Enter your Zip Code and select the Coverage Type of insurance you are interested in. Your ZIP Code: Individual & Family Plans - Ages 19 - 64 Child Only Plans - Ages 0-18 Senior Plans - Ages 65+

Special enrollment periods will last for 60 days from the date of the triggering event unless the regulation specifically provides otherwise.

All requests for special enrollment periods must be evaluated by the Exchange as part of the eligibility determination process.

For purposes of special enrollment periods, a dependent is any individual who is or may become eligible for coverage under the terms of a QHP because of a relationship to an enrollee.

Triggering Events:

• Loss of other minimum essential coverage, defined as any event that triggers a loss of eligibility for other minimum essential coverage.

• Examples would include:
  • o Decertification of a QHP outside of the annual open enrollment period;
  • o Legal separation or divorce ending eligibility of a spouse or step-child as a dependent;
  • o End of dependent status;
  • o Death of an individual enrolled in minimum essential coverage ending eligibility for covered dependents;
  • o Termination of employment or reduction in the number of hours required to maintain coverage;
  • o Relocation outside the service area of the QHP.
  • o Termination of employer contributions for a qualified individual or dependent who has coverage that is not COBRA continuation coverage;
  • o Exhaustion of COBRA continuation coverage;
  • o Reaching a lifetime limit on all benefits in a grandfathered plan;
  • o Termination of Medicaid or CHIP.

HHS is seeking comment on its limitation of the special enrollment period to only those who lose minimum essential coverage, as opposed to any coverage. This was done to avoid adverse selection.

• Addition of a dependent through marriage, birth, adoption, or placement for adoption;

HHS seeks comments as to whether States might consider expanding the special enrollment period to include gaining dependents through other life events.

• Error in enrollment where the Exchange finds that enrollment or non-enrollment in a QHP is unintentional, inadvertent or erroneous and is the result of the error, misrepresentation, or inaction of an officer, employee, or agent of the Exchange or HHS, or its instrumentalities as evaluated and determined by the Exchange.
• QHP in which an individual was enrolled substantially violated a material provision of its contract in relation to such individual and their dependents. One example would be misrepresentation of the plan while marketing.
• Becoming newly eligible or newly ineligible for premium tax credits or a change in eligibility for cost-sharing reductions.

Enter your Zip Code and select the Coverage Type of insurance you are interested in. Your ZIP Code: Individual & Family Plans - Ages 19 - 64 Child Only Plans - Ages 0-18 Senior Plans - Ages 65+

Health Care Reform requires Exchanges to have an initial open enrollment period, an annual open enrollment period, and certain special enrollment periods. Individuals will only be able to enroll in a Qualified Health Plan through an Exchange during one of the enrollment periods. Individuals will not be allowed to purchase coverage unless an enrollment period is available.

 Initial Enrollment Period

The initial open enrollment period is expected to run from October 1, 2013 through March 31, 2014. Coverage will have an effective date of January 1, 2014, for qualified individuals whose Qualified Health Plan selections are received by the Exchange on or before December 15, 2013. For any selections received between the first and 15th day of January, February or March 2014, coverage will be effective the first day of the following month. For selections received between the 16th day and the last day of any month between December 2013 and March 31, 2014, the Exchange must ensure coverage is effective the first day of the second following month.

Special Enrollment Periods

Qualified individuals and enrollees may be allowed a “special enrollment period” under certain circumstances (similar to a qualifying event under Section 125 plans), during which they could enroll in a plan or change enrollment from one plan to another. Each special enrollment period will be 60 days from the date of the triggering event. The effective date of any coverage elected during a special enrollment period follows rules similar to those applicable during initial enrollment. However, coverage would be effective on the date of birth, adoption or placement for adoption, when that is the special enrollment triggering event. Click here for the list of Triggering Events.

Annual Enrollment Periods

The annual enrollment period for 2015 and subsequent years will begin October 15 and extend through December 7 of the preceding calendar year. Starting in 2014, the Exchange must provide advance written notice to each enrollee about annual open enrollment no earlier than September 1, and no later than September 30.

