adult couple reviewing bills and open enrollment materials

4 Myths About the Individual Health Insurance Open Enrollment Period

We’ve heard a lot of Open Enrollment myths over the years and want to set the record straight.

Myth #1 “There are fewer insurers to choose from.”

Many carriers who initially fled the federal exchange have returned and now offer plans alongside others who have entered the marketplace. This increase in the number of plans being offered has allowed many individuals and families to re-examine their needs and adjust their coverage amounts accordingly.

In addition to having access to the same carriers and plans listed on the federal exchange, the SPARK Health Insurance Marketplace can offer members even more options. To view the full range of available ACA-compliant health plans, please visit https://spark.memberbenefits.com/.

Myth #2 “The premiums are too expensive.”

Now that the federal exchange marketplace has stabilized, there may be lower-cost options for ACA-compliant health plans than past Open Enrollment periods. For example, Blue Cross Blue Shield has filed for a 2.03% decrease in premiums in Texas.

Even if your coverage needs remain the same, you may be able to find a lower premium being offered by a different insurer. We recommend always reviewing the health insurance options available to you during the annual Open Enrollment period.

Myth #3 “You’ll be penalized at tax time for not having insurance.”

In previous years, if an individual did not have health insurance for more than 2 months of the year and did not qualify for an exemption they would face a tax penalty of $695 or 2.5% of their taxable income (whichever amount was greater). As of January 1, 2019, the tax penalty known as the individual mandate has been repealed, though some states may still enforce penalties on individuals who don’t have health insurance.

Myth #4 “Applications are processed instantly.”

On average, our team will process an enrollment application within 24 business hours and submit it to the carrier. Once the application is with the carrier, their team will take over and require an additional 10-15 business days to process the application.

The carriers often get overwhelmed with applications during the Open Enrollment period, so we recommend enrollees submit their health insurance applications as early as possible.

Securing ACA-Complaint Coverage for 2020

This year, Open Enrollment runs from November 1 through December 15 with a coverage effective date of January 1, 2020. This is the one time of year where individuals and families can enroll in ACA-compliant health insurance plans.

Ready to start shopping? Visit https://spark.memberbenefits.com/ to shop ACA-compliant health plans today.

Not sure where to start? Schedule an appointment with one of our licensed benefits counselors and let us walk you through finding the best health insurance fit for your needs.

happy family on couch browsing health insurance options on tablet

Getting the Most out of Open Enrollment

With 2020 Open Enrollment period in full swing, families across the country are reviewing their current insurance coverages and seeing what other options may be available to them. Below are a few tips to help you navigate the process.

  1. Learn the Language

Insurance jargon may be enough to make some people’s heads spin but learning just a few key terms could help you pick the best health coverage for you and your family. To make it easy, here are a few words we feel you should know:

  • ACA-compliant” refers to plans that follow all the guidelines and regulations in the Affordable Care Act. These plans are only available during the annual Open Enrollment period or through a Special enrollment period, if you have a qualifying event.
  • Non-ACA plans” also known as short term health plans do not adhere to all of the Affordable Care Act’s guidelines and regulations.
  • Deductible” the amount of money you must pay out of pocket before your insurance kicks in
  • Premium” the amount you pay to your insurance company every month
  • In-network” refers to a provider that has a contract with your insurance provider
  • Out-of-network” refers to a provider that does not have a contract with your insurance provider
  1. Think of the Future

No one can predict the future, but you may be able to take an educated guess as to what the next 12 months could hold. Thinking about the coming year could help you determine how much coverage is right for you and your family. Have you had any health issues in the past year? Are you taking any medications? By examining your current health status and concerns you may be able to narrow down your health insurance plan options.

  1. Utilize Your Resources

Did you know as a benefit of your SPARK membership, you have access to our team of licensed Benefits Counselors? Our Benefits Counselors are experts in their field and are standing by to help you navigate the Open Enrollment process and find the best health insurance for you and your family’s needs.

