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This article is dedicated to YOU, yes, you all, especially my fellow healthcare professionals and advocates, with a special shout-out to my esteemed colleagues in the health insurance industry. Your unwavering dedication to addressing the soaring healthcare costs in the United States and revolutionizing our healthcare system is commendable.

India holds a special place in my heart, and I am often asked why this extraordinary land inspires me so much. After what felt like an eternity of waiting due to the pandemic, I recently embarked on a long-awaited trip to India, and it was nothing short of magical. 

During my visit, I had the privilege of spending four incredible days in the vibrant city of Mumbai as a speaker at the prestigious, transformative @moneyexpoindia2023 conference. The energy and enthusiasm of the attendees was contagious, and they reminded me of the limitless possibilities that lie within the inspiring world of finance. 

Following my time in Mumbai, I embarked on a soul-nourishing self-retreat at the Fazlani Natural Nest among the breathtaking mountains that gracefully connect Mumbai and Pune. Surrounded by nature's beauty, I found peace and serenity, allowing me to reflect and reconnect with myself. 

One of the highlights of my trip was the simple joy of sitting down with a cup of my morning coffee and reading the daily newspaper. In a delightful twist of fate, an article in the #TimesofMumbai caught my attention, reminding me of the power of global collaboration and sharing in healthcare. It reinforced the notion that we can find common ground and create a more inclusive world by remaining open and receptive to different perspectives. 

Imagine my delight when an article titled: “Experts ask why docs reluctant to prescribe generic medicine’ gently reminded me that we can form a meeting point by embracing and learning from diverse healthcare practices worldwide. It is a timely reminder to look to those who have achieved commendable milestones in providing affordable healthcare access. Witnessing how health services can be streamlined and forced without compromising the quality of care was a revelation. 

In April 2017, the government of Maharashtra announced a new rule in Mumbai stating that all doctors must prescribe generic drugs to their patients or face penalties. This rule aims to make healthcare more affordable and accessible for the citizens of Mumbai. Under this rule, doctors are required to write prescriptions using generic names instead of brand names. Generic drugs have the same composition, dosage, safety, and effectiveness as their brand-name counterparts but are usually cheaper. 

The government believes that promoting the use of generic drugs will help reduce patient healthcare costs and alleviate the burden on the healthcare system. Generic medicines are significantly cheaper than brand-name drugs. Additionally, this rule encourages transparency by removing the influence of pharmaceutical companies in medication prescriptions. Doctors who fail to comply with this rule may face penalties and potential suspension of their medical licenses. However, some doctors have raised concerns about the quality and availability of generic drugs and how it may affect their income. 

Even though the rule has generated mixed reactions among doctors, some support the move to provide affordable healthcare that is cost-effective and accessible. In contrast, others argue it restricts their professional autonomy and discretion in prescribing medication. 

I am by no means suggesting a one-size-fits-all approach. Instead, I propose a paradigm shift in which we explore, integrate, and merge the strengths of various healthcare systems. By venturing beyond our borders, we hold the key to transforming the very essence of this game and laying the groundwork for a future where affordable, high-quality healthcare is accessible to all. 

The U.S. is a private, market-based model emphasizing specialized services, but administrative expenses drive up costs. 📈 Insurance plays a central role, as well as providers and the complicated public approach to health. 

We can explore and create a vibrant tapestry that embraces compassion, professionalism, and enthusiasm in care, which is the modern way to heal and fix our healthcare system. Further,  employers must have their share of understanding on how to emphasize and choose the most influential care for health. Let us rise above borders and forge a unified path towards a healthier world.

With heartfelt appreciation and unwavering commitment,

Yours, on the journey, Naama

Elayne Serrano

10/28/1964 - 08/18/2022

was an important part of our lives and our clients' lives. She is truly missed.

Here is a tribute video for Elayne.