UnitedHealthcare recognizes that our American health system requires fundamental change to provide affordable, quality care. Health reform is a start but more is needed to address health care costs that are rising continually and a system where care is too variable. Innovative, value-oriented and outcome-focused approaches can help make the system work better for everyone.

At UnitedHealthcare, our goal is helping people live healthier lives.TM Through the use of best practices, UnitedHealthcare is working to build a better, more affordable health care system. We help make this happen by:

• Providing innovative and affordable choices in the health plans we offer
• Modernizing delivery of health care by development of tools and programs to make health care easier to understand and navigate
• Focusing on quality of service and simplicity of administration
• Informing and engaging your employees regarding their health to help them make healthier choices

The Affordable Care Act (ACA) brings significant changes to how Americans access and pay for health care. And while change is good, it can be challenging. We want to help you understand health reform and let you know that you are not
in this alone. We’re with you every step of the way. We are taking steps to ensure that UnitedHealthcare’s plan designs conform to the ACA’s mandates.

Changes in federal law are just one way to move toward a more modern health care delivery system. UnitedHealthcare is at the forefront of improving access to quality care, containing costs, using technology to increase transparency and
changing the way the system pays for care. We understand that when physicians, insurance companies, employers, consumers and government bring their best ideas to the table, we can help improve access to quality and affordable care.

The Big Picture

The ACA is rolling out in phases that began in 2010 and extend through 2019. Generally, the provisions fall into one of these areas:

• Standards for minimum health benefit plan offerings
• State-based Health Benefit Exchanges (Exchanges)
• Mandates for employers and individuals to provide or purchase health care coverage
• Premium credit or cost-sharing subsidies to qualified individuals to purchase coverage Taxes and fees
• Requirements that insurance companies spend a certain percentage of premium dollars on patient care
• Certain preventive care services covered without cost-share
• Insurance market reforms
• Expanded appeal rights for consumers
• Expanded Medicaid eligibility
• Changes to Medicare reimbursement

Keeping Your Grandfathered Plan

For employers who decided to “grandfather” their health benefit plan, some of the health reform changes are not required. Grandfathering a plan means that you decided to keep the plan that you had in effect on March 23, 2010, and made no or only minimal changes as permitted by the grandfather rules. However, there are a number of changes that apply to all plans whether or not they are a grandfathered plan.

As we approach 2014, grandfathered plans will not be required to implement a number of health reform law provisions, including:

• Rating restrictions such as adjusted community rating (small group plans only)
• Capping deductibles and/or implementation of the ACA’s out-of-pocket limits
• Providing essential health benefits (small group plans only)
• Providing coverage for clinical trials

In general, plan changes that can cause loss of grandfathered status include eliminating certain benefits, increasing coinsurance, increasing fixed-dollar cost-sharing (copayments, deductibles and out-of-pocket limits) beyond allowed amounts, and the plan sponsor’s decrease in its contributions toward the cost of coverage by more than 5 percent below the contribution rate on March 23, 2010.

So, if you have chosen to maintain grandfathered status, you will need to satisfy the notice and recordkeeping obligations that are required to maintain grandfathered status.

Five Things Employers Need to Know

As regulations, mandates and laws become effective over the next months and years, it’s important to know where to begin and what to focus on as you prepare your business and employees. Depending on your group size, some of these changes may involve changing your processes as well as updating plan documents and materials to comply with the new regulations. Read more below and on Page 6 in “On the Horizon for 2013.” Here are five things employers need to know:

Looking Back

Here are key health reform changes that went into effect on or before December 31, 2012:

• Accountable Care Organization (ACO) requirements
• Appeals provision*
• Dependent coverage up to age 26
• Limitation on Flexible Spending Account (FSA), Health Reimbursement Account (HRA) and Health Savings Account (HSA) coverage for over-the-counter medications
• Medical Loss Ratio (MLR) rebates
• Patient-Centered Outcomes Research Institute (PCORI) Fee
• Patient Protections*
• Preexisting condition protections for persons under age 19
• Preventive services as well as an expanded list of women’s preventive services with no cost-sharing*
• Quality bonus began for Medical Advantage plans
• Removal of lifetime and per-beneficiary annual restricted dollar limits for EHB
• Summary of Benefits and Coverage (SBC), the Uniform Glossary and
• 60-day advance notice of material modifications

*Not required of grandfathered plans

On the Horizon for 2013

Flexible Spending Account (FSA) Limits

Starting in 2013, there is a new maximum of $2,500 that can be set aside in a health FSA. In subsequent plan years, this will change based on inflation. This change is in addition to no longer allowing health FSAs to be used for over-the-counter medications that became effective in 2011.

