Stream Benefits Newsletters

Ensuring Your Company's Insurance Needs

Thank you for attending the Stream Benefits Group Open House!

This event was in conjunction with the Kirkwood Des Peres Chamber of Commerce.  And other tenants in my office building also opened their doors.

There was food, refreshments, entertainment and over $750 in door prizes given away!

Thank you to all those who attended!

Scott

Thank you for attending the Stream Benefits Group Open House!

 

This event was in conjunction with the Kirkwood Des Peres Chamber of Commerce.  And other tenants in my office building also opened their doors.

There was food, refreshments, entertainment and over $750 in door prizes given away!

Thank you to all those who attended!

Scott

Available through Stream Benefits Group

Last month I reached out to you about a new partnership that Stream Benefits Group has with HR360.  This is a state of the art human resources library.  HR360 acts as an online HR department, providing your company with the most current employment laws, downloadable forms, interactive tools and sample employee handbook.

If you haven’t taken the quick video tour, please do so at www.HR360.com/take-tour.html 

If you would like to access your online HR information library, please visit http://streambenefits.com/hr360.html  Please call the office for your login and password.

HR360 is a resource that I am providing to you and your firm just for allowing me to work with you on your insurance programs. I look forward to interacting with you in the future about this tool.

As we enter the 4th quarter of 2016, there are many group health insurance plans that will be coming up for renewal under the Grandfathered phase of the Affordable Care Act.  If you are one of those employer groups, all of the insurance carriers are allowing you to stay with your same plan for another year, if you so desire.  But this year, the insurance carriers are also offering the opportunity to keep your plan through December 31, 2017. 

As your renewal becomes available, I will be reaching out to you with all of your options.  Included in that is the possibility of moving into an ACA compliant plan.  Each group has different needs and characteristics, so it is important to work specifically on what that means for you and your employees.

Regards,
Scott

You Are Invited!

Please join me at the Stream Benefits Group Open House!  

WHAT:    
Open House

WHEN:   
Thursday, September 22, 2016
5:00 PM – 7:00 PM

WHERE: 
206 W. Argonne Dr.  Ste. 102
Kirkwood, MO  63122

This event is in conjunction with the Kirkwood Des Peres Chamber of Commerce.  And other tenants in my office building will also be opening their doors.

There will be food, refreshments, entertainment and over $750 in door prizes.  No need to RSVP…just drop in.  Hope to see you there!

Regards,

Scott

This year has been very interesting with many moving parts in the individual health insurance world.  Insurance carriers are continuing to evolve within the Affordable Care Act(ACA) product portfolio.  Listed below are just a few of the key points that the individual health insurance carriers are facing.  There is a very good chance that you fall into one of the following categories.

1) Anthem - Grandfathered Individual Health Insurance
You may have a grandfathered individual health insurance plan with Anthem.  These plans were put in place prior to the introduction of the ACA.  You will be able to stay with that same plan, if so desired, for another year.

2) United Healthcare/Golden Rule ACA
If you have a United Healthcare/Golden Rule ACA plan, you will be able to stay with the program for another year, if so desired.  But United Healthcare will not be offering new plans in 2017 and does expect to leave the individual health insurance world after 2017.

3) Aetna/Coventry
You may have a policy with Aetna/Coventry.  And you may have seen news that they are getting out of the ACA business.  But it is only for the ON EXCHANGE policies in 2017.  If you have a plan via the Exchange, then we will need to work to find you a new plan.  If you have a plan OFF EXCHANGE, then you will be receiving a renewal notice later this year for 2017 along with options.

The bottom line is this.  I am here to assist you through this maze.  If you have any questions along the way with your current or renewal health insurance program, please don’t hesitate to contact me.

Regards,

Scott

I am pleased to introduce the new look, updated website for Stream Benefits Group.  We have made it easier to navigate with revised pages and content. The product portfolio has been expanded, including a dedicated page to the Affordable Care Act. Go to www.streambenefits.com

There is new information including my partnership with HR360, a Human Resources platform.  This is a free, value added benefit for the group clients of Stream Benefits Group.  More information will be forthcoming on this exiting venture.  

