Have you been wondering what the difference is between Open Enrollment and Special Enrollment? Are you unsure as to when you can enroll in health coverage? Understanding all of the different health care terms can be confusing, but we are here to help!
Open Enrollment happens only once a year for a short period of time and allows any eligible consumer to enroll in health coverage or existing members to make changes to their current coverage. The Open Enrollment Period usually takes place from November to January. This year Open Enrollment will be shorter: 11/01/17- 12/15/17 for effective date of 01/01/18.
- Special Enrollment happens all year long, but you must experience a qualifying life event. You can qualify for Special Enrollment if you experience certain life events, like losing other health coverage, getting married, or having a baby. However, for most qualifying life events, you only have 60 days from the date of the qualifying life event to enroll
- You may enroll under a short term policies throughout the year!
- You may also apply and enroll in Medi-Cal any time during the year!
(CNN) Lined up one by one behind a glass door, tiny black fuzzy heads peer out at a forbidden Nirvana. They stare at a privilege only the older and wiser among them get to experience.
Just out of reach is a sea of sweet, spongy goodness: fresh, unclawed yoga mats.
Typically, the Good Mews cat shelter in Marietta, an Atlanta suburb, with its bright walls and white volunteer-scrubbed floors, is home to 100 or so cats who lounge and chase and bat at the odd toy, all while they wait for humans to come find them and give them a forever home. Tonight, however, they are in for something special. Tonight, their home in the cage-free adult cat room transforms into a studio for the ultimate in challenging exercise fads. Classes have popped up on New York's Lower East Side, in San Francisco, even in Des Moines and in Mobile, Alabama.
Tonight, it's yoga with cats.
If you've ever tried a hero's pose with your cat around, you know the challenge has nothing to do with your breathing or flexibility. The Herculean task is keeping your yoga mat feline-free. Whatever they make yoga mats out of, the material must come from the catnip family. Turn your back just once to grab your water bottle, and you'll instantly hear the pop, pop, pop of their claws on your pristine $70 Lululemon.
On this night, however, a group of about 15 Spandex-clad women have deliberately plunked down their mats in the middle of the cat room. And true to form, the sleeping cats that had been lounging -- furry legs dangling from cat trees around the room -- instantly jolt awake. They start climbing down toward their prey.
One of the shelter managers, along with a longtime volunteer who is a certified yoga instructor, got the idea for the class -- where else -- after seeing a cat video on the Internet. Only, in that case, people brought cats to a yoga studio.
"I thought with people with allergies, it might be hard to clean up the studio afterward, so I thought, why not bring the class to the shelter?" said the instructor, Lisa Bass. The manager of the shelter, Lisa Johns, thought it was a great idea. She'd wanted another way to get people into the shelter to see the adoptable animals. With Bass donating her time, the class participation fee becomes a donation to help support the animals. Besides the usual assortment of cats and kittens, the shelter runs an expensive program that places cats with special medical needs, continuing to pay for their care even after they've left the shelter.
The class has been a huge hit. It sells out almost as soon as the times are announced online three times a month.
"I really like the class and really like hanging out with all the cats," said Katie Misencik, a volunteer and regular yoga practitioner.
Misencik has taken other theme yoga classes, including one that involves beer, but she says the cat class is pretty special. "It's all about fun and is a little more relaxing," she said. "There's not as much pressure to make my form perfect."
Studies show that yoga can improve your balance, your breathing, your sense of self and your overall health. It can reduce anxiety and fight off depression. It strengthens your core and can help ease chronic pain.
There are no studies about the health benefits of cat yoga, but Bass does see a difference in her students after they've shared their practice with a tiger cat. "In general, yoga is great for lowering the heart rate, and it's great for flexibility," Bass said. "Cat yoga is good for your soul."
From the happy looks on the women's faces, the class does seem to be a hit -- even if, collectively, they may suffer a little from what Bass calls CADD, or cat attention deficit disorder. But even the most senior of yogis might struggle in a room with such present creatures.
As soon as the soothing music starts, cats do make a beeline for the students and the yoga mats.
A calico wanders through a woman's legs as she tries to balance in a low lunge. A white cat sniffs and rubs against a woman in cow pose as she instantly becomes a kind of cat jungle gym. One nestles into the discarded jacket next to a woman's mat. Two tabbies gang up and attack a woman's long dangling ponytail as she attempts downward dog, or "downward cat," as the instructor calls it. A tuxedo perched high in a cat tree looks down at another woman, a little judgy at her attempt at a cat pose. To a person, each woman laughs at these antics. Some even dangle fuzzy toys as they make their complicated moves. The cats seem to like the attention.
