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Tonya Kimrey

Tonya Kimrey

Tonya is our Senior Account Manager and brings eleven years of prior insurance company expertise to Fall River, having worked at Anthem Blue Cross and Great-West Healthcare (now part of CIGNA). Tonya holds a Bachelor of Science in Psychology from Texas A&M University. Originally from Minnesota, she loves the Colorado outdoors and enjoys family time with her young daughter.

In 2014, Colorado legalized same sex marriage, which allowed a spouse of either gender to be a qualified dependent for benefits. Domestic partnership is still a different situation. A domestic partner is defined as an employee’s unmarried partner who lives with them and is of the same or opposite sex. The definition of an eligible dependent for benefit plans may vary depending on the employer and carrier definitions, so it’s important to check in your carrier documents. 

Tuesday, 13 February 2018 11:16

Review your HIPAA Practices

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) was enacted to protect the privacy of healthcare consumers, including who has access to a patient’s medical records and who can be designated to act on their behalf.  You have probably filled out a HIPAA Authorization or Acknowledgment form for every new provider you’ve seen over the last 20 years.  On the surface, HIPAA compliance seems to adhere primarily to providers and insurance carriers; however, if you are an employer sponsoring health plans for your employees, there are some basic provisions you need to be aware of.  Fines for not complying with HIPAA are very real and can range into the tens of thousands of dollars.

 
Tuesday, 30 January 2018 14:59

The Ever-Changing World of ACA Taxes

There are several healthcare-related taxes that employers have been responsible for under the Affordable Care Act.  Some have gone through a sunset while others continue, and some were given a temporary holiday and were scheduled to start anew in 2018.

Following a short government shut-down, President Trump signed a short-term spending bill (a Continuing Resolution or “CR”) on January 22nd to reopen and fund the federal government through February 8, 2018.  Attached to the bill are suspensions of three ACA taxes and a six-year extension of the Children’s Health Insurance Program (CHIP). 

Wednesday, 29 November 2017 17:11

How Tax Reform Impacts your Benefits

Republicans have promised to get a tax bill on President Trump’s desk by the end of the year. In response, the House and Senate have created separate versions of the Tax Cuts and Jobs Act (TCJA) in the last several weeks, leaving little time for them to be debated. 
 
These bills represent the largest proposed tax code overhaul in 30 years, and it would affect nearly every American family and business. The House passed their bill on 11/16/17, and the Senate passed their bill out of committee on 11/28/17. The full Senate is expected to vote as soon as this week.
 
The TCJA also would affect what benefits you can offer your employees, repealing some provisions effective 1/1/2018, even though you may have already enrolled employees for those very programs. Please note all of these provisions are changing rapidly and this blog post may already be out of date by the time you read it!
Typically when we think of employer wellness programs, we think of things like biometric screenings and health risk assessments.  But recent research shows that financial worries are a top stressor in many Americans’ lives.  
 
At first glance, the financial problems of the workforce may seem of a personal nature and not a corporate one.  Employers might be wary of legal issues and privacy concerns.  However there is a compelling argument for employers to include financial health in their wellness programs:  employee financial woes are costing companies money. 
Monday, 18 September 2017 18:51

Mandatory Compliance Notice Due October 15th

Do you know if your employer prescription benefits are creditable when compared Medicare Part D benefits? Are you informing your plan participants of the plan’s status on an annual basis? 
 
The Medicare Part D Notice is just one of the many compliance responsibilities to which most employer health plans are subject. 
These days, most companies have some sort of worksite wellness program, whether it’s a monthly wellness newsletter, an annual health fair, or weekly exercise challenges.  At Fall River, for example, we participate in weekly Fitbit challenges, which definitely encourages us to log more steps every day!
 
When you think about your company’s wellness program, you may wonder how effective it is in actually improving the health of your employees.

The American Health Care Act (AHCA) bill was passed by the House of Representatives on May 4, 2017. (To catch up on the content of the House bill, click here).  Instead of agreeing with The House proposal, Senate Republicans instead drafted their own bill, released on June 22, called the Better Care Reconciliation Act (BCRA).

This BCRA bill includes features such as:

Wednesday, 24 May 2017 11:22

Frustrated with Your Healthcare Costs?

Are you tired of seeing your benefit costs skyrocket year after year? Frustrated about having little or no control over the cost of healthcare? These frustrations make some employers worry about the future of their benefits package, and thus, their ability to attract and retain the right workers.  

Friday, 14 April 2017 09:49

The Final Market Stabilization Rule

There is much uncertainty around what will happen with the Affordable Care Act, and the Individual Exchanges created by the ACA have suffered from:

  • carriers exiting the marketplace (in part due to the uncertainty over subsidies and enforcement of the mandate);
  • skyrocketing prices in many areas; and
  • concerns over the risk pool the market is attracting.  

Stabilizing the individual and small group markets is a top area of concern, and HHS issued final regulations for market changes on April 13, 2017.  

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