HHS Announces New Policy to Make Coverage More Accessible and Affordable for Millions of Americans in 2023

In April, the Department of Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) announced that they have new measures that will allow consumers to more easily find the right form of quality, affordable health care coverage. Beginning November 1st, 2022, health insurance coverage will be more accessible and affordable to millions of Americans.

The 2023 Notice of Benefits and Payment Parameters Final Rule

gavel next to a book
The new policy, beginning November 1st, will help grant health insurance access to millions of Americans.

This new policy will make regulatory changes in the individual and small-group health insurance market, establishing parameters and requirements.

“The Affordable Care Act has successfully expanded coverage and provided hundreds of health plans for consumers to choose from,” said Health and Human Services Secretary Xavier Becerra. “By including new standardized plan options on HealthCare.gov, we are making it even easier for consumers to compare quality and value across health care plans. The Biden-Harris Administration will continue to ensure coverage is more accessible to every American by building a more competitive, transparent, and affordable health care market.” 

“The recent Open Enrollment Period demonstrated the demand for high-quality, affordable health coverage. These steps increase the value of health care coverage on HealthCare.Gov and further strengthen the health insurance Marketplace,” said CMS Administrator Chiquita Brooks-LaSure. “This policy will make it easier for people to choose the best plan that meets their needs by standardizing plan options, like maximum out-of-pocket limitations, deductibles, and cost-sharing features.”

Policies Include:

Advancing Standardized Plan Options -President Biden’s Executive Order 14036 on Promoting Competition in the American Economy helps simplify the consumer shopping experience by establishing standardized plan options for issuers offering Qualified Health Plans (QHPs) to maximum out-of-pocket limitations, deductibles, and cost-sharing features.

Implementing New Network Adequacy Requirements – Patients will have access to the right provider at the right time, and inaccessible locations. The new rule also set standards requiring routine Primary Care appointments to be available within 15 business days of the enrollee’s request, as well as review the distance between provider and enrollees, and make sure that it is not an issue that they are not too far apart.

Increasing Value of Coverage for Consumers – The CMS will be updating the allowable range and medical coverage levels for non-grandfathered individual and small-group market plans.

hundreds of people
The new policy will expand health insurance access to essential community providers.

Increasing Access for Consumers and Removing Barriers to Coverage – This will protect consumers from discriminatory practices related to the coverage of essential health benefits. They will refinance the EMS non-discrimination policy, specifically, the one that limits coverage for essential health benefits on a base that is protected from discrimination.

Expanding Access to Essential Community Providers – CMS is increasing the Essential Community Provider (ECP) threshold from 20% to 35% of available ECPs in each plan’s service area to participate in the plan’s provider network. The higher ECP threshold will increase access to a variety of providers for consumers who are low-income or medically underserved.

The health insurance Open Enrollment Period is open until January 15 (depending on your state), so now is the perfect time to reconsider getting a health insurance plan or looking into your current one and making sure it will cover all of the above-mentioned costs. And if your plan doesn’t cover everything you need it to, it’s time to find a plan that does, so you can save as much money as possible. If you’re shopping for a plan, your best bet is to speak to a licensed EZ agent. Our agents work with the top-rated insurance companies in the nation, so we can compare plans in minutes. We will not only find a plan that has all the benefits you’re looking for, but we will also make sure the plan meets your financial needs. To get free instant quotes, simply enter your zip code in the bar above, or to speak to a local agent, call 888-350-1890. No obligation.

Start the New Year Right with These Healthcare Tips

The new year is here, and we could all definitely use a better year than we’ve had the past couple of years. Maybe you’ve made some resolutions to help make this a better year – but is being healthier one of those resolutions? If not, it should be, because the healthier you are, the better you feel! One of the best ways to get healthier is by having great health insurance, and since the Open Enrollment Period is still ongoing, you still have the chance to find a plan that meets your needs and your budget. But aside from being insured, here are some other things you can do for your health that will help you start off the year right!

