California Group Plans, Georgia Individual Plans and Georgia Group Plans will be experiencing rate changes next week. Rates are going up on average around 10%, so if you are interested in enrolling with Kaiser Permanente now is the time to act. Get enrollment forms submitted now for a June 1^st effective date. Submit applications by the end of May 2009 to lock in the current rates. Those who apply by the end of this month can lock in the current rates for a year.

You may experience longer processing times because lots of others are trying to get in by the deadline as well. Increased amounts of applications means more work for underwriters who are already quite busy. Also, Kaiser Permanente support staff may be a bit more difficult to reach over the next week.

Despite the inconvenience, we highly recommend getting your applications in now. It’s never fun giving support to customers the week after the deadline when they find out they could have decreased their premium for the entire year by simply applying a few days earlier.

Posted: May 27th, 2009 under Kaiser Permanente.
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The IRS has Increased HSA Contribution Maximums for 2010. Individuals will be able to contribute $50 more and families may contribute $200 more in 2010. The Internal Revenue Service (IRS) has also changed the minimum deductible and maximum out-of-pocket limits for single and family HSA compatible health plans. See details below.

Posted: May 21st, 2009 under Uncategorized.
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We’ve had a few applicants say, “I was approved for the wrong plan. There must have been a mistake!” Often, when this happens it is not due to a processing error, but rather is the result of the decision of an underwriter. It’s possible that this customer didn’t qualify for the plan they requested. Rather than simply denying the application, the underwriter gives the applicant the option to get individual health insurance coverage on a different plan. 

Why does this happen?
This usually happens when a customer applies for a plan that has rich coverage in an area where the customer has historically had high usage of healthcare. For example, if an applicant was getting $450 worth of prescription drugs a month, they would most likely be denied coverage on an individual and family plan. However, if this client was generally healthy and the RX usage was the only big issue, an underwriter might offer the client coverage under the $50 Copayment Plan which doesn’t cover prescriptions. In such cases the applicant is usually disappointed that she is unable to lower her monthly prescription drug bills, but she is grateful that she can at least get covered on some type of medical insurance plan. 

Can I switch plans?
In such cases where an applicant is denied coverage on the plan he selected and offered another plan, this customer cannot “switch” plans.   

How do I know if I was “moved to a different plan”?
This is important to know because if there was a processing error, you can switch to another plan, but if you’ve been moved to another plan by an underwriter on purpose, then you can not change plans. To find out if you have been moved, you will need to Sign In to your online application. Once you’re in your account, if it says “moved to different plan,” this means that you did not qualify for the one you selected. If you want to contest this decision, there should be instructions on the KP notification. If it does not say “moved to a different plan,” it could have been a mistake. In this case, you will need to use the Change Plans Form or contact Member Services to switch plans.

Posted: May 20th, 2009 under Kaiser Permanente.
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What is the deadline to apply for a Kaiser Permanente Georgia Individual Health Insurance Plan? In the past, we have told Kaiser Georgia applicants that the deadline to apply for the first of the month is the first of the month, meaning you could apply on the first and get an effective date for that very day. However, the answer to this question is now a bit more complicated. The answer depends on whether you are applying with a paper application or whether you are applying online. 

Online Applicants
If you are applying online for a KP Georgia Personal Advantage Plan, the deadline is the last day of the month at 4:30 PM. Your application must be completed and submitted, and payment must be received. If these requirements are met by 4:30 PM Eastern Standard Time on the last day of the month, then you are eligible for an effective date of the next day. 

Paper Applications
If you apply using a paper application, the deadline is 4:30 PM on the first of the month in order to qualify for an effective date of that very day. This means the application must be received (by mail or by fax) along with the payment for the first month’s premium by 4:30 PM Eastern Standard Time on the first. 

Note Regarding Last Minute Applications
If your application/payment is submitted before the deadlines described above, you will qualify for your coverage to start on the first. However, applications usually take one to two weeks to process by underwriters. Applicants who wait until the last minute to apply may not find out whether they are approved until a week or two after their desired effective date.

