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How One Pharmaceutical Company Priced Its Drug

May 6, 2016 By Phil Lee

I want to share with you the following WSJ article detailing how one major pharmaceutical company took advantage of the health care system to enrich itself, its shareholders and Wall Street with drug prices that produce “99% gross profit margins”.

I hope this will give you with some insight into the behind-the-scenes forces that are driving up health care costs.

How One Pharmaceutical Company Priced Its Drug

Phil Lee

Lee Health Insurance Services (BLIS Corporation)

www.health-insurance.com

925-284-2000

www.linkedin.com/in/philwlee www.yelp.com/biz/lee-insurance-services-lafayette-7Affordable

Wall Street Journal 5/2/2016:

Valeant’s CEO Was Key Force on Pricing

Documents collected during a Senate investigation provide look at how Valeant arrived at sharp price increases

Michael Pearson, chief executive officer of Valeant, lobbied for aggressive price increases on acquired drugs in recent years. PHOTO: DREW ANGERER/BLOOMBERG NEWS

By JACQUIE MCNISH and LIZ HOFFMAN

Updated May 2, 2016 10:33 a.m. ET

In early 2015, when Valeant Pharmaceuticals International Inc.’s top brass met to set prices on a soon-to-be-acquired cardiac drug, some executives suggested slow, staggered price increases. Chief Executive Michael Pearson disagreed.

To reach Valeant’s internal profit targets, Mr. Pearson lobbied for a single, sharp increase. Hospitals could still make a profit at the higher price, he argued, which meant patients would still have access to the drug. The team deferred. The day it completed its February 2015 purchase of the drug, called Nitropress, Valeant tripled the cost.

The exchange, recounted in a document reviewed by The Wall Street Journal, shows in greater detail than was previously known how Valeant and its now-outgoing CEO Mr. Pearson pursued quick, aggressive price increases on acquired drugs in recent years—a strategy that sparked widespread backlash and landed Mr. Pearson in front of a Senate investigative panel last week.

A spokeswoman for Valeant, Laurie Little, said, “We heard very clearly the concerns raised by the Senate Special Committee on Aging, and the board is working to map out a new path for the company going forward. That will include consideration both of how best to set drug prices and of the appropriate role of patient assistance programs in helping to ensure that patients can obtain the drugs that doctors prescribe for them.”

At last week’s Senate committee hearing Mr. Pearson said Valeant was “too aggressive” with drug price increases.

Dozens of documents collected during the Senate investigation provide a deeper look at how Valeant arrived at sharp price hikes on some of the drugs it sells. The documents underscore the challenges Valeant faces now that it has promised to roll back some prices and rely less on acquisitions for which price increases are a major driver. That pivot has investors and analysts concerned about where Valeant’s profits will come from and how it will service the $30 billion in debt it carries.

Related Video

Valeant CEO Michael Pearson testified at a Senate hearing investigating drug pricing Wednesday that he and the company made mistakes and “Valeant was too aggressive.” Watch an excerpt of his testimony. Photo: AP

Concerns over the company’s reliance on price increases, its accounting and other business practices hammered Valeant stock, which has fallen more than 85% since its high last summer. Valeant has said it is comfortable with its liquidity.

William Ackman, a major Valeant shareholder and recently appointed director, told the Senate committee that he and other new directors have “stabilized” a company that has made “significant mistakes.” The company’s stock has gone up about 27% over the past month as the company filed a long-overdue annual report, hired a new CEO and reached an agreement with lenders to avoid a technical default.

Under Mr. Pearson, a former McKinsey & Co. consultant, Valeant earned a loyal following on Wall Street for its profitable strategy of buying existing drugs with price-increase potential rather than developing them in-house. “Bet on management, not on science,” he often said. While Valeant did have a research program, Mr. Pearson said that most of Valeant’s R&D products are reformulations of existing drugs, such as a new delivery method for a glaucoma medicine, according to the Senate documents.

Valeant’s pattern of price increases, including on Nitropress, was the subject of a page-one story by the Journal last year. That strategy drew criticism amid broader political scrutiny of pharmaceutical costs. The Senate panel last week—the third in a series of hearings on drug pricing—focused on four Valeant drugs in particular, including Nitropress and Isuprel, which Valeant acquired from Marathon Pharmaceuticals in February 2015.

