Family Glitch Resolution
The IRS released a final rule that changes the eligibility rules for the premium tax credit (PTC). The PTC is available to eligible individuals who purchase health insurance coverage through the Exchange. Individuals do not qualify for the PTC if they have access to employer-sponsored health coverage that is affordable and provides minimum value.
Effective 2023, more family members will likely be eligible for the PTC for coverage purchased through the Exchange. Our Compliance Specialist, Corbin Granger, hosted a webinar discussing how this impacts your employer clients and their employees. Please click here for a PDF version of the presentation.
HealthKeepers Expanding Out-of-State Coverage
Effective with the plan’s renewal date in 2023 and for all new groups, Anthem HealthKeepers will use their national BlueCard PPO network, (including more than 1.7 million doctors and hospitals in all 50 states) for care received outside of Virginia. By doing so, the plan:
- Expands healthcare access outside of the Virginia service area through participating BlueCard PPO providers
- Extends in-network benefits to all healthcare services covered by the plan, not just urgent or emergency care
- Adds flexibility to use participating BlueCard PPO laboratory providers outside of the Virginia service area
- No longer requires individuals to register with Guest Membership to use in-network benefits when out of the service area
Optima's Unique Option for Individuals Off-Exchange
Optima's 2023 OptimaFit Direct Unique plans offer Individuals lower premiums (even without subsidy) and include all the comprehensive benefits, wellness programs, preventive services, and useful tools that Optima offers. Click here to see the Unique plans and their benefits.
Quoting and Enrolling Individuals in the 2023 OptimaFit Direct Unique Plans
These Unique plans are only offered outside the Marketplace (Off-Exchange) and can only be quoted on OptimaHealth.com. To get started, log in to your Optima Broker Portal. Click here for step-by-step instructions.
You can enroll Individuals in a Unique plan through your Optima Broker Portal, or you can use the 2023 Off-Exchange app.
Anthem 2023 CE Days
Anthem will conduct virtual continuing education (CE) courses on January 17 and January 19, totaling eight hours of approved courses for Virginia resident agents only. You must register in advance to receive credit for your attendance. Registration will close 24 hours prior to each day of classes.
Cigna Pharmacy Change
Due to failed contract negotiations, Cigna has begun the process of removing Kroger and their affiliated pharmacies from all Cigna commercial pharmacy networks, effective January 1, 2023. Cigna will inform impacted customers via a letter or email in the coming weeks so they have ample time to find a new pharmacy.
Please click here to learn more about this pharmacy change.
Optima 2023 Updates
Optima has many updates and changes to their group and individual plans for 2023. Click here to see these updates, as well as print and download 2023 plan guides, broker guides, and more.
Click here to see the 2023 Optima broker bonuses and commissions.
The information herein should not be construed as legal or tax advice in any way. This content is provided for informational purposes only. You should seek the advice of your attorney or tax consultant for additional or specific information.