Business

Consumer Protections Against Surprise Billing through the No Surprises Act

The No Surprises Act protects people from getting surprise medical bills when they have an emergency, get services from an out-of-network provider at an in-network facility, or get services from an out-of-network air ambulance service provider. It also establishes a process for payment disputes between plans and providers. It provides new opportunities for dispute resolution for people who are uninsured or self-pay individuals when they receive a medical bill that is much greater than the good faith estimate they get from the provider. If you have private health insurance, the new protections - which started in 2022 - will ban most types of surprise bills. If you're uninsured or decide not to use your health insurance for a service, you can get an estimate of the cost of care before your visit. If you disagree with your bill, you may be able to dispute the charges. Here are some frequently asked questions about the No Surprises Act:  Am I protected against surprise medical bills? Starting in 2022, the federal No Surprises Act (NSA) established new protections that prevent surprise medical bills for individuals covered under group and individual health plans. These new protections ban the most common types of surprise bills. What types of surprise medical bills does the No Surprises Act protect against? The No Surprises Act protects people covered under group and individual health plans from receiving surprise medical bills when they receive: most emergency services; non-emergency services from out-of-network providers at in-network facilities; and services [...]

What to Know If Your Small Business Is Considering a Qualified Small Employer Health Reimbursement Arrangement (QSEHRA)

Employers should consider the full financial impact a QSEHRA could have on their employees’ premium costs. While QSEHRAs can help reduce employees’ health care costs, QSEHRAs can increase health care costs for some employees who purchase individual health plan coverage through the Health Connector and receive premium tax credits or ConnectorCare state premium subsidies. Under federal tax law, employees cannot get both a QSEHRA benefit from their employer and a full premium tax credit through the Health Connector. If an employee qualifies for a premium tax credit through the Health Connector, and their employer offers a QSEHRA benefit (even if the employee does not use it), the employee’s premium tax credit amount will be reduced or eliminated by the federal government when they file taxes and the employee will have to pay the federal government back either some or all of their premium tax credit amount. For more information about how QSEHRAs work and what employees should know about QSEHRAs, please visit https://www.mahealthconnector.org/help-center-answers/hra-and-your-aptc The following example demonstrates how an employee’s costs may increase if they are eligible for premium tax credits and their employer provides a QSEHRA:[1] Consider an employee in Boston earning 200% of the federal poverty level (FPL) or $24,280 annually. Under current law, she would be eligible for an APTC of $140 and a ConnectorCare state premium subsidy of $49. Her employer cannot afford group coverage but decides to make a QSEHRA contribution of $100 per month. The QSEHRA offered to the employee is considered affordable coverage [...]

Assigning, Changing, and Terminating a Broker

Who is this guide for? Employers who want to assign, change or remove a broker for their Employer account on Health Connector for Business. Step 1: After logging in to your Health Connector Employer account, click the "Brokers" tab on the left- hand side of your account page under My Health Connector.   Step 2: Search for your Broker by name or by agency. Step 3: Once you've found the Broker you want, click "Select Broker." Step 4: You will need to confirm your Broker selection by clicking the red "CONFIRM" button. Another way to search for a Broker is on our Get Expert Help page: http://my.mahealthconnector.org/enrollment-assisters Changing or Terminating a Broker Step 1: If you need to change the broker you selected, login to your Health Connector Employer account and click "Change Broker". Step 2: Next, click "Terminate Broker" to return to the Broker browsing screen. Step 3: If you want to assign a new broker, please reference the "Assigning a Broker" steps above.    