The other two drugs, Cuprimine and Syprine, are used to treat Wilson’s disease, a rare ailment involving a buildup of copper in the body, and were acquired by Valeant in 2013. Months after it raised the price of the cardiac-care drugs in 2015, Valeant sharply raised its price tags on Cuprimine and Syprine.

The price of Cuprimine has risen 5,787% to $26,189 since 2013, with most of the increase occurring in the summer of 2015, according to an analysis prepared by Senate committee staff for the hearing. The cost of Syprine jumped 2,934% to $19,783 during the same period. A doctor testified at last week’s Senate hearing that a liver transplant, an alternative treatment for Wilson’s disease, is now cheaper than a lifetime of Valeant drugs.

The Senate analysis referred to wholesale acquisition costs that hospitals and other purchasers pay for drugs.

Although the four drugs made up only a fraction of Valeant’s $10.3 billion in 2015 sales, they ranked among Valeant’s 30 most profitable drugs as measured by net profit, Valeant Chief Financial Officer Robert Rosiello told the Senate committee last month in a written response to questions.

So valuable were Syprine and Cuprimine that when a senior Valeant official learned that Valeant’s customer-service group lacked a way to log inquiries from patients complaining about their rising costs, he wrote in an email that “for these…drugs we need to find a way asap.” He inquired about purchasing software to track their complaints. “These patients are too valuable to lose,” Laizer Kornwasser a former Valeant executive vice president, wrote, according to the Senate hearing documents.

Mr. Kornwasser didn’t immediately respond to requests for comment.

At the 2015 meeting on Nitropress, which was attended by Valeant’s then-finance chief,Howard Schiller, Mr. Kornwasser and other top executives, some of the executives recommended gradual price increases to avoid alienating core hospital buyers of the drug, the Senate documents show. Mr. Pearson argued it wasn’t an “exorbitant” price for a drug that saved lives and represented only a fraction of hospital costs, according to the documents.

Upon completing its purchase of the two drugs in February, Valeant sharply raised the price of both Isuprel and Nitropress.

A month later, when a Deloitte consultant studied further price-tag spikes on the two drugs, the consultant asked a senior Valeant executive in an email: “Are you ok with the above assumptions? They are leading to high gross margins (more than 99%).”

The Valeant executive replied in an email that the analysis “looks right, and I’m not surprised they are extremely profitable.”

Filed Under: Affordable Care Act, Drug Pricing, Health Care Reform, Health Insurance, Individual/Family Plans Tagged With: ACA, Affordable Care Act, big pharma, Drug Price, Family Health Insurance, Health Care Reform, health insurance, Individual Health Plans, Obamacare, Patient Protection and Affordability Act, Patient Protection and Affordable Care Act, pharmaceutical company, pharmaceutical company profits, PPACA, Prescription Drug, Rx, Valeant

Understanding Special Enrollment Period (SEP) and Qualifying Events (QE)

March 12, 2016 By Phil Lee

(This information concerns Individual & Family Health Plans. It does not concern you if you are either on a Medicare Health Plan or on an Employer-Sponsored Group Health Plan)

The year-end Open Enrollment Period for Individual Health Plans ended on January 31, 2016. However, certain individuals may still be able to apply for a health plan in 2016. This special circumstance is called the Special Enrollment Period (SEP). You need to have a Qualifying Event (QE) to qualify. Here’s what you need to know.

You can buy health coverage outside of the open enrollment period when you have a qualifying life event—through a special enrollment period (SEP). Most SEPs last 60 days from the date of the qualifying life event.
Qualifying life events for a SEP include:

Getting married or entering a domestic partnership
Child aging off a plan
Gaining a dependent or becoming a dependent through marriage, birth, adoption, or placement for adoption or foster care
Permanently moving to a new area that has different health plan options
Employer coverage not being considered minimum essential coverage
Losing other healthcare coverage that is considered minimum essential coverage, such as due to job loss, termination of employer health plan by the employer or expiration of COBRA coverage
Returning from active military service
Change in eligibility for advance premium tax credit or cost-sharing subsidies

Please note that voluntarily terminating other health coverage or being terminated for not paying premiums is not considered a qualifying event.

All insurance companies will require written proof that you have an acceptable qualifying event. When enrolling during an SEP, please make sure to include qualifying events verification documents in the application.

