How to Close Out Open Enrollment for Individual & Family Health Plans

Overview: Individuals and families can understand what steps to take to properly close out a health insurance plan.

Open enrollment is a period of time each year when you can sign up for health insurance or change your plan, but sometimes circumstances might prompt an individual to close out their plan.

With open enrollment, you have the option to keep your current health insurance if you are satisfied with your coverage. However, open enrollment is also an opportunity to remove yourself from a plan if it’s been provided by an employer and you no longer want the coverage.

Reasons People Want to End Open Enrollment :

There are a number of reasons why you might decide to cancel your health insurance plan.

Maybe you started a new job and are now eligible for the company’s better coverage.
Perhaps you recently turned 65 and now qualify for comprehensive Medicare.
Or unfortunately, maybe you got laid off and can no longer afford healthcare coverage on your own due to the high cost of premiums, deductibles or co-sharing — or all three.

Regardless of the reason for cancelling a health plan, individuals who are interested in a different coverage within their medicare plan can take advantage of open enrollment. However, it isn’t recommended to request a mid-month termination.

Your health or dental insurance company is not obligated to refund prorated premiums if you request a mid-month termination. Additionally, you may also have a gap in health coverage because your next health plan or dental plan will probably start on the first day of the next month. For these reasons, if you need to terminate your plan, Covered California highly recommends to request a cancellation to be effective at the end of a month.

Tips to Closing Out Your Health Plan :

Best Practice Tip #1: Don’t close out unless absolutely necessary.

Remember close out will end the current plans and enrollments; ended & archived enrollments are not eligible to be modified. The only exception for closing out early is when using 834 files to electronically transmit data to the carriers. Carriers often require the files typically 10 days prior to the enrollment effective date.

Best Practice Tip #2: Don’t end your Marketplace plan until you know for sure when your new coverage starts.

Once you end Marketplace coverage, you can’t re-enroll until the next annual Open Enrollment Period (unless you qualify for a Special Enrollment Period).

Read more about closing out your open enrollment plan here and here.

Closing Out Health Insurance as an Individual or Family:

Your best steps to cancel health insurance will depend on various factors, including your provider’s particular protocols, your reasons for dropping coverage, and whether your plan covers your dependents.

Individual Health Insurance:

Contact Your Provider: If you want to cancel health insurance you bought from a private insurer, you’ll need to contact that insurer for directions. Different carriers have different cancellation protocols. Some insurers may send you a form to fill out; others may want a more formal written confirmation to end coverage. Call the customer service number listed on the back of your health insurance card to get the details you need to follow.

We highly recommend checking out Healthcare Insider’s article on cancelling health insurance. The article addresses almost every case regarding health insurance cancellation, including the following:

Health Insurance Purchased from a Private Insurer
Employer Health Insurance and Private Plans
Medicaid or CHIP Programs
Canceling Health Insurance on Behalf of a Deceased Person

Family Health Insurance:

If you’re ending coverage for everyone on the application, your termination can take effect as soon as the day you cancel, or you can set the Marketplace coverage end date to a day in the future — like if you know your new coverage will start on the first day of the following month.

If you’re ending coverage for just some people on the application, in most cases their coverage will end immediately. In some cases, coverage will not end immediately, including when the household members who remain enrolled in coverage qualify for a Special Enrollment Period. The best way to make sure coverage ends on the right date is to contact the Marketplace Call Center and request the change.

December 21, 2021December 20, 2021

Here’s what you need to qualify for the Earned Income Tax Credit

Learn what determines tax credits eligibility (and non-eligibility) to help pay for your health insurance

If you want guidance on how to pay for your health insurance, it might be helpful to know if you qualify for tax credit and what counts as income according to the Earned Income Tax Credit Eligibility (EITC).

Here are some quick facts about the earned income tax credit:

For the 2021 tax year (the tax return you’ll file in 2022), the earned income credit ranges from $1,502 to $6,728depending on your filing status and how many children you have.
You can use either your 2019 income or 2021 income to calculate your EITC — you might opt to use whichever number gets you the bigger EITC. (In general, the less you earn, the larger the credit.)Be sure to ask your tax preparer to run the numbers both ways.
You don’t have to have a child in order to claim the earned income credit.
The earned income tax credit doesn’t just cut the amount of tax you owe — the EITC could also score you a refund, and in some cases, a refund that’s more than what you actually paid in taxes.
If you claim the EITC, the IRS cannot issue your refund until mid-February by law.

WHO QUALIFIES AND WHAT COUNTS AS EARNED INCOME FOR THE EITC:

Federal and state laws and regulations seem to change faster than you can keep up.

