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How SBMA Makes Healthcare Affordable by Focusing on Insurance Needs

November 13, 2022/in ACA Compliance, MEC, News

SBMA makes healthcare affordable by focusing on the insurance needs of people and trimming away the things most people don’t actually want. How do we do it? Let’s discuss.

SBMA Provides Affordable Care Act Compliant Benefits

Any ACA-compliant benefit plan must cover these 10 health benefits:

  • “Ambulatory services
  • Emergency services
  • Hospitalization
  • Pregnancy, maternity, and newborn care (before and after birth)
  • Mental health and substance use disorder services
  • Prescription drugs
  • Rehabilitative and habilitative services and devices
  • Laboratory services 
  • Preventative and wellness services and chronic disease management 
  • Pediatric services”

Minimum Essential Coverage (MEC) is a classification of insurance plans that meet the Affordable Care Act requirements for health insurance coverage. Plans that meet MEC requirements include marketplace, job-based plans, Medicare, and Medicaid.

MEC can be a cost-effective way to ensure that families are protected in times of need but employers aren’t overpaying for unnecessary services.

Why Do Employers Need to Offer Coverage?

Employers must offer at least Minimum Essential Coverage (MEC) to any benefit-eligible employee. Non-compliance will generally result in a penalty of $2,750 annually PER eligible employee. 

SBMA provides benefits that will meet these requirements and keep employers from being penalized without making them pay for the services they don’t need. We offer affordable coverage for all clients, with a variety of options, including telehealth, vision, and dental voluntary benefits.

How Affordable Are SBMA’s ACA Compliant Plans?

Many of SBMA’s plans cost less than $100/month and include virtual health, worksite benefits, vision, dental, and ACA-compliant plans that are affordable for both employers and employees.

SBMA plans also offer the bundling of medical and ancillary benefit options, making affordable healthcare options easy for employers. This is a significant contrast to many employers paying thousands of dollars a month for major medical coverage.

Let’s Talk Telehealth Services: Giving People Medical Care at the Right Place and Time

Telehealth services experienced a spike in popularity during the COVID-19 pandemic. Why? Telehealth services allow patients to stay home and keep others safe as well as work around a collection of other challenges, such as:

  • Problems finding childcare
  • Issues driving to or navigating a hospital due to a disability
  • Difficulty getting time off work

SBMA’s virtual health and telemedicine services offer plan participants 24/7 access to their doctor, at no cost to them. They can speak to a licensed physician as and when they need, by phone or video, and find the complete solution to their health care needs.

Learn more about telehealth services.

SBMA Gives Users What They Want: Hassle-free, Basic Care

SBMA knows what the users of its insurance want, need, and expect: they want to go to the doctor when they need a check-up, they want to be able to get their kids registered for school with all their shots, and they want doctor visits and prescriptions to be as efficient and hassle-free as possible. 

Learn more about SBMA and our benefit plans, then read on to learn more about the Chief Executive Officer of SBMA, Frank Crivello. 

Frank Crivello: Meeting Real-World Insurance Needs to Make Healthcare Affordable For All   

Frank Crivello, CEO of SBMA believes that success is not a destination, but a journey. He defines success as the balance of achievement and satisfaction.

“If you don’t like what you’re doing but you have a ton of money, that’s not success. If you do like what you’re doing and don’t have any money, well, that’s not success either,” he says.

Meeting the real-world insurance needs of people

Despite not having gone to Harvard or pursued advanced degrees, Frank achieved success just by learning from everyone around him.

“I’ve absorbed incredible insights and lessons from business owners and co-workers, from janitors and motivational speakers. SBMA is successful because we listen to the needs of our brokers and the companies we serve, and then exceed expectations,” he states.

When Frank first started out in the insurance industry, he noticed that all the third-party administrators were offering all kinds of products that their employer groups didn’t want or need. So when he built SBMA, it was specifically to meet the real-world needs of the people they served. 

SBMA provides ACA-compliant benefits administration for large employers all across the US. The company’s offices and customer care center are located in sunny San Diego, CA.