This is a link to Blue Shield of California’s interpretation of the ACA laws regarding SEP and QE’s. Different carriers may have slightly different interpretations and requirements.

https://bliscorp.egnyte.com/dl/QJhtXag1KT

Phil Lee

Lee Health Insurance Services (BLIS Corporation)

www.health-insurance.com

925-284-2000

www.linkedin.com/in/philwlee www.yelp.com/biz/lee-insurance-services-lafayette-7Affordable

Filed Under: Affordable Care Act, Covered California, Health Care Reform, Health Insurance, Individual/Family Plans Tagged With: ACA, Affordable Care Act, Anthem Blue Cross, Blue Shield, California Health Exchange, California Health Insurance, children health insurance, Covered California, Covered California Health Exchange, coveredca.com, Family Health Insurance, Family Health Plans, HBEX, Health Care Plans, Health Care Reform, Health Care Reform Act, Health care subsidy, health insurance, Health Insurance California, Health Insurance Marketplace, Health Plans California, Individual Health Insurance, Individual Health Plans, Individual Mandate, Individual Subsidy, Kaiser, Obamacare, Patient Protection and Affordable Care Act, QE, Qualifying Event, SEP, Special Enrollment Period

HSAs Offer More Advantages Than 401K — Wall Street Journal article

March 12, 2016 By Phil Lee

Dear Friend,

For years, we have been suggesting to many of our clients that HSAs (Health Savings Accounts) frequently offer more benefits and flexibility than pension plans such as IRA’s. This article from the WSJ appears to agree with that.

We are obviously not suggesting that you replace pension plans with HSAs, but in many instances, you may want to contribute to an HSA before a pension plan, or use the HSA to increase your tax-sheltered contribution limits.

I welcome your comments.

Sincerely,

Phil Lee

Philip W Lee, Lee Health Insurance Services www.health-insurance.com 800-286-7445

Wall Street Journal, Jan. 29, 2016:

HSAs Offer Tax Benefits Beyond 401(k)s

Health-savings accounts can be used to cover medical costs, a major expense, in retirement

Most people overlook health-savings accounts, or HSAs, as a retirement-savings vehicle. A SeniorsPLUS networks representative talks with a Bangor Savings Bank official in Maine. PHOTO: GORDON CHIBROSKI/PORTLAND PRESS HERALD/GETTY IMAGES

ANNE TERGESEN

January 29, 2016

27 COMMENTS

When saving for retirement, there is a place to put money that may be even better than your 401(k).

Most people overlook health-savings accounts, or HSAs, as a retirement-savings vehicle. But these accounts, which were authorized in 2003, come with more tax advantages than 401(k)s and individual retirement accounts when used to cover medical costs, which are a major expense in retirement.

“It’s the most tax-preferred account available,” says Michael Kitces, director of financial planning at Pinnacle Advisory Group Inc. in Columbia, Md. “Using one to save for retirement medical expenses is a better strategy than using retirement accounts” to cover those expenses, he says.

As with a traditional 401(k) or IRA, an HSA allows you to set aside pretax money without paying federal or state income tax on it. Most people who contribute through payroll deductions also save 7.65% in FICA tax, which finances Social Security and Medicare.

Money in HSAs grows tax-free and, if used for medical expenses, can also be withdrawn tax-free. In contrast, with a traditional 401(k) or IRA, you pay income tax on your withdrawals.

‘A lot of people don’t think about how to save for health care in retirement, yet it’s one of the major expenses people will have.’

—Roy Ramthun

Due to this combination of tax advantages, HSAs—which are paired with the HSA-qualified health plans available on health-care exchanges and offered by 43% of employers—can even be a better deal than a 401(k) with an employer matching contribution. That is most likely to be the case if you are in a high tax bracket and the 401(k) match is less than dollar for dollar, says Greg Geisler, an associate professor of accounting at the University of Missouri-St. Louis.

For people with a high deductible health plan, “an HSA should be either the first or second place they look to save” for later life, Prof. Geisler says.

To open an HSA, you must be covered by an HSA-qualified health plan. For 2016, these plans have deductibles of at least $1,300 for individuals and $2,600 for a family. In return for exposing policyholders to potentially higher out-of-pocket costs, the plans generally charge lower premiums and offer individuals and families the chance to save up to $3,350 or $6,750 a year, respectively, in an HSA. (Those over 55 can save $1,000 more).