Low- to moderate-income workers with qualifying children may be eligible to claim the Earned Income Tax Credit (EITC) if certain qualifying rules apply to them.

According to the IRS, you may qualify for the EITC even if you can’t claim children on your tax return. Learn more about how to claim the EITC without a qualifying child here.

Eligibility for tax credits is determined by several criteria, including the amount of income you make.

You must have at least $1 of earned income (pensions and unemployment don’t count).
Your investment income must be $10,000 or less.
For the 2021 tax year, you can qualify for the EITC if you’re separated but still married. To do so, you can’t file a joint tax return and your child must live with you for more than half the year. You also must have not lived with your spouse during the last six months or you must have a separation agreement or decree.
You must not have to file Form 2555, Foreign Earned Income; or Form 2555-EZ, Foreign Earned Income Exclusion.

There are also additional requirements such as age, foreign income, investment income, and dependents that you can read more about here on the Disability Benefits 101 (DB101) website. Below is a list of more common criteria:

You must meet adjusted gross income requirements.
You must have earned income from employment, self-employment, or employer-paid disability benefits received prior to retirement.
You must have a Social Security Number valid for employment.
You cannot file your taxes as “married filing separately.” If you’re married, you must file a joint tax return.
You must be a U.S. citizen or resident alien. If not, you must be married to a U.S. citizen or resident alien and filing a joint tax return.
You must live in the U.S. for more than half of the year.

Here’s what counts as earned income:

Federal taxable wages
Tips
Self-employment income
Unemployment compensation
Pandemic Unemployment Compensation ($300/week)
Social Security
Social Security Disability Income (SSDI)
Retirement or pension
Excluded (untaxed) foreign income
investment income
Alimony (only if divorce or separation finalized before Jan. 1, 2019)

Employer-paid disability payments received prior to retirement are considered earned income under the EITC program. But benefit payments received from a policy you paid the premiums for, or that you received post-retirement, would not be considered earned income.

WHAT DOES NOT COUNT AS EARNED INCOME FOR EITC:

Child support
Gifts
Supplemental Security Income (SSI)
Veteran disability payments
Worker’s compensation
Proceeds from loans (like student loans, home equity loans, or bank loans)
Child Tax Credit checks or deposits (from the IRS)
Stimulus payments (Economic Impact, American Rescue Plan, Golden State, etc.)

HealthCare.gov provides an extended list of qualifications (and non-qualifiers) to help you estimate what your household income is likely to be for the year.

IN SUMMARY:

If you fall within the guidelines for the credit, be sure to claim it on your return when you do your taxes And if you didn’t claim the earned income credit when you filed your taxes in the last three years but you think you qualified for it, the IRS encourages you to let it know so you can get that money back.

https://www.bdhealthinsurance.com/

August 14, 2019January 27, 2020

California Vaccination Rates Dropping: What You Need to Know

For 3,000 years, smallpox was among the worldâ€™s most feared diseases. Over 80 percent of children faced an early death with the foreboding diagnosis. But in 1796, Edward Jenner developed the first successful vaccine against smallpox. And upon his discovery, millions of lives were spared from this deadly disease. So today, we celebrate Jennerâ€™s genius and the worldwide eradication of smallpox.

Since 1796, 14 more diseases have been held at bay or made less-prominent by the invention and wide administration of vaccines. They are now generally non-threatening to western civilization. These diseases include polio, tetanus, flu, hepatitis B, hepatitis A, rubella, Hib, measles, whooping cough, pneumococcal disease, rotavirus, mumps, chickenpox, and diphtheria. While they still exist, each of these is far less common in the United States. Today, our society is healthier and safer thanks to modern medicine the contributions of vaccines.

smallpox While vaccines are essential to the prosperity of humankind, communities of non-medical skeptics have turned against immunizations. Anti-vaccine groups strongly oppose these preventative measures, causing some regression in societal health in recent years. Just this year, weâ€™ve seen the repercussions of this dangerous anti-vaccine sentiment. According to the California Department of Public Health, the 2018-2019 school yearâ€™s vaccine rate among California kindergarteners dropped from 95.1 percent to 94.8 percent. This drop is likely due to the 70 percent increase in medical vaccine exemptions obtained by parents this past year.

While medical exemptions were distributed, physicians are suspicious that in such a short period, so many people developed new illnesses, keeping them from receiving vaccinations. It is more likely that these exemptions were given for the patientsâ€™ personal beliefs, which under California law, is illegal.