Exchanges – Online Insurance Marketplace

Exchanges are intended to help individuals and small groups shop for, select and enroll in highquality, affordable private health plans that fit their needs at competitive prices.

Public Exchanges
The ACA requires Exchanges to be established in each state by Jan. 1, 2014. If a state does not establish an Exchange, the federal government will step in and operate the Exchange. Between 2014 through 2016, only individuals and employers in the small group market are eligible to participate in an Exchange. In 2017, states may permit employers in the large group market to participate. Exchanges will open for business beginning Oct. 1, 2013, offering coverage beginning Jan. 1, 2014. Exchanges may be operated by the state or federal government or as a partnership between a state and the federal government. In 2014, small groups will be defined as businesses with up to 100 employees, although until 2016 a state may choose to limit the definition to businesses of up to 50 employees. The definition for large groups will remain as businesses with more than 100 employees.

In late summer or fall (future guidance is expected on complying with this notice requirement), employers must provide written notice to current employees and going forward, new employees, to inform them of the Exchanges and the circumstances under which an employee may be eligible for health insurance subsidies.

Employees meeting certain requirements who cannot afford the coverage provided by their employer may purchase a plan in the Exchange.

Employers with at least 50 full-time employees who decide not to offer a health benefit plan to their employees, and instead leverage the Exchange, are subject to penalties referred to as the employer mandate. Read more on Page 8 in “What’s Coming in 2014.”

Private Exchanges

Private exchanges are being established by a variety of different entities such as consulting firms and cooperatives. Private exchanges are available to all business segments and fully insured or self-funded groups of all sizes. Because private exchanges are operated by private entities, subsidies are not available to those purchasing health care insurance through a private exchange.

Taxes and Fees

To fund several of the changes mandated by the health reform law, new fees will apply to health insurance issuers and self-funded plan sponsors. Based on the government rule and industry analysis for fully insured customers, in 2014 the cumulative impact of the health reform fees shows an increase in the premium by about 3.8 percent. For self-funded plan sponsors, it is about $5 to $6 per member per month.

• The Patient-Centered Outcomes Research Institute (PCORI) Fee applies to health insurance issuers and employers sponsoring self-funded group health plans. The temporary fee helps to fund research on the comparative effectiveness of medical treatments. Beginning with plan years ending on or after Oct. 1, 2012, the fee is $1 per covered life for the first year, $2 per covered life for the second year, and indexed to medical inflation in subsequent years. The fee began in 2012 and ends in 2019. The PCORI fee is due by July 31 of the calendar year immediately following the last day of the plan year. So, the 2012 fee must be paid by July 31, 2013, regardless of renewal date. – In the case of fully insured coverage, UnitedHealthcare is responsible for filing Form 720 and paying the required PCORI fee. The fee is rolled into the premium rates and is not called out separately on the invoice. – Self-funded customers, as the plan sponsor, must file federal excise Form 720, and pay the fee directly to the IRS.
• The Excise Tax, also known as the Cadillac tax, begins in 2018, and imposes a 40 percent excise tax on the value ofhealth insurance benefits exceeding a certain threshold. The thresholds are $10,200 for individual coverage and $27,500 for family coverage (indexed to inflation). The thresholds increase for individuals in high-risk professions and for employers who have a disproportionately older population.
• The Pharmaceutical Manufacturer’s Fee is an annual fee that began in 2011 and is imposed on any manufacturer or importer of branded prescription drugs with sales of more than $5 million.
• The following three fees under the ACA will be progressively incorporated into fully insured plan premiums and not called out separately on the invoice beginning Feb. 1, 2013, as renewals or new business cases begin and state regulatoryapprovals are received. Because groups with a February 2013 effective date will have one month of coverage subject to taxes and fees (January 2014), the fee for this month is included in the 2013 rates. Likewise, groups with a March 1 effective date will have two months of impact; groups with an April 1 effective date will have three months of impact; etc. The fees are prorated and spread over 12 months. – The Insurer Fee, also called the health insurance industry tax or premium tax, is an annual, permanent fee on health insurance issuers beginning in 2014. The Insurer Fee applies only to health insurance issuers, such as UnitedHealthcare. Therefore, it affects fully insured business only. The fee will fund premium tax subsidies for low-income individuals and families who purchase health insurance through an Exchange. The amount of the Insurer Fee is determined by the market share of the health insurance issuer. It is based on its net written health insurance premiums in the previous year, with certain exclusions. Although we have not received final federal guidance on the Insurer Fee, based on the government rule and industry analysis, the impact of the fee during the first year is about 2.3 percent of the premium. – The Transitional Reinsurance Fee is designed to stabilize non-grandfathered individual market plans (in and out of the Exchange). It is assessed on a per capita basis for both fully insured and self-funded members and applies to group and individual business. The Reinsurance Program will exist for the first three years of the Exchanges’ operation (2014-2016). The impact of the Transitional Reinsurance Fee, based on the government rule and industry analysis, is about $5 to $6 per member per month for the first year. – A Risk Adjustment Fee of about $1 per member per year is assessed on issuers of risk-adjusted plans in the nongrandfathered individual and small group markets, whether in or out of the Exchanges. The permanent fee helps fund the administrative costs of running the Risk Adjustment Program. The program is intended to protect health insurance issuers of risk-adjusted plans, such as UnitedHealthcare, against adverse selection by redistributing premiums from plans with low-risk populations to plans with high-risk populations. The Risk Adjustment Fee begins in 2014.