"They get stimulation from the humans," said Johns, the manager. "They are very curious about what is going on. They get a lot of loving and affection and get more socialization." Johns also thinks the humans benefit from the special kind of happiness you can only feel bonding with a cat.
"You're not just doing something healthy for yourself," Johns said. "You are doing a bit of good too for these shelter cats that will only get even more adoptable with the extra time and attention."
Photo Credit: CNN
10 Easy (Eating)Tips to Live By
Eating healthily is all about balance. Every now and then it’s perfectly OK to have pie for dinner or a nice slice of cake at teatime – treats are a part of life – but it's also important to recognize when we're pushing things too far. Indulgent food should be enjoyed and savored, but only occasionally – it's important to remember that the majority of our diet should be made up of balanced, nutritious everyday foods. Make healthy food a priority in your life and allow it to bring your family and friends together. Learn to love how it makes you feel, how delicious it is and remember that a healthy balanced diet and regular exercise are the keys to a healthy lifestyle.
1. COOK FROM SCRATCH
This is one of the most important life skills you can learn. It allows you to have complete control of what goes into your food.
2. EAT A BALANCED DIET
Aim to eat a balanced diet that contains each of the food groups in the correct proportions.
3. VARIETY IS KEY – EAT THE RAINBOW
Fill your diet with a wide range of fruits, vegetables, lean meats, fish, eggs, pulses, nuts, seeds, wholegrains and naturally low fat dairy foods. When it comes to fruit and veg, different colours provide your body with the different nutrients it needs to stay strong and healthy – it's not just greens that are good for you!
1. Opportunity for Growth
L.A. Care Covered is ranked as the second most affordable plan throughout Los Angeles County for the 2017 Open Enrollment Period.
The Covered California trend has demonstrated that existing enrollees like both coverage and lower pricing. In Los Angeles County, approximately 70% of the overall enrollment is within the silver plans. Therefore, making the L.A. Care Covered Silver and the Silver Enhance Plans a top choice for consumers is a priority this year.
2. Provider Network Expansion
L.A. Care continues to grow its network to expand the number of doctors, hospitals and medical groups within its provider network. Since 2013, it has more than doubled the number hospitals and expanded its contracts with medical groups, which includes Health Care Partners. L.A. Care has also exponentially increased the number of primary care physicians and specialists in its network.
The impressive list of available L.A. Care Covered hospitals includes some of the highest-quality, top-ranked institutions in the area, including:
• Children’s Hospital Los Angeles
• Alhambra Hospital Medical Center
• Centinela Hospital Medical Center
• Glendale Adventist Medical Center
• Huntington Hospital
• Methodist Hospital of Southern California
• Providence Holy Cross Medical Center
• San Gabriel Valley Medical Center and more
3. Angelenos Helping Angelenos
As the largest publicly operated plan in the United States with over 2 million members throughout Los Angeles County, L.A. Care Health Plan (L.A. Care) is the only health care plan that focuses exclusively on Los Angeles County. L.A. Care provides a localized customer service center for the agent community that is committed to the agent needs and satisfaction.
4. My Health In MotionProgram
L.A. Care will reward your L.A. Care Covered members for taking the right steps to improve their health! By participating in L.A. Care’s My Health In Motion Program and successfully completing their health appraisal survey, health coaching plan, tobacco cessations workshop (if a smoker), and healthy weight workshop, L.A. Care Covered members can earn up to 215 points (1 point = $1 in gift cards). These points can be redeemed for gift cards to more than 100 retail outlets.
5. Community Presence
L.A. Care Family Resource Centers offer a vibrant space for the community members to come together and learn skills for a healthy life. They offer free health education and exercise classes that are open to everyone.
L.A. Care Health Plan members can get one-on-one help to learn more about the following:
• Member orientation
• Choosing a doctor
• Making an appointment
You could say I’ve worked on wellness my entire life: for myself, for my family, and for the world at large mainly for my clients and colleagues that I love. I went into the Healthcare Industry with the whole-hearted intention of helping others stay well and teaching life practices to facilitate this.
Working on wellness is truly a lifelong pursuit. I personally know how difficult it is to get people to change comfortable habits that they have perfected for many years. But while people don’t generally want to change, sometimes it is necessary. In some cases, the decision to choose wellness and throw out old habits can literally make the difference between life and death.
We now think of technology and devices as things that promote health and wellness in our lives. But it was still a surprise for me to encounter the new Pokémon app and to observe how it instantaneously changed people’s exercise habits worldwide. I was amazed to discover how the Pokémon app pushed people out of their comfort zones and forced them to develop new habits of walking and being outside, all while being fun and engaging. I was startled to see how many people play this new game called ~ Pokémon.
Around the time that the Pokémon app emerged, I found myself on a beautiful beach playing the game with my 21-year old son. It was right before he was going off to college.