ENLARGE

Because employers save on premiums too with a high-deductible plan, many contribute to employees’ HSAs as an incentive to get them to enroll, says Eric Remjeske, president of Devenir Group LLC, which advises banks offering HSA investment platforms.

The biggest payoff with an HSA comes when the money set aside isn’t all used for current medical bills and instead compounds over time, before being used for qualified expenses. Those expenses can include not just medical bills but also dental and vision-care expenses, Medicare premiums and a portion of long-term-care insurance premiums.

According to Fidelity Investments, a 65-year-old couple who retire today and live another two decades will spend $245,000 on expenses including Medicare premiums and the 20% of medical costs Medicare doesn’t cover—a number that doesn’t include dental and long-term-care expenses.

“A lot of people don’t think about how to save for health care in retirement, yet it’s one of the major expenses people will have,” says Roy Ramthun, president of HSA Consulting Services in Silver Spring, Md.

Once you are enrolled in Medicare you can no longer contribute to an HSA. But you can continue to tap your HSA balance for medical expenses for yourself, your spouse and any dependents you may have.

You can also use your HSA for nonmedical expenses, but you will owe income tax on your distributions—and a 20% penalty if you are younger than 65.

Experts recommend that those who can afford to contribute to both an HSA and a 401(k) kick in the maximum to both. And what if that isn’t feasible? If you don’t incur much in the way of medical bills and can sock away a significant portion of your HSA contributions for retirement, the HSA has an edge, says Mr. Kitces. Some employees may want to allocate enough dollars to a 401(k) to get the company match and then direct the next dollars of savings to the HSA.

Some people go so far as to suggest maximizing the balance in an HSA by opting to pay current medical bills in cash, rather than tapping the HSA. Here, the advice is less clear, says Mr. Kitces.

While the HSA will “get better tax treatment in the future,” you will pay a price for preserving it since you will likely have to pay your current medical expenses in after-tax, rather than pretax, dollars, he says. “You have to decide whether it’s worthwhile to spend more today” on your medical bills “to get more dollars into a tax-free medical account that’s turbocharged for the future,” he adds.

Some people stockpile medical receipts for many years and file for reimbursement in retirement to create tax-free withdrawals to supplement their income in years in which tapping other accounts would push them into a higher tax bracket.

If your goal is to use an HSA to save for medical expenses in retirement, be sure to invest the account in a diversified portfolio of stocks and bonds. (If you don’t like your HSA’s investment options, you can transfer your money tax-free to an HSA elsewhere.) By leaving your contributions in a low-risk option like a money-market fund, you won’t get much return, which limits the tax-free growth that is one of the HSA’s biggest advantages, says Mr. Kitces.

Write to Anne Tergesen at [email protected]

Filed Under: Group Plans, Health Insurance, Health Savings Accounts, Individual/Family Plans Tagged With: California Health Insurance, Family Health Insurance, Family Health Plans, Group Health Insurance, Group Health Plans, Health Care Plans, health insurance, Health Insurance California, Health Plans California, Health Savings Account, Health Savings Accounts, HSA Accounts, HSA Health Plans

The Pitfalls of Leaving Original Medicare & Supplement Plan for Medicare Advantage HMO

October 27, 2015 By Phil Lee

(This information concerns Medicare Health Plans. It does not concern you if you are either on an Employer-Sponsored Group Health Plan or on an Individual & Family Health Plan)

We frequently hear stories about seniors who made this change hastily because they attended a meeting, or an agent came to their home. Frequently these agents would represent a limited number, usually just one, Medicare Advantage HMO plan. They typically do not give prospects an adequate overview or understanding of the entire universe of plans in the marketplace because they have limited knowledge and products to offer. They don’t fully explain the consequences of your making such a switch.

If you are contemplating such a change, you should not do so lightly. You should only do this after much thought and research. It’s not a matter of simply changing plans or changing carriers. It’s nothing short of changing from one world of plans, Original Medicare with Medicare Supplement, to another entirely different world of plans, Medicare Advantage.