Guide to Making Payments to Your Business Account

How to pay your premiums online This guide shows Small Business owners how to pay health insurance premiums online through secure electronic check payment in your Health Connector for Business account. It covers: Making your first payment (binder payment) Setting up or deleting recurring payments (AutoPay) Making a one-time payment Making Your First Payment (Binder) Your first payment is called your binder payment. You must follow these steps to make your first payment. If you would like to set up AutoPay, you can do so after making your binder payment. Step 1.   Login to your Health Connector employer account. Step 2.    Select "Billing" from the left menu.   Step 3.    Select the "Statements" tab to view the invoice for your first month of coverage. Record the total amount due – you will need it when you set up your payment. Step 4.    Select the "Pay My Bill" tab. Step 5.    Select "Pay Online". Step 6.    Select "Pay Online". Step 7.    Select 'Pay My Bills'. Step 8.    Select the row that says 'Due Date' and 'Payment Note'. You'll see a row with 'Health Connector for Business Account Number 1' expand below. Step 9.    Select 'Initial Binder Payment from drop down menu Step 10.  Enter the total amount due from your invoice. Step 11.    Select 'Add A Payment Method'. Step 12.  Enter bank account information. Select 'Add'. Important: Double check your routing and account numbers to make sure we process your payment accurately. [...]

Qualifying Life Events (QLEs) – Terminating Coverage

Throughout the year your circumstances may change which may make you eligible for a Special Enrollment Period (SEP).  If you have a baby, you or your dependent gain or lose other coverage, etc., you may be able to change your plan, enroll in a plan for the first time, add or drop family members, or terminate your plan. You must report the event WITHIN 30 DAYS of the event to be eligible for an SEP. Once you report the event in your account, DC Health Link will guide you through the options available to you and your family. Step 1: Report the Qualifying Life Event In each employee's account, consumers will have the option to report a qualifying life event. Please select the life event that applies to the primary subscriber or dependent (For Example: "Drop coverage due to new eligibility"). Note: There are three different pages of QLEs that can be viewed by clicking the arrow Step 2: Enter the Date of QLE Report the date of your qualifying event by selecting the date from the calendar or keying in the date. Then click "Continue". Step 3: Confirm the QLE If you are eligible to apply for a SEP, a green confirmation box will appear. Click "Continue" to proceed. Step 4: Confirm Household Once you have confirmed your household, click the "Continue" button. Step 5: Select Waive Coverage Click "Waive Coverage" for the plan that you wish to terminate. Step 6: Select Waiver Reason Select the reason why you [...]

Qualifying Life Events (QLEs) – Removing a Dependent

Throughout the year your circumstances may change which may make you eligible for a Special Enrollment Period (SEP).  If you have a baby, you or your dependent gain or lose other coverage, etc., you may be able to change your plan, enroll in a plan for the first time, add or drop family members, or terminate your plan. You must report the event WITHIN 30 DAYS of the event to be eligible for an SEP. Once you report the event in your account, the Health Connector will guide you through the options available to you and your family. Step 1: Report the Qualifying Life Event In each employee's account on www.MAhealthconnector.org, consumers will have the option to report a qualifying life event. Please select the life event that applies to the primary subscriber or dependent (For Example: Divorced or ended domestic partnership, Drop Family Member due to new Eligibility). Note: There are three different pages of QLEs that can be viewed by clicking the arrow Step 2: Enter the Date of QLE Report the date of your qualifying event by selecting the date from the calendar or keying in the date. Then click "Continue". Step 3: Confirm the QLE If you are eligible to apply for a SEP, a green confirmation box will appear. Click "Continue" to proceed. Step 4: Update Household You will be able to add/remove any members of your household. In the next steps you will have the option to add/remove any dependent from the policy without [...]

Qualifying Life Events (QLEs) – Adding a Dependent

Throughout the year your circumstances may change which may make you eligible for a Special Enrollment Period (SEP).  If you have a baby, you or your dependent gain or lose other coverage, etc., you may be able to change your plan, enroll in a plan for the first time, add or drop family members, or terminate your plan. You must report the event WITHIN 30 DAYS of the event to be eligible for an SEP. Once you report the event in your account, the Health Connector will guide you through the options available to you and your family. Step 1: Report the Qualifying Life Event In each employee's account on www.MAhealthconnector.org, consumers will have the option to report a qualifying life event. Please select the life event that applies to the primary subscriber or dependent (For Example: Married, Had a Baby, Lost or will soon lose other Health Insurance). Note: There are three different pages of QLEs that can be viewed by clicking the arrow Step 2: Enter the Date of QLE Report the date that of the qualifying life event. Step 3: Confirm the QLE Click "Continue" to proceed. Step 4: Add Member to Household Adding a member to the household does not add them to the policy, in the next steps you will have the option to add/remove any dependent from the policy. Step 5: Enter dependent information Enter the date of birth, gender and relationship to primary. Check the "NO SSN" box if the SSN is [...]