“Insurance is not a new industry and, to be honest, major medical is not a place where much innovation takes place. At SBMA we saw the opportunity to innovate in the MEC space, and seized the chance to really make a difference,” states Frank.

He notes that SBMA provides affordable coverage for all of its clients, with a variety of options, including telehealth, vision, and dental voluntary benefits. Their revolutionary idea was to offer plan participants real-world benefits they can actually use.

Providing affordable healthcare options for all

SBMA benefit plans provide a complete solution for employers who want to provide affordable benefits to their workers. The firm offers the most competitive limited medical plans in the industry, with seamless benefits that work like major medical, ensuring ACA compliance for the employer at a price they and their employees can afford.

Many of SBMA’s plans cost less than $100/month, and include Virtual Health, Worksite Benefits, Vision, Dental, and ACA-compliant plans that both employers and employees can afford.

SBMA plans also offer the bundling benefits of medical and ancillary options, making affordable healthcare options easy for the employers. Frank points out that not everyone wants to pay out thousands of dollars a month for major medical.

“Our benefits provide coverage for those who value acute care, prescription coverage, and regular DR visits, but don’t want to pay for comprehensive major medical. We created healthcare that costs between $40 to $125/month, by carving out the big ticket items to build plans that give people benefits they actually use. Practical, useable, affordable, and ACA-compliant benefits for everyday people! That’s our revolution!” he declares.

Frank points out that, prior to the pandemic, the majority of patients preferred in-person doctor visits over telehealth options. However, when a contagious airborne virus appeared, telehealth options expanded dramatically. Almost all health insurance providers now have new, simple-to-use options.

With a Virtual Health medical professional on the line at any time of day or night, nationwide telehealth services help avoid unnecessary doctor visits and provide numerous financial benefits to both healthcare providers and patients.

Telehealth services can help reduce transportation costs and save money for both patients and providers. Virtual visits aid in increasing patient retention, streamlining time on task, improving appointment compliance, lowering overhead costs, and reducing in-person liability.

SBMA’s virtual health and telemedicine services offer plan participants 24/7 access to their doctor, at no cost to them. They can speak to a licensed physician as and when they need, by phone or video, and find the complete solution to their health care needs.

Flipping the MEC model on its head

Minimum essential coverage (MEC) is an insurance plan that meets the Affordable Care Act requirements for health insurance coverage. Plans under MEC include marketplace, job-based plans, Medicare, and Medicaid.

Prior to the Affordable Care Act, insurers would refuse to insure people with preexisting medical conditions. Those who had used too much of their medical coverage in the past were also at risk of losing it.

MEC ensures that all enrollees have access to insurance, regardless of their health status or the plan they choose. It can be a cost-effective way to ensure that families are protected in times of need. Frank points out that the MEC space has traditionally been filled by those providing minimum essential coverage paired with minimum service.

“We flipped the model on its head by providing gold standard service to accompany the government mandated MEC coverage that employers must offer to be ACA compliant,” he states.

SBMA knows what the users of its insurance want, need, and expect. They want to go to the doctor when they need a check-up, they want to be able to get their kids registered for school with all their shots, and they want doctor visits and prescriptions to be as hassle-free as possible. 

SBMA also knows what its employer groups want: Fast enrollment and off-boarding, no hassle ID cards, no hassle claims, and coordinated technology that streamlines their experience. And finally, the firm makes brokers’ lives better by taking all the hand-holding off their plates. 

Brokers are able to provide employer groups not only with great rates and easy compliance with the ACA requirements, but they can also hand those employer groups off to SBMA, knowing that there will be a gold standard support team handling every phase of their relationship, from the moment the group enrolls.

A respected leader who commands trust and faith

Frank defines his leadership style as casual, collaborative, and authoritative. “Don’t mistake that for authoritarian. I know what needs to be done, and am clear with everyone around me. I move fast, make decisions with certainty, and I pivot easily,” he points out.

As CEO, Frank ensures that SBMA is on track to be the best in the industry. His relationships with the leading brokers keep his finger on the pulse of the industry, allowing SBMA to be more agile, more responsive, and a better partner for its brokers, and employer groups, with the freedom to be the best ACA-compliant MEC coverage provider in the industry.

