2019 Medicare and Health Care Planning Guide

MEDICARE 2019:

MEDICARE’s Annual Enrollment Period begins on October 15, 2018 and ends December 7, 2018. It is during this time that all individuals Aged 65+ should evaluate and review their health care needs for the upcoming new year. If already enrolled, you will receive a letter from your current carrier that will include an Annual Notice of Change (ANOC), which will give you a side by side comparison of what the plan you are on in 2018 will do in 2019. You will want to consider cost, doctor networks, co-pays, deductibles, Maximum out of Pocket amounts and your Prescription Drug tiers. If you simply pay the January 2019 updated premium, you will automatically be renewed with the plan updates.

Our office is available to discuss plan changes, updates and options available to you in 2019. If you are happy with your plan and do not anticipate any changes, simply pay your updated premium for January 2019.  If your needs have changed and you wish to re-look at your options, please contact us as soon as possible so we can help you evaluate for 2019. Please be prepared with your list of providers and any RX’s you are taking (include the exact spelling of the RX, the dosage level and frequency taken). Our Benefits team is certified in 2019 with Regence, Providence, Health Net, United Healthcare/AARP, Pacific Source, MODA and ATRIO Health Plans and are happy to review your options with you. Any changes you wish to make will need to be done by December 7, to be effective January 1, 2019.

INDIVIDUAL & FAMILY HEALTH PLANS 2019:

OPEN ENROLLMENT into the Individual/Family Plans for 2019 will start November 1, 2018.  Open Enrollment will end on DECEMBER 15, 2018. If currently enrolled, your carrier will be sending you a letter on what your plan is doing for 2019. If you would like additional information on your plan choices for 2019, please contact us and we can discuss your options. If interested in a quote, please be prepared to provide your address, income information, and any details specific to your situation.

PLEASE NOTE THE FOLLOWING:   Average rate changes: Pacific Source (-9.6% decrease) Providence (+9.5% increase) Regence (0% change) Kaiser (+9.4% increase) Moda (+6.3% increase) Bridgespan (+4.5% increase)

  • IF YOU DO NOTHING – Your carrier will renew your plan automatically and will initiate payment if you have not stopped it. The plan you have for 2019 will be the plan that they have MAPPED you to and you will be charged that premium for January 2019.
  • IF YOU WANT TO CHANGE PLANS or CARRIERSPlease contact us as soon as possible to review your options.
  • IF YOU ARE ON THE EXCHANGE WITH TAX CREDITS and/or COST SHARINGYou MUST update your “Estimated Adjusted Gross Income” (AGI) for 2019 and review and secure your plan option. Please contact us for assistance.
  • IF YOU WANT TO CANCEL your plan because you no longer need coverage, you MUST contact the carrier to terminate.

If you are interested in receiving a quote or hearing available plan options for 2019, please contact our Benefits Specialist, Jamie L. Smith, at 971-233-8559 or jsmith@premiernw.net OR click on the following link:

Get A Quote

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Oregon employers to receive money back as workers’ comp costs continue to decrease

For the ninth year in a row, SAIF declares a substantial dividend for policyholders.

posted September 12, 2018

Today the SAIF board of directors declared two dividends for customers: a $120 million primary dividend to be paid to SAIF’s policyholders, and a $40 million safety performance dividend to be paid based on each policyholder’s safety results.

“We’re a not-for-profit insurance company. That means when we have a good year, we’re able to return premium directly to our customers in the form of a dividend,” said President and CEO Kerry Barnett. “We also want to give special recognition to customers with strong safety records. Preventing injuries through effective safety programs is the best way to keep rates low for everyone.”

This is the ninth year in a row SAIF has returned a substantial dividend to its customers. On average, eligible customers can expect to receive 28.6 percent of the premium paid in 2017. The dividends are possible because of SAIF’s overall financial results, including investment returns and favorable trends in claim costs.