New Employers – How to Offer Health Coverage through the Health Connector

Who is this guide for? Employers who offer coverage through the Health Connector for the first time. New employers may be offering health coverage to their employees for the first time, OR they may have previously offered employer-sponsored coverage outside of the Health Connector. Get Started - Setup Your Account Click on the "CREATE ACCOUNT" menu and select "Employers". Or, click here now to create an account. Create Your Employer Account Fill out your email address and create a password (8 characters minimum) and then click the "CREATE ACCOUNT" button. NOTE: Please be sure that you record your password somewhere secure. You'll use your email address as your login in the future. Next, provide some basic information about you and your business. As the point of contact for the small business, provide your name and date of birth. Then, provide information about the small business, including company legal name, DBA name, federal employer identification number (FEIN), entity kind, and primary office location then click the "Create Employer" button. If you have more than one office location click "Add Office Location" and fill in the information for your other location(s) before proceeding to "Create Employer". NOTE: Brokers setting up accounts for Employers MUST use the information for the POC for the business and not their own information when filling out this section. Add Your Eligible Employees to Roster Creating Your Employee Roster: IMPORTANT - Make sure that the date of birth and SSN is accurate for each of your employees. [...]

New Employees – How to Enroll in Health Coverage through the Health Connector

Who is this guide for? This guide will walk employees without a Health Connector account through setting up their employee account, selecting a plan, or waiving coverage. Get Started - Setup Your Account Go to the Create Employee Account page fill out your email address and create a password (8 character minimum) and click the "Create account" button. Please be sure to record your password somewhere secure. You'll use your email address as your login in the future. Your Information and Matching to your Employer Your Information - Step 1: Fill out your personal information (name, DOB and SSN) and then click the red "CONTINUE". Your Information - Step 2: The Health Connector will match you to your employer by verifying your date of birth (DOB) and Social Security Number (SSN). Click "Continue" if the employer information displayed is correct. NOTE: If you are not matched to an employer, confirm you have entered your SSN and DOB correctly above. If you are still not matched to your employer, confirm your employer has your correct SSN and DOB and that you have been added to the employee roster. Your Information - Step 3: Fill out your contact information where needed, such as your address, email address, and phone number. The pre-populated information was submitted by your employer but may be edited by you. NOTE: By default, you opt into receiving electronic communications. To change this selection, select "only paper communications" or "paper and electronic communications" from the dropdown menu at the [...]

Guidance for Business Owners

Health Insurance planning is an important part of the financial planning process for small businesses. Securing the right insurance begins with selecting the right insurance adviser. Make sure you have a broker who is responsive and shows flexibility and understands both your business and your business needs. You also need a broker who is capable of adhering to your desires and goals—it is not what is best and the fastest thing for the broker, it is what is best for you as the client and what is the best way to achieve your goals in the short and long term. The following checklist will help you find the right broker: Your Personal Advocate An experienced, trustworthy, and competent insurance broker should be your personal representative and advocate to point out the pros and cons of policy comparisons from various insurers, as well as to alert you to the company’s claims paying policies and ratings. Although the Health Connector system will provide automatic price and plan comparisons based on information provided in the marketplace that you are interested in, a broker will work on your behalf and is your personal adviser, looking out for your company’s best interest. Dependable Advisor Your relationship with your insurance broker does not end once the policy is active. When you select a broker as your agent, they will serve as your representative throughout the plan coverage period and should be easily accessible at claim time to help you resolve any issues that may arise [...]

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