We’ve been providing health insurance answers and guidance for over 30 years. Be sure to visit the SPARK Health Insurance Marketplace for access to appointment scheduling services, webinar replays, and other informational resources designed to help make the Open Enrollment process as quick and easy as possible.

  1. Know Your Deadlines

Like last year, the annual individual health insurance Open Enrollment period began on November 1 and will run until December 15. For those who enroll in one of these ACA-compliant plans, you can expect an effective date of January 1.

Non-ACA plans typically do not follow the ACA open enrollment period dates and are available in most states year-round.

Ready to make your decision? Visit https://spark.memberbenefits.com/health-insurance/ today to secure ACA-compliant coverage for you and your family in 2020.

Upcoming 2020 Individual Health Insurance Open Enrollment Webinar

Join us for a free webinar on Tuesday, October 29 from 12:00pm-12:30pm EDT, where we’ll review the upcoming 2020 Individual Health Insurance Open Enrollment period and cover topics such as important dates, preparation tips, industry updates, and more! Reserve your spot by registering today. Can’t make it to the webinar? Register anyway and we’ll send you a link to the video replay later that day.

mother and child practicing good dental hygiene in bathroom

Helpful Dental Hygiene Hacks for Kids

A common question among parents is when they should begin teaching their children oral hygiene. Many dentists assert that parents can start laying the groundwork for good brushing habits before their child’s first tooth even breaks the surface.

According to the Centers for Disease Control (CDC), tooth decay is the most common chronic disease found in children and adolescents, and is four times more likely to affect teens between 14 and 17 than asthma.

But for many parents, getting their kids to brush their teeth is a battle not unlike getting them to eat their broccoli or go to bed on time, But it doesn’t need to be this way. There are many ways parents can set their children up for success when it comes to their oral health without needing to resort to bargaining or threats.

Start Early

For newborns, it is common for parents to use gauze or another type of clean cloth to wipe down their gums down after feedings to discourage germs and bacteria from lingering and developing into problems down the line.

According to the American Academy of Pediatric Dentistry (AAPD), a child’s first trip to the dentist should coincide with the arrival of the first baby tooth, and should happen no later than their first birthday.

Early exposure to dentist visits and cleaning their mouths can help get your child used to these activities in the future. Starting good oral hygiene habits early can help show them that these activities are not out of the ordinary and are just part of the routine and nothing to be afraid of or anxious about.

Lead by Example

Whether it’s what you say or what you do, kids love to imitate adults. So, when it comes to oral hygiene, make sure you’re setting a good example. Try dancing, making funny faces, or even singing or humming a song while brushing. No matter what you do, just be sure that your child sees you enjoying brushing your teeth. This will teach them that brushing is a fun activity that they can look forward to.

Make It Fun

Toothbrush makers know that the more fun they can make brushing for kids, the more likely those kids will grow into adults with healthy brushing habits. That’s why so many toothbrushes now come in flashy colors – some with cartoon characters, some that play music, and others that light up.

And while you won’t be able to find any toothpaste to sing songs to your kids, you will find it available in a variety of colors, flavors, and some even with glitter or other special effects.

Having a cool toothbrush may be half the battle but using positive reinforcement techniques to encourage your toddler to keep brushing also helps. Sticker charts, a special snack, and even an extra ten minutes of play time are all great ideas.

Find What Works

No two children are the same and what works for one, may not work for another. Some children’s gums may be more sensitive than others which will force parents to opt for soft or silicone bristled toothbrushes. Ultimately, it is up to you, the parent, to figure out what works best for your child and hygiene structure.

For parents with children who struggle with developmental disabilities such as autism, the process for learning good oral health habits may prove even more challenging. And with roughly one out of every 40 children in America diagnosed with autism, there is a growing need for more dentists and dental practitioners to be both better equipped and knowledgeable when it comes to serving patients with developmental disabilities.

If your child falls into this group, and getting them to practice good oral hygiene proves too strenuous for both of you, a Board-certified Behavior Analyst (BCBA) may be able to help.

