At the end of 2022, Congress passed a $1.7 trillion omnibus package that avoided a government shutdown. The massive spending package includes two major NAHU-supported provisions regarding telehealth and long-term care. Individuals will now be able to use existing retirement accounts to pay for long-term insurance. More specifically, the provision will permit individuals to pay up to $2,500 each year for long-term care insurance with their 401(k)s, 403(b)s and IRAs without a 10 percent early withdrawal penalty tax.

The package also includes a two-year extension of telehealth-related regulatory flexibilities put in place during the pandemic. In 2021, the CARES Act provided temporary relief during the pandemic by allowing HSA-qualified high-deductible health plans to cover telehealth services before reaching the deductible. It also allowed patients to choose and purchase telehealth services outside their HDHP without impacting their eligibility for an HSA. Prior to today’s bill, these flexibilities were set to expire at the end of 2022. Now, these waivers will remain in place through December 31, 2024. “As an insurance agent, it is important to be aware of how these legislative updates affect our clients. SAHU, CAHIP, and NAHU give agents the opportunity to be in the know and part of the change as it happens,” says Antonette Vanasek, SAHU Media Chair.

Other major health policies include a bipartisan deal to end the Medicaid policy that provided states with additional funding and barred them from kicking people off federally funded insurance, setting a new end date of April 1, 2023, instead of July 2023. This date change will have an impact on what has been dubbed the “Medicaid unwinding,” when nearly 85 million people enrolled in Medicaid will have their eligibility redetermined at the end of the public health emergency, triggering a high risk of coverage loss of eligible individuals.

In addition, the omnibus bill includes $1.5 billion in state grants for substance abuse prevention and treatment and several key investments to expand access to mental health, including grants for maternal mental health, the Community Health Service Block Grants and the Substance Use and Prevention, Treatment and Recovery Block Grants.

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For over 30 years, SAHU has worked to improve our members’ ability to meet the health, financial and retirement security needs of all Californians and Americans through education, advocacy, and professional development. For more information, please visit: sahu-ca.com. 

A recent study has shown that LASIK surgery may be more dangerous than previously thought. A recent investigation by the FDA found that there have been several complications reported after LASIK surgery. These complications include dry eyes, halos around lights, and starbursts.

The president of the Sacramento Association of Health Underwriters, Rosamaria Marrujo, stated that “LASIK is not as safe as we were once led to believe” and urged people to do their research before getting the surgery. This is not the first-time concerns have been raised about the safety of LASIK surgery; a class action lawsuit was filed against the makers of LASIK devices in 2016. Despite these concerns, many people continue to undergo the procedure each year.

Lasik eye surgery is a popular vision correction procedure that involves reshaping the cornea. To ensure patients are informed of all potential risks associated with this treatment, the FDA mandates medical professionals to go over every possible outcome – including those for individuals living with diabetes who may suffer from long-term complications at an increased rate compared to non-diabetics.

Despite the high cost and lack of insurance coverage, Lasik eye surgery remains a popular procedure for 500,000 Americans annually. However, surgeons are not pleased with the FDA’s new regulatory requirements.

Lasik eye surgery is an important decision, and it is up to the individual whether they pursue it. To help people make a well-informed choice that works for them, the FDA has put together a comprehensive document outlining all the essential facts regarding this procedure.

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For over 30 years, SAHU has worked to improve our members’ ability to meet the health, financial and retirement security needs of all Californians and Americans through education, advocacy, and professional development. For more information, please visit: sahu-ca.com.

Medicare beneficiaries can rejoice for the first time; there will now be a cap on their out-of-pocket costs for prescriptions each year. This brand-new provision is part of the Inflation Reduction Act of 2022, including limits to out-of-pocket insulin payments and making vital vaccines accessible. 1.3 million people spent over $2K in 2020 without this protection based on Part D plans – highlighting how critical these changes are going forward! Plus, all will roll out gradually via staggered implementation as with many other parts of this law – so keep an eye open if you’re eligible soon enough!

In 2024, Medicare beneficiaries will no longer have any out-of-pocket costs once they enter what Medicare calls catastrophic coverage. The way catastrophic coverage worked in 2022 is that once an enrollee’s out-of-pocket costs reached $7,050, they must pay 5 percent of their prescription drug costs, with no limit. But beginning in 2024, that 5 percent coinsurance requirement will be gone, and enrollees won’t have to pay anything for their prescription drugs for the rest of the year.