My kids and I were together on a final, end-of-summer getaway in sparkling La Jolla, CA. With our busy schedule we only had three days of vacation together and were looking forward to wrapping up summer and going back to our new realities. For me, of course, the end of summer meant that the 4th Open Enrollment for the ACA/Obama Care was right around the corner.
My kids had spent most of their summer immersed in nature at Camp, where my son worked as an advisor and my daughter as a camp counselor. They love that camp and consider it a second home, in spite of being completely cut off from technology while there. This actually caused them to really stay active, enjoy nature. They always look, taller, happier, and healthie when they return from camp. Sometimes, I barely recognize them.
We decided on La Jolla for our three-day jaunt because the Insurance License Board Test was being offered there at that time. We could spend quality time together as a family and also get the licensing exam under their belts. Yes, my kids are both are getting certified ~
What is Form 1095-A?
The Affordable Care Act, also known as Obamacare, requires most U.S. residents to have health insurance. It also offers a tax break, the Premium Tax Credit commonly known as APTC to help offset the costs of health coverage. You should receive a copy of Form 1095-A if you bought your plan from a state exchange. If you bought your plan direct from a carrier, you’ll receive a Form 1095-B. These forms provide information needed to claim the tax credit on your tax return.
Form 1095-A Health Insurance Marketplace Statement
If enrolled in a health plan through the Health Insurance Marketplace in 2015 you will receive a Form 1095-A, Health Insurance Marketplace Statement from the Marketplace, not the IRS.
The Form 1095-A will tell you the dates of coverage, and the total amount of monthly premiums for your insurance plan.
If you set-up a HealthCare.gov account, Covered CA or Washington Healthplanfinder account, you can get a copy of the Form 1095-A, Health Insurance Marketplace Statement online.
*** you may receive multiple 1095-A forms for each policy ID
More information is available for Marketplace members at the following website:
Form 1095-A Disputes
If you dispute the coverage information provided from their 1095-A form(s) here is what you need to do:
The member will need to file a HICS Case.
- FL, MI, NM, OH, TX, UT, and WI - the Member needs to contact the Marketplace Exchange directly.
- CA - The member will contact Covered CA.
- WA - The member will contact WA Healthplanfinder.
Once the HICS case is reviewed, a determination will be made.
The Marketplace is responsible for consumer outreach and the generation of a corrected 1095-A form back to the you.
Consumers who experience a qualifying life event can enroll in a Covered California health insurance plan even outside of the open-enrollment period. This is called special enrollment. Below is a list of common qualifying life events for special enrollment that apply year-round.
- Losing health coverage. For example, consumers are no longer eligible for Medi-Cal, or they lose health coverage through their job.
- Income changes so much that a consumer becomes newly eligible or ineligible for help paying for their insurance. For example, if a consumer is already getting help paying for their insurance premium, and their income goes down, they may be able to get extra help.
- Turning 26 years old and are no longer eligible to stay on your parents’ plan.
- Change in place of residency, which allows a consumer to gain access to new Covered California health insurance plans. This includes moving to California from another state. This also applies to individuals who are released from jail or prison.
- Having a child or adopting a child, receiving a child into foster care, or placing a child in adoption or in a foster home.
- Getting married or entering into a domestic partnership.
- Becoming citizens, national or lawfully present individuals. This event applies only to people who were not previously citizens, nationals or lawfully present.
- Being a member of a federally recognized American Indian or Alaska Native tribe. A consumer in this category may enroll in health insurance or change health insurance plan once a month even if the open enrollment period is over.
- Covered California can also determine, on a case-by-case basis, that the consumer experienced an exceptional circumstance, which could allow for a special enrollment period.
These are just some of the more common qualifying life events. Consumers can click here to read more about special enrollment and qualifying life events. To apply for coverage through special enrollment, click here.
Signing Up for Health Insurance or Changing Health Insurance Plans After a Qualifying Life Event
Consumers have 60 days from the date on which the qualifying life event happens to enroll in a Covered California health insurance plan or change their existing Covered California plan. For example, if a consumer has a child on June 1, they have until July 31 to notify Covered California, complete an application for their new child, choose a health plan and pay for it. If they do not get health coverage for their child, they may have to pay a tax penalty.
If 60 days pass and consumers do not sign up for health coverage, they will have to wait until the next open enrollment period.
Keep in mind that consumers can enroll in Medi-Cal at any time. They do not need a special enrollment period to enroll in Medi-Cal. To find out if they are eligible or someone in their family is eligible for Medi-Cal, they should complete the online application by clicking on "Apply".