The Right Choice for Your Family

When was the last time your child made a trip to the dentist? With our Comprehensive PPO dental plan, your family will have the freedom to visit any licensed dentist in the country. You can save even more when you visit one of over 135,000 preferred dentists and 32,000 specialists nationwide. Make your family’s oral health a priority by visiting https://spark.memberbenefits.com/dentalvision/ today.

young business man explaining group health insurance options to business group at a table in an office

New Strategies to Save Money on Group Health Costs in 2019

As group health insurance costs continue to increase, many employers are looking for new, creative ways to save money while still providing their employees with coverage.

Reference Based Pricing

Reference Based Pricing is a rapidly growing strategy that a number of employers are using to save money on group health insurance costs. This technique gives the employee the ability to choose any provider without the limitations and higher costs of a traditional provider network. By choosing to take advantage of this method, employers have the potential to save between 15 and 20 percent on group health insurance costs.

Association Health Plans

According to the U.S. Department of Labor (DOL), Association Health Plans are defined as “group health plans that employer groups and associations offer to provide health coverage for employees.”

In April of this year, the federal government will begin to allow small employer groups to form new associations based on industry and finally receive access to group health insurance plans typically only reserved for larger companies. While many association health plans already exist, the new legislation eliminates the geographic barriers previously in place.

According to the Congressional Budget Office, “four million Americans, including 400,000 who otherwise would lack insurance, will join an AHP by 2023.”

Direct Primary Care

Direct Primary Care (DPC) is an alternative payment model to third-party billing. With DPC, there is a flat monthly membership fee and nothing else. Employees have access to a physician of their choice and the physician remains accountable to only their patients. This option can also exist alongside a comprehensive major medical plan.

Level Funding

For groups of five or more, level-funded plans are becoming increasingly popular. These plans boast a nationwide network of hospitals and physicians and are offered by a number of reputable insurance carriers. Designed to offer more flexibility to employers, level-funded plans are ERISA compliant and partially self-insured with a savings potential of 10 to 15 percent. Many also offer return-of-premium potential.

Learn More

Want to learn more about these strategies? Visit https://spark.memberbenefits.com/employer-group-solutions/ for more information.

professional woman on phone outside smiling

Knowing Your Options Outside of Open Enrollment

While the annual Open Enrollment period focuses on ACA-compliant individual major medical insurance, there are still other forms of insurance available for potential enrollees.

Knowing Your Options

According to healthinsurance.org, “ACA-compliant coverage refers to a major medical health insurance policy that conforms to the regulations set forth in the Affordable Care Act (Obamacare)…This means they must include coverage for the ten essential benefits with no lifetime or annual benefit maximums, and must adhere to the consumer protections built into the law.”

Unless you qualify for a special enrollment period, you cannot receive ACA-compliant individual health insurance coverage outside of the annual Open Enrollment Period, which typically runs from November 1st until December 15th of each year.

If you missed out on Open Enrollment but still need individual health insurance, you still have a few options available:

    1. COBRA

According to the U.S. Department of Labor, “The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances such as voluntary or involuntary job loss, reduction in the hours worked, transition between jobs, death, divorce, and other life events. Qualified individuals may be required to pay the entire premium for coverage up to 102 percent of the cost to the plan.”

  1. Qualifying Life Event (QLE)

There are certain life circumstances called Qualifying Life Events (QLEs) that can qualify you for a special enrollment period. Special enrollment periods allow you to obtain ACA-compliant health coverage outside of the annual Open Enrollment period for you and your eligible dependents. The most common QLEs pertain to:

  • Loss of health coverage
  • Changes in household
  • Changes in residence

If you find yourself matching any of the above circumstances or feel your unique circumstance should qualify you for a special enrollment period, please contact us and our team will help guide you in the right direction based on your individual needs.

  1. Non-ACA Compliant plans

Non-ACA compliant plans, also referred to as short-term medical plans, have recently become more appealing to a growing number of people due to their lower rates. According to the Henry J Kaiser Family Foundation, “Late last year (2017), President Trump issued an executive order directing the Secretary of Health and Human Services to take steps to expand the availability of short-term health insurance policies, and a proposed regulation to increase the maximum coverage term under such policies was published in February.”