Beginning in 2025, Part D prescription drug out-of-pocket costs will be capped at $2,000 annually. This applies to stand-alone plans with original Medicare or private Medicare Advantage plans, which also cover prescription drugs. It should be noted that this cap may change over time due to inflation and other factors affecting the healthcare industry landscape. These cost savings are expected to begin rolling out gradually until then so beneficiaries can start planning for their future healthcare needs accordingly!

Also, in 2025, Medicare drug plans are introducing a new feature to alleviate the burden of large drug bills. Smoothed cost-sharing allows enrollees to spread out their out-of-pocket costs over an entire year and protect those who may have difficulty covering one lump sum payment for medication expenses. “This is a great benefit for our Medicare Beneficiaries,” says SAHU Medicare Chair, Kerri Sanford.

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For over 30 years, SAHU has worked to improve our members’ ability to meet the health, financial and retirement security needs of all Californians and Americans through education, advocacy, and professional development. For more information, please visit: sahu-ca.com.

By Jessica Word
CEO, Word & Brown General Agency

Open enrollment is just around the corner – and all of us in the health insurance space are about to get a lot busier!

As we meet with clients in the next month to review existing coverage, discuss any adjustments or new benefits, keep an eye on the following trends – they will set you and your team up for a successful fourth quarter.

Leverage the expertise of others

While we all like our solitude now and again, it can be challenging even for the most seasoned broker to work without any input from others. That’s what it’s important to leverage the knowledge and experience of team members, colleagues, and co-workers – they can help problem-solve, share what they are hearing from their clients, share insights into best practices and more.

Partners can also help. For example, our Word & Brown team knows brokers appreciate the efforts we make to help their business operations run smoothly and be more productive. In fact, we are committed to helping our broker clients get more time back in their day through tools ranging from online dashboards to downloadable tools.

The bottom line here is to not be shy in asking for input and advice. Your partners and colleagues are all willing to help – your success is good for everyone.

Digital experiences are here to stay

When the pandemic shut down in-person corporate America in 2020, very few of us successfully predicted that our efforts to deliver meaningful digital experiences would forever transform how we work with brokers.

A remote deployment strategy is now common in the health insurance space. Many companies, including us, have committed to a digital transformation of our internal processes to increase efficiency and streamline operations. This also means remaining open and adaptive to the continuing need for videoconferencing and collaborative workflow platforms. While “Zoom fatigue” is something we can all relate to, there’s no putting the proverbial genie back in the bottle – it is the new conference call.

Adapting and improving your client’s digital experience is key to providing stellar and invaluable customer service to better support them year around.

Thoughtfully invest in technology

Demand to handle services remotely, such as quoting and enrollment, will continue to rise. Brokers will seek out outside resources and struggle to stay on top of constantly shifting technological advances. Whether that means integrating a quoting engine, or enrollment management into an online portal, investment in technology is essential to a brokers’ servicing division.

It’s important to be thoughtful when investing in technology solutions. Digital tools that can eliminate account management and online enrollment burdens may prove cumbersome integrating with existing systems and software; or a new offering might assume that its API will work within your system platform when it can’t.

The bottom line is that you must treat new technology as you would any capital improvement. Tap opinions of your IT team, but also make sure to gather opinions of other brokers by taking advantage of shared knowledge provided by groups such as SAHU.

Ongoing legislative and compliance challenges

We all will continue to face new legislation and compliance burdens, especially related to the impact of the COVID-19 employer and employee mandates. For example, the Occupational Safety and Health Administration (OSHA) rolled back the Biden administration’s COVID-19 vaccine mandate for companies with more than 100 employees earlier this year. Clients will need guidance, and brokers need to stay updated on these changing policies to remain trusted counselors.

The topic of single-payer healthcare will continue to come up in conversation. Even though Assembly bill 1400 (the single-payer healthcare proposal), did not advance in the state assembly, as healthcare experts we must remain a part of this important conversation with legislators and policymakers. Our community needs to continue demonstrating our commitment to make healthcare more accessible for all, while not depending 100% on the government to uproot a system that works for an overwhelming majority of Californians. We must be advocates for options: from employer-sponsored and private health coverage to government subsidized options through Covered California, Medi-Cal, or Medicare.

Lastly, a new compensation disclosure for brokers just became effective late last year. The Department of Labor and Employee Benefits Security Administration released long-awaited guidance to help brokers better understand the new disclosure requirements and the impact they have on their client groups. The good news: there are resources available to help break down what this means for brokers and customers. Your colleagues and partners can help!