Schedule A Physical

blood pressure cuff next to other medical instruments on the wall
It is very important to catch any hidden issues you might have by getting a yearly physical.

92% of Americans agree that it is important to get an annual physical, however only 62% actually do get a physical. If you haven’t been having a yearly physical, now is the time to get on it! It’s very important to have your annual checkup, because having one allows your doctor to catch any early symptoms of issues that you may be unaware of. Annual checkups help you keep your relationship with your doctor going, and allow them to understand you and your needs better: they can track your health conditions, and help you stay on top of them, by recommending routines or prescribing medications that will help.

Get Your Teeth Cleaned

According to a study by Delta Dental, 31% of Americans fail to brush their teeth at least twice a day, with 2% admitting to not brushing at all. That’s a pretty alarming statistic! Not only that, but only 79% of people who have dental insurance, and 50% of people without dental coverage, actually see the dentist once every year. It’s very important to get your teeth checked twice a year by a dentist in order to prevent cavities, and to avoid a root canal in the future. 

In addition, if you aren’t brushing properly and seeing your dentist regularly, you could develop gum disease or periodontal disease. Periodontal disease has been associated with higher risk of kidney disease, dementia, and certain types of cancers, so make sure to call your dentist and schedule an appointment!

Get Your Eyes Checked

Did you know that 5% of Americans have never even seen an eye doctor? 46% of people haven’t had an appointment in the past year, with 1 in 6 seeing an eye doctor more than two years ago! If you think your  eyes are healthy because you can see well, and that you don’t need to go to the eye doctor, you could end up with an undiagnosed and untreated vision impairment. In fact, 16 million Americans have an undiagnosed and untreated vision impairment, according to the American Optometric Association (AOA).

Dr. Chris Marquardt, a recent past president of the Wisconsin Optometric Association, says many people equate good vision with healthy eyes, but that isn’t always the case:

“..There are a lot of conditions that can be detected in a regular eye exam, an in-person exam with a Doctor of Optometry. You may go years without seeing any sorts of signs or symptoms. Things like glaucoma, macular degeneration, even systemic things like diabetes or high blood pressure can be going on in the back of the eyes and you would never know it…”woman looking into the ye of another woman with light

So what are you waiting for? Get your eyes checked!

Is It Time For A Mammogram Or Colonoscopy?

Going to get a mammogram or a colonoscopy is probably not anywhere near the top of your list of things you want to do – the words alone are enough to send people running, but these screenings are very important. If you are the recommended age for these tests, you need to make an appointment and get the mammogram, or colonoscopy as soon as you can.

Consider this: according to information released by John Hopkins Medical Center, “40% of diagnosed breast cancers are detected by women who feel a lump. Establishing a regular breast self-exam is very important.” So, if you examine yourself and find a lump, get checked right away! That also means, though, that 60% of diagnosed breast cancers are found by other means, so make sure you’re seeing your gynecologist regularly, and scheduling mammograms every year after you turn 40. anatomy of the stomach

As for your colon health? “There are more than 20 million adults in this country who haven’t had any recommended screening for colorectal cancer and who may therefore get cancer and die from a preventable tragedy,” said CDC Director Tom Frieden, M.D., M.P.H. “Screening for colorectal cancer is effective and can save your life.”

Get Great Insurance

One of the most important things you can do for yourself and your family is getting a comprehensive health insurance plan that will allow you to see the above doctors, and have the screenings that can keep you healthy. EZ.Insure can help you find a great plan that will save you money on your doctor visits, medications, and monthly premiums. Because our agents work with the top-rated insurance insurance companies in the nation, we can search through all the available plans in your area and find the right one for you. And all of our services are free of charge! No hassle or obligation. To get free instant quotes, simply enter your zip code in the bar above, or to speak to a local agent, call 888-350-1890.