What’s Coming in 2014

Employer Mandate, Requirements and Penalties

Beginning in 2014, employers with 50-plus full-time employees and full-time equivalents may be subject to a penalty if they do not offer affordable Minimum Essential Coverage (MEC). The penalty is calculated as follows:

• Employers Not Offering Coverage: If an employer does not offer MEC and one or more full-time employees receive a premium credit or cost-sharing subsidy through the Exchange, the penalty is $2,000 per year per full-time worker. When calculating the penalty, the first 30 full-time workers are subtracted from the payment calculation.
• Employers Offering Unaffordable Coverage: If an employer offers MEC but the employee contribution exceeds 9.5 percent of household income, and one or more full-time employees receive a premium credit or cost-sharing subsidy through the Exchange, the penalty is $3,000 per employee who receives a premium credit or cost-sharing subsidy.

Individual Mandate

In 2014, most individuals who can afford coverage will be required to purchase health insurance or pay a penalty. The penalty for 2014 will be $95 or 1 percent of the individual’s income, whichever is greater and will rise for 2015 and 2016. Individuals who earn up to 400 percent of the federal poverty level may be eligible for federal subsidies to help them purchase insurance from the Exchange.

Adjusted Community Rating

Adjusted community rating (ACR) rules will apply to non-grandfathered individual and small group insurance markets effective for plan years (policy years in the individual market) beginning on or after Jan. 1, 2014. Under the ACA provision, the use of actual or expected health status or claims experience to set rates for premiums is prohibited. Other rating factors such as age, geographic area and tobacco use may be used to vary premiums, within certain limits. The only groups not affected by the rating changes are self-funded groups and grandfathered plans along with large fully insured groups in most states.

Removal of Preexisting Conditions

For plan/policy years beginning on or after January 2014, the health reform law will remove any restrictions on preexisting conditions for individuals of all ages. Therefore, coverage may not be denied for preexisting conditions nor will individuals with preexisting conditions be charged more. This is an update to the provision from 2010 that did not allow exclusions for children under the age of 19 with a preexisting condition. This applies to grandfathered and non-grandfathered plans; however, grandfathered individual health plans are exempt from this requirement.

Questions employers may want to discuss with their tax adviser or legal counsel with the employer mandate in mind:

• 1. How does our product portfolio measure up to the minimum value requirements that will become effective in 2014?
• 2. Do we offer affordable health care according to the definition in the employer mandate?
• 3. How is our prescription drug coverage?
• 4. Should we continue to offer coverage but change what we offer to suit the ACA’s guidelines?
• 5. Does it make more sense to pay the penalty of $2,000 per full-time employee per year minus the first 30 full-time employees than to offer employer-sponsored health coverage?