And check out the testimonials, where a link to the client’s website provides easy access to their website and services.

Please let me know your thoughts regarding the new website.  And as always, thank you for allowing me to work with your on you insurance needs.

Regards,

Scott

United Healthcare has recently announced that they will not be participating in the individual market Affordable Care Act plans, effective January 1, 2017.  This will affect many individuals in the St. Louis area, but only with individual plans.  This announcement does not have an impact on the small group plans that United Healthcare offers.  Please don’t hesitate to contact me with any questions you may have on this subject.

Last year I announced that I was a candidate for mayor of the City of Kirkwood.  The election was held on April 5th.  Unfortunately, I did not win.  And though disappointed by the final results, I enjoyed the entire campaigning process.  I was very humbled by all of the volunteers that worked by my side during the past year.  I felt we ran a very positive campaign and had a very upbeat message.  Thank you to everyone that wished me well on this endeavor.  I will continue to stay involved with our community and work hard for you as your insurance broker.
Sincerely,

Scott Stream

YOU ARE INVITED TO OUR

OPEN HOUSE!

Please join us for the Stream Benefits Group Open House!

WHAT: Open House
WHEN: Thursday, November 19, 5:00 PM – 7:00 PM
WHERE: 206 W. Argonne Dr. , Ste. 102, Kirkwood, MO 63122

This event is in conjunction with the Kirkwood Des Peres Chamber of Commerce. The other tenants in my office building will also be opening their doors.

There will be food sponsored by Raising Canes, refreshments and door prizes. No need to RSVP…just drop in. Hope to see you there!

Regards,
Scott

As we move through the year 2015, our health insurance carriers continue to provide their interpretation of the Affordable Care Act (ACA) regarding coverage renewals.  And there are a handful of possible interpretations that follow.  But one aspect of insurance for all of these carriers remains constant–your group will have an opportunity to stay with the same plan for another year, if you so desire.

Most of you have a coverage renewal already set for the 4th quarter of 2015.   Depending on the insurance carrier, you may have several options at your disposal, including:

  • To remain with your grandfathered plan
  • To downgrade your current plan
  • To move to an ACA plan, or
  • To change your renewal date for 2016.

In the next few weeks I will be providing more information directly to you regarding your specific situation.  I will work with you on all of your options, making sure we have met the needs of your firm, and ensure that we reach the best possible conclusion for your needs.

Scott Stream Community Involvement Update

As many of you know, I have been involved with a number of activities in Kirkwood for quite some time.  I have served as President of the Kirkwood Board of Education and Chairman of the Kirkwood Des Peres Chamber of Commerce during the past 5 years.  And now, after much consideration, I have decided to run as a candidate for Mayor of Kirkwood.  The election is April 5, 2016.

If I am fortunate enough to be elected, I will still be very active as an insurance broker with my agency, Stream Benefits Group.  The mayoral position in Kirkwood is not a full time position.  Even though I will have a number of responsibilities, the city charter provides for the Chief Administrative Officer to oversee the daily operations of the city.

I look forward to working with you and your employees for years to come.  Please don’t hesitate to contact me with any questions you may have.

Regards,

Scott

In a 6-3 decision on Thursday, the Supreme Court of the United States ruled that federal tax credits, also known as subsidies, will continue to be available for qualified individuals who apply for and purchase health insurance on the Federal Marketplace.

This decision, which was in response to the case, King v. Burwell, was a highly anticipated verdict.  Earlier this year, I had provided a newsletter reviewing this Supreme Court case.  Click here to read more about ACA…

How does this decision impact you?  At this time, it means that nothing is changing with this component of the law.  Subsidies are still available in Missouri via healthcare.gov for ACA individual plans.  And for those of you on group plans or grandfathered plans, you will be able to continue to stay on your plan through your renewal.

On a separate note, there is much activity in the health insurance industry concerning potential mergers.  Anthem Blue Cross has made an offer to purchase Cigna.  Aetna is in negotiations with Humana.  And United Healthcare is also in the mix.  These potential mergers may have a significant impact on the access to providers, pricing and quality of care moving forward.  I will be staying on top of these items throughout the year.