These are the issues you must consider:

This change may not be reversible in the future because Medicare Supplement plans are not guarantee-issue, except at age 65. Supplement plans do not have an annual open enrollment period as Advantage plans do. If you ever want to go back to Medicare Supplement from an Advantage plan, you will have to be medically underwritten and approved on your application before you will be enrolled.
90% of our clients choose Medicare Supplement F plans because of the freedom to choose their own providers anywhere in the country, and also because of the freedom from Copays, Coinsurance and Deductibles for all medical costs, excluding Rx. However over the years, many non-clients have approached us for help to make the difficult transition from Medicare Advantage, such as Kaiser back to Original Medicare and Supplement. This process is not easy, and is full of tricky timing and health approval issues.
Medicare Advantage HMO plans like Kaiser Advantage or Scan Health require you to use only those doctors that are in their network. You will not have the option to see any outside doctors such as from UCSF, Stanford, etc. You will be required to obtain referrals and authorization for all specialists, procedures, etc.
Advantage plans do not include Foreign Travel benefits.
Kaiser Medicare Advantage does not cooperate with independent agents. So we will not be able to service you on your Medicare plans at all.
CMS (Center for Medicare & Medicaid Services) has ruled that Medicare Supplement F plans can no longer be offered to new enrollees after the year 2020. If you think you might want a Medicare Supplement F plan in the future, you must enroll before 2020.
Medicare Trial Period and Medicare 24 Month Rule – Under very limited circumstances, Medicare beneficiaries who enroll in an Advantage plan at age 65 may have a 12 to 24 month Medicare Trial Period where they may switch back to Original Medicare, a Medicare Supplement plan and a Medicare PDP (Rx) plan, guarantee-issue. But it must be done within 24 months from age 65 Medicare ICEP (Initial Coverage Enrollment Period).

Phil Lee

Lee Health Insurance Services
800-286-7445

www.linkedIn.com/in/philwlee

www.Health-Insurance.com

Filed Under: Health Insurance, Medicare Plans Tagged With: 24 Month Rule, 65+, AARP, Age 65+, Alta Bates, Anthem, Anthem Blue Cross, Blue Shield, Brown & Toland, Center for Medicare Medicaid Services, CMS, CPMC, guarantee-issue, Health Care Plans, health insurance, Health Insurance California, Health Net, Health Plans California, HMO, ICEP, Initial Coverage Enrollment Period, John Muir, John Muir Medical, Kaiser Advantage, Kaiser Medicare Advantage HMO, MA-PD, Medicare A and B, Medicare Advantage 24 Month Rule, Medicare Advantage HMO, Medicare Advantage Trial Period, Medicare Advantage., Medicare F, Medicare Gap, Medicare Gap F Plan, Medicare Gap Plan F, Medicare Gap Plans, Medicare HMO, Medicare MA-PD, Medicare PDP, Medicare Plan F, Medicare Rx, Medicare Supplement, Medicare Supplement Plan F, Medicare Supplement Plans, MedSupp, Original Medicare, PDP, Scan Health, Seniors, Stanford Hospital, Trial Period, UCSF, UHC, United Healthcare

Medicare Annual Enrollment Period (AEP) 2015

October 8, 2015 By Phil Lee

(This information concerns Medicare Health Plans. It does not concern you if you are either on an Employer-Sponsored Group Health Plan or an Individual & Family Health Plan)

Medicare Annual Enrollment Period (AEP) 2015

(A) When is the 2015 Medicare Annual Enrollment Period (AEP)?

Once again this year, Medicare AEP will run from Oct. 15th to Dec. 7th.

You may do the following during this time:

Enroll or change your Medicare Advantage plan (MA-PD).
Enroll or change your Medicare Rx (PDP) plan.
Enroll in a Medicare Supplement and PDP plan (the supplement is not guarantee-issue).

(B) Is Medicare Supplement Plan F going away?

Yes, CMS (Center for Medicare Medicaid Services) has announced this year that they will not allow Medicare Supplement Plan F, the most popular supplement plan, to be offered after year 2020.

However, anyone who is already on an F plan at that time will be grandfathered and permitted to keep it indefinitely.

In other words, if you think that you may ever want a Plan F, you must enroll by 2020. If you lapse your F plan before 2020, you will never be able to get it back again. Those who will turn 65 after the year 2020 will unfortunately never be able to experience the benefits of Plan F.

Some concerns were raised that the premium for F plans may skyrocket, after 2020, due to there being no new future new entrants into the risk pool. Although this is a possibility, it is unlikely to be a cause for alarm for the following reasons: (1) Unlike under age 65 plans, supplement plans are secondary payers (Medicare is the primary payer) and not subject to the brunt of the risk. (2) In the past when older supplement plans were frozen, such as the Anthem Classic J plan, there was no great increase in rates. (3) After the freezing of Plan F, other plans like G and N will still be available, although these other plans are not as comprehensive as F. (4) Even if premiums should escalate, the Birthday rule allows members to switch to like, or downgrade, plans, guarantee-issue, every year, on their birthday month.