Posted: May 14th, 2009 under Georgia Individual.
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The Kaiser Permanente HSA Plans have become very popular. However, customers tend to have questions about them:

1. What is an HSA?
2. Do I have to open up an HSA?

What is an HSA?
HSA is a three letter acronym which stands for Health Savings Account. When a health insurance plan is said to be an HSA Plan, this means the federal government has given approval for individuals who are enrolled in these plans (provided they are not minors) to open up an HSA Account. These healthcare plans are government qualified for HSA’s. The plans do not come with an HSA and the health insurance carrier does not provide the HSA. If you are enrolled in an HSA-qualified plan, you may open up an HSA at the financial institution of your choice.

Do I have to get an HSA?
If you choose an HSA plan, you are not required to open up an HSA account. You have the option of opening up a Health Savings Account, but it is not mandatory. The HSA account would need to be opened in the name of the person who has the HSA-qualified health insurance plan. When you file taxes, you can deduct your HSA contributions from your federal taxes.

Posted: May 13th, 2009 under Kaiser Permanente.
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The deadline is actually the last day of the month to apply online for a Kaiser Permanente Georgia Individual Plan. For this month, you will need to apply by the May 31st deadline in order to get a June 1st effective date. If you apply online after 5/31, your effective date will be 7/1, which means you won’t get in before the rates go up.

If it’s June 1st and you still want to get in for a June 1st effective date, there may be a way. You would have to submit a paper application and fax it in by 4:00 PM Eastern Standard Time. Fax your application to 1-866-439-9993.

Processing applications usually takes a week or two, so I’d recommend not waiting until the deadline. If you apply sometime in mid-May, you will be much more likely to find out if you’ve been approved before your effective date.

Posted: May 7th, 2009 under Georgia Individual.
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The other day, I fell roller-skating and didn’t take care of my wound very well. It was green and pussy, so I got nervous. I called the advice nurse and she thought I should see a doctor. I was hoping she’d be able to cure me over the phone, so I wouldn’t have to pay the $75 for the office visit. I have the $1500 Deductible Plan with HSA and I haven’t reached my deductible yet, so I’m still paying the full member price to see the doctor.

The advice nurse was friendly and she got me scheduled to see a physician that evening. I went to a Kaiser Permanente Facility in Santa Rosa, California about 10 minutes away from my house. Everything happened like clockwork and I was sitting in a little room with a doctor in no time. That was just after they extracted the necessary $75 from me at the register. I was expecting to pay it, so it wasn’t a huge deal. But, when you pay out 75 bucks, you feel it and it makes you really hesitate next time before going to the doctor. I definitely wanted to take care of the wound myself if I could, but it wasn’t getting better, so off to the doctor I went.

I figured that since I was paying out that kind of money, I was going to get my money’s worth. I planned on asking her about my knee, my fungi-filled toenail and my stuffy nose. The doctor was female, spry and very friendly. Beyond that she knew her stuff. She hooked me up with the right ointment for my knee and told me to soak it a couple of times a day. She checked my nose and let me know that it was an allergy problem. She fixed that with some Zyrtec, decongestants and a recommendation to rinse my nose out with salt water. Regarding my toe, she said just to pee on it twice a day. She said if I soaked the toe in my urine for about three minutes twice a day, it would probably go away after 6-9 months. I haven’t been so faithful with the toe soaking, but I did everything else she said and it worked. Now, I just got to get more consistent at working on this toenail.

About a month later, I got a bill from Kaiser. Apparently, my $75 doctor visits have now gone up to $85. But, I learned how to take care of sinus problems, fungi-infected toes and pussy knees, so that may help me stay away from the doctor longer. Also, I’m going to call the advice nurse a bit more quickly next time to increase my chances of NOT having to go to the doctor.

Posted: May 5th, 2009 under California.
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