So excited to share the new book that Naama is a part of "Voices of the 21st Century!" She has contributed a chapter, titled "Medicate or Meditate: Mindful Leaders in the Current Meta Hybrid Workplace," which looks at the benefits of a holistic approach to healthcare, incorporating meditation and mindfulness at all levels of the organization. For more information: https://voicesofthe21stcenturybook.com/

As Open Enrollment season comes to an end this month, a gentle reminder that if you haven't updated your plan, you might be losing money! Whether you are on CoveredCA or privately insured, there are new programs designed to help relieve the costs of insurance for many middle income families. Thanks again to @bryanweatherford and the @biztv team for having me on to discuss these important deadlines! December 31 is the deadline for a January 1, 2022, effective date for all private and Covered CA insurers, save for Kaiser which is December 15. Get covered, stay covered!

Yes, the holidays are over, and Open Enrollment is here!

October 15th marks the beginning of Medicare Open Enrollment season. This is an essential period to review and assess your coverage, plans, and healthcare needs.

Open enrollment is the ONLY time you can make changes to your Medicare Advantage Plan and Part D Plan. This year's Open Enrollment runs October 15th – December 7th for a January 1st, 2022 effective date.

During this time, Medicare recipients can change their Part D medication plan, change their current Medicare Advantage plan, switch from original Medicare to Medicare Advantage, or elect to revert to original Medicare.

It is vital to remember, Medicare Parts A&B helps pay for hospital care outpatients and doctor visits, but it doesn’t cover everything. Medicare Parts A&B does not pay for prescription drugs, routine dental, acupuncture, long-term care, travel, etc. Depending on your current and projected needs, different Medicare options, such as Medicare Advantage Part C, Part D (prescription drug coverage), or a Medicare supplement, may work better for you and provide more coverage.

Considerations when choosing a Part D plan or reviewing your Medicare Advantage plan drug

coverage:

1. Your monthly premium varies depending on the plan you choose
2. Be aware of your brand-name prescriptions to ensure your needed medication will be covered

     and at what tier for 2022.

3. What the deductible is and whether it applies to brand name prescriptions or generic
4. Copayments and coinsurance costs: these keep changing yearly!
5. If you take insulin, which plans special offer savings
6. Which pharmacies contract with that plan (there can be a significant cost difference)
7. Whether you will reach the coverage gap during the year and what that means cost-wise
8. Finally, the plan's Star Ratings, which shows their track record for handling claims and providing good customer service.

Original Medicare does not cover you if you travel outside the US. If you're planning any overseas travel, affordable and comprehensive travel insurance, evacuation, and COVID coverage are available.

After the intense past two years of the COVID crisis, we have all learned a bit more about the

importance of maintaining our health. Eating well, getting proper sleep, nutrition including plenty of green vegetables, and drinking enough water are the simplest things we can do to keep our body and mind strong. Reviewing your medications yearly with your provider is an important step. Coordinating care and learning about accessing the best possible providers is crucial. On many occasions accessing alternative medicine in combination with our Western medicine will be life-saving.

We also know how important our mental health is. We encourage you to take advantage of the excellent Medicare offering for so many kinds of therapies. Physical and Mental prevention treatment has never been more critical than now. Meditating, spending time in nature, walking, and gathering together safely with loved ones will be essential for our mental health breaks. 

So many medical conditions are the result of being stressed and overwhelmed. We don’t need to wait to get diagnosed to take care of ourselves. We are all on this healthy ride together, no matter how old or young we are. Please get in touch with our team for advice and allow your resources on these topics - we would love to hear from you and help in any way possible.

Much ❤

Naama & The RightPlan team.

Good news, Californians and our community!

Covered CA is now more affordable than ever. With over 1.6 million members, the popular program is seeing lower rate increases and a more significant number of families who qualify for subsidies, with premiums for over 730,000 Californians as low as $0 or $1 per month!

The American Rescue Plan benefits that went into place this summer will continue through 2022, lowering costs for many members. These benefits build on California’s state subsidies to provide financial help and lower premiums for many middle-income Californians for the first time.