The practical implication is that seniors may keep Plan F and take a wait and see attitude. If rates go out of line, then simply downgrade, guarantee-issue, on their next birthday.

We would be delighted to help you find affordable solutions to your health care needs.

Phil Lee

Lee Health Insurance Services
800-286-7445

www.linkedIn.com/in/philwlee

www.Health-Insurance.com

Filed Under: Health Insurance, Medicare Plans Tagged With: Anthem Blue Cross, Blue Shield, California Health Insurance, Discontinue Plan F, health insurance, Health Insurance California, Health Plans California, Medicare Gap Plans, Medicare Plan F, Medicare Plans, Medicare Supplement Plans, Plan F 2020, Senior Health Plans, Supplement Plan F

Premium Reimbursement is a Costly Violation

August 13, 2015 By Phil Lee

(This information relates only to Employer-Sponsored Group Health Plans. It does not concern either Medicare Plans or Individual and Family Health Plans)

Re: Premium Reimbursement by Employers (outside of an ACA-Approved Group Health Plan) is a Costly Violation

Starting on July 1st, the IRS will begin assessing a penalty of $100 a day (per employee for each affected employee) to employers who continue to pay for employees’ individual health plans. Please click below link to this article.

http://eba.benefitnews.com/news/regulation/premium-reimbursement-is-a-costly-violation-2746335-1.html?zkPrintable=true.

We would be happy to help your company find affordable solutions to comply with local and federal requirements regarding health insurance.

Phil Lee

Lee Health Insurance Services
800-286-7445

www.linkedIn.com/in/philwlee

www.Health-Insurance.com

Filed Under: Affordable Care Act, Group Plans, Health Care Reform, Health Insurance Tagged With: ACA, ACA Violation Penalty, Affordable Care Act, Affordable Health Insurance, Affordable Health Plans, California Health Insurance, Employer Premium Reimbursement, Group Health Insurance, Group Health Plans, Health Care Plans, Health Care Reform, Health Insurance California, Health Insurance Marketplace, Health Plans California, Individual Health Plans, IRS Guidelines, Obamacare, Patient Protection and Affordability Act, Premium Reimbursement, Reimburse Employee Premium, Violation Penalty

Last Chance to Enroll into a Health Plan in 2015

April 28, 2015 By Phil Lee

(This information relates only to Individual and Family Health Plans, not Medicare or Group plans)

If you are uninsured and do not have a special Qualifying Event, Thursday April 30th is the last day that you may enroll into an Individual Health Plan using the Govt.’s special extension by claiming that you are unaware of the uninsured penalty.

If you apply by April 30th, you will receive a June 1st effective date. Otherwise, you will have to wait until the end of the year.
In order to apply for coverage during this extended enrollment period to a plan either On or Off the Covered California health exchange, most carriers require you to do so through a certified agent. Anthem Blue Cross further requires the application to be on paper through an agent.

At Lee Health Insurance Services we would be happy to serve as your agent. As always, there are no costs, no fees for our services. The premium rates you pay are the same approved and regulated rates whomever you get them from. If you qualify, you will receive the tax subsidies that you are eligible for based on your household income.
Phil Lee
Lee Health Insurance Services
800-286-7445
www.health-insurance.com

Filed Under: Affordable Care Act, Covered California, Health Insurance, Individual/Family Plans Tagged With: ACA, Affordable Care Act, Anthem Blue Cross, Blue Shield, California Health Exchange, California Health Insurance, children health insurance, Covered California, Covered California Health Exchange, coveredca.com, Family Health Insurance, Family Health Plans, Health Care Plans, Health Care Reform, Health care subsidy, health insurance, Health Insurance California, Health Insurance Marketplace, Health Insurance Penalty, Health Net, Health Plans California, Individual Health Insurance, Individual Mandate, Individual Subsidy, Obamacare, Patient Protection and Affordable Care Act, Uninsured Penalty

Extended Enrollment Deadlines for Individuals

April 28, 2015 By Phil Lee

(This information relates only to Individual and Family Health Plans, not Medicare or Group plans)

For those of you who are still uninsured or who just found out from doing your 2014 tax return that you have to pay a penalty, there is still time to enroll. If you are currently uninsured and can testify that you were not aware of the penalty, you may still enroll. However, there’s not much time left. The deadlines are:

April 15th, for a May 1st Effective Date.
April 30th for a June 1st Effective Date.