Some of the people on Frank’s leadership team have been with him since the early days, which he feels is a testament to the strength of their trust and faith in him as a leader.

“Nobody gave me anything starting out,” Frank observes. “I had to earn everything from the ground up. That might make some people resentful, but not me. I’m grateful for all the hard work I put in to get here. The view from the top is amazing, especially if you took the stairs.”

Today, SBMA is the industry leader in providing MEC coverage. Over the past five years, the firm has grown to become the gold standard in customer service by building the technology to streamline all of its operations. “I see blue skies and market domination in our future. And, I’m just getting started!” states Frank.

As a father, Frank dotes on his two beautiful daughters who keep him grounded and balanced. “They’re everything to me. Watching them grow up, and creating a life for them where they see that hard work pays off, and that grit and determination is enough to succeed, gives me great satisfaction,” he says.

Frank’s parting advice to aspiring business leaders is to: LISTEN. Don’t let ego get in the way of learning. It’s easy to think you already know, or even to worry that someone will think you’re stupid if you don’t know the answer. Lose that perspective as fast as possible. If you can absorb everyone else’s knowledge and experience around you, you will accelerate your own trajectory to success.

https://www.sbmabenefits.com/wp-content/uploads/2022/09/How-SBMA-Makes-Healthcare-Affordable-by-Focusing-on-Insurance-Needs.png 628 1200 Amanda Rogers https://www.sbmabenefits.com/wp-content/uploads/2021/12/SBMA_Website-Logo_250x150.png Amanda Rogers2022-11-13 07:00:162022-09-23 12:42:41How SBMA Makes Healthcare Affordable by Focusing on Insurance Needs

Why SBMA is the Gold Standard of Customer Service

October 23, 2022/in ACA Compliance, Employer Resources, MEC, News

At SBMA, we serve employers who want to offer their employees affordable benefits. We simplify the complexity of providing those benefits and ensure compliance with the Affordable Care Act. 

We’re in the business of providing health care to everyday people, ensuring peace of mind through trust and transparency. 

We pride ourselves on our personal service, speed of  implementation, and innovative approach to providing benefits coverage.


Today, we’d like to chat a bit more about the exceptional service we provide and why SBMA is, therefore, the gold standard of customer service for minimum essential coverage (MEC) insurance providers.

(Hint: Our one-stop-shop benefits portal plays a large role in our successful customer service efforts!)

Let’s dive in.

What Problem Do We Solve?

With us, you get peace of mind, security, and the insurance your employees want at a price everyone can afford. Providing affordable benefits to your employees not only ensures you employees remain motivated and excited about work, but they also ensure you remain in compliance with the ACA.

What Makes SBMA Benefits Different?

Our customer service is what sets us apart. We work when you work. Our carrier partners have given us exclusive offerings to complement our medical plans, giving you the best possible price. Our quick execution and advanced approach to benefit coverage is second to none.

How SBMA Supports the Onboarding and Offboarding Processes

At SBMA, we support businesses beyond providing affordable minimum essential coverage (MEC). We are proud to support the employee onboarding process so your human resources (HR) teams have more time to focus on the daily tasks that keep your business running.

This is why we offer a complete insurance solution that covers:

 

  • Implementation
  • Enrollment
  • Administration, and
  • Reporting

Our benefits professionals are fully equipped to support onboarding and offboarding procedures to eliminate the hassle for businesses.

How? Using our benefits portal.

Our Benefits Portal

Employee benefits administration can be a pain for any HR department. At SBMA, we aim to simplify the process by giving you access to everything you need in one place.

Our one-stop-shop portal is proprietary and unlike any other. Our portal grants you access to all of the tools necessary to support a new hire (from beginning to end).

We eliminate the headache of unnecessary paperwork with benefits management portal access. You can:

  • Make plan changes
  • Order ID cards
  • Check a claim status online
  • Track onboarding and offboarding
  • And more

Resources are only a click away.

Besides creating a seamless onboarding process with our all-in-one portal, we also provide video tutorials for our partners. These resources provide instructions that assist navigation through the portal.