We Can Help

It’s important to help your employees understand the health reform changes that affect them now. Take advantage of UnitedHealthcare’s online tools to communicate changes or create programs for your employees: Health Care Lane,SM Healthy Mind Healthy Body® e-newsletter, member portals, videos from the award-winning “Health Care Reform Demystified” video series and the interactive health and wellness communications plan builder.

Questions?

Talk with your broker or account representative, who can address your specific concerns. We’re here to help you:

• Stay updated on ongoing policy changes through our e-newsletters and special websites dedicated to health reform news
• Find the most affordable health benefit plans
• Talk about health reform with your employees
• Refer to the United for Reform Resource Center for updates and more detailed information at uhc.com/reform.

The content provided is for informational purposes only and does not constitute medical advice. Decisions about medical care should be made by the doctor and patient. Always refer to the plan documents for specific benefit coverage and limitations or call the toll-free member phone number on the ID card.

This communication is not intended, nor should it be construed, as legal or tax advice. Please contact a competent legal or tax professional for legal advice, tax treatment and restrictions.
Federal and state laws and regulations are subject to change.

Insurance coverage provided by or through UnitedHealthcare Insurance Company or its affiliates. Administrative services provided by United HealthCare Services, Inc., or its affiliates.

UnitedHealthcare is committed to moving toward a modernized care delivery system, ensuring that changes in health care are made as effectively as possible for the health of the American people. Please refer to the United for Reform Resource Center for updates and more detailed information at uhc.com/reform.

©2013 United HealthCare Services, Inc.

Enter your Zip Code to begin your Aflac Medicare Quote. Your ZIP Code: Medicare Supplements

AFLAC Medicare Supplement Plans are now available for sale in South Carolina. New agent starter kits will begin shipping this week to all agents appointed in South Carolina. Sales material is now available on the AIMC agent portal.

If you are not currently set up for South Carolina and would like to be, please fax your California and Washington D.C. state license along with the Credit Card Authorization form to 866-300-0127 and we will get you set up as quickly as possible.

If you have any questions, please feel free to call us at  (866) 300-0127.

As of 04/08/2013, the following states are approved and sales materials are available for AFLAC Medicare Supplement Plans.

1. Alabama
2. Alaska
3. Arkansas
4. Arizona
5. California
6. District of Columbia (D.C.)
   
7. Georgia
8. Hawaii
9. Iowa
10. Idaho
11. Illinois
12. Indiana
13. Kentucky
14. Louisiana
15. Michigan
16. Missouri
17. Mississippi
18. Montana
19. North Carolina
20. Nebraska
21. New Jersey
22. New Mexico
23. Nevada
24. Ohio
25. Oklahoma
26. Oregon
27. Pennsylvania
28. South Carolina – NEW
29. South Dakota
30. Tennessee
31. Texas
32. West Virginia
33. Wyoming

Enter your Zip Code and select the Coverage Type of insurance you are interested in. Your ZIP Code: Individual & Family Plans - Ages 19 - 64 Child Only Plans - Ages 0-18 Senior Plans - Ages 65+

April 08, 2013

In December 2012, Aetna sent notices to Missouri Aetna Advantage Plans for Individuals, Families and the Self-Employed policyholders about a Missouri law requiring insurers to give them the opportunity to opt-out of contraceptive coverage on the basis of a religious, moral or ethical objection.  Shortly after those messages were sent, a temporary federal court order was issued on December 21, 2012 prohibiting the Missouri Department of Insurance from enforcing the contraceptives coverage opt-out or opt-in provisions of Missouri law.

On March 14, 2013, the Federal District Court in the Eastern District of Missouri found that certain sections of Missouri Statute 376.1199 related to contraceptives are pre-empted by federal law.

Policyholders of an individual or family Aetna Advantage Plan cannot drop contraceptive coverage.

Aetna will provide customers with a notice explaining this information in the near future.

We appreciate your understanding.

