Your one stop for insurance needs! 2018

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1 Your one stop for insurance needs! s Our Exclusive Newsletter for Individuals IN THIS ISSUE: Medicare posts 2019 rates, pinches high earners pg1-3 Mike s Notes Pg 2 Appealing a Health Care Claim That Was Denied Pg 4 ABM Bad Jokes of the month Pg 4 5 Most Expensive Causes of Home Property Damage Pg 5 Meet our Representatives... Pg 6 How to Compare Health Insurance Plans Pg 6 Home Insurance: Save with ABM Pg 7 Referral program Pg 8 Our Clients Say it Best! Pg 8 Medicare Posts 2019 Rates, Pinches High Earners Part B premiums will rise faster than Social Security for couples earning more than $750,000 per year Medicare managers announced today that they will hold increases in Medicare Part B premiums to about 1.1% for most enrollees in For some high-income enrollees, however, premiums will rise 7.4%. Medicare Part B is the component of the traditional Medicare program that covers physician services and hospital outpatient care. Here s a look at how the monthly Part B premiums will change, by annual income level: Individuals earning less than $85,000, and couples earning less than $170,000:$ in 2019, from $134 this year. Individuals earnings $160,000 to $500,000, and couples earning $320,000 to $750,000: $ in 2019, from $ this year. Individuals earning $500,000 or more, and couples earning $750,000 or more: $ in 2019, from $ this year. The annual Medicare Part B deductible will increase 1.1%, to $185. Another component of the traditional the Medicare program, Medicare Part A, covers inpatient hospital bills.

2 Mikes Notes Thank you for allowing our agency to provide you with your insurance protection. As a part of our complete protection portfolio, we wanted to make sure you knew that we are upon the Medicare and Individual Health Insurance Open Enrollment season. If you or a family member need coverage or maybe seeking a lower cost option, please call us during this open enrollment season (November 1st to December 15th). Eligible participants must enroll in a comprehensive plan during open enrollment or wait until next open enrollment the following year (2020). As a responsible person, you secure health coverage to protect your family in the event of a health concern so that you or your family will be able to receive the care required to regain good health. Today s individual health insurance market place, include HMO s with high rates and high deductibles. What good is having health care coverage if you cannot afford to access care? We have solutions for every family. New exclusive products are providing lower cost alternatives with first dollar coverage. You will have the security knowing that you will be able to get the care you need when you need it - providing coverage that is affordable and provides health care options that are customized for you and your family. Our agency has over 30 years of experience, providing the protection and/or insurance that is customized to each individual family. We appreciate the relationship you have with our agency and will always work to provide you with valuable information and services. Please call me or our team at Ask for myself, Crystal, Stevan or Frank. We are looking forward to speaking with you and serving your health coverage needs. Crystal Frank Stevan Mike Jr. Continued from page 1 Medicare managers use payroll taxes to cover most of the cost of running the Medicare Part A program. Few Medicare Part A enrollees pay premiums for that coverage. But, for the enrollees who do have to pay premiums for Medicare Part A coverage, the full premium will increase 3.6%, to $437 per month. The Medicare Part A deductible for inpatient hospital care will increase 1.8%, to $1,340. Why are high earners paying so much more for Medicare Part B? 2

3 Continued from page 2 Congress has been increasing the share of Medicare costs that high earners pay in recent years. For 2018, the top annual income category for Medicare Part B rate-setting purposes was for $160,000 and over for individuals, and for $320,000 and over for couples. Premiums from those Medicare Part B enrollees are supposed to cover 80% of their Part B claims. In the Balanced Budget Act of 2018, Congress added a new annual income category: for individuals earning $500,000 or more and couples earning $750,000 or more. Premiums from Part B enrollees in that income category are supposed to cover 85% of those enrollees Part B claims. Who do these rate increases actually affect? Medicare now has about 60 million enrollees of all kinds, according to the CMS Medicare Enrollment Dashboard. About 21 million are in Medicare Advantage plans and other plans with separate premium-setting processes. About 38 million are in the traditional Medicare Part A, the Medicare Part B program, or both the Medicare Part A and the Medicare Part B programs. CMS refers to the traditional Medicare Part A-Medicare Part B program as Original Medicare. The rate increases have a direct effect on the Original Medicare enrollees costs. How do the Medicare increases compare with the Social Security cost-of-living adjustment (COLA)? The Social Security Administration recently announced that the 2019 Social Security COLA will be 2.8%. That means the size of the COLA will be greater than the increase in Medicare premiums for all Medicare enrollees other than the highest-income Medicare Part B enrollees and the enrollees who pay the full cost of the Medicare Part A premiums. Why should financial professionals care about Original Medicare premiums? For consumers who already have traditional Medicare coverage, the Part A and Part B premiums may affect how much they have to spend on other insurance products and related products, such as Medicare supplement insurance coverage. For retirement income planning clients, Medicare costs are something to factor into income needs calculations. Because access to Medicare coverage is critical to all but the very wealthiest retirees, knowledge about how to get and keep eligibility for Medicare coverage on the most favorable possible terms is of keen interest to many consumers ages 50 and older. Some consumers may like to get information about that topic from their insurance agents, financial planners and other advisors. Resources Officials at the Centers for Medicare and Medicaid Services, the agency that runs Medicare, will publish the official 2019 Medicare rate notices in the Federal Register on Wednesday October 17, Written by: Allison Bell 3