Specifically, the American Rescue Plan expanded Marketplace subsidies in 2021 and 2022 for enrollees above 400% of the federal poverty level and increased subsidies for those making between 100% and 400% of the federal poverty level. These changes have resulted in consumers being eligible for higher subsidies and made cost-sharing reduction plans more attainable. It is more important than ever to connect with a qualified Covered CA Storefront agent to help you determine if you qualify for these new lower rates.

The official Covered CA Open Enrollment period this year runs from November 1, 2021 until

January 31, 2022. While December 31 is the last day to apply for an effective date of

January 1, 2022, the last day of enrollment on January 31st will allow a start date of

February 1, 2022.

MORE CHOICES in 2022:

• All Californians will have at least two choices for Covered CA plans. In addition, 94% will have 3+ options, 81% will have 4+ options.
• Anthem Blue Cross will return to Alameda, Contra Costa, El Dorado, Marin, Napa, Placer, Sacramento, San Francisco, San Mateo, Solano, Sonoma and Yolo counties.
• Blue Shield of California will bring its Trio HMO plan into portions of Monterey and Santa Barbara counties.
• Valley Health Plan will expand into San Benito and Monterey counties.
• NEW CARRIER- Bright HealthCare, which currently operates in 13 other states and covers more than 500,000 people in the individual market, will begin offering coverage in Contra Costa County.

IMPORTANT NOTES FOR RENEWALS:

• Unemployment Insurance: any Covered CA member who received the extra Unemployment Benefit of $300 (which ended 9/4) must report this income and will need to adjust your income with Covered CA.
• Silver 70 plans will have a lower medical deductible of going from $4,000 to $3700 and lower RX deductible going from $300 to only $10.
• There will now be $0 Premium Silver plans available for income-qualifying individuals and families.

CoveredCA for Employers:

Small businesses are available for coverage as well – Covered CA is not just for individuals. There are many benefits for small businesses needing small group health coverage with various options.

New Groups are easy to set up!

Employees enroll online, and there is minimal paperwork for employers to complete. This is also the fastest group approval of all options.

• Employers can offer up to 4 tier options to employees (Bronze/Silver/Gold/Platinum plans)
• Several carriers have a variety of plans/rates to offer employees choices (HMO/PPO/EPO)
• Brand-name insurance like Blue Shield, Health Net, Kaiser and Oscar all participate with multiple plans
• Coverage is available for out of state employees
• Optional child and family dental plans are available
• Employer Contributions can be customized with a separate class for Management
• Groups under 25 full-time employees with an average annual salary of $56,000 or less may qualify for tax credits
• Employer online access is newly improved, with more billing details and auto payment with a checking account now available

 With Covered CA, you can get cost controls for you as a business owner combined with flexibility and coverage choices for employees – a win-win!

As a community Covered CA storefront, we at Rightplan.com can match you with the best plan that meets the unique needs of your family or business. So, if you haven't re-assessed your Covered CA eligibility in the past six months and updated your income, now is the time to do so.

As always, your health and longevity begin with YOU and the choices you make daily. Dean Ornish, M.D., Clinical Professor of Medicine at University of California, San Francisco says, "Think about it: heart disease and diabetes are completely preventable by making comprehensive lifestyle changes. On many occasions without drugs or surgery." This is an absolute fact!

We are committed to helping every client achieve their health goals, whatever their current situation. Moving closer to eating plant-based and whole foods, making time for mindful moments and sharing your gratitude for the people, places, and blessings in your life are just a few of the ways we can get in touch with our most healthful self.

Much ❤ 

Naama and the RightPlan team

On March 11, 2021, President Joe Biden signed the $1.9 trillion American Rescue Plan, with benefits to help Americans affected by the pandemic. Specific health care provisions include new and expanded financial help to benefit an estimated 3 million Californians.

More than 9.5 million workers have lost their jobs in the wake of the pandemic, with 4 million out of work for half a year or longer. The plan will help people in need in many different ways. We share how it will affect health insurance beneficiaries if you are currently uninsured,  a CoveredCA subscriber, Medi-Cal recipient, or an off-exchange (private) member.