So, what separates the ACA-compliant health plans from the ones that are not? One of the biggest factors being the ACA’s ten essential health benefits. Non-ACA compliant plans do not need to adhere to the numerous rules and regulations laid out in the Affordable Care Act.

To learn more about health insurance and what else the SPARK Health Insurance Marketplace can do for you, please visit https://spark.memberbenefits.com/health-insurance/ today.

children eating ice cream cones on a park bench

Two Things Your Teeth Want You to Avoid This Summer

Summer is finally here. This is the time of year where families all over the country can sit back, relax together, and enjoy the warm weather. But while you and your family are trying to keep cool, there are a few summer staples you should avoid in order to prevent tooth decay and the resulting costly dental procedures.

Fruity Drinks

No summer is complete without at least a few fruity drinks by the pool. And while the fruit may be good for you and help keep you hydrated in the summer heat, the excess sugar won’t do you any favors. Despite the main ingredient being fruits and/or veggies, smoothies can contain lots of hidden sugar which can wreak havoc on not just your waistline, but your teeth as well.

According to WebMD, “tooth decay is caused by bacteria that feeds on sugars from food and drinks. That bacteria — called plaque — can stick to your teeth, producing acids that eat through the enamel on your teeth.” So, while a fruity drink or smoothie may sound great, don’t forget that water can be just as refreshing.

Chewing Ice

When it comes to ice cubes, those frozen cubes are best left melting in your cup.

Chewing on ice may seem like a harmless zero-calorie way to keep cool but it can lead to enamel damage. Like all hard foods, chewing on ice cubes can cause chips and cracks to your teeth and create a passageway for bacteria to get in and cause infections.

Aside from the potential for dental damage, chewing or craving ice can also be a sign of a larger health concern such an iron deficiency, or an eating disorder.

Keeping Your Mouth Protected

When it comes to maintaining good oral health and protecting yourself from costly dental work, the best thing you can do is to get covered.

Want to learn more about what dental plan options you have access to as a SPARK member? Visit https://spark.memberbenefits.com/dentalvision/ to learn more and to pick a plan that best fits your needs.

elderly man wearing eyeglasses and magnifying glass sitting at work bench tinkering with tools

What Medicare Supplemental Insurance Can Do That Medicare Can Not

Getting older is never any fun passed the age of 21. But oftentimes with age comes maturity, experience, and perspective. And by the time you find yourself approaching the golden age of 65, you’re probably able to look back at your earlier years and note a few things you wish you had done differently—drink less alcohol, quit smoking earlier, save more money and spend it wiser; invest more time with the people you love, and in taking care of yourself.

Don’t put taking good care of yourself on the backburner anymore.

Making Sure Your “Golden Years” Are Golden

Throughout our lives, there are a number of birthday milestones that stand out— one, 13, 16, 18, 21, 40, 65, and if you’re lucky, many more beyond that. Each of these years has their own reasons for being special, but few birthdays carry the same significance that turning 65 does.

Beginning three months prior to your 65th birthday, you become eligible for a seven-month open enrollment period where you can enroll in Medicare benefits. If you miss your initial open enrollment period, you will still become eligible again during the general open enrollment period which begins January 1st and ends March 31st, with coverage beginning July 1st.

According to a Money Crashers article written by Michael Lewis, “There is a direct correlation between healthcare costs and age: The older you are, the more likely it is that you will need medical care. The elderly are more apt to suffer chronic conditions that require treatment for years, and accidents are more common, often requiring complicated treatment. As a consequence of the high healthcare costs for older Americans, private insurers prior to 1965 either did not offer health insurance to the elderly, or charged such high premiums that insurance was not affordable. Medicare was created to solve a human welfare crisis that threatened to unravel the social and economic fabric of the nation.”