This is frightening. While the vaccination rate among kindergarteners has dropped less than one percentage point (.9%), the concentration of unprotected people is what is concerning. According to physicians, 95 percent of people near one another must be immunized to prevent the spread of disease. This is called herd immunity. So, if a few people are not vaccinated, there is no significant threat. However, an entire community could be at higher risk for disease outbreak if it contains multiple low-vaccine-rate schools. And several California communities fit these alarming criteria.

According to data collected by the L.A. Times, about 1,500 schools in California reported a kindergarten vaccine rate under the safe limit of 95 percent. And 400 of these schools can be found in Los Angeles county, half of which are located within a half-mile of each other. So, in the case of disease outbreak, entire communities could be at serious risk.

What to doâ€¦

Be sure that you and your children are up to date on required immunizations, including the yearly flu shot. These preventative measures will not only impact your own health but that of those around you. And if you are concerned about the vaccination rate at your school, check out Shots for School to see how yourâ€™s is doing. Take careÂ and stay up-to-date on your vaccines!

We at Bernardini and Donovan strive to promote the health of you and your family. We are here for your health insurance needs and prepared to assist your particular requirements. Do not hesitate to call on us for unmatched health insurance services.

August 6, 2019

Back to School Health Checklist

With the close of Summer, August marks the start of the next school year. And in anticipation for the first day of school, there are a few things that first must be accomplished. You’ll, of course, make your annual school supplies Target run. You might pick up a few fresh outfits. And you’ll want to be sure to make the most of these last summer days. However, it is also important that you consider your children’s health and preventative care as they enter a new grade. There are several ways to ensure their preparedness and start the year off right! Check out our checklist on your children’s’ back-to-school health!

9 Ways to Prepare Your Children for the Start of School.

1. Immunize.

This is a significant step in ensuring the safety of your children and those they encounter. Vaccines have eradicated several deadly diseases, making our society far safer. So, be sure to do your part and keep your children’s’ vaccinations up to date. It is also required in all 50 states, that school-aged children be immunized against measles, mumps, rubella, pertussis, and chicken pox. Receiving immunizations can be coupled with your child’s annual doctor’s check-up.

2. Get a flu shot.

Flu shots similarly promote the safety of your child and those around them. However, this is not only good for your children. Everyone over the age of 6 months should get a flu shot every year. So, you ought to join in on the fun as well! Take your whole family to receive your shots, ideally before the start of flu season in October.

3. Prioritize good sleep hygiene.

Summer is likely to throw off your schedule a bit. So make sure that a proper sleep routine is re-implemented before the start of the school year. Remember that children require plenty of sleep: 10 hours for school-aged kids, and 9-10 hours for teens. Without adequate amounts of sleep, your child will struggle to focus and engage in the classroom.

4. Value the lunch box.

The food your children eat at school will influence their ability to learn, interact with others, and enjoy their day. So make sure to pack with them, nutritious and kid-approved food. Include fresh fruits and vegetables, protein-rich items such as nuts and lean meats, and swap out white bread for whole-grain! Find what healthy foods your kids enjoy eating and cater to those preferences.

5. Inform your kids of the ways of the road.

If your kids make their own way to school, either by foot or bicycle, be sure that they are aware of traffic safety rules. Teach them to use the sidewalk when available. And in the case that there is no sidewalk, to use the shoulder of the road, facing traffic.

6. Lighten their load.

Backpacks are often stuffed with books, binders, colors, and everything in between, making them quite heavy. This load can be harmful to your child’s neck, back, and shoulders. So, to ensure their comfort and health, watch the weight of their backpacks. It is advised that their packs to not exceed 10-15% of their body weight.

7. Get their eyes checked.

One’s ability to see is integral to their learning capabilities. So, be sure to take your child to get their eyes checked in case they require glasses. Also, look for signs of any sight-impairments. If they are squinting, closing one eye to read, or they hold their book exceptionally close, you may need to check the status of their vision. A child who is unable to see properly faces a significant learning barrier.

8. Emphasize good hygiene and cold-preventing habits.

Returning to school also marks the return of abounding germs. And while your children are up against all odds, there are several ways to help maintain their good health. Emphasize the importance of thorough hand washing, cover their sneezes and using tissues, and not touching their eyes, nose, and mouth.

9. Inform your school of health issues.

Keep your school updated on special restrictions and instruction to keep your child healthy. Make sure that they are aware of all allergies and health problems.

This school year, be sure to prioritize your children’s health and well-being. From packing their lunch to scheduling doctor’s visits, you have the opportunity to give them the best start! And to insure your health care needs, do not hesitate to call on us at Bernardini and Donovan for expert advice and counsel. We are here for you and your entire family in this upcoming school year!