Read on to view our enrollment portal walkthrough.

https://www.sbmabenefits.com/wp-content/uploads/2022/09/Why-SBMA-is-the-Gold-Standard-of-Customer-Service.png 628 1200 Amanda Rogers https://www.sbmabenefits.com/wp-content/uploads/2021/12/SBMA_Website-Logo_250x150.png Amanda Rogers2022-10-23 07:00:522022-11-18 10:05:52Why SBMA is the Gold Standard of Customer Service

Preventative Services Covered by MEC

August 7, 2022/in MEC, News

Minimum essential coverage is health insurance that meets the Affordable Care Act requirements. Employers have a requirement to offer at least Minimum Essential Coverage to any benefit-eligible employee. Non-compliance can result in a penalty of $214.17 PER eligible employee per month without coverage.

 

Take a look at our MEC calculator to discover how much you can save by investing in MEC for your employees.

 

At SBMA, we aim to offer affordable, flexible, and compliant coverage for all employers.

What Does Basic MEC Cover?

Our Basic MEC plans cover 100% of preventive services and wellness visits to the doctor. In addition, all members have access to 24/7/365 telehealth services and discounts on generic and brand prescriptions. 

 

These plans are the most affordable option under Minimum Essential Coverage. 

What Does Ultimate MEC Cover?

Ultimate MEC covers the preventative services and wellness visits mentioned above, as well as primary care and specialist visits with a $15 copay. As well as urgent care, labs, and X-rays with a $50 copay. 

 

24/7/365 telehealth services are included under this plan, along with access to behavioral health telehealth services

 

Prescriptions under the Ultimate MEC plan are covered based on your coverage tier.

 

*$50 fee max 3 per year

Preventative Services Covered Under MEC

Both plans cover preventative services and wellness visits. The services covered depend on age and gender. Here’s a look at the coverage offered under preventative services:

Covered Preventative Services for Adults

  • Abdominal aortic aneurysm one-time screening for men of specified ages who have ever smoked
  • Alcohol misuse screening and counseling
  • Aspirin used to prevent cardiovascular disease in men and women of certain ages
  • Blood pressure screening for all adults
  • Cholesterol screening for adults of certain ages or at higher risk
  • Colorectal cancer screening for adults over 50
  • Depression screening for adults
  • Diabetes (Type 2) screening for adults with high blood pressure
  • Diet counseling for adults at higher risk for chronic disease
  • Falls prevention (with exercise or physical therapy and vitamin D use) for adults 65 years and over
  • Hepatitis B screening for people at higher risk
  • Hepatitis C screening for adults at increased risk, and one time for everyone born 1945 –1965
  • HIV screening for everyone ages 15 to 65, and other ages at increased risk
  • Immunization vaccines for adults — doses, recommended ages, and recommended populations vary: Hepatitis A, Hepatitis B, Herpes Zoster, Human Papillomavirus, Influenza (flu shot), Measles, Mumps, Rubella, Meningococcal, Pneumococcal, Tetanus, Diphtheria, Pertussis and Varicella
  • Lung cancer screening for adults 55 – 80 at high risk for lung cancer because they’re heavy smokers or have quit in the past 15 years
  • Obesity screening and counseling for all adults
  • Sexually Transmitted Infection (STI) prevention counseling for adults at higher risk
  • Statin preventive medication for adults 40 to 75 years at higher risk
  • Syphilis screening for all adults at higher risk
  • Tobacco use screening for all adults and cessation interventions for tobacco users
  • Tuberculosis screening for certain adults with symptoms at higher risk