By Jose Pagliery @CNNMoney April 4, 2013: 6:12 AM ET

March 20, 2013

By REED ABELSON

OAKLAND, Calif. — When people talk about the future of health care, Kaiser Permanente is often the model they have in mind.

The organization, which combines a nonprofit insurance plan with its own hospitals and clinics, is the kind of holistic health system that President Obama’s health care law encourages.

Kaiser has sophisticated electronic records and computer systems that — after 10 years and $30 billion in technology spending — have led to better-coordinated patient care, another goal of the president. And because the plan is paid a fixed amount for medical care per member, there is a strong financial incentive to keep people healthy and out of the hospital, the same goal of the hundreds of accountable care organizations now being created.

“Over the course of the last 15 years, they’ve been just going into high gear and doing everything right,” said Dr. Thomas S. Bodenheimer, a health policy expert at the University of California, San Francisco who recently chose Kaiser as his own health plan.

Yet even with all of its effort, its chairman and chief executive, George C. Halvorson, acknowledges Kaiser has yet to achieve the holy grail of delivering that care at a low enough cost. He says he and other health systems must fundamentally rethink what they do or risk having cost controls imposed on them either by the government or by employers, who are absorbing the bulk of health insurance costs. “We think the future of health care is going to be rationing or re-engineering,” he said.

Mr. Halvorson is convinced that Kaiser’s improvements in the quality of care save money. But he also says that the way to get costs lower is to move care farther and farther from the hospital setting — and even out of doctors’ offices. Kaiser is experimenting with ways to provide care at home or over the Internet, without the need for a physical office visit at all. He also argues that lower costs are going to be about finding ways to get people to take more responsibility for their health — for losing weight, for example, or bringing their blood pressure down.

“The obesity work is incredibly difficult,” he said. “It’s very, very hard to move the needle.”

Other health care experts say that while Kaiser has a place in the future, whether it is the best model for the country’s health care remains unclear. “They have not translated some of their strengths into better prices,” said David Lansky, the president and chief executive of the Pacific Business Group on Health, which represents employers on the West Coast, many of whom purchase coverage from Kaiser for their workers.

And there are other concerns, such as whether an all-encompassing system like Kaiser’s can really be replicated and whether the limits it places on where patients can seek care will be accepted by enough people to make a difference. Or whether, as the nation’s flirtation with health maintenance organizations, or H.M.O.’s, in the 1990s showed — people will balk at the concept of not being able to go to any doctor or hospital of their choice.

“The more you restrict the patient’s ability to do what they want, you risk reigniting the backlash we had in the past,” Mr. Lansky said.

In many ways, Kaiser has been ahead of the curve on health care for decades. Started by a surgeon running a tiny hospital near Desert Center, Calif., to serve construction workers, Kaiser became an H.M.O. with its own doctors and hospital in the mid-1940s and expanded beyond California over the next 50 years. But, as H.M.O.’s fell out of favor, it was forced to leave states like New York, Connecticut and Texas.

But Kaiser persevered, and its membership, which peaked in 1998, is now about the same as its previous high of 9.1 million, about three-quarters of whom are in California. It still operates in a half-dozen states from Maryland to Hawaii and is looking to expand in the Mid-Atlantic region, where membership had been dropping.

The organization, with some $50 billion in annual revenue, owns 37 hospitals and employs 17,000 doctors, all on salary. And its integrated model is in favor again. Hospitals across the country are buying physician practices or partnering with doctors and health insurers to form accountable care organizations, or A. C.O.’s, as a way of controlling more aspects of patient care. Doctors are also creating so-called medical homes, where patient care is better coordinated.

The days when doctors, hospitals and other providers are paid separately for each procedure will disappear eventually, health experts say. Instead, providers will have financial incentives to encourage them to keep people healthy, including lump sums to care for patients or provide comprehensive care for a specific condition. “All of care is going to move down this path, and it has to,” Mr. Halvorson said. “Medical homes are doing it; the very best A. C.O’s are going to figure out how to do it.”

The move by hospitals to buy physician practices is being viewed cautiously by health experts, who say there are downsides to the creation of large health care systems that may be motivated by the desire to increase their clout in the market, making it easier to fill beds and charge the insurers more for care. “They become these huge local monopolies,” said Dr. Robert Berenson, a health policy expert at the Urban Institute.