Health Insurance Open Enrollment FAQ

The Open Enrollment Period for health insurance is a very important time, when you can change or enroll in a health insurance plan for coverage beginning the following year. It runs from November 1 to December 15, and is the only time during the year when you can purchase a plan, unless you qualify for a Special Enrollment Period. To better prepare you for the Open Enrollment Period, including what to expect and how to find a great plan, we’ve answered some FAQ below. 

When Is The Annual Open Enrollment Period?

calendar with the date on november 1
Health insurance Open Enrollment begins on November 1st every year.

The Open Enrollment Period is the one time of the year that you can buy or change your health insurance; if you do not buy health insurance during the Open Enrollment Period, you will have to wait until the following year to do so, unless you experience a qualifying life event. 

The Federal Open Enrollment Period starts on November 1st and ends December 15, which gives you just about six weeks to choose a health insurance plan and sign up for one. However, some states have permanently extended their Open Enrollment Period until January 15th or 31st, with coverage beginning February 1st.

Am I Eligible To Enroll In Marketplace Health Insurance?

To be eligible to enroll in ACA Marketplace health insurance, you must:

  • Be between the ages of 18 and 64
  • Live in the United States
  • Be a U.S. citizen
  • Not currently be incarcerated
envelope in a blue circle
Be sure to review the ANOC letter you will receive about your current plan’s coverage for next year.

What Changes Can I Make During Open Enrollment?

If you currently have a health insurance plan, you will receive an annual notice of change (ANOC) letter in the mail prior to Open Enrollment; you’ll need to carefully review this because there might be changes being made to the price or coverage of your plan. But if your plan is not changing and you are happy with it, you will be automatically re-enrolled for next year

If you are unhappy with your health insurance plan, you can switch to a new one, but you will have to review all of the plans in your area, including new ones that might have been added. If you don’t review plans in your area during the Open Enrollment Period, you won’t know if there is a better plan for you; the best way to do this is by working with one of EZ’s licensed local agents, who can compare plans easily for you in minutes.

What If I Miss The Open Enrollment Period?

If you miss the Open Enrollment Period, your choices will be very limited until next year’s Open Enrollment Period, unless you qualify for a Special Enrollment Period. To qualify for a Special Enrollment Period (SEP), you’ll need to have experienced one of the following qualifying life events:

  •  Getting married or divorced
  •  Death of a spouse or policyholder 
  •  The birth or adoption of a child
  •  Loss of health insurance coverage
  •  Moving to a new area where the health plans are different from what you currently have

If you are looking for health insurance temporarily until the next Open Enrollment Period, you have the option of short-term health insurance, which will cover you for up to 36 months, but this type of plan has limited coverage. 

Can I Afford Health Insurance?red money sign next to a green question mark

The first thing you should do if you’re looking to save money is work with an agent who can compare plans for you and find one that fits your budget. Next, check to see if you qualify for subsidies, such as premium tax credits and cost-sharing subsidies. Premium subsidies are available in every state, and help make health insurance more affordable. Eligibility for subsidies is based on your household income; it’s definitely worth checking to see if you qualify, since President Biden recently extended premium subsidies to millions of Americans, making them easier to get, even for those with an income of 400% of the federal poverty level or higher.

How Do I Find A Plan?

If you have any further questions, or need help finding a plan during the Open Enrollment Period, an EZ agent can help you. We will provide you with a local licensed agent who will search all available plans in your area and find the best one for your medical and financial needs. We will also double check to see if you qualify for any subsidies to save you even more money. All of our services are done in minutes and at no cost to you. To get free instant quotes, simply enter your zip code in the bar above, or to speak to a local license agent call 888-350-1890.

How To Switch Plans During The Open Enrollment Period

Not happy with your health insurance plan? Looking to make a change during this year’s Open Enrollment Period? Well, now is the time to make the switch to a plan that better suits your needs – you only have from November 1st to December 15th to do so! But we get it, health insurance can be complicated and it can be confusing trying to figure out which plan to choose: there are so many plans from so many different insurance carriers, so you might not even know where to begin. So to make the process easier for you, we’ve laid out what to look for and how to execute the switch. 