Covered Preventative Services for Women

  • Anemia screening on a routine basis for pregnant women
  • Breast Cancer Genetic Test Counseling (BRCA) for women at higher risk for breast cancer (counseling only; not testing)
  • Breast cancer mammography screenings every 1 to 2 years for women over 40
  • Breast cancer chemoprevention counseling for women at higher risk
  • Breastfeeding comprehensive support and counseling from trained providers, and access to breastfeeding supplies, for pregnant and nursing women
  • Cervical cancer screening
  • Chlamydia Infection screening for younger women and other women at higher risk
  • Contraception: Food and Drug Administration-approved contraceptive methods, sterilization procedures, and patient education and counseling, as prescribed by a health care provider for women with reproductive capacity (not including abortifacient drugs). This does not apply to health plans sponsored by certain exempt “religious employers.”
  • Diabetes screening for women with a history of gestational diabetes who aren’t currently pregnant and who haven’t been diagnosed with type 2 diabetes before
  • Domestic and interpersonal violence screening and counseling for all women
  • Folic acid supplements for women who may become pregnant
  • Gestational diabetes screening for women 24 to 28 weeks pregnant and those at high risk of developing gestational diabetes
  • Gonorrhea screening for all women at higher risk
  • Hepatitis B screening for pregnant women at their first prenatal visit
  • HIV screening and counseling for sexually active women
  • Human Papillomavirus (HPV) DNA Test every 5 years for women with normal cytology results who are 30 or older
  • Osteoporosis screening for women over age 60 depending on risk factors
  • Preeclampsia prevention and screening for pregnant women and follow-up testing for women at higher risk
  • Rh Incompatibility screening for all pregnant women and follow-up testing for women at higher risk
  • Sexually transmitted infections counseling for sexually active women
  • Syphilis screening for all pregnant women or other women at increased risk
  • Tobacco use screening and interventions for all women, and expanded counseling for pregnant tobacco users
  • Urinary tract or other infection screening, including urinary incontinence
  • Well-woman visits to get recommended services for women under 65

Covered Preventative Services for Children

  • Alcohol and drug use assessments for adolescents
  • Autism screening for children at 18 and 24 months
  • Behavioral assessments for children at the following ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years.
  • Bilirubin concentration screening for newborns
  • Blood pressure screening for children at the following ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years
  • Blood screening for newborns
  • Cervical dysplasia screening for sexually active females
  • Depression screening for adolescents
  • Developmental screening for children under age 3
  • Dyslipidemia screening for children at higher risk of lipid disorders at the following ages: 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years.
  • Fluoride chemoprevention supplements for children without fluoride in their water source
  • Fluoride varnish for all infants and children as soon as teeth are present
  • Gonorrhea preventive medication for the eyes of all newborns
  • Hearing screening for all newborns, and for children once between 11 and 14 years, once between 15 and 17 years, and once between 18 and 21 years
  • Height, weight, and Body Mass Index measurements for children at the following ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years.
  • Hematocrit or hemoglobin screening for all children
  • Hemoglobinopathies or sickle cell screening for newborns
  • Hepatitis B screening for adolescents ages 11 to 17 years at high risk
  • HIV screening for adolescents at higher risk
  • Hypothyroidism screening for newborns
  • Immunization vaccines for children from birth to age 18 — doses, recommended ages and recommended populations vary: Diphtheria, Tetanus, Pertussis, Haemophilus influenza type B, Hepatitis A, Hepatitis B, Human Papillomavirus, Inactivated Poliovirus, Influenza (Flu Shot), Measles, Meningococcal, Pneumococcal, Rotavirus and Varicella
  • Iron supplements for children ages 6 to 12 months at risk for anemia
  • Lead screening for children at risk of exposure
  • Maternal depression screening for mothers of infants at 1, 2, 4, and 6-month visits
  • Medical history for all children throughout development at the following ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years.
  • Obesity screening and counseling
  • Oral Health risk assessment for young children Ages: 0 to 11 months, 1 to 4 years, 5 to 10 years.
  • Phenylketonuria (PKU) screening for this genetic disorder in newborns
  • Sexually transmitted infection (STI) prevention counseling and screening for adolescents at higher risk
  • Tuberculin testing for children at higher risk of tuberculosis at the following ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years.
  • Vision screening for all children.

Read on for more information on MEC insurance plans and what they cover.

https://www.sbmabenefits.com/wp-content/uploads/2022/07/iStock-1331029732-scaled.jpg 1703 2560 maddie https://www.sbmabenefits.com/wp-content/uploads/2021/12/SBMA_Website-Logo_250x150.png maddie2022-08-07 07:00:532022-07-28 15:25:03Preventative Services Covered by MEC

Understanding the Affordable Care Act Individual Mandate

July 17, 2022/in ACA Compliance, Employee Retention, Employer Resources, MEC

The Affordable Care Act (ACA) implemented the individual mandate, also known as the “individual shared responsibility provision” that requires that most Americans have a qualifying Minimum Essential Coverage (MEC).

