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Tonya Young

Tonya Young

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.

Monday, 10 December 2018 12:09

Top Four Wellness Plan Tips for 2019

Most Employers running a wellness program already have their 2019 game plan in place. For those that don’t, or if you are just starting to implement a program, here are some top thoughts and trends to consider.

Monday, 12 November 2018 08:35

Fall River is growing!

We are very excited to announce our incredible growth in the past few years, and the addition of two new professionals to our amazing team!

Monday, 24 September 2018 15:05

The Fate of ACA Depends on a Texas Courtroom

The partisan battle over the Affordable Care Act (ACA) heated up once again during the first week of September, when Judge Reed O’Connor in Fort Worth, Texas heard arguments from Republican attorneys general stating that the ACA is unconstitutional.  Although it may take a few weeks or even months for the judge to render his decision, the healthcare industry continues to speculate about the potential implications for the market, individuals, and employer group plans.  The crux of the issue is around the individual mandate and the preexisting condition protections that the ACA introduced.

Friday, 24 August 2018 10:30

Healthcare Claims Get Even More Confusing

At Fall River we are committed to helping our members understand their health benefits and provider bills. We know that navigating the benefits world can be confusing, and unfortunately, we are seeing more and more claims situations that prove it’s getting ever more complicated. 

Here are recent examples of some complex and downright outrageous claims issues we want you and your members to be aware of.

If you have a self-funded or partially self-funded plan (including all “Level Funding” plans), you need to know about New York State’s Health Care Reform Act (HCRA) of 1996, even if you don’t have employees in New York. The HCRA, which still applies today, was created to generate funding for a wide variety of health care initiatives in the state, and requires providers of health care services and Third Party Administrators (TPAs) to participate in that funding. In 1997, the State created the New York Public Goods Pool to collect funds for those initiatives and for indigent care in the state. 

Monday, 16 April 2018 15:08

HIPAA Compliance Made Easy

HIPAA is an important guideline for employers, health care practitioners, and insurance companies to follow. Since the fines for non-compliance can be in the tens of thousands of dollars, it’s imperative that employers pay attention to their obligations in keeping employees’ information private.

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!
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