Reasons To Switch Plans

There are a number of reasons why you might want to switch plans during the Open Enrollment Period, including: network connected with silhouettes of people, one red and the rest black

  • Changes to your plan’s network– Every year, there will be changes made to your health insurance plan, including to your network of doctors and specialists. This means doctors that you might have been going to for a long time might no longer be in your network, and if you choose to continue seeing them, you will have to pay a lot more out-of-pocket.
  • You are moving–  If you are moving, your current health insurance plan might not work in the area you are moving to, so you will have to find a new plan and doctor. 
  • Your family situation has changed– If you are adding a family member to your plan or if you have lost a family member, you’ll need a plan with more or less coverage.
  • You’re not happy with your coverage– If you’re looking to save some money, you might want to look for a plan with less coverage, or if you feel that your plan doesn’t offer enough coverage for you and your family, you’ll want to look for one with more benefits.

Things To Keep In Mind When Switching Plans 

Before you make a decision to switch plans, there are a few things that you have to consider. When looking for a plan that is right for you, focus on:

  • All of the costs associated with each plan– You’ll need to take into consideration not just  the price of each plan’s monthly premiums, but also the deductibles, co-pays, and coinsurance that you’ll be responsible for paying out-of-pocket.
  • The network– Do you have a particular doctor who you want to continue seeing? Make sure that you review each network’s plan, so you will know if your doctors are covered.
  • The coverage– Each plan will cover services differently: for example, some will not cover a medical procedure or drug, while others might cover it completely. You need to determine what you need covered, as well as review the preventive care services, prescription drug formulary, and other coverage associated with each plan.

How To Switch Plans

illustration of a woman with a headset on sitting in front of a computer
Working with an EZ agent will allow you to find the best plan and deal in your area, for free. 

The best way to find a plan that suits your needs is by working with a licensed agent who is familiar with all the plans in your area, and who can go over any changes to your plan, like increases to your premiums, with you. EZ offers personal agents who will compare all available plans in your area and even help you switch plans for free – they will even take care of all the little details of switching and making sure everything is all set with your new plan, like notifying your current health insurance company that you are moving on.

Our agents work with the top-rated insurance companies in the country, so they have quick and easy access to all plans in your area. They will go over your medical and financial needs, and then compare all plans, including their coverage, premiums, deductibles, and other costs associated with each plan. We will help you find an affordable plan, and maybe even lower your health insurance costs! To compare plans in your area for free, enter your zip code in the bar above, or to speak to one of our highly trained, licensed agents, call 888-350-1890.

If You Missed The Covid Special Enrollment Period, You’ve Got Another Chance To Sign Up!

Life can get pretty hectic, so it’s totally understandable if you missed out on the Covid-19 Special Enrollment Period, which ran from February to August of this year, and allowed Americans to sign up for health insurance outside of the usual Open Enrollment Period. But if you’re kicking yourself for not changing your plan or enrolling in a plan when you had the chance, don’t worry! You now have the opportunity again to find a great plan and save money: the ACA Open Enrollment Period started November 1st and will run through December 15 in most states, with an extension into January for others. Don’t miss out again on finding a great affordable plan!

Know Your Deadline!

a red circle with the word deadline inside of it multiple times around
Depending on the state you live in, your deadline might be longer.

As we mentioned, some states have different Open Enrollment Period deadlines. The deadline to change or sign up for a plan in most states is December 15, except for:

  • California: January 31
  • Colorado: January 15
  • Connecticut: January 15
  • Idaho: December 31
  • Massachusetts: January 23
  • Minnesota: December 22
  • Nevada: January 15
  • New Jersey: January 31
  • New York: January 31
  • Pennsylvania: January 15
  • Rhode Island: December 31
  • Washington DC: January 31

Extra Savings You Can Get Now

The Covid-19 pandemic has taken a toll on everyone, and the government took initiative to try and help Americans stay protected by opening the Special Enrollment Period in February, but that is not all they did. President Biden has also extended extra savings to Americans signing up for health insurance: his American Rescue Plan (ARP) is allowing more Americans to qualify for premium subsidies. Now, households with income up to 150% of the federal poverty level are eligible for subsidies that fully cover the cost of the benchmark plan, meaning they can select either of the two lowest-cost Silver plans and have no monthly premium.