Thank you for allowing me to work with you on your insurance needs.  Have a safe and fun 4th of July.

On April 1, 2005, Stream Benefits Group LLC opened its doors. Having over 20 years prior experience gave me a strong foundation in this industry. However, this was my first endeavor into insurance agency ownership.

The journey has been exciting, rewarding and challenging, and I appreciate you joining me on this ride. I have really enjoyed establishing many new relationships and business partnerships during the past 10 years. And, I’m very grateful for the confidence you’ve placed in my staff and me by allowing us to handle your insurance needs.

I look forward to what the future has to offer the employee benefits industry, especially in the area of healthcare. Shifts and changes are constantly occurring within our legislature, making it challenging for laypeople to stay educated. Valuable, timely updates can always be found on my website at www.streambenefits.com regarding product offerings and Affordable Care Act information. For example, there has been a recent uptick in interest with voluntary benefit offerings for employees. I would be more than happy to discuss and demystify the various options with you.

On Friday, April 24, at 3 PM, I will be hosting an anniversary ribbon cutting at my office. If you are in the Kirkwood area that afternoon, please join our celebration. There will be a few short comments and light refreshments to enjoy.

Thank you again for your business. As always, please don’t hesitate to contact me with any questions or issues you may have.

Regards,

Scott

The U.S. Supreme Court is hearing arguments this week in the case King v. Burwell.  It is a highly anticipated case challenging the legality of subsidies available for individuals purchasing health insurance on the federal exchange under the Affordable Care Act.

And even though you may have your health insurance via a group employer plan, or have a grandfathered plan, or have an individual plan directly through the insurance carrier, this case and how the Supreme Court rules on it will impact you in some form.

At issue are four words within the law…“established by the state.”  A major component of the law is the availability of subsidies, usually in the form of tax credits, to be available to citizens based on their income.  And these subsidies are available only if the person purchases the health insurance program through an exchange.

But only a very few states established their own exchange.  The majority of the states, including Missouri, use the federal exchange, also known as healthcare.gov.  And so the argument by the plaintiffs is that if the subsidy was not obtained via a state based exchange, then the subsidies are invalidated.

The implications could be far reaching.  What happens to the 7.5M individuals that have purchased coverage on the federal exchange and received a subsidy?  Will the rest of the public have to pick you the additional costs for those individuals?  And would it be different from state to state?  The Supreme Court is due to have a ruling by late June.  Stay tuned.

Many of you are current or past subscribers to Anthem Blue Cross. Be it via an employer group plan or individual policies. Within the past few days Anthem Blue Cross was the target of a very sophisticated external cyber attack. Here is what is known at this point:

  • The cyber attackers gained unauthorized access to Anthem’s Information Technology(IT) system and have obtained personal information from its current and former members, such as their names, birthdays, member health ID numbers/Social Security numbers, street addresses, email addresses and employment information, including income data.
  • Anthem’s investigation to date indicates there is no evidence that banking, financial or medical information, such as claims, test results, or diagnostic codes were targeted.
  • Anthem immediately contacted the FBI and also retained Mandiant, a leading cybersecurity firm, to provide incident response and security assessment services.
  • Anthem is not aware of any fraud that has occurred as a result of this incident against its members, but all impacted members will be enrolled in identity repair services. Free credit monitoring will also be provided.
  • Anthem has created a dedicated website www.AnthemFacts.com where you can access information such as FAQ and a phone number that members can call 1.877.263.7998
  • Click here for a letter from Anthem to its members on this situation

Please don’t hesitate to contact me with any questions on this issue or any other items.
Regards,Scott

The 4th quarter of 2014 has been very interesting for individual health insurance plans.  The insurance carriers are handling their renewals in different ways.  Here are some of the key issues that you may be facing:

  • My plan design is coming to an end on December 31, 2014 and I need to move into a new Affordable Care Act(ACA) plan and rate.
  • My current plan design is being renewed December 1, 2014 for another year but I have a very large rate increase.
  • My physician and hospital network is changing effective January 1, 2015 and I may have to make a change with my provider.
  • I keep hearing about the Healthcare Exchange but I have many questions how it works.