April 23, 2019January 27, 2020

Aging Well

Aging Well

â€œOld age is no place for sissiesâ€ We couldnâ€™t agree more Bette Davis! Aging is an inevitable process. However, there are ways that you can help yourself as you mature with dignity. In this blog, we will discuss a few ways that you probably have heard and some that you havenâ€™t to help you age well.

Eat Well

This may be a no brainer as eating healthy is one of the tenants of good health. But a well-balanced diet helps your body age well! One of the best things you can do is just to cut out processed foods. Processed foods are anything that comes prepackaged. By cutting these out, you are cutting out unnecessary sugars and salts. Along with eating well, you will want to ensure that you are drinking enough water. Well hydrated skin can better combat signs of aging like wrinkles and fine lines. But parched skin loses its glow and looks dull and flaky.

Sleep Well

To age well it is recommended that you get anywhere from 7 and a half hours to nine hours of sleep. When you are sleeping your body is releasing growth hormones that help build up collagen and help you look younger. Skin cells can reproduce quicker during your sleep and can help you significantly.Â Lack of sleep can lead to a higher chance of obesity, diabetes and heart disease.

Exercise

As we age our metabolism slows down and for some, that means weight gain. Exercise can help keep weight off and also help you lose a few extra pounds as well. Also, as we age, we can lose muscle mass and bone density. Both of these can be helped through resistance and weight training. Talking a walk around your neighborhood, going for a swim, picking up some weightsâ€¦ all of these can help you age better.

Check your Attitude

Studies have shown that those who look on aging fondly have a better likelihood of living up to 7 years longer than those who donâ€™t. The people who can see their aging as growth of wisdom and maturity and no longer being run by their emotions or overwhelmed by their circumstances have been known to live longer. So the next time someone brings up your birthday, instead of grumbling about your age, plan a fun party with some of your friends and family to celebrate!

We hope that these have given you a new pep in your step to look fondly on your aging process.

July 18, 2018

When to change your plan

When to change our plan

Its July now, and for many of us, we have had our current health insurance plans for seven months out of the year. This timeline has walked us through flu season, allergy season and an extended enough period to get a good read on whether or not your current health insurance plan is a good fit. At this time of year, we always recommend going back over your year and checking off your health needs.How many times did you need to go to Urgent Care?

How many times did you go to the Emergency Room?

How many times did you need to visit a specialist?

How many times did you need to visit your doctor?

Was there any unexpected change to your health this year?

Were there any diagnoses that would potentially need extended lasting care?

All of these questions can have a significant impact on the type of insurance that is best for you and your family. For example, let’s say that you have a Bronze level plan which is known for their low monthly premiums but high costs when you need care. In this last year, you have gone to urgent care more than expected and required more time with your family’s doctor. This plan would not be very affordable for you as you are continuing to pay more out of pocket with each doctor’s visit and care that was provided.

If you have seen significant changes in your health or your family’s health, now is an excellent time to make a note of it. You cannot make changes to your health insurance plan unless there is a qualifying life experience (lose current coverage, changes in household…). But you can make a note of how many times you paid out of pocket for care. If this number is significant enough, we recommend talking to us during open enrollment to change your plan. With information like this written down, we can help you find the best health insurance plans for your needs and finances. Please feel free to call us at any time of the year for any guidance on your health insurance needs.

May 25, 2018

Pros and Cons of Kaiser

Kaiser Permanente is one of the staples of our local health providers.

They have recently built a facility in Redlands and continue to provide health services to our community. But bringing up the name Kaiser Permanente can come with some very mixed results. You’ll find people who love Kaiser and feel that they have never experienced better or more organized care. You’ll also find people with vitriol and fury in their descriptions of the healthcare company. This may be because of the unique type of business model that Kaiser holds to, which is different than any other health provider.

Kaiser not only provides health care through doctors, nurses and specialists; they also provide the health insurance to help pay for that care.

Medical health insurance that is purchased through them makes all of their doctors and facilities available to you. However, you will not have access to anyone outside of their care. If it is an emergency situation, they will cover attention that was received at another hospital.

It is this system that makes people have such polarizing opinions on Kaiser.

For many, they experience a system with a lot of ease. All of your medical records are accessible and ready at any time to any doctor that you may see. The costs are usually lower than other health insurance and care providers. They are dedicated to providing your excellent, whole health care. Their website states “Kaiser Permanente was founded on the radically simple idea that everyone deserves the chance to live a healthy life. That’s why you can find high-quality care and coverage in one place.” But on the rare case that you become ill with something that their specialists cannot find an answer to, and if there is another specialist outside of their system who could better treat you, it is not likely that it would be approved.