Until 2018, those who did not prove themselves to have health insurance when filing taxes were penalized. The Tax Cuts and Jobs Act of 2017 then eliminated that requirement. This bill effectively eliminated the individual mandate penalty, as of 2019 on a federal level.

Read more
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Retaining Employees with Minimum Essential Coverage Plans

July 10, 2022/in Employee Retention, MEC

Over the past two years, employees have been leaving their jobs in record numbers. In fact, this phenomenon, termed The Great Resignation, resulted in 20 million people leaving their jobs in the second half of 2021 alone. Due to mass resignations, employers are searching for solutions to successfully recruit and retain employees.
There are, of course, a variety of factors that contribute to an employee’s decision to leave or stay with a company. Today, we’ll be discussing just one of these factors: How health benefits can contribute to employee recruitment and retention.

Read more
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Review: “Biden Bid to Expand Health Subsidies: ‘Family Glitch’ Explained“

July 3, 2022/in ACA Compliance, MEC, News

President Joe Biden continues seeking ways to make healthcare more affordable for Americans. His efforts include aiding over five million people who fall into the ‘family glitch’ of the Affordable Care Act (ACA).

The ‘family glitch’ is a section of the ACA that decreases the ability for families to qualify for health subsidies that make healthcare more affordable.

Read more
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How to Use Your Health Insurance To Meet Your Health Goals

March 20, 2022/in Employee Engagement, Healthy Living, MEC, News, Personal

New Year’s resolutions are known to fall by the wayside just as quickly as they begin. Old habits die hard. The exercise routines, juice cleanse, and promises of a healthier fresh start can easily be put on the backburner. No matter where you are on your health journey – you can still use your health insurance to meet your health goals. But how? It’s simpler than you’d think. Let’s dive in.

Read more
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What Happens if Your Employee Misses Open Enrollment?

February 20, 2022/in ACA Compliance, Employee Engagement, Employee Retention, MEC, Open Enrollment, Personal

There are strict deadlines for open enrollment each year. It opens nationally on November 1st, and closes on January 15th. Some states, such as New York and California, have extended deadlines through January 31st. Click here to see your state’s open enrollment period.

During this period, people have the opportunity to enroll in healthcare coverage, or change their plans. Failing to take action during this time can pose serious consequences because open enrollment is the time employers can take advantage of having health, dental, vision, life and other voluntary benefit insurance plans.

Read more
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Record Number of People Enroll in Health Insurance Coverage

February 13, 2022/in ACA Compliance, Brokers, Employee Engagement, Employee Retention, MEC, News, Open Enrollment

Open enrollment for health insurance in the United States begins annually on November 1st and ends on January 15th. Some states, like California, however, extend the enrollment date for residents to the end of January.

Over the past few years, enrollment rates dipped due to funding cuts from the previous administration for advertisements and navigators aiding sign-ups for coverage.

Read more
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The No Surprises Act: What Plan Sponsors Need to Know

January 30, 2022/in ACA Compliance, Brokers, MEC, News, No Surprises Act

Plan sponsors are no longer allowed, under the No Surprises Act (NSA), to bill an insurer more than the in-network cost for emergency services. The goal of this new piece of legislation is to reduce surprise medical billing costs for the insured seeking emergency services.

Read more
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These cookies collect information that is used either in aggregate form to help us understand how our website is being used or how effective our marketing campaigns are, or to help us customize our website and application for you in order to enhance your experience.

If you do not want that we track your visit to our site you can disable tracking in your browser here:

Other external services

We also use different external services like Google Webfonts, Google Maps, and external Video providers. Since these providers may collect personal data like your IP address we allow you to block them here. Please be aware that this might heavily reduce the functionality and appearance of our site. Changes will take effect once you reload the page.

Google Webfont Settings:

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Privacy Policy

You can read about our cookies and privacy settings in detail on our Privacy Policy Page.

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