You Compliant in 2011 & Beyond
  • Carrier Links to HCR
  • Legislative Updates

COBRA - Link to COBRA Articles
  • 5 Tips for Life After COBRA
  • Goodbye, COBRA Subsidy
  • New Federal COBRA Regulations - Updates & Changes
  • Cal-COBRA Update
  • COBRA Tracking Log
  • COBRA Notices to Employees

NEWSLETTERS - Link to Newsletters
  • Employee Newsletters - Payroll Stuffers
  • Employer Newsletters - Maternity Leave Benefits, Employer Best Practices for Workers with Caregiving Responsiblities, and more

FORMS - Link to Forms

  • Frequently Used Employer Forms - Employee Termination Forms to Carriers, etc.
  • Frequently Used Employee Forms - Employee Application for Benefits, etc.

Al's Referral Spotlight

Cline's Business Equipment

Cline's Business Equipment, Inc.

I have been a pleased Cline's customer for several years. Not only do they offer excellent equipment, but their service is bar none!  If my copier needs service or I have a printer networking issue, a  service technician is at my office, often within 20 minutes. They offer a complete range of Konica-Minolta digital copiers, printers, faxes, scanners, and office solutions. This company knows what service is all about!  They are also an authorized Samsung dealer/Service center. Located in the heart of downtown Visalia, they service a wide area of the valley, including Fresno, Tulare, Bakersfield, Hanford and Lemoore. 

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