Telemedicine sounds like a new thing, but the origins of “remote” healthcare lie all the way back in the 1950s. Many decades ago, patients learned that they didn’t always need to visit their physician in person when a simple phone call would suffice.
Today, telemedicine is supported by high-speed internet access, allowing us to attend face-to-face virtual “visits” with our healthcare providers. And in the time of Covid-19 and shelter-in-place orders, many insurance carriers are now covering telemedicine appointments.
Telemedicine actually encompasses three areas of patient care:
- Interactive care allows patients and healthcare providers to “meet” virtually to discuss symptoms and other concerns
- Remote patient monitoring allows providers to collect data on patients remotely, such as blood sugar levels, blood pressure, and more
- Store and forward is a method of sharing a patient’s healthcare information with other providers and specialists (with the patient’s permission, of course)
While telemedicine does include all of these areas of practice, most of us associate the term with virtual medical appointments conducted via video call. These interactive care appointments can benefit the patient in a number of ways, including:
- No need to travel to an appointment; the visit can be conducted from home or anywhere else the patient is located
- No worries about obtaining childcare or juggling schedules in order to attend appointments
- Fewer hours missed from work and/or school
- Limiting exposure to other illnesses in hospitals or medical offices
- Quicker access to care
- Affordability of care; telemedicine appointments are often priced much lower than in-office consultations
- Covered by many health insurance plans
- Reimbursed by Medicare and Medicaid/Medi-Cal in many situations
Of course, telemedicine appointments should not be used for emergency situations. Patients should always call 911 or proceed to an emergency room if they suspect heart attack or stroke, have sustained a serious injury, or otherwise need immediate lifesaving care. But for routine care, minor illnesses and injuries, mental health treatment, and many other non-emergency situations, telemedicine provides safe and quality healthcare at greater convenience to the consumer.
Even better, the monetary savings help us all by helping to lower the cost of healthcare. Ask your healthcare provider if they offer telemedicine appointments, and familiarize yourself with the process so that you know what to do next time you need healthcare services.
From school openings to job security, to personal budgets and safety, we all have plenty to worry about right now. Luckily, your health insurance premium might not be one of them. Many health insurance providers have announced that they will be offering a variety of solutions to help consumers make their regular health insurance premium payments.
The pandemic situation has created a curious combination of events in these past few months. Due to fears of coronavirus, and shutdowns in many areas, the numbers of elective procedures and office visits at this time have sharply declined. With consumers avoiding both doctor appointments and emergency rooms, healthcare providers have reported a 30 percent drop in inpatient care, a 25 percent drop in outpatient care, and a 35 percent drop in physician services.
Naturally, such an enormous drop in healthcare services has equalled a decline in health insurance claims. Many of the major health insurance providers will be extending that savings to their customers, which can be great news if you’re worried about making premium payments right now or in the near future.
Depending upon your carrier, you might be able to take advantage of these provisions:
- A credit for premiums paid in previous months
- A discount on upcoming premiums due
- An extended grace period for making premium payments
- Suspension of out-of-pocket charges on some healthcare services
Look for a notice from your health insurance provider, or you can call them directly to discover what help they might be offering to their customers. Alternately, feel free to call us and we’ll assist you in locating answers.
This is all great news, but we do want to caution you about one potential problem: Considering that preventive care accounts for many of the healthcare services postponed at this time, some of those avoiding doctor visits might be at increased risk of chronic health problems in the future. Stay in touch with your doctor, and discuss with them alternate means of accessing care. They will advise you of which preventive tests or procedures are most important, considering your personal risk factors, and help you make a plan to catch up on preventive care.
This month, we wanted to reach out to all of our business clients. How are you holding up during these challenging times? Is there anything we can do for you?
Just a few reminders…
Have you applied for the Paycheck Protection Program yet? Or, do you anticipate applying in the near future?