In addition to dividends for SAIF’s policyholders, average workers’ compensation costs continue to fall for Oregon employers. Since 1990, Oregon has gone from having one of the worst workers’ compensation systems to one of the best. During that time, workplace safety has improved, and claims incidence have gone down 70 percent, with a similar percentage decrease in average pure premium rates.

“Think about your home, car, or life insurance-are any of those actually costing you 70 percent less than they did 30 years ago?” said Barnett. “Oregon has a real success story to tell, and we’re proud to be such a big part of it.”

47,488 policyholders are eligible for SAIF’s primary dividend. Of those, about 94 percent are also eligible to receive all or part of the additional safety performance dividend.

Checks will be mailed in October to eligible employers.

About SAIF

SAIF is Oregon’s not-for-profit workers’ compensation insurance company. Since 1914, we’ve been taking care of injured workers, helping people get back to work, and striving to make Oregon the safest and healthiest place to work. For more information, visit the About SAIF page on saif.com.

Workers’ compensation costs to drop for sixth-straight year

Salem, OR—Oregon employers next year, on average, will pay $1.12 per $100 of payroll for workers’ compensation insurance, down from $1.23 in 2018, under a proposal by the Oregon Department of Consumer and Business Services (DCBS). That figure covers workers’ compensation claims costs, assessments, and insurer profit and expenses.

This will mark the sixth year in a row that businesses will experience an average decrease in their workers’ compensation costs. Those costs have steadily declined over the years – even as workers continue to receive strong benefits – because of Oregon’s long-running success in managing the workers’ compensation system.

“Everyone from employers and workers to insurers and government has played a role in making workplaces safer and keeping business costs low,” said Cameron Smith, DCBS director. “As the numbers show, Oregon’s comprehensive approach continues to pay off.”

Part of Oregon’s success stems from efforts by the Workers’ Compensation Division. Those efforts include enforcing requirements that employers carry insurance for their workers, keeping medical costs under control, and helping injured workers return to work sooner and earn their pre-injury wages. Another part is Oregon OSHA’s focus on preventing on-the-job injuries by enforcing workplace safety and health rules, and advising employers about how to improve worker safety and health.

Employers’ cost for workers’ compensation insurance covers the pure premium and insurer profit and expenses, plus the premium assessment. Employers also pay the Workers’ Benefit Fund assessment, which is a cents-per-hour-worked rate.

The pure premium rate – filed by a national rate-setting organization and approved by DCBS – is the base rate insurers use to determine how much employers must pay for medical claims and lost wages. Under DCBS’s proposal for next year, the pure premium would drop by an average 9.7 percent. In fact, the pure premium will have declined by an average of 40 percent during the 2013 to 2019 period.

Pure premium is the key factor behind annual cost changes. The decrease is an average, so an individual employer may see a larger or smaller decrease, no change, or even an increase depending on the employer’s own industry, claims experience, and payroll. Also, pure premium does not take into account the varying expenses and profit of insurers.

Driving the average decrease in the pure premium are lower medical care costs and less severe claims. Underpinning the steady decline in pure premium are the successful efforts of the Workers’ Compensation Division, Oregon OSHA, the Workers’ Compensation Board – which resolves disputes over the state’s workers’ compensation and workplace safety laws – and injured worker and small business advocacy services.

Those programs are funded by the premium assessment.

The premium assessment is a percentage of the workers’ compensation insurance premium employers pay. It is added to the premium. It would increase from 7.4 percent this year to 7.8 percent in 2019. The increase is needed to partially offset the decline in pure premium and to keep pace with a growing economy. This modest increase maintains stable funding for state workers’ compensation regulation and worker protection programs that preserve historically low costs.

The Workers’ Benefit Fund assessment provides benefit increases to permanently disabled workers and to families of workers who died from a workplace injury or disease. It also supports Oregon’s efforts to help injured workers return to work sooner – through incentive programs to employers – and earn their pre-injury wages.

The fund’s revenue comes from a cents-per-hour-worked assessment. It would decrease from 2.8 cents per hour worked in 2018 to 2.4 cents per hour worked in 2019. The fund is healthy, made so by a growing economy, which allows the rate to be reduced.