The truth is, that while highly beneficial, Medicare Part A and Part B may not necessarily cover everything you may need as you get older. A prime example of this is the often-cited fact that Medicare does not cover basic eye health, most forms of dental care, and hearing aids. And while many may be under the impression that they won’t need something like a Long-Term Care Insurance policy because Medicare will cover the costs, unfortunately, it won’t because while Medicare Part A will cover care in a nursing home, it will not cover custodial care meaning, the activities of daily living such as getting dressed, bathing, eating, etc).

Investing In Your Health With Medicare Supplemental Insurance

A Medicare Supplemental Insurance policy can help you fill in the gaps left behind between the services and care that you need and the services and care that Medicare is willing to pay for.

If you or a loved one is approaching the age of 65, it may be wise to discuss with your doctor if all of your medical needs will be covered by Medicare. Oftentimes, people assume that Medicare will cover them no matter what and ultimately find out otherwise. In order to avoid any surprises, it is always wise to consult with your primary care physician about your individual health needs now and any that you may be at risk of developing in the future.

For more information regarding Medicare Supplemental Insurance (Medigap) and what it can do for you or someone you love, please visit https://spark.memberbenefits.com/medicare-supplement/.

african american man holding jaw in pain from tooth

5 Most Common Dental Problems And How To Avoid Them

According to American author William Arthur Ward, “A warm smile is the universal language of kindness.” Smiling is something we do instinctively as infants and something we carry with us all throughout our lives. Unfortunately for some, their smiles may not prove to be as warm and welcoming as they would hope. Problems such as gum disease, yellowed teeth, and chronic bad breath can have a negative impact when meeting new people and could be a sign of a deeper issue due to the close link between oral and overall health.

Many people learn the importance of oral hygiene at a young age. Those who don’t may face a variety of oral health problems down the road, some being scarier than others. So, what are some of the most common dental diseases?

  1. Bad Breath

While some cases of bad breath can be the result of eating foods like onions, garlic, or hard-boiled eggs, other cases may prove to be more serious. Bad breath, otherwise referred to as, Halitosis, may be something that even a good solid brushing won’t be able to fix. Halitosis can be a symptom of larger problems such as gum disease, infection, dry mouth, or even other seemingly unrelated issues like gastric reflux, diabetes, liver or kidney disease. In some instances, Halitosis may even require a trip to your doctor.

  1. Gum Disease

According to the Mayo Clinic, there are over 3 million cases of gum disease each year. And while gum disease, otherwise known as Periodontitis, may be common, that doesn’t make it any less serious. In fact, those with gum disease have a higher chance of developing diabetes, osteoporosis, heart disease and other ailments. In order to lessen your chances of developing gum disease, it is advised to practice good oral hygiene and schedule regular cleanings with your dentist, who may decide whether more preventative action is needed.

  1. Yellow Teeth

While not exactly a disease, yellow teeth can be a sign of poor oral hygiene and can, in some cases, indicate other dental issues that may be lurking just beneath the surface. Visiting the dentist once every six months for a thorough cleaning can help prevent yellowing teeth due to diet or lifestyle choices. In some severe cases, veneers may be recommended.

  1. Toothaches

A toothache should never be ignored. While some cases of a toothache may be related to minor inflammation, other cases could indicate the presence of gum disease, cavities, pulpitis, a broken tooth, or more. When confronted with a persistent toothache, the best course of action is to have a dentist find the underlying cause.

  1. Tooth Erosion

There are few substances within the human body that are stronger than our enamel. This is why everyone from our dentists to television commercials are constantly urging us to protect it — because once our enamel is gone, it cannot be brought back. The loss of enamel is referred to as tooth erosion. Soda, sugar, and some acidic foods can eat away at our enamel. In order to combat the chances of experiencing tooth erosion, brushing with a soft-bristled brush is suggested as well as reducing the number of acidic drinks consumed.

Taking Control of Your Oral Health

When was the last time you visited the dentist? Could you be at risk of developing one, or even all, of these potentially costly dental problems?

Members can secure dental and vision insurance coverage for the whole family. Visit us to learn more about what our dental and vision insurance plans can do for you.

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