You should have received a letter from your insurance carrier stating your situation.  And, during the past few weeks, my office has tried to reach out to as many of you and walk you through your particular situation.

If you had not heard from me, or if you have any questions about your insurance program, please don’t hesitate to contact me.  We will work hard to make sure your needs are met.

Thank you and have a Happy Thanksgiving.

Regards,

Scott

Most workers do not typically plan for expenses not covered by health insurance such as loss of income, childcare, and unforeseen costs if they become ill or injured.

Voluntary Benefits – disability, life, accident, critical illness, cancer and supplemental health – can help your employees rest a little easier knowing they have a financial plan to help cover additional expenses if they can’t work due to an illness or injury.

These programs have been around for a number of years, and in the past, only the large employer groups would provide them for their employees.  But that has been changing.  And now, many of the insurance carriers that offer these products are strongly encouraging small businesses and their employees to participate.

How do you as a business owner/manager benefit:
Expand your benefit options without increasing your costs
Give employees access to benefits that help protect savings
Opportunity to reduce your payroll tax for each enrolled employee
How do your employees benefit:
Benefits paid directly to them when they need it most
Don’t have to solely rely on savings to cover additional expenses
Pay premiums through payroll deduction, many qualified on a pretax basis
Many employers are adding these benefits “off-anniversary” of their health insurance renewal.  Please don’t hesitate to contact me if you would like additional information or would like a quote.

During the past few months there have been numerous changes and adjustments to the individual plans offered under the Affordable Care Act(ACA).   And this past week we received word of another delay in the implementation of the program.

Many of you signed on to the “early renewal” option with your current plan last December 1st.  And some of you were able to get health insurance coverage by December 31st, thereby getting on the medically underwritten programs.  Some of you have been grandfathered with your older plan because you hadn’t made any adjustments to it for a few years.

But for those of you that obtained coverage after January 1st you are now on one of the ACA compliant plans.  This coverage offers full coverage of the Essential Health Benefits(EHB) which include maternity and pediatric dental.  The rating and payment methods are also different.

And now word comes out of Washington of a delay in implementing ACA plans for all individuals.  The president announced last week that a two(2) year delay was being requested.  What does this mean?  We are still awaiting specific points from the insurance regulators, but in general, if you have a non ACA compliant plan, you may not need to move into an ACA plan for some time.

Bottom line…if you have any questions or receive letters from the insurance carriers that seem to be confusing or contradicting, please contact me.  Also, I am able to assist you if you would like to research an ACA plan either on or off the Exchange.  And thank you again for allowing me to work with you on your insurance needs.

Affordable Health Care Act and Your Business

On Tuesday, February 11, Scott Stream spoke on the Affordable Care Act.  The educational opportunity took place at the Kirkwood Des Peres Area Chamber of Commerce luncheon at Greenbriar Country Club.

During the past year, I have also have had a number of requests for Voluntary Worksite Benefit programs.  These programs allow the employee to pick and choose certain benefit options. The most common plans are accident, cancer/critical illness and disability income.  These benefits can help protect your employees’ finances if they can’t work due to an illness or injury.

Affordable Care Act
Education Feb. 11, 11:30am – 1pm

I hope everyone is having a good start to 2014.  The health insurance situation continues to evolve.  But most of you are either locked in with a grandfathered plan or decided to take the early renewal option effective December 2013.

And during 2014, if you took the early renewal option or are due for a regular renewal, your organization will need to move into an Affordable Care Act(ACA) plan.  There are many nuances with plan designs, benefits, networks and rates for these plans that are different from the past.

On Tuesday, February 11, I will be speaking on the ACA.  It will be part of the Kirkwood Des Peres Area Chamber of Commerce luncheon at Greenbriar Country Club.  For reservations please contact www.kirkwooddesperes.com

During the past year, I have also have had a number of requests for Voluntary Worksite Benefit programs.  These programs allow the employee to pick and choose certain benefit options. The most common plans are accident, cancer/critical illness and disability income.  These benefits can help protect your employees’ finances if they can’t work due to an illness or injury.