Funded through the Small Business Association, the Paycheck Protection Program provides businesses with a loan to cover eight weeks’ worth of payroll and other expenses. The goal is to help your business remain viable during our current economic climate, and of course, to help your employees keep their own bills paid.
You can obtain a loan in the amount of 2.5 times your average monthly expenses, or $10 million, whichever is less.
If you follow guidelines correctly, 100 percent of your loan could be forgiven (you won’t have to pay it back)
You can qualify for Paycheck Protection if your business employs 500 or fewer workers, and you can demonstrate that the coronavirus pandemic has negatively impacted you economically.
As you might expect, numerous rules and regulations apply to both qualification for the program, and in order to have your loan forgiven. Since this is quite a chunk of change, you will want to follow those guidelines to the letter.
You can also apply for an Economic Injury Disaster Loan, for up to $10,000. This loan can also be forgiven in certain situations. And yes, you can apply for both programs, but you cannot use money from both programs toward the same purpose.
If you have questions about HR and Benefits during this ongoing situation, give us a call. We can help you identify solutions to the unique problems your business is facing.
Remember, we’re here for you! Sticking together makes us all stronger – so let us know if you need help with anything at this time.
Employees might decline enrollment in their company’s small group health insurance policy for any number of reasons, but what happens if they later change their minds? Fortunately, the law does provide for a Special Enrollment Period under those circumstances. That’s good news, because under California law we all must enroll in a health insurance policy or face a penalty at tax time next year. That requirement began on January 1 of this year.
For many reasons, a worker might change their mind after once declining coverage. In most cases, such as loss of coverage under another plan, or due to marriage or addition of a new child, they have 30 days to request enrollment in the small group plan. However, if the lost coverage was CHIP or Medi-Cal, a 60-day enrollment period will apply.
Currently, anyone who previously denied coverage for any reason can now enroll in a healthcare plan. You do not need to experience a qualifying life event in order to take advantage of this opportunity. However, the time to enroll does differ from one carrier to the next, so we advise acting now in order to have access to as many options as possible.
Coverage will be equivalent to other enrollees. Special enrollees in small group plans must be offered the same benefits as those who signed up during the original enrollment period. They cannot be charged more than those who enrolled when first eligible.
Benefits cannot be denied on the basis of a preexisting condition. The Affordable Care Act protects potential enrollees from being denied healthcare coverage on the basis of a condition which was present prior to enrollment.
Enrollees cannot be asked to complete a physical or submit a health history before joining the small group plan. A general questionnaire may be used, provided it does not request genetic information and is not used to deny, restrict, or delay benefits.
A group health plan cannot charge an individual more than any other similarly situated individual, based on any health factor.
Contact us to learn more about small group health coverage, and we can help you determine whether a Special Enrollment period applies to your situation.
Historically, employees of small businesses have enjoyed few options with regard to retirement planning. With only four out of ten small businesses offering any sort of retirement benefit, many Californians faced challenges with regard to their financial futures. Looking toward the future, and envisioning millions of citizens retiring at barely above the poverty line, lawmakers stepped in to create a state-operated retirement system.
CalSavers is now open for enrollment, with small businesses employing five or more workers required to enroll. Enrollment deadlines are staggered over the next two years, with the end goal of enrolling seven million Californians into a retirement savings plan (unless they take steps to opt out).
The set-up is relatively simple: CalSavers will provide an IRA (Individual Retirement Account) and eligible employees of participating businesses will be automatically enrolled at a 5 percent contribution rate. A one percent automatic escalation will apply, up to an 8 percent contribution rate. Accounts stay with employees even if they change jobs.
Business owners, also, can enroll in CalSavers if they are also employees of their businesses. Those who are not employees of their businesses can participate, but must make contributions from their bank accounts rather than payroll deductions. Self-employed workers are also eligible to join the program via the same process.
Are all business owners required to enroll in CalSavers? No, not necessarily. Enrollment in CalSavers is required of small businesses who employ more than five workers, but only if they do not already participate in a retirement benefits program. If you have already established a qualified retirement plan for employees, or decide to establish one through another provider, you will not be required to participate in CalSavers.
