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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.

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.  

At Fall River, we pride ourselves on bringing our clients valuable information pertaining to their benefits package and other aspects of their jobs.  We are exploring options that will provide our clients with useful Human Resources information and assistance.  To this end, we’d like your feedback on what HR topics you would like to either know more about or get help with. Please answer our 3-question survey at the following link:


Thank you very much for your participation!
Tuesday, 14 February 2017 13:22

Ready for your ACA Reporting due March 2nd?

Although there is much speculation about the future of The Affordable Care Act (ACA), it’s still the law of the land for now. For all large employers and small employers that are self-funded, the deadline of March 2nd to distribute 1095-Bs and 1095-Cs to employees is fast approaching. If your organization does not have all the necessary information to complete these forms, it’s time to act fast!
Wednesday, 18 January 2017 13:56

On Wellness, One Size Fits ONE

Guest Article by Brad Cooper, CEO of US Corporate Wellness

 

The research is in, and it warrants an exclamation point!  An effective employee wellness program will provide a 125-600% ROI or more through decreased health care, sick time and disability costs, as well as improved recruitment, retention and employee engagement (and that doesn’t take into account the personal enhancements participants experience in their own lives!).  The result of this research has been a two-fold increase in the number of organizations that have launched wellness programs for their employees in recent years.  Only one problem – the first word in the phrase “Effective Employee Wellness Program.”

 

There are many approaches to employee wellness.  Common entry level approaches include holding an internal “biggest loser”-like contest or providing paid memberships at the local health club. 

One of the root causes of rising healthcare costs is that services are often delivered in more costly locations than needed.  Anyone who has attended a Fall River enrollment meeting knows that we continually educate employees about how accessing care in the right place can save time and money.  
 
One way to do this is to become more familiar with Convenience Care Clinics, or Retail Health Clinics. These walk-in clinics in some grocery stores and pharmacies allow you to access care immediately, without waiting for a doctor’s appointment or visiting a more expensive Urgent Care center. 
If your company administers a self-funded medical plan, you need to be aware of benefit changes that should be made in 2017 to comply with Section 1557 of the Affordable Care Act. Section 1557 prohibits discrimination on the basis of sex, age, race, color, national origin, and disability. 
 
The regulations were released by the Department of Health and Human Services (HHS), and specific requirements were laid out for health insurance coverage for transgender individuals. 
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