We hope that this light perusal of Kaiser Permanente has been helpful. If you ever have questions about your health insurance and what it covers, please always feel free to call us at Bernardini and Donovan.

January 5, 2017September 15, 2016

What to consider prior to buying health insurance for you and your family

As the time comes for open enrollment or to renew your health insurance, here are some helpful hints to look at before your purchase a plan.

Look before you renew
As the landscape for health insurance continues to change it is important that you make sure that your fully check out your options before opting to renew. Not only do the options available in your plan change from year to year but your personal circumstances change. You may have moved, found a new job, or had a child and all of these can change what you need from your provider. Also, if your plan is being replaced make sure you fully look over what it is being replaced with so you are not surprised later down the road and find that what you need is not covered.

Doctors and prescriptions, oh my…
You will want to make sure that your preferred doctor accepts that coverage before you enroll. And going to a doctor outside of your coverage can cost you substantially more that going in your plan. Also, you will want to know what your prescription medication is going to cost you. Most companies will assign medications to a different level or tier so that between different companies the medication you need may be covered but it may be on a different tier and therefore would cost you much more.

Consult an insurance broker
When the Affordable Care Act come into effect its purpose was to let people comparison shop relatively easily for different health care options. However, the health care market is wide and varied and you can very easily not see a special savings or find out that what you need is not covered when it is too late. Health Insurance brokers are working hard to stay ahead of the changes in the law, know all the different nuances of plans being offered and want to help you find your best fit. Contact us at Bernardini & Donovan and let us help you look beyond the bare essentials to finding a package that fits you and your family perfectly.

September 15, 2016September 15, 2016

Health and Wellness Benefits

There are so many benefits to having health insurance. From the simple fact that when you are feeling not at your best you have a place to go to get some care. Even having the peace of mind of knowing that when your baby won’t stop coughing you have an expert at hand who will give you everything you need to take care of your little one. But did you know that there are many additional benefits to your health insurance besides your basic doctor visits, prescription drugs and hospital care.

Online access – How many times have you lost your ID card and need to call to get a new one mailed to you. With online access you can print out a new ID card immediately. You can also see your claims, changed doctors, and never be on hold for over an hour again. You can do all of these and more online.

Gym Membership – Many insurance companies are now offering gym memberships, discounts on gym membership or even reimbursement on a gym membership if you check in a certain number of times at the gym per month. They may also offer discounts on gym equipment. So if you are looking to invest in an elliptical or a treadmill check to see if you get a discount.

Diet plans – You may find a discount on certain weight loss and diet plans such as Weight Watchers, Jenny Craig or Nutrisystem.

Homeopathic Medicine – more insurance programs are covering homeopathic remedies such as acupuncture or chiropractic care. If they don’t completely cover it they may also offer to add it on for a small fee.

24 hours nurse care – small children always seem to get every cold that is out there. And with this service you can call a nurse hotline and get advice if it is enough of an emergency situation to go to urgent care or emergency room.

Employee Assistance Program – get financial advice for today or for your future financial planning.

Mental Health – Talk to someone via telephone as well as in person visits if needed.

Health insurance costs are continuing to go up but there are other benefits available to you that adds to the value to your health insurance plans.

April 23, 2015September 8, 2016

What The ACA Reforms Mean For Children

Health Insurance for Children

With the recent twists and turns of the Affordable Care Act, there have been many changes to health insurance. While most people talk about how this will affect the health insurance needs of adults, not many people think about how it can help children. The Affordable Care Act has made it easier than ever for children to be covered with the right health insurance policy.

In order to sign up for health insurance, adults have to wait for an open enrollment period or have a qualifying life event. However, children are able to get covered with the right health insurance plan at any point in the year through Medicaid and the Children’s Health Insurance Program, also known as CHIP. Both federal and state programs offer low cost or free health care to children, which help to bring the number of uninsured children to record lows.

Many private health insurance providers are now offering the same services that CHIP and Medicaid are offering, including various preventive care services that come at no cost. These preventive services include immunizations, autism screenings, depressions screening, obesity screenings, and more to help ensure the health of children across the country.

All health insurance plans are now required to offer 10 services, including vision and dental care for children, as well as maternity and newborn care. It is important to keep in mind that insurance companies do not have to offer dental and vision care to children who are over the age of 19, so look carefully when deciding on the right policy to fit your needs.

Contact the insurance experts at Bernardini & Donovan Insurance Services in Redlands, California for all of your child health insurance needs. We will work with you to ensure that you have the right amount of coverage for everyone in your family, all at the right price.

Category: Family Health Insurance