Otherwise, yes, small businesses will be required to enroll in CalSavers according to the following schedule:
Businesses with 100 or more employees should enroll by June 30, 2020
Businesses with 50 or more employees should enroll by June 30, 2021
Businesses with 5 or more employees should enroll by June 30, 2022
Of course, you can enroll earlier than those dates as well. Businesses that fail to comply with the mandate can be charged a penalty of 250 dollars per employee up to 90 days after the deadline, and 500 dollars per employee after 90 days have passed without compliance.
For more information on enrolling in CalSavers, or to discuss other retirement benefit options, give us a call. We can help you understand your options and select the course of action that best suits your needs.
You may have heard the alarming news reports regarding the coronavirus outbreak in China. Although this news is concerning, mostly for those in China, arming yourself with knowledge can be the best antidote for your own worry.
What is coronavirus? Coronavirus is actually an entire class of viruses, and they’re nothing new. In fact, coronaviruses are one of the frequent culprits behind the common cold.
Concern over this particular strain of coronavirus is due to its unusual strength, and the fact that it is a strain we haven’t previously encountered before.
What are the symptoms of coronavirus? Those infected with this new strain of coronavirus present with coughing, breathing difficulties, and fever. It might appear as a bad cold at first. However, the progression of the virus into respiratory distress and pneumonia is the true risk in this situation.
What is the treatment for coronavirus? As with other viruses, antibiotics are not effective. Antiviral drugs commonly used against the flu also will not work against coronavirus.
Treatment includes admission to the hospital, fluids, rest, and support for infected lungs. Recovery mostly depends upon the patient’s immune system.
How lethal is this coronavirus? As of February 7, the infection tally has reached 31,161 inside China, with an additional 280 cases in 28 other countries. The death toll includes 636 Chinese, one death of a Hong Kong resident, and one death in the Philippines. The mortality rate of the virus stands at 2 percent.
Most of the deaths have occurred in individuals with already compromised immune systems, the elderly, and people who are otherwise in poor health already.
Health experts have suggested that many cases of coronavirus have gone undetected because symptoms were mild, and the affected individuals assumed they simply contracted a common cold. In that case, the lethality of the virus would be even lower than the estimated 2 percent.
Are we at risk of infection in the US? So far, five cases of this particular coronavirus have been diagnosed in the United States. These patients recently traveled to China or had close contact with a traveler. So far the virus seems contained to these five patients, and health officials don’t believe it was spread within their communities.
With travel to China heavily discouraged at the moment, it is unlikely that we will see a widespread outbreak of this viral strain in the US.
Billing misunderstandings are common, due to the confusing nature of medical bills in general. But if you receive a bill that seems unexpected, it’s always a good idea to investigate it before paying it. In some cases you might have been billed erroneously.
One problem that we see occasionally is a situation called “balance billing”. This practice goes against your group insurance provider’s rules, and is actually illegal.
For example, let’s say a medical practice normally charges 300 dollars for a particular service. As an in-network provider with your insurance company, they have agreed to accept a pre-negotiated amount for that service, which is always less than the “cash” price. In this example, let’s assume that the pre-negotiated amount is $200.
If this practice then sends you a bill for the remaining 100 dollars, this is called “balance billing” and it not only violates their agreement with the insurance provider, but it is also illegal. Unfortunately, that fact hasn’t completely stopped some providers from engaging in this practice.
Any time you receive an unexpected bill, you have the right to question it before paying it. In some cases the bill is simply a mistake. The first thing to do is call the physician and inquire about the charges. Most often, the billing error is not intentional and the provider will fix the issue. However, if you believe your medical provider is engaging in balance billing and they refuse to adjust the charges, the next step would be to notify your health insurance company.
Of course, you also have the right to inquire about fees and insurance payments before scheduling an appointment with any doctor or healthcare provider. If you know what to expect, it can be easier to compare services and choose a provider that is right for you.