Not only that, but the American Rescue Plan Act also allows those who earn over 400% of the federal poverty level to receive subsidies to purchase health insurance through the ACA Marketplace, requires that Americans pay no more than 8.5% of their income on health insurance premiums, and provides a larger tax credit to people who already receive financial assistance. Depending on your family size and income level, you could pay as low as $0 for a plan, or save up to $1000 a month in premiums. 

Save More With EZillustration of a man in a suit with a graph going upwards and a coin money sign above the graph

We get that trying to find a great plan while saving as much  money as possible is not easy; it can be time-consuming and downright frustrating. But EZ is here to help: our agents work with the top-rated insurance companies in the nation, making it easier and faster to compare plans in your area. In fact, we can compare plans in your area for you and your family in minutes! We will provide you with an agent who will find a plan that covers your medical needs, and will allow you to stay within your budget. 

And unlike other companies who just want to make a dime off you, we just want to help you stay healthy by finding a great plan that won’t break the bank. That’s why all of our services are free! Let an EZ agent start comparing plans for you now, before Open Enrollment is over. To get free instant quotes, simply enter your zip code in the bar above, or to speak to a licensed local agent, call 888-350-1890.

The Complete Guide to Open Enrollment for Employers

It’s here! Open Enrollment for your group health insurance plan has come around again, running from November 1 – December 15. Now is the time when you can choose new benefits, or review and change existing health insurance benefits for your employees, and we get it: this time of year can be hectic and stressful, with all of the questions that employees (and you!) might have. Not only that, but you’ve got the weight on your shoulders of knowing that this is your one chance to get this done until next year! But don’t worry, we’ve got you – first, check out our tips below for a smooth Open Enrollment, and then speak to an EZ agent who can help you find the perfect plan for you and your employees. 

employees sitting at desks in an office
To qualify for group health insurance, your business must have at least 1 full time employee other than yourself or your spouse.

Does Your Small Business Qualify for Group Health Insurance?

Let’s start with the basics. If you’re new to offering group health insurance to your employees, you might be wondering how you qualify to offer it. Well, it’s actually pretty simple, and more likely than not, your business will qualify! You need to:

  • Have at least one full-time employee who is not the business owner, or the spouse of the business owner
  • Be legally registered as a business entity in your state (regulation for this varies from state to state)
  • Contribute at least 50% to your employees’ monthly premiums

Why Take Advantage of Open Enrollment?

Ok, so your business qualifies to offer group health insurance, but should you? And if you’ve already got a plan in place, why review it during Open Enrollment? Well, there are a few very good reasons to do both:

  • You and your employees can save money – Enrolling in a group health insurance plan is often cheaper than enrolling in an individual plan. Not only that, but the more employees you can get to sign up, the cheaper the plan could be.
  • Changes in life circumstances mean changes in insurance needs – If you do already offer group health, you definitely need to take advantage of Open Enrollment and use this time to reassess your and your employees’ needs. Has anything major changed, like births, deaths, or marriages? If so, you might be able to find a plan that offers better or more tailored coverage for a better price.
  • Group health can mean tax advantagesWho doesn’t love to save on their taxes? Take this time to look into ways you could be saving, like checking if you qualify for the small business health care tax credit, or by choosing to offer tax-advantaged healthcare options, like HSAs, FSAs, or HRAs. 

What Should You Be Thinking About When Choosing a Plan?