And the cost is picked up entirely by the employee through payroll deduction.  The products can be integrated into your benefit package at any time during the year.

Please don’t hesitate to contact me with any questions or issues you may have on any of these products.  And thank you again for allowing me to work with you on your insurance needs.

Click here for more information and Stream Benefits video on the Affordable Care Act…

Affordable Care Act
Education Feb. 11, 11:30am – 1pm

I hope everyone is having a good start to 2014.  The health insurance situation continues to evolve.  But most of you are either locked in with a grandfathered plan or decided to take the early renewal option effective December 2013.

And during 2014, if you took the early renewal option or are due for a regular renewal, your organization will need to move into an Affordable Care Act(ACA) plan.  There are many nuances with plan designs, benefits, networks and rates for these plans that are different from the past.

On Tuesday, February 11, I will be speaking on the ACA.  It will be part of the Kirkwood Des Peres Area Chamber of Commerce luncheon at Greenbriar Country Club.  For reservations please contact www.kirkwooddesperes.com

Read more

In the past few weeks I have had couple claims issue arise regarding “Network Services.” These have been with health insurance carriers and how they contract with their providers health insurance carrier.

In these cases it was a laboratory and an urgent care center. With the laboratory, a member had blood drawn and tests to be completed with a stand alone laboratory. This lab was an in-network provider with their health insurance carrier. but the lab sent the blood to be completed in a laboratory out-of-network provider with their health insurance carrier.

Read more

In the past few weeks I have had couple claims issue arise regarding “Network Services.” These have been with health insurance carriers and how they contract with their providers health insurance carrier.

In these cases it was a laboratory and an urgent care center. With the laboratory, a member had blood drawn and tests to be completed with a stand alone laboratory. This lab was an in-network provider with their health insurance carrier. but the lab sent the blood to be completed in a laboratory out-of-network provider with their health insurance carrier.

Read more

INDIVIDUAL HEALTH INSURANCE PLANS – THE WINDS OF CHANGE

As we enter the final weeks of 2013, there has been much activity surrounding the individual health insurance market.  And you may have been right in the middle of some adjustments or staying the course.

Over the last few months the insurance carriers may have offered you an opportunity to “renew early” effective December 1, 2013.  By doing so, you will be able to maintain your current plan design and provider network along with a new twelve month rate.  If you have not seen your letter from your insurance carrier on this opportunity, please contact me ASAP.

Read more

AFFORDABLE CARE ACT – IMPACT ON YOUR HEALTH INSURANCE PLAN

You can’t pick up a newspaper or turn on the TV without hearing about the Affordable Care Act(ACA) and the introduction of the Marketplaces(Exchanges) beginning October 1st.

Questions that may be on your mind:

Q:      What is the big deal about October 1, 2013?

A:    This date is the “go date” for the Exchanges.  But the new ACA plans don’t go into effect until January 1, 2014.  And you have health insurance coverage now and until your plan renews, you don’t need to do anything if you choose.  The federal exchange being used in Missouri will have at least a couple insurance carriers participate, Anthem Blue Cross and Coventry.

Q:    Do I have to change to an ACA plan?

A:    Once your current plan renews, and that can be anywhere between January 1 – December 1, 2014, you will need to switch into an ACA plan that has Essential Health Benefits(EHB).

Read more

HEALTHCARE REFORM LAW – REBATE CHECKS, EARLY RENEWALS AND MARKETPLACE TRAINING

Each day brings a new regulation or adjustment with the Healthcare Reform Law (Affordable Care Act – ACA). A month ago, the employer mandate for large groups was delayed and earlier this week it was announced that the maximum out of pocket provision would also be delayed until 2015. This part of the health insurance policy was to assist individuals in keeping their medical expense at a manageable amount.

MARK YOUR CALENDARS

On Thursday, August 22nd I will be hosting an Open House/Business After Hours at my office in Kirkwood. It is in conjunction with a few other tenants in office building and is in partnership with the Kirkwood Des Peres Chamber of Commerce. It runs from 5:00 – 7:00 PM. Burgers, brats, appetizers, refreshments for all. Please stop by even if for a few minutes.

