Premier Health Insurance of Iowa

07/10/2025

New Affordable Care Act Changes

Below is a list of the proposed changes. Please keep an eye out for our newsletter as we will keep you informed if and when these changes are made.

The monthly Special Enrollment Period (SEP) for individuals under 150% Federal Poverty Limit would be discontinued - This change will restrict SEP eligibility unless the consumer experiences a Qualifying Life Event (QLE).

A new $5 monthly premium for fully-subsidized passive renewals - Consumers eligible for $0 premium plans who don't actively confirm their income may be required to pay $5/month until they verify.

Reinstatement of Failure to Reconcile (FTR) APTC eligibility restrictions - Consumers will become ineligible for advance payments of the premium tax credit (APTC) if they didn't file their taxes and reconcile their APTC for one year (current regulations stipulate two years).

Shorter Open Enrollment Period (Nov 1-Dec 15 for PY26) - The annual Open Enrollment Period (OEP) will be shortened to November 1-December 15 (currently OEP is November 1-January 15). These were the original dates when the Affordable Care Act was first put into place.

Resumption of SEP pre-enrollment verification - If the Marketplace can't verify your Special Enrollment Period, you may lose eligibility to enroll outside of Open Erollment. You will need to ensure you have proper documentation to avoid SEP verification issues.

06/07/2024

President Biden Limits Lower Priced Term Health Insurance Plans To Last Only 3 Months

https://premierhealthia.com/blog/

04/08/2024

President Biden Moves Forward To Limit Individual Lower Priced Non-Affordable Care Act Options:

President Biden Moves Forward To Limit Individual Non-Affordable Care Act OptionsPlease note we are not making political statements, we are simply stating what has happened and how it will affect our customers.As we previously wrote about, President Biden's proposal to limit Allstate and United Heal...

08/08/2023

https://premierhealthia.com/blog/

Dan Walterman Invited To Discuss Healthcare.gov in Washington D.C.: On May 24th, Dan Walterman was invited to Washington D.C. by the Centers for Medicare and Medicaid Services (CMMS), along with a handful of other advisors, to discuss Healthcare.gov and the Affordable Care Act. Dan was able to bring forth some of the issues many of our clients have expressed concerning the Affordable Care Act operations. Although Dan has been invited to discuss these topics multiple times before, this is the first time the Biden Administration has invited any advisors to discuss their focus and agenda.

05/16/2023

GlicRx Issues Statement Reiterating Customer Privacy: GlicRx provides prescription discounts much like GoodRx. However, unlike GoodRx, they do not sell your personal health data. As we reported in our February Newsletter, GoodRx was fined $1.5 million for violating customer privacy. If you would like to enroll in the FREE prescription discount card through GlixRx, you may do so HERE:

Get your free discount card and save up to $95 on your prescriptions.

04/13/2023

Wellmark Sends Out Incorrect Medical Cards: Wellmark Blue Cross sent out 1,140 incorrect insurance cards. You will be receiving a new insurance card if your previous card was incorrect. Please make sure to use the new card and NOT the old card.

04/07/2023

Medicare Has Breach of Protected Health Information

Medicare Breach of Protected Health Information: Not surprisingly, as with many federal agencies, a breach of privacy occurred with Medicare's outsourced Medicare eligibility and entitlement records processing company, Healthcare Management Solutions, LLC. Because of this, Medicare will be mailing new cards to those affected. Protected information involved in the breach include:

Name
Address
Date of Birth
Phone Number
Social Security Number
Medicare Beneficiary Indentifier
Banking Information
Medicare Entitlement, Enrollment, & Premium Information

10/28/2022

Inflation Reduction Act and What It Means To Healthcare:

There is a lot going on with this Act, but we will stick to the healthcare side only. Foremost it has maintained the increased Affordable Care Act tax credits per the American Rescue Plan Act. Without continuing these tax credits, those on Affordable Care Act "Obamacare" plans could expect to see 10- 200% premium increases this fall. Here's a few other points of what it affects:

The enhanced premium tax credits, which eliminated the subsidy cliff and increased the tax credit amount for people at all income levels, will continue another three years. That means that clients receiving financial assistance won’t see a big price increase this fall.
Medicare will be able to negotiate drug prices, which should help save some seniors money.
Medicare Rx out-of-pocket costs will be capped at $2,000.
Lawmakers failed to reach an agreement on capping insulin costs for people with private health insurance.

10/07/2022

National General was previously purchased by Allstate. They are now rolling out the Allstate name and branding. Clients will receive new cards and all communications will be Allstate branded.

Members will now log in and register accounts at

We have created a new process to provide you with an added level of account security.Existing Users: Sign in and follow the prompts to set up your account security. New Users: Click the button below and follow the steps to register and set up your account security.When you have completed the process...

09/19/2022

United Health Care Experiences Billing Issues in September: On September 1 and 2, 2022, an error occurred with our payment processing showing some policies as not paid, even though successful payment was collected. This caused some plans to show as terminated in our system. Some members also received a letter automatically generated by this incorrect indicator. About 5,000 Short Term Medical, TriTerm Medical, long term and select ancillary plans were affected.
Summary of action:
We are working to resolve this issue and return affected plans to proper active/paid status. We anticipate having this issue fully resolve by early next week.
Our claims team is reviewing all affected claims to ensure they are properly handled, and applicable benefits applied, if eligible.
No action needed from client(s).

08/11/2022

Federal Trade Commission To Investigate 6 Largest Pharmacy Benefit Managers: The Federal Trade Commission announced today that it will launch an inquiry into the prescription drug middleman industry, requiring the six largest pharmacy benefit managers to provide information and records regarding their business practices. The agency's inquiry will scrutinize the impact of vertically integrated pharmacy benefit managers on the access and affordability of prescription drugs. As part of this inquiry, the FTC will send compulsory orders to CVS Caremark; Express Scripts, Inc.; OptumRx, Inc.; Humana Inc.; Prime Therapeutics LLC; and MedImpact Healthcare Systems, Inc

As reported by The Washing Post, your medical records are a big market and may be sold. How is this happening? Often when "signing in" at a doctor's visit, a person signs forms agreeing to certain things. Within the "small writing" of those forms, you may be agreeing to share you information with 3r...

07/21/2022

Are Your Medical Records Being Sold?
https://premierhealthia.com/blog/