Another important basic step in the process: knowing what you should be thinking about when exploring your options. Here are 4 essential factors that should go into your decision-making process:woman in a blue button up shirt with her hand on her chin and question marks around her

  • Costs associated with the plan – You’ll want to consider how much employees want to pay in premiums, while also remembering that you have to contribute at least 50% of the amount each month. Also keep in mind things like deductibles, copays, and coinsurance that can all add up, depending on how often your employees access medical services. 
  • The metal tiers of available plansFamiliarize yourself with the so-called metal tiers of plans: Platinum, Gold, Silver, and Bronze. These terms have nothing to do with quality of care, rather they indicate what percentage of costs a plan will pay for covered benefits. For example, popular Silver plans will usually cover around 70% of costs, with the insured paying the remaining 30%. 
  • The type of plan you want – In addition to choosing a metal tier, you’ll also have to consider what type of plan you want to offer to your employees. For example, you can choose from HMO, PPO, POS, and EPO plans; each of these types of plan will offer different price points, since some are more flexible about things like network coverage.
  • Insurance companies – Check out which insurance companies offer plans in your area, and what their networks look like; you want to be sure that they offer affordable care in locations that are convenient for your employees.

What Should Employees Consider?

So you know what you need to be thinking about, but are you ready to answer your employees’ questions, or take on their concerns? You can help guide them in choosing or changing their plan by telling them to take the following factors into consideration:

  • The price of the plan – Let your employees know exactly how much the plan will cost them per paycheck.
  • Their dependents – Your employees should think about who they will need to have covered by their plan, especially if they plan on adding on family members in the coming year, or if they have added any new household members since last year. You’ll also need to make clear your policy on contributing to dependent coverage.person with a megaphone and exclamation points coming out of it
  • Any changes in coverage – Make sure your employees know what is covered under the plan, especially if there is anything new being added, like dental or vision coverage. 
  • Any added benefits – In addition, if your plan is going to have any new benefits, like telemedicine or wellness programs, let your employees know.

Top Tips for Employers

Group health insurance can seem a bit overwhelming, especially since studies show that 35% of employees have little to no understanding of their healthcare coverage! Not only that, but  22% of employees are confused during open enrollment, 20% are anxious, and 21% are stressed, so it can be tough to know how to approach this subject. But there are some ways to make the process go a little more smoothly. For example, you can:

  • Go digital – You don’t have to print out reams of paper, or have endless meetings with employees about benefits (which might be tough with all of the work-from-home going on right now)! Save paper, toner, and your and your employees’ sanity by offering everything in PDF form, and by considering holding a virtual benefits fair, which employees will be able to access when it works for them from the comfort of their home. 
  • Keep it simple – When emailing employees about their benefits, be as concise as possible, with price per paycheck and benefits clearly laid out, using language that is easy to understand. You can also include any FAQ sheets you get from your insurer or agent, as well as a glossary of terms and acronyms. 
  • Send out a surveyWhile you do have to be careful about privacy when it comes to employees’ health, there is no reason why you can’t send out an anonymous survey to find out what your employees are most interested in when it comes to their insurance plan, so you can either make a choice to change the plan you’re offering, or can recommend the right plan to them.
  • Be creative with your communication – Email is great, but you have tons of options when it comes to follow-up communication and reminders about enrollment, including:person sitting at a table with their cell phone in their hands
    • Text messages
    • Posters
    • A dedicated intranet webpage
    • Videos on screens in common spaces
    • Notices on paychecks (both hard checks and online)
    • A chat channel, through a platform like Slack
    • A Twitter chat, complete with hashtags that other employees can search

Yes, it’s Open Enrollment time again, what some might consider the most confusing time of the year. But you know? You got this, and we’ve got your back if you need help choosing, reviewing, or changing your employees’ healthcare plan. Come to EZ.Insure for a dedicated agent who can answer all of your questions, every step of the way, as well as find you fast, accurate quotes and sign you up for a great plan – all for free! No hassle, no obligation. To get started with us today, simply enter your zip code in the bar above or to speak to an agent, call 888-350-1890.