In order to apply for coverage during this extended enrollment period to a plan either On or Off the Covered California health exchange, you must do so through a certified agent or broker. We at Lee Health Insurance Services (800-286-7445) would be happy to serve as your agent. As always, there are no costs, no fees for our services. The premium rates you pay are the same approved and regulated rates whoever you get them from. If you qualify, you will receive the tax subsidies that you are eligible for based on your household income.

Covered California Application Problems

We are finding that many of you trying to enroll onto Covered California online got stuck or sent off to MediCal (Medicaid). E.g. if you happen to put an Employment End Date, you would likely be sent to MediCal.
We, at Lee Health Insurance Services, have figured out the “fixes” to these issues, and would be delighted to help you resolve them in order to secure coverage from Covered California.

Very sincerely,
Phil Lee
Philip W Lee MBA
Lee Health Insurance Services
Employee Benefits and Health Insurance
800-286-7445
www.Health-Insurance.com

Filed Under: Affordable Care Act, Covered California, Health Care Reform, Health Insurance, Individual/Family Plans Tagged With: ACA, Affordable Care Act, Anthem Blue Cross, Blue Shield, California Health Exchange, California Health Insurance, children health insurance, Covered California, Covered California Health Exchange, coveredca.com, Family Health Insurance, Family Health Plans, Health Care Plans, Health Care Reform, Health care subsidy, health insurance, Health Insurance California, Health Insurance Marketplace, Health Plans California, Individual Health Insurance, Individual Health Plans, Individual Subsidy, Patient Protection and Affordability Act, tax subsidy

Anthem Blue Cross Offers Free Identity Protection Service To Those Affected By Cyber Attack

March 8, 2015 By Phil Lee

To follow up on my alert regarding the Cyber Attack of Anthem Blue Cross, Anthem is now offering to all those affected, free Identity Protection Services.
If you are a current or former Anthem Blue Cross member, you may sign up as follows:
Go to www.anthem.com/ca
On the homepage, under the “yellow shield”, click “Learn More”.
On the 4th paragraph, click https://anthem.allclearid.com/
Please read and follow the instructions carefully.
We are happy to be of service to you.
Please don’t hesitate to call us should you need help on your health plan coverage.
Phil Lee
www.health-insurance.com
800-286-7445

Filed Under: Group Plans, Health Insurance, Individual/Family Plans Tagged With: Anthem, Anthem Blue Cross, Blue Cross of California, children health insurance, Group Health Insurance, Health Care Plans, Health Insurance California, Health Plans California, Individual Health Insurance, Individual Health Plans

Cyber Attack – Letter from Anthem Blue Cross

March 8, 2015 By Phil Lee

Anthem Blue Cross asked Agents to send this email to all their current and former Anthem members. I am sharing this with all of you whether you have an Anthem plan or not.
“Anthem wants to keep you informed about its actions in response to the cyber-attack. If members have given Anthem their email address, they will get an email about identity protection and credit monitoring services. Anthem is required to send this email, due to state laws around breach notifications. The subject line of the email will be “Important Message From Anthem, Inc.” and it will direct members to visit AnthemFacts.com to sign up for credit protection services. The email will not ask for personal information. Anthem encourages all members to read the email and visit AnthemFacts.com to sign up for the services provided by Anthem.”
Phil Lee
Lee Health Insurance Services
www.health-insurance.com
800-286-7445

Filed Under: Group Plans, Individual/Family Plans Tagged With: Anthem Blue Cross, Group Health Insurance, Group Health Plans, Health Care Plans, health insurance, Health Insurance California, Health Plans California, Individual Health Insurance, Individual Health Plans

How One Pharmaceutical Company Priced Its Drug

Understanding Special Enrollment Period (SEP) and Qualifying Events (QE)

The Pitfalls of Leaving Original Medicare & Supplement Plan for Medicare Advantage HMO

Medicare Annual Enrollment Period (AEP) 2015

Last Chance to Enroll into a Health Plan in 2015

Extended Enrollment Deadlines for Individuals

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