This new care act will help lower monthly healthcare costs, to make healthcare more accessible and affordable for many Californians now. It will also allow many more to be covered and help them save on their premium costs. Covered CA hopes to get as many uninsured people, insured as possible.

Three categories of people benefit from this act:

• Individuals who are currently uninsured and are eligible for the new financial help through Covered California, with many qualifying for $1 dollar health plans.
• Individuals who are currently have health coverage directly through an insurer outside of Covered California and are now eligible for financial help for the first time. These consumers may be able to save hundreds or even thousands of dollars by switching to the same or similar health coverage through Covered California.
• Individuals who are currently insured in Covered California health plans and are now eligible for more financial help.

Why it’s imporant to reach out to your existing clients and prospects about the ARPA subsidy expansion – Right now, state exchanges and the federal exchange are doing outreach (emalls, ads, marketing, etc.) Letting everyone know that 1. SEP has been extended, and 2. Members and non members can apply for coverage, change plans, or re-apply on the same plan to see if they qualify for the new subsidy. What they are NOT doing is advising these members/clients to refer back to their agent. Instead, they are telling people to come to their website and apply for coverage direcly.

What is it – ARPA subsidy was recently signed into law, increasing and expanding eligibility for ACA premium subsidies, as well as COBRA updates!

What Changed

Primarily it affects those between 100% - 150% FPL and those making over 400% FPL.

FPL  - Before, someone at 100% FPL (single person, $12,880) would still have to contribute 2.07% of their annual income towards monthly premium, and 4.14% of their annual income for those at the 150% FPL mark. Now, those earning up to 150% FPL will have fully subsidized, $0 dollar plans, and even premium free Silver plans.

Over 400% - Those making over 400% FPL (single person, roughly $51,040 annually) will pay no more than 8.5% of household income which significantly helps the higher age consumers. For example, say, a 24 year old, making $51,000 a year, their premium for a bronze plan might cost less than their 8.5% threshhold (i.e. they might be paying less than $4338 for the year for their plan because of their age.) However, on average, a 64 year old, normally paying $8,349 annually for their health plan, they would pay no more than 8.5% of their income. If they make $51,167 (401% FPL) annually, they would pay no more than $4,394 annually for the same coverage; essentially cutting their premium in half.

✅ Covered California is opening a new special-enrollment period on Apr. 12 that runs through Dec. 31, and consumers can see savings reflected on their monthly health care bills as soon as May 1 if they enroll by Apr. 30.

✅ Consumers at any income level may be eligible for more financial assistance.

✅ Consumers who enroll in Covered California health plans will not have to pay more than 8.5% of their household income for a benchmark plan.

✅ Individuals who are currently uninsured and are eligible for the new financial help through Covered California, with many qualifying for $1-dollar health plans—including some Silver plans.

✅ Consumers who earn more than 400% of the Federal Poverty Level may be eligible for federal financial help for the first time.

✅ Consumers currently insured off-exchange may save hundreds or even thousands of dollars by switching to the same or similar coverage through Covered California.

✅ Most current on-exchange members (Covered CA) subsidies automatically redetermine to maximize their savings.

✅ The Medi-Cal income threshold was updated recently for 2021 and has gone up to $17,775 for individuals and $36,570 for families of four. If you now fall under this threshold, please contact us before April 12, as you will qualify for Medi-Cal benefits!

✅ Consumers receiving unemployment compensation during 2021 may be eligible for the maximum amount of subsidies if enrolled in Covered California plans.

✅ If you are not currently receiving subsidies today, please contact our Covered CA StoreFront team. We will ensure that your applications are updated with current income and determine if you are eligible.

✅ If you are in any of these categories, we recommend that you connect with us as soon as possible to make sure you are not missing out on potential financial help.

The reduced health care premiums under the American Rescue Plan will remain in place for all of 2021 and all of 2022, unless Congress extends or makes these provisions permanent.