But having an integrated system seems essential to the success of Kaiser and a handful of similar, if smaller, organizations, like Intermountain Healthcare in Utah and Geisinger Health System in Pennsylvania, although some work with doctors whom they do not employ. In California, Kaiser controls nearly every aspect of a patient’s care, from providing the M.R.I. for a diagnosis to filling a prescription at one of its pharmacies to running a hospital where the patient undergoes surgery.

“We have all the pieces,” said Philip Fasano, Kaiser’s chief information officer. “Anything a patient needs you get in the four walls of our offices,” he said. As a result, while Kaiser can point to an analysis done by Aon Hewitt, a benefits consultant, showing that its plans are typically at least 10 percent less expensive than others, especially where they control all the providers, its costs are more like the average in places in Ohio, where it does not have its own hospitals and offer as broad a range of services.

And some patients outside of California, where Kaiser operations are less concentrated, complain about being forced to travel for treatment by Kaiser providers. Arva Priola, a 62-year-old Kaiser patient in Fredericksburg, Va., said her Kaiser doctors “are wonderful,” but that the plan recently started requiring her to get some treatments where they had physical facilities.

To get IV antibiotics after surgery, for example, she recently had to drive an hour and a half to a Kaiser office in Tysons Corner, Va. “Who wants to drive when you’re sick?” she asked. Kaiser says it is adding more services closer to Fredericksburg.

A California state agency recently criticized Kaiser for the long wait times its members had for mental health services and for providing inaccurate information about what services it provides. Kaiser says it has corrected the misinformation and is working to reduce and better track member wait times.

Where Kaiser has a head start that others may have difficulty catching up to is its use of electronic records and technology systems for tracking patient care.

When Dr. Jennifer Slovis, a Kaiser internist in Oakland, recently saw a patient, she was able to spot that the patient had an abnormal blood test several years ago. By reading through the patient’s medical history, she determined he was now overdue for an M.R.I. to check the status of a growth in his brain. She was able to e-mail his endocrinologist and schedule the necessary tests without the patient having to make an appointment with the specialist or her having to make her own diagnosis. “It saved a lot of starting over,” she said.

In the last five or so years, Kaiser has also been using the information to identify those doctors or clinics that excel in certain areas, as well as those in need of improvement. The organization has also used the records to change how it delivers care, identifying patients at risk for developing bed sores in the hospital and then sending electronic alerts every two hours to remind the nurses to turn the patients. The percentage of patients with serious pressure ulcers, or bed sores, dropped to well under 1 percent from 3.5 percent.

“The tool is an enabler to give information to people who give a damn,” said Dr. Jack Cochran, the executive who represents Kaiser’s physicians through the Permanente Federation.

Mr. Halvorson, the Kaiser chief, who plans to retire at the end of this year, says the organization is providing evidence to other health systems that re-engineering works. “All of that adds up to better care and cheaper care,” he said.

Enter your Zip Code to begin your AFLAC Medicare Quote. Your ZIP Code: AFLAC Medicare Supplements

AFLAC Medicare Supplement Plans are now available for sale in California and Washington D.C.. New agent starter kits will begin shipping this week to all agents appointed in California and Washington D.C.. Sales material is now available on the AIMC agent portal.

If you are not currently set up for California and Washington D.C. and would like to be, please fax your California and Washington D.C. state license along with the Credit Card Authorization form to 866-300-0127 and we will get you set up as quickly as possible.

If you have any questions, please feel free to call us at  (866) 300-0127.

As of 03/20/2013, the following states are approved and sales materials are available for AFLAC Medicare Supplement Plans.