REBATE CHECKS

Some of you may have received rebate checks from your insurance carrier. This is based on part of the law that went into effect in 2011 regarding the Medical Loss Ratio. Under the law, an insurance carrier has to spend at least 80% of their medical premium on medical expenses on their individual and small group business statewide. If they do not, then the insurance carrier must provide a rebate to those policyholders. As an employer, you may have questions on how these funds need to be dispersed. Please don’t hesitate to contact me regarding the guidelines.

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HEALTHCARE REFORM LAW – INDIVIDUAL MANDATE AND EXCHANGES

As discussed in previous newsletters, there are many components to the Healthcare Reform Law (PPACA). A major component of the law regarding large employer groups was affected a few weeks ago.

The large group employer mandate was to be implemented on January 1, 2014. This part of the law also went by the phrase “play or pay”. The implementation date has been delayed until January 1, 2015. This part of the law is for employers that have more than fifty(50) full time employee equivalents. If an employer does not offer coverage or offers unaffordable coverage, there will be a penalty. Again, this part of the law is delayed for a while.

Individual Mandate

The individual mandate is still on track for introduction on January 1, 2014. In essence, everyone must purchase a health insurance program or pay a penalty. An individual has options for purchasing health insurance. They can obtain coverage through their employer, obtain coverage through the traditional market or through the new insurance market exchange.

Read more

On March 23, 2010, President Obama signed into law the health care reform bill.  It is also known as the Patient Protection and Affordable Care Act (PPACA). This legislation makes sweeping changes to the U.S. health care system. Some of the changes have already begun but many do not take effect until 2014.

Key changes that are in place for group plans include extended coverage for young adults until age 26, the elimination of pre-existing condition exclusions for children and the elimination of annual and lifetime limits.  There also has been a phase-in of a tax credit for small businesses if they qualify.

For individual and group plans additional preventive health coverage is now mandated. You may now be eligible to receive wellness visits and testing at no charge. If you participate in a Flexible Savings Account, you have already seen the change with the over-the-counter (OTC) medications not being eligible for pre-tax status. And if you participate in a Medicare Part D prescription plan, there is now a $250 rebate if you fall into the “donut hole.”

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I have often heard that it is very confusing to understand health insurance due to the number of acronyms used for programs.  I will review one of those programs in this article, and then others later on.

There have been many changes over the last few years with health insurance programs, both for the individual and for group plans.  One major change has been the introduction of Health Savings Accounts, or better known as an HSA.  These were first introduced in 2004 as part of the Medicare Prescription Drug Improvement Act.  The key ingredient of the HSA is to make the individual a better consumer of healthcare.

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Healthcare Reform Law – Benefits and PlansThere have been numerous parts of the Healthcare Reform Law (PPACA) implemented since it was signed into law on March 23, 2010. But the parts that will have the largest impact on every citizen will take effect January 1, 2014. Over the next few issues of my newsletter I will highlight these important pieces.

Essential Health Benefits (EHB)

Non-grandfathered individual and small group plans offered inside and outside of exchanges must provide certain benefits. The PPACA specified a list of 10 service categories that must be included in the plans. These are:

Read more

During the past few days, the United States Supreme Court has been listening to oral arguments about the Health Care Reform Law (PPACA).  There has been much discussion on both sides of the table.  But when you get to the bottom of it, there are four main areas that the Court is considering:

(1.)  Anti Injuction Act:  The Court will decide if the individual mandate penalty is a tax.  If they deem the penalty a tax, it can only be challenged after the tax is collected, most likely in 2015.

(2.)  Constitutionality of the Individual Mandate:  Does the Constitution’s Commerce Clause allow Congress the power to enact an individual mandate?

(3.)  Severability:  If the Supreme Court rules the individual mandate unconstitutional, does the entire Health Care Reform Law get struck down or just the individual mandate?

(4.)  Constitutionality of Medicaid Expansion:  Are the spending conditions imposed on the states in funding additional Medicaid beneficiaries deemed coercive?  In other words, does it amount to the federal government taking state revenue?

The Supreme Court is expected to make their rulings by the end of June.  No doubt this will have a major impact on virtually everyone.