Covered California health plans cover:

✅ COVID-19 vaccinations and testing, as well

✅Any medical treatment necessary due to COVID-19 at no charge or minimal co-payments.

✅ All plans must offer essential benefits under the Affordable Care Act, ranging from maternity care and hospitalizations to preventive and mental health care.

✅ No-cost preventive health care includes annual checkups with your doctor and screenings for diabetes, cancer, and high blood pressure.

Remember to stay healthy! We are responsible for our health. Health starts with walking 10,000 steps per day, drinking lots of water, green tea, eating lots of greens, having positive thoughts, spending time in stillness, and scheduling our annual physical, women wellness exams, and a Colonoscopy. A little concern for our health, goes a long way.

Much love from Naama & the A+ Team

As a regular contributor to BenefitsPro Magazine, I was asked to reflect on the state of the industry after the most unusual year of 2020 for an article titled: Diary of a Bad Year. We all have experienced a lot of sadness, loss and dark moments, to be sure, but the industry as a whole proved to be more responsive and resilient than we might have imagined. For those without a subscription, please see the full article below.

Industry Reflections, The Key for Modern Essential HealthCare

October 2020 – Benefits Pro: Naama O. Pozniak

We all are experiencing a year like no other, you don’t need me to tell you that. Navigating the health insurance industry has never been boring, we have always faced one change after another, but this year has proven that our knowledge as healthcare professionals has never been more essential.

In California, we have seen an Open Enrollment season that never has truly ended, with the pandemic, job losses, wildfire disasters and protests. All of these changes have created a constant flow of new concern clients seeking help. Even the legendary health insurance for SAG will have to let go of all subscribers at the beginning of 2021!  I can feel and sense the energy of loss all over. I can hear the heartbeat of every client and I can sense the fear that is currently influencing so many decisions. We have found ourselves navigating new and challenging situations that constantly change in real time, including Covid and diagnostic testing that should be covered, sometime get denied, and fought by my team on behalf of our clients.

We have been serving the majority of our clients remotely, thanks to my incredible, dedicated team who were able to smoothly transition to working from home. It became clear early on in the pandemic that we needed to be super-efficient, consistent, and creative at a time when our clients were suffering loss all around.  We try to bring conscious culture, technology, and solutions to our employers' benefits options, serving them frequently either remotely or, as restrictions slowly lift, in a hybrid working model. There is a huge need for a compassionate, empowering way to heal, and we feel the need strive and provide clients with a stronger healthcare plans that can remind us how can we go back to being whole, to being healed.

Additionally, I must share that even though the amount of travel has decreased dramatically, travel insurance has never been in more demand. Cancellation, trip extension, and most importantly Covid coverage while abroad, or family uniting, is an absolute must. We are seeing quite an increase in inquiries from agents and clients for complex inbound and outbound policies, as a result of the U.S. being restricted from foreign travel policies. I do believe that savvy travelers will continue to incorporate such policies well into the future.

I have found the key to succeeding in the face of change, anxiety and uncertainty many years ago, and believe that it is actually essential to us all in the ‘New Now’ – a regular meditation practice. I have continued leading virtual meditation and stress reduction sessions to as many stakeholders as possible, to encourage the adoption of mindfulness practices by employers and leaders from all professions and industries. Opening the virtual door and allowing teaching, sharing and maintaining our connections, even remotely, has been a lifesaver in this insane year.

Mindfulness – the act of being present and aware – has been challenged in ways that we never dreamt before.  The CE's that I wrote for the healthcare industry few years ago on how meditation can improve overall health and even reduce healthcare costs were received in a profound energy of change. My biggest learnings have been from technology leaders who have shared their progress and vision for the future, and the vital race to use data and AI to bring our healthcare system to a new level of delivery.

I am personally very positive about the current conversation. It is clear that a shift in mindset is happening, and my wish is for the collective advancement of medicine to rise. We can unlock the power of transformation in the very near future of health.

#Namaste