Meet clients and team members where they are

While you and your team might be back in the office, clients might now prefer to work from home or only come into the office a couple of days a week themselves. Everyone on your team needs to understand it’s time to put the client first when it comes to how and when to meet. In setting meetings, the question to ask now is “do you prefer in-person or virtual?” — giving them the choice.

It’s important to show clients you’re okay with letting them set the parameters. Flexibility is key, especially since everyone now knows that setting up Zoom or Teams meetings is as easy as scheduling a conference call.

The same goes for your team. Make sure to regularly check in with your team members either in person or virtually. Remind your team that you are available to talk through any problems (and possible solutions) as they arrive.

So, as you prepare for the busy open enrollment season, make sure to leverage your partners’ expertise, and recognize the importance of digital expansion and technology investment for an increasingly online future. Additionally, legislative and compliance challenges will continue to impact how brokers advise and serve employers of all sizes. Finally, meet clients and team members where they are – this sets you up as a valued broker and internal team leader, increasing the potential for a successful fourth quarter.

Keeping an eye on all these issues and pivoting, as needed, helps us increase the value that we offer to businesses to help them to succeed throughout open enrollment and beyond.

Jessica Word is CEO of Word & Brown General Agency. Established in 1985 and headquartered in Orange, Calif., Word & Brown is one the state’s largest independently owned general agents. For additional information, visit www.wordandbrown.com.

By Jessica Word

CEO, Word & Brown General Agency

As the daughter of one of the co-founders of Word & Brown GA, I grew up in the health insurance industry. It would have been easy to turn away from the “family business,” but I was fortunate that there were professionals over the years who took the time to help me focus, find my path, and recognize my leadership potential.

My journey made me recognize the significant role that mentorship plays for anyone who wants to advance in their career.

Then, it is no surprise that one of my areas of focus as a CEO is to foster and create development opportunities for young women looking to become benefits professionals. It’s important that agencies and brokerage houses make the time to nurture the development of women team members – they are our industry’s future leaders.

While we might all understand the need for mentorship, the last few years of pandemic work-at-home might have us out of practice. Let’s look at three cornerstones to successful mentorship.

It Starts Early: If a woman develops a personal relationship with a more seasoned professional early in her career, she is likely to be promoted more quickly than those without mentors, according to a study from SAP HR Research. This is why I’m passionate about mentorship – it’s a mutually beneficial relationship that helps both the mentee and mentor.

Over the last several years, I have mentored a student at California State University, Fullerton, every semester. I have learned so much from this woman and others during our regular conversations and they inspired me with their resiliency during the pandemic. Make no mistake, though, they need encouragement as much as anyone to develop a passion and nurture the drive necessary to make a mark in the business world.

One-on-One Relationships Are Critical: Most adults in a young person’s life are either family or faculty. One-on-one relationships, especially those with women just starting out in their careers, are key to seeing a broader picture of the business world.

This requires a regular time commitment to establish deep, meaningful, and organic connections. It can be challenging in our busy schedules, but we can all break away for a quick cup of coffee or lunch. A regular cadence of meetings not only is valuable for topics discussed, but it teaches the importance of holding to your commitments.

Having someone readily available to lend an ear when you need advice for a career shift, big move, or promotion is invaluable. Not only does it increase a mentee’s chances of success, but it creates a “pay it forward” mindset. And this kind of mindset has the potential to grow the number of women professionals in our industry, which is a great thing!

Network, Network, Network: We’re all familiar with the mantra, but beyond what it does for a young woman trying to get ahead, it is just as important to growing the number of women candidates applying to join our teams.

That’s one of the reasons why Word & Brown partnered with California State University, Fullerton, on a half-day event in the fall 2021. I worked closely with the college’s Center for Leadership; one of its key business programs is to create opportunities for women students to hear seasoned women leaders from a variety of industries talk about under-the-radar and hidden job opportunities. This event was truly one of the highlights of my year!

Finally, here’s a challenge from me to you: take the leap and reach out to a new women industry professional in the next month. There is power in reaching out to someone early in her career to offer important guidance that will help her to succeed. Who knows – she may eventually become a president of the National Association of Health Underwriters!

Jessica Word is CEO of Word & Brown General Agency. Established in 1985 and headquartered in Orange, Calif., Word & Brown is one of the state’s largest independently owned general agents. For additional information, visit www.wordandbrown.com.