High-deductible Health Plans – Lower Premiums
  • Posted

High-deductible Health Plans – Lower Premiums

Employers are finding High-deductible Health Plans (HDHPs) an attractive way to reduce their employees’ health insurance premiums.

Coverage for Routine and Complex Procedures
  • Posted

Coverage for Routine and Complex Procedures

In the past, you may have had to go to a hospital for certain healthcare services. Today, many of those same things are done in your doctor’s office. How much you pay for those services depends on if they are routine or complex.

How We Make Coverage Decisions
  • Posted

How We Make Coverage Decisions

We work to make sure our members get the right healthcare in every care setting. We support proper care decisions based on medical necessity and the member’s specific health plan. When a service needs pre-authorization, our Medical Director and clinical staff follow QualChoice Medical Coverage Policies. They also follow the peer-reviewed and nationally noted guidelines of MCG Health, LLC.

  • Posted

Transition Policy Extended for Non-ACA Compliant Plans

The Centers for Medicare and Medicaid Services (CMS) recently extended an existing transition policy for non-ACA compliant plans through the end of 2018.

  • Posted

Amended Medical Coverage Policy

Preventive health benefit BI062 has been updated to allow virtual colonoscopy with pre-authorization. Added that Cologuard and Epi proColon tests will not be covered.

Health Coverage and Your Taxes
  • Posted

Health Coverage and Your Taxes

The Affordable Care Act (ACA) requires everyone to have health insurance. You must report it on your 2016 federal tax return.

  • Posted

Heart Health & QCARE

February is American Heart Month, the national awareness campaign aimed at preventing cardiovascular disease. If your plan includes QCARE, your employees have access to our Heart Health program, with nationally accepted practices and personal support for hypertension (high blood pressure).

  • Posted

Employee Group Size Now Determined by ATNE

To meet compliance regulations, the employer group's Average Total Number of Employees (ATNE) is required.The ATNE is defined as: the sum of the number of employees on the last day of each month in

  • Posted

IRS Extends Deadline for Providing Individual Statements

On November 18, the Internal Revenue Service released Notice 2016-70, which provides an extension of certain due dates for 2016 ACA health coverage reporting.As a result, the due date for employers to

  • Posted

November is American Diabetes Month

Diabetes is one of the leading causes of disability and death in the United States. One American in 11 has diabetes --- that's more than 29 million people.