1. Alabama
2. Alaska
3. Arkansas
4. Arizona
5. California  – NEW
6. District of Columbia (D.C.) – NEW
7. Georgia
8. Hawaii
9. Iowa
10. Idaho
11. Illinois
12. Indiana
13. Kentucky
14. Louisiana
15. Michigan
16. Missouri
17. Mississippi
18. Montana
19. North Carolina
20. Nebraska
21. New Jersey
22. New Mexico
23. Nevada
24. Ohio
25. Oklahoma
26. Oregon
27. Pennsylvania
28. South Dakota
29. Tennessee
30. Texas
31. West Virginia
32. Wyoming

Enter your Zip Code and select the Coverage Type of travel health insurance you are interested in. Your ZIP Code: Individual & Family Plans - Ages 19 - 64 Child Only Plans - Ages 0-18 Senior Plans - Ages 65+

People travel both in country and internationally every day. When people are getting ready to travel they usually have things like packing, bag weight limits, tickets, lodging, passports, business plans, sightseeing, and dreading long lines at the airport on their mind. Last is usually the what-if’s of being hurt or getting sick while traveling. Travel health insurance will take care of these issues and give peace of mind to those who take the time to purchase it.

Why should I buy it? This is a great question and is probably best answered using some scenario’s that have happened to our own clients. A businessman is sent to Mexico to visit some manufacturing facilities. While he is out to eat he gets food poisoning and needs some medical attention. A young couple is walking some cobble stone streets of Paris and one falls and breaks a tooth. You, along with your church group, are visiting a small village building schools and hurt yourself. Let’s say that it is bad enough that you need to be sent back to the United States for surgery. This would all be taken care of under your travel health insurance policy.

What will be covered? Under a comprehensive plan you will have coverage for medical costs that you incur at a physician’s office, an emergency room, surgery costs, dental costs, and much more. You may have coverage for some physical therapy, accidental death and dismemberment, as well as emergency evacuation. Travel health insurance may also cover ambulance services and even dental work.

What types of policies are there? Several different types of travel health insurance plans exist. Single trip plans for someone going overseas. Multi-trip plans for frequent travelers or business travelers. There are also plans for groups like school groups or missionaries and there are policies specifically built for expatriates who have decided to live in other countries. The policies for expatriates can be designed to cover someone both inside and outside the U.S. to be sure all their needs are met depending on how much they travel.

What is the cost? Travel health insurance is quite affordable. Short term plans are less expensive than long term and expatriate plans. Factors like age will be considered when producing a rate but many times health factors are not taken into account and you may be able to have coverage for pre-existing conditions. Always talk with your broker about this.

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Enter your Zip Code and select the Coverage Type of insurance you are interested in. Your ZIP Code: Individual & Family Plans - Ages 19 - 64 Child Only Plans - Ages 0-18 Senior Plans - Ages 65+

Interest in travel medical plans has greatly increased over the years. As the world becomes a bit more dangerous to travel in in terms of political strife as well as the inability of some countries to control the spread of infectious disease we do not want to stop visiting this beautiful world we live in. Combine that with the fact that individual and group health insurance policies are either greatly reduced once you leave our borders or those policies lose all their benefits you need to have something in place, just in case. You must be aware of limitations to make sure you are protected properly.

Travel medical insurance policies are specifically built to pick up where you may have any gaps in your current health insurance coverage outside the borders. Many health plans over cover you in the 50 states and sometimes Mexico (be sure to check with your provider). If you do not have any health coverage your travel medical insurance plan will act as your primary insurance. Depending on what plan you choose your policy may have more than just emergency benefits. It may cover some doctor office visits, prescriptions, and even ambulance services. The best policies will even cover sickness and injury due to a pre-existing condition or a terrorist attack. Finally, many of these plans will pay providers overseas on a direct basis so you don’t have to deal with shuffling paperwork back and forth. Finally, the best travel medical insurance plans offer large global provider networks and choose their providers based on how well they will bill your carrier rather than billing you and how proficient they are in speaking your language to offer you the best care.

When you are in the market for travel medical insurance you do want to be on the lookout for a few things. Make sure you know whether or not the policy you are going to purchase is admitted or non-admitted. An admitted policy will be sold by a company based on shore and subject to the laws and regulations of various insurance departments. A non-admitted policy may be sold by a company who sits offshore outside of the reach of any authority of the U.S. legal system. Those non-admitted policies can put you in a world of hurt if they decide not to play by the rules. Furthermore, admitted policies must be written in plain language and conform to the consumer protection laws in the United States. These admitted plans often offer much deeper benefits and safety. Be sure to discuss with your broker what type of plan you are purchasing.

If you have any questions or need a quote please fill out our contact form or feel free to give us a call.