Nov 10, 2022Are You Ready for ACA Informational Reporting?
2022 ACA Informational Reporting for applicable Large Employers (ALE) and small employers with self-insured plans will be due in March 2023
Preparing for Open Enrollment can often be an overwhelming amount of new information to process. Understand what to do and how to view and make changes to or reconfirm your benefits elections.
Below we’ll discuss three of our most commonly asked about topics to ensure a smooth enrollment period:
Even if you are keeping everything the same with your plan for the next year, you still need to confirm those same selections online in your benefits administration portal. This process is quick and simple but vital to do before the deadline closes.
You can complete the confirmation by logging in to your benefits portal. There, you can view your current elections and will have the option to make changes to your benefits plan. If you have a Qualifying Event to report, please reach out to your HR department.
Confirmations and signatures can be done electronically via your online benefits portal as well. Please note that your enrollment is not considered complete until you have signed off and submitted your enrollment via the platform.
Once you’ve confirmed and submitted your elections, you’re good to go! You can wait now for your carrier to reach out with updated insurance cards and other required information.
If you do not have access to an online benefits portal, you may reach out to your HR administrator or account manager with M&G for further assistance
In some circumstances, your employer may elect to provide coverage from a different insurer requiring a change in your carrier.
In the event of a carrier change, some things to think about include your deductible credit rollover, administrative processing times, prescriptions, and reauthorizing any continued treatment on the new carrier. Let’s break it down.
What you should know first and foremost, is that your deductible credit from your previous carrier will roll over to your new carrier after the transition. This means whatever fund you’ve already paid towards your current plan deductible will transfer with your transition to a new carrier, rather than starting again at zero that calendar year. This is a pretty simple process of making a call and getting some paperwork to your new carrier.
The processing time to transfer over your deductible credit will take at least 30 days. Transferring medical records may take a few days. Prescriptions that require authorization may take up to 2 weeks – contact your ordering doctor for this purpose. With this in mind, if you have any active prescriptions you’re taking and know that you are switching insurance carriers this year, get those prescriptions refilled first so you won’t run out of medication during any potential gaps in time during the transition process.
Finally, if you are currently receiving any treatment that requires authorization, you will need to get that care re-authorized on the new carrier. You can ask your current providers if they are currently contracted with your new insurance, otherwise new providers will need to be set up.
If you’re considering switching to a new HMO plan during Open Enrollment this season, make sure you understand the differences between an HMO plan versus a PPO.
An HMO (or Health Maintenance Organization) plan can save you a lot of money in premiums each year, but it comes with some limitations worth considering. With an HMO, medical coverage is limited to in-network providers which, in more rural areas, could mean less available options or potentially having to change primary care doctors and specialists.
Additionally, authorization from your Primary Care Physician is usually required before seeing a specialist, getting an x-ray, or accessing other medical care beyond your annual preventative care. For new patients, this can mean potentially facing long wait times and delays.
HMO plans are very cost-effective but with the cost savings come strict rules about accessing specialty services. Make sure you understand the plan’s limitations and ensure an HMO will work for your needs before making the switch!
For help with any of this and more, our advocacy team at Morris & Garritano is here for you! Don’t hesitate to call our office for a direct connection to one of our friendly and helpful representatives. We’re available to provide this personalized service to you as part of your employer’s benefits offering.
You can reach us by calling 855-662-1029 or emailing AdvocateServices@morrisgarritano.com.