MARCH 1, 2016
Exemption From Tax Penalty
Members of federally recognized Tribes or those eligible to receive services
from an Indian Health Service, Tribal or urban Indian health program may
claim an exemption from the penalty. The exemption should be claimed on a
federal income tax return using IRS Form 8965.
If you already applied for and received an Exemption Certiicate Number,
then use this number to complete Part I of IRS Form 8965. If you did not
already obtain an ECN, you can still claim the exemption using IRS Form
8965 by entering code “E” in Part III of the form.
You will need to submit this form every year that you ile a federal income
tax return and are requesting an exemption, even if you have an ECN. You
don't need to apply for an exemption if you are not iling a federal income tax
return.
https://www.ihs.gov/newsroom/index.cfm/ihs-blog/february2016/aca-and-
tax-season-what-you-need-to-know/
Reporting health
coverage on taxes
Everyone must report health insurance
on their federal income tax returns
In the next few months, everyone who had health coverage in 2015
should begin receiving one or more 1095 tax forms. These forms provide
information about the health care coverage a person had or was offered in
2015. People will need these forms when they ile their federal income tax
return. These forms should be kept with other important tax documents.
There are three types of 1095 forms:
• Form 1095-A is sent to individuals who enrolled in health coverage
through HealthCare.gov. This form includes:
o The names of each person in your family (dependents) who en-
rolled;
o The amount of their coverage;
o Any tax credits they were entitled to and applied toward their
insurance costs;
o The amount they paid for insurance.
• Form 1095-B is sent out by employers with fewer than 50 full-time
employees that offer health coverage, health insurance companies
that sell plans directly to customers instead of through HealthCare.gov
and by the Oregon Health Authority for anyone who was also covered
by the Oregon Health Plan (OHP). In some instances, people with
Medicare coverage under Part A (hospital insurance) will receive this
form.
• Form 1095-C is sent out by large employers to full-time employees
as well as any employee who has enrolled in their health insurance
plan.
Form 1095-B and Form 1095-C include the same sort of information:
• The type of coverage you have;
• Names of your dependents covered ;
• Period of the coverage.
Receiving more than one form
It is possible for someone to get more than one form if they had cov-
erage from more than one source or if they worked for more than one
employer that offered coverage. Someone is also likely to get more than
one form if they changed coverage or employers during the year or if dif-
ferent members of their family received coverage from different sources.
People should use all of the forms they receive to complete their federal
tax return to show that they had required coverage.
More about 1095-B and OHP coverage
The Oregon Health Authority will mail everyone who was covered by
OHP in 2015 a 1095-B form, even children. All 1095-B forms reporting
OHP coverage were mailed on Jan. 29, 2016. People should keep the
1095-B with their important papers. OHA will also send the information
to the Internal Revenue Service.
Don’t get caught
without your medication
Grand Ronde Health & Wellness Center Pharmacy hours:
8:30 a.m. to 5:30 p.m.; closed 12:30 to 1:30 p.m.
Monday, Tuesday, Wednesday and Friday.
9:30 a.m. to 5:30 p.m.; closed 12:30 to 1:30 p.m. Thursday.
REFILL LINE: 503-879-2342
S moke S ignals
25
17
Letters from Restat/OptumRx
If you have received a letter from Restat/OptumRx about a pre-
scription you are taking, please follow the directions on the letter.
OptumRx is now our pharmacy beneit manager. OptumRx stan-
dards require longtime prescriptions be reveriied to ensure that our
members still need and are taking the speciied drugs.
If you have any issues getting your prescriptions paid for, please
contact the Grand Ronde Health & Wellness Pharmacy at 503-879-
2342. Our pharmacy staff will work with OptumRx and your providers
to get any prior authorizations or denials resolved.
If you have questions, please call me at 503-879-2008 or Kandee
Little in our pharmacy at 503-879-2342.
Thank you,
Tresa Mercier
Health & Wellness forming
Pain Management Committee
To best serve Tribal members and patients suffering from chronic pain,
the Grand Ronde Health & Wellness Center is convening a Pain Manage-
ment Committee.
This committee will evaluate the current pain management policy and
contract utilized by GRHWC to ensure the protocols support best clinical
practices for the patients and conform to regulatory guidelines.
One of our goals is to consider potentially enhancing pain management
services already provided by the GRHWC. We are excited about the future
of the GRHWC and plan to keep you informed along the way.
Certiied Application
Assister dates scheduled
Tribal Certiied Application Assister Loretta Meneley will be at the
Portland area ofice, 4445 S.W. Barbur Blvd., to help Tribal members
renew or sign up for the Oregon Health Plan on Wednesday, March 9
and 30 and April 6 and 20.
She also will be at the Grand Ronde Food Bank, 9675 Grand Ronde
Road, on Friday, March 4 and 18.
For more information, contact Meneley at 503-879-1359 or via e-mail
at lorettta.meneley@grandronde.org.
Important information for Tribal
members with The Skookum
Health Assistance Program
If you reside outside of the service delivery area,
this is important information for you.
For several months, the Save Our Skookum team has provided
information and correspondence to Tribal members and providers
about receiving Out of Network services. What does that mean?
That means Skookum uses a network of providers
(there are many networks and where you live determines what pro-
vider network you are in) to receive discounts on services you receive.
This saves Tribal dollars while providing a large
selection of provider choices to the membership.
Starting in 2016, if you chose to receive services from an Out
of Network provider, the Skookum Health Assistance Program will
only pay up to 70 percent of the charges your provider bills for the
services you receive. You will be responsible for the other
30 percent of the charges.
THIS DOES NOT APPLY TO TRIBAL
MEMBERS WITH MEDICARE!
Please share this information with your friends and family and be
sure to contact us with any questions you have.
Tresa Mercier – tresa.mercier@grandronde.org; 503-879-2008
Barbara Steere – barbara.steere@grandronde.org; 503-879-2487
Melody Baker – melody.baker@grandronde.org; 503-879-2011
Tauni McCammon – tauni.mccammon@grandronde.org; 503-879-1406
Erica Mercier – erica.mercier@grandronde.org; 503-879-2080