Many of us rely upon an annual physical exam, to detect developing health conditions and discuss prevention strategies with our doctors. But a lot can happen in a year’s time.
You might be surprised to know that your dentist or eye care professional can also detect several serious health conditions, even those that seem unrelated to your mouth or eyes. By staggering your check-ups throughout the year, you might stand a better chance at early detection of several chronic health problems.
For example, did you know that a routine eye exam can uncover signs of the following conditions? Each of these conditions produce changes that can be seen within the eyes.
- High blood pressure
- Thyroid disorders
- Several types of cancer
- High cholesterol
- Certain tumors
- Multiple sclerosis
- Sickle cell disease
- Early signs that you might be susceptible to a stroke
Your dental health can also indicate concerning symptoms of more serious underlying conditions. During a regular dental exam, your dentist might detect early progression of health problems such as…
- Pancreatic cancer
- Oral cancer
- Heart disease
- Kidney disease
- An oncoming heart attack
In fact, research has shown that over 90 percent of systemic diseases can include symptoms that manifest in your mouth! Your dentist might be the first to notice subtle signs of something going wrong. He or she won’t necessarily diagnose you with one of the above conditions, but will advise you to visit your primary care doctor immediately to conduct further investigation of a concerning oral health symptom.
If your health insurance does not offer coverage for dental and vision care, you can actually add a supplemental policy for this purpose. Contact us to learn more about dental and vision care coverage, and we can match you with a policy that suits your needs.
Although the Affordable Care Act resulted in healthcare coverage for the vast majority of Californians, a small percentage still are not enrolled in an insurance plan. Now, with the federal income tax penalty for coverage failure set at 0 dollars, some policymakers expressed concern that the number of uninsured California residents could grow.
With that fear in mind, the state has now instituted its own mandate. Those who remain uncovered by a health insurance policy in 2020 will be subject to a penalty, this time on their state tax return rather than federal.
The penalty will amount to $695 per uncovered adult in the household, and half of that amount for each uncovered child. The penalty goes into effect with regard to the 2020 tax year, with penalties charged in Spring of 2021 when California residents file their state income tax returns. Some exemptions to the law do apply.
In order to avoid the potential penalty, health insurance coverage must be maintained throughout 2020. That makes the current Open Enrollment season vitally important for all Californians.
If you are not currently enrolled in a health insurance plan, you must choose one by December 15 in order for coverage to begin on January 1, 2020. Get started today, so that you have time to adequately compare plans and select one that best suits your needs. Give us a call and we’ll be happy to help you protect your family, while avoiding any unnecessary tax penalties in 2021.
Many companies in the small group market want to offer health insurance coverage to employees, but are unsure of how to make that happen. What about the cost? Will employee participation be high enough? Will we get turned down if enough employees don’t want to participate? The small group special enrollment period is the answer to these questions.
What is the small group special enrollment period? Once per year, the small group special enrollment period allows smaller companies to establish a group health insurance plan for employees without the usual minimum participation or contribution rates. During this one-month enrollment period, your company does not need to contribute to premiums. And, you only need one enrolled employee in order to establish a group plan.
A tax-friendly strategy. As an added bonus, you can help your employees earn a valuable tax benefit as they pay their premiums. Premiums can be deducted from paychecks on a pre-tax basis, meaning they will reduce income tax liability by that amount each year. The strategy works in a manner similar to 401(k) contributions, adding a valuable benefit for your employees.
When is the small group special enrollment period? This opportunity comes around each November 15, and lasts until December 15. During the special enrollment period, the usual participation and contribution requirements are not enforced. Those who enroll by the deadline of December 15 will have coverage that begins on January 1.
Certain rules regarding employer contributions can feel a bit tricky to navigate. Contact us before November 15 so that we can answer your questions about the small group special enrollment period, and help you decide how to proceed with this important benefit for your employees.