How to Enroll After a Qualifying Life Event
For many qualifying life events, consumers can enroll online. They can also call the Covered California Service Center at (800) 300-1506. Service Center representatives can answer any questions consumers have about a qualifying life event and can help them enroll in or change health insurance plans. Consumers can also get help from a Covered California Certified Enrollment Counselor, Covered California Certified Insurance Agent, Certified Plan Based Enroller, or county eligibility worker.
If consumers would like help working with Covered California or their health insurance company, contact the Health Consumer Alliance at (888) 804-3536 to get free local assistance. Consumers can also visit the alliance's website at HealthConsumer.org.
Avoiding Gaps in Coverage
Consumers will need to plan ahead to avoid gaps in health coverage. It helps to know that in general, the start date for coverage depends on the date of enrollment. If consumers enroll by the 15th day of the month, their coverage will start on the first day of the next month. If consumers enroll after the 15th day of the month, their coverage will start on the first day of the second month. For example, if consumers enroll on June 13, their coverage will start on July 1. If they enroll on June 16, their coverage will start August 1. Consumers can use this rule as a guideline to help plan their new coverage and avoid gaps.
Start Dates for Coverage
For most qualifying life events, the start date for coverage depends on the date that consumers enroll, as discussed above. If consumers enroll by the 15th day of the month, their coverage will start on the first day of the next month. If consumers enroll after the 15th day of the month, their coverage will start on the first day of the second month.
But there are a few exceptions to the start date rule:
- A consumer loses Medi-Cal coverage, job-based coverage or other coverage, and they use a special enrollment period, their coverage would start on the first day of the next month following plan selection, regardless of when during the month they make their plan selection.
- A consumer gets married and uses a special enrollment period, their coverage will start on the first day of the next month following their plan selection, regardless of when during the month they make their plan selection.
- A consumer adopts a child or places a child in adoption or foster care, and they use a special enrollment period, their coverage starts on the date of the birth, the adoption or the placement for adoption or foster care.
- On a case-by-case basis, Covered California may start consumers’ coverage earlier.
Signing Up for Medi-Cal Coverage
Consumers can sign up for Medi-Cal at any time. They do not need a special enrollment period to sign up for Medi-Cal. To find out if they or someone in their family is eligible for Medi-Cal, complete the online application by clicking on "Apply" or by calling the county human services office.
Canceled Medi-Cal Coverage and Special Enrollment
Losing Medi-Cal coverage is considered a qualifying event that would trigger a special enrollment period for consumers. Other qualifying events include the loss of a job, a marriage or divorce, or the birth of a child. In the case of such an event, consumers would be eligible to enroll within 60 days of that event. During that period they could not be denied coverage by a health plan in Covered California or in the individual market, and would be eligible for the premium assistance that is only available through Covered California.
Originally posted by CoveredCalifornia
The third Open Enrollment of Covered California and the Private market is wrapping up!
The final two deadlines are:
1/15/2016 for a start date of 2/01/2016 and
1/31/2016 for a start date of 3/01/2016!
These dates apply to BOTH Covered California policies AND private market policy coverage. Final applications must be submitted by the end of this month to avoid penalties. Now is the time to review your current coverage!
You may be eligible for a subsidy with Covered CA or pay the full cost under a private policy but you need to act quickly.
Beyond 1/31/2016, only people with a Qualifying Event (QE), such as a marriage, divorce, relocating residence, losing employer coverage, or a pregnancy will be able to buy a new policy or make changes to an existing policy. People who qualify for Medi-Cal may enroll at any time. Small or Large Employers may review or get new group coverage throughout the year.
If you unable to enroll before the deadline, it is to your benefit to acquire a Short Term Health Insurance Policy. Such plans are available throughout the year but they are not ACA compatible plans. They do offer comprehensive coverage in case of emergency and better coverage than stay uninsured.
The A+ Insurance team and myself are in the process for rapping up this 3rd Open Enrollment here in CA.
~Spread the love & light ~ this is the only way, blessings from our heart to yours!
While traveling outside the U.S. with your family during the holidays, remember to get medical travel insurance!
Travel with a "Peace of Mind".
When traveling abroad with your family, the last thing you want to worry about is how would you be protected if something unfortunate were to happen to you. HTH Worldwide Travel Medical Insurance is the best solution that is also very affordable.
As a member, you will have access to wonderful physicians in more than 180 countries. Your are also able to see any health care provider of your choice. The plan also covers: office visits, prescription drugs, hospital care, surgery and more.
This cheat sheet provides a quick reference for small businesses on health reform (aka the Affordable Care Act or ObamaCare).
Small businesses (with fewer than 50 employees) are largely unaffected by health reform. Yet, many small business owners and HR managers feel confused about their requirements under health reform.
The purpose of this article is to provide a quick reference guide for small businesses about how health reform impacts your business and your employees - and how to take advantage of health reform changes to offer more affordable health benefits.