4 Appealing a Health Care Claim That Was Denied If your health care plan denies your claim, you can ask the plan to reconsider its decision. Every plan has an internal appeals process. Next step: external review If you re not happy with how the appeal turned out, you can ask for an external review. This lets an independent third party review the health plan s decision. You can ask for an external review of a service that your plan denied because it didn t consider it to be medically necessary or because the service is experimental or investigational. The health plan must honor the decision made during the external review. External reviews are free to you. Asking for an external review Usually you must go through your plan s appeals process before asking for an external review. But you can skip the internal appeals process if your condition is life-threatening or your plan stops covering a medication you re already taking. Plans through a job with a large employer: Visit the U.S. Department of Labor s website to file an appeal. Marketplace plans, CHIP plans, stand-alone dental or vision plans, and most small-employer plans: Ask for a review by calling or visiting externalappeal.com. You have 60 days from the date your plan sent you the final decision to ask for an external review. Marketplace plans bought before March 23, 2010: Ask your health plan for an external review form. Your plan should send you the form when it denies a service. There isn t a deadline for requesting a review, but it s best to ask for a review as soon as possible. Plans through a job with a school district, city or county government, union, or church: Follow the process outlined in your employee s benefit booklet or ask the benefits coordinator at your job. Should you need further assistance contact our offices at ABM Bad Jokes Of The Month... What do you call a fish with no eyes? A fsh. Did you hear about the Italian chef who died? He pasta-way. 4 4

5 5 Most Expensive Causes of Home Property Damage When you leave your home, there s no guarantee that it will be there when you get back. Unpredictable accidents can happen at any time. Gas leaks, burst pipes and extreme weather can rain destruction on a home in minutes. And while homeowners insurance is a reliable form of coverage, certain events may fall under coverages. In a recent report from Travelers, researchers have identified the most common and costliest causes of home damage. The report examines eight years of Travelers national homeowners insurance claim data from 2009 to 2016 in order to inform clients about the biggest risks threatening their properties. By sharing the most common causes of problems we see, we hope people protect their most valuable asset, Scott Humphrey, second vice president, risk control at Travelers, said in a statement. With this in mind, check out the five most expensive causes of home property damage. 5. Weather-related water 7% Leaky roofs, frozen pipes that burst and ice dams can really take a toll. 4. Wind 17% High velocity winds can uproot trees, damage roofs, collapse walls or worse. 3. Non-weather related water 17% Plumbing, sewer or appliance leaks and failures can create devastating losses. 2. Hail 20% Hail typically damages roofs, but may also harm windows, siding and more. 1. Fire 25% Electrical, cooking, wildfire and other sources can put homes at risk for fire. Call us to make sure you are receiving the best coverage for your home. Call Misty or Rose at Nice from a lady- that I was able to get her covered by insurance, after she applied for Medicaid and got denied. Now she is scheduled to have her procedure. Just part of what we do for our clients at ABM. Crystal Calaway Hi Crystal, it s me Ms. Connie and wanted to Thank You soooooo much for my Insurance!! I will be having surgery November 6 and I can t wait, you have led me in the right direction I m so grateful to You!! I will just keep paying my premium and it will keep me with coverage. I definitely don t want to lose my plan!! Thank you again for everything you re definitely My Insurance Angel! - Connie 5 5