The decrease in the pure premium is effective Jan. 1, 2019, but employers will see the changes when they renew their policies in 2019. The assessment changes are effective Jan. 1, 2019.

Oregon’s workers’ compensation premium rates have ranked low nationally for many years. Oregon had the seventh least expensive rates in 2016, according to a nationally recognized biennial study conducted by DCBS. That was an improvement from Oregon’s ranking as the ninth least expensive state the last time the study was done, in 2014.

The following chart summarizes all of the changes and includes the date, time, and place of the assessment public hearings: https://www.oregon.gov/DCBS/cost/Documents/wc-summ…

Annual Oregon average pure premium rate changes and average changes by industry: https://www.oregon.gov/DCBS/cost/Documents/pure-pr…

More information about Oregon workers’ compensation costs: http://www.oregon.gov/DCBS/cost/Pages/index.aspx

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The Department of Consumer and Business Services is Oregon’s largest business regulatory and consumer protection agency. For more information, visit http://www.dcbs.oregon.gov/.

Contact information:
Aaron Corvin, public information officer
971-718-6973
aaron.corvin@oregon.gov

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AGC/SAIF Members Rewarded for Safety Efforts

AGC/SAIF workers’ comp participants to receive $7.9M retro return

The Associated General Contractors Oregon-Columbia Chapter (AGC) and SAIF announced today a $7,876,242 retrospective return for the 638 companies who participated in the AGC/SAIF group workers’ compensation program during 2016-2017. This represents a 22.2 percent return of paid premiums during the policy year.

Increased construction activity and a continued shortage of qualified workers have presented unique challenges this year, making these results more significant. The actual total payout to participants will surpass $9.3 million after the Department of Consumer and Business Services (DCBS) and non-disabling claim reimbursement adjustments are made. Individual results and retro checks will be mailed directly from SAIF to policyholders in mid-August 2018.

“For 26 years, this plan has had consistently strong results-due to the partnership between workers, employers, agents, AGC, and SAIF,” said Christy Witzke, VP of marketing, sales, and communication at SAIF. “The true success is that thousands of Oregon construction workers go home safe and healthy day after day because of the hard work of all those involved.”

The retro return combined with the 10 percent upfront premium discount savings creates a total combined savings this year of 32.2 percent. A retro return has been paid out to AGC members 25 of the past 26 years. Total retro returns spanning the 26-year history for the AGC/SAIF program now surpass $188 million.

Employers will see additional savings this year due to a significant reduction in Oregon pure premium rates for 2018. The contracting industry decreased 12.6 percent overall, and the AGC group weighted average rate decrease is 15.2 percent.

The retro return is based on the safety performance of all group members. Employers in the program make investments and commitments to safety and training. Employees carry out the work. And industry professionals from SAIF, AGC, and agent brokers train and educate, manage claims costs, and help injured workers get back to work.

“This partnership has been in place for 26 years, and our members continue to produce tremendous results,” said Mike Salsgiver, Oregon-Columbia Chapter executive director. “Our goal is to create safer workplaces, reduce workplace injuries and illnesses, save lives, and save money.”

Dennis Barlow, AGC director of Safety Services, added, “Each year we improve this program to provide optimum results. Year after year, we see improvements in our members’ safety leadership, culture, and commitment. The premise that ‘safety pays’ is clearly understood.”

About SAIF

SAIF is Oregon’s not-for-profit workers’ compensation insurance company. Since 1914, we’ve been taking care of injured workers, helping people get back to work, and striving to make Oregon the safest and healthiest place to work. For more information, visit the About SAIF page on saif.com.

About AGC

Since 1922 the AGC Oregon-Columbia Chapter has served as the voice of the commercial construction industry. The association provides its members with a forum for the exchange of ideas and services designed to enhance the professionalism of the construction industry, including workers’ compensation and health insurance, legislative and governmental representation, safety management consulting, professional education, and training and workforce development programs.