6 Meet Our Representatives... Jake Prosser is a Commercial Lines Sales Agent for ABM. Jake is a graduated from the University of Houston and has several years in the insurance industry, working as an underwriter, Manager and Producer. Jake is dedicated to his clients and has become a welcomed team member. How to Compare Health Insurance Plans By Ronni Sandroff How much time should you devote to choosing a health insurance plan? A survey found that about a quarter of Americans spend five minutes or less on this important decision. That may be because 90% of employees simply stick with what they ve got, choosing the same plan as they had last year. That can be a mistake, as your employer s offerings may have changed, as could the plans themselves. There might be a better choice for you in the offing. Here we use Aetna and Cigna PPO plans offered by employers as examples. The details even for these companies will vary among employers. But the tips for comparing the plans will help you make your own decisions, whether it s among plans offered by your company or among policies offered on the individual market through healthcare.gov s Affordable Care Act s Health Insurance Marketplace/ Exchange. Survey Your Options The first step is to take a look at your choices. You re likely to have a number of plans to choose among. For example, employees of the federal government who live in New York have a mind-bending 25 plans to choose from. And in many areas of the country, the choices are plentiful at healthcare.gov. In either case, it pays to check every year to see if there s a newly available or expanded plan available to you. Consider the Company Aetna and Cigna, which we are comparing here, both insure a very large number of people and rank among the top 10 for sheer size. While a large health insurance company is not necessarily better, it s likely that a large one will have a good number of doctors to choose from in your provider network, and that you will also be able to find people you know who have had local experience with the plans you re being offered. One distinction is that Aetna is a U.S.-focused company, offering medical insurance through employers and on the individual market. Cigna is a global provider of health insurance for employers in 29 countries. If you work abroad or travel a lot, you ll find that Cigna has a number of international medical Insurance policies. Check How Plans Rank in Your State Rankings of health insurance plans according to consumer satisfaction and other factors have become easy to access and use. The nonprofit National Committee for Quality Assurance (NCQA) creates detailed quality rankings each year of PPOs and HMOs available in every state. 6 6

7 If your choice is between Aetna and Cigna PPOs, the rankings for reveal that both insurance companies are well regarded by consumers overall. Their scores on a scale of one to five are identical in Pennsylvania, at 3.5. But in Vermont, the Cigna plan gets a 3.5 in consumer satisfaction while Aetna gets only a 3.0. You can dig deeper on each, using the compare tool to focus in on plans you re considering and see how consumers rate them on such matters as getting care quickly and quality of primary-care doctors. In Vermont, Aetna rates highly on getting care quickly but falls short on quality of primary-care doctors. Cigna also rates highly on getting care quickly and rates a bit better on quality of primary-care doctors. Consider What s Important to Your Family The details in the rankings may be important. If you re planning on adding to your family, check the ratings for the company s prenatal and postpartum care. If someone in your family has asthma, check the plan s rating for asthma control and asthma drug management. Ask Around If you have doctors you like, you ll want to check with their offices before switching insurance plans. Many doctors and hospitals take multiple plans, so this may not be a problem. If you re looking for a new doctor, don t just pick at random from the insurer s book of practitioners. Ask around. Colleagues, neighbors and healthcare professionals can give you useful reviews of doctors in your area. It may take some time to gather a list of doctors and winnow it down, but once you do you can call their practices to ask about the insurance plans they accept. Asking around is a good idea when considering a plan, too. Ask others about their experience with physicians who accept the plan, how out-of-pocket costs mount up and whether they ve had problems filing claims or having services denied. These factors can vary by locale, so a colleague who lives in your area will be best informed. One more tip: If your routine care involves tests or consultations with specialists, make sure that everyone involved in your care takes your insurance plan. Using in-network doctors and services will keep your costs down. Ask an Expert Please use a licensed benefit professional - One with experience working in the state or market you are seeking coverage in. ABM Insurance and Benefit Services employs professionals with an average of 15 years experience in working with health insurance and Medicare markets. Call us for help at Save Money with ABM - up to 37%! If you have questions regarding your Home, Auto, Flood or RV insurance, please call our renewal expert at Our team is here to answer questions for our clients or visit 7 7

8 333 N Sam Houston Pkwy #750 Houston, TX Misty is knowledgeable, responsive, and caring. I am a first time home buyer and her support has been helpful in navigating the process. -Andie N. IN THIS ISSUE: Medicare posts 2019 rates, pinches high earners pg1-3 Mike s Notes Pg 2 Appealing a Health Care Claim That Was Denied Pg 4 ABM Bad Jokes of the month Pg 4 5 Most Expensive Causes of Home Property Damage Pg 5 Meet our Representative... Pg 6 How to Compare Health Insurance Plans Pg 6 Home Insurance: Save with ABM Pg 7 Referral program Pg 8 Our Clients Say it Best! Pg 8 ABM Referral Program Be sure to ask ABM about our bonus referral program which rewards our clients who send us business with $25 Visa Gift card to use at your favorite store or restaurant. ABM offers $ 25 gift certificate for those who refer a client to us and they buy a policy with ABM. $ 25 Our Clients Say It Best! They were all wonderful and found me a policy that was so much cheaper than what I was on, Crystal did ask the work for me and made it so easy, I would recommend them to anyone needing medicare assistance, -Cheryl B. We ve been with ABM for over 10 years. I think since 2004, or maybe Either way, they have insured us through 3 homes and 5 vehicles. They have always found us best rate and have always been very helpful when we call in. Thanks -Adam A.