(Yahoo
Finance)
The booklet
has been prepared by The Word & Brown Companies, CHOICE Administrators®
Exchanges’ parent company and the nation's leading developer and administrator
of consumer-choice health insurance exchange models.
“Our goal is
to provide simple answers to health reform’s complex issues so that employers
better understand the principal changes that are coming about,” said CHOICE
Administrators President Ron Goldstein. “It is important that employers get
ready for these changes, take advantage of new tax benefits and tax credits,
and prepare for the new employer requirements as established by law.”
One of the
most significant aspects of health reform, as discussed in the new booklet, is
the mandating that every state establish a health insurance exchange by
CHOICE
Administrators has been successfully operating such exchange models since 1996;
and its flagship product, CaliforniaChoice®, is
The new guide
also provides answers to such questions as “Will my current health plan
benefits change?”... “Will I pay more or less for insurance coverage?” ...
“Will I be required to provide employees with health insurance?” In addition,
the guide includes a simple time line of “What happens when ...” along with the
“10 things every employer should know about health reform.”
Goldstein
recognizes that a great many parts to the new legislation have yet to be worked
out, with many awaiting procedural guidelines from various government agencies,
including the state. So while he believes that it’s not too soon for employers
to become educated and aware of the changes, he strongly urges that employers
work with a licensed health insurance broker to help in the process.
“Ultimately
working with a licensed and trusted broker is the best way to make sure that
business is properly prepared for the new realities. Brokers can also answer
any questions regarding changes to benefits, how to select the right health
plan, and how to keep your employees and your business healthy and strong,” he
says.
BizPlan, a medical reimbursement plan based on Internal Revenue Service Code Section 105, has helped tens of thousands family farmers and small business owners receive 100 percent deductibility of their family medical expenses for over 30 years. In 2008, the average BizPlan client had a total tax savings related to their healthcare premiums and out-of-pocket medical expenses of $4,031.
Every year, TASC,
the third-party benefits administrator of BizPlan, collects medical expense
information from clients as part of the adjudication process, which is a
necessary step to ensure compliance with
Thanks to this system, TASC is able to
track the costs of health care for nearly 30,000 small business owners and
their families. Those findings reinforce
those of countless other studies: the cost of health insurance has increased
dramatically over the years. In 2001,
the BizPlan client paid $4,576 on average a year for their family’s health
insurance. By 2008, that average had
risen to $6,719 a year, an increase of nearly 47%.
In 2001, the average BizPlan client reported $3,236 in uninsured medical expenses. By 2008, that average had jumped to $4,719, an increase of 46%. When added to their health insurance premium, the total healthcare costs for BizPlan clients grew from $7,812 annually in 2001, to $11,516 in 2008, an increase of 47%.
BizPlan clients use a legitimate,
proven plan to reduce their medical debt, which reduces the financial strain of
increasing medical costs on the family budget. Those without BizPlan can deduct
100 percent of their medical insurance premiums on their Federal taxes only.
BizPlan clients experience a 100 percent deduction of their medical premiums
and non-insured medical expenses on
their Federal, State and Self-employment taxes.
The moral of the story? Enroll in BizPlan as soon as possible. BizPlan has a solid history of being a reliable hedge against the rising costs of healthcare.
05.21.10While many people are aware the
cost of healthcare continues to rise, they might be surprised to learn just how
significantly costs increase each year. According to the Kaiser Family
Foundation in their March 2009 Trends in
Health Care Costs and Spending, health insurance premiums have consistently
grown faster than inflation or workers earnings in recent years. This report
gives us the startling statistic that between 1999 and 2008, the cumulative
growth in health care insurance premiums was 119%, compared with cumulative
inflation of 29% and cumulative wage growth of 34%.
The figures cited above do not
take into account the added cost of non-insured health care expenses which
families pay for out of their pockets. Examples of out-of-pocket expense are
deductibles, co-payments, and over-the-counter medications.
In a Kaiser Health tracking
poll conducted in February 2009, one in five families reported serious
financial problems due to family medical bills. Consider some of the other
finding of this poll.
·
21% did not fill
a prescription for medicine
·
23% skipped a
recommended test or treatment
·
27% put off or
postponed getting health care they needed
·
35% relied on
home remedies or over-the-counter drugs instead of going to see a doctor
Is there a better way to
reduce the cost of healthcare without reducing or eliminating healthcare
itself?
Older adults and people with disabilities in particular will lose if the Medicare improvements in health reform are not implemented.
People with Medicare now face a gap, or “doughnut hole,” in their drug coverage, when their benefits stop and they must pay the full price for their drugs in addition to the premiums for drug coverage. In 2010, people must spend nearly $4,000 out of pocket to get out of the gap; most never get out and many split pills or stop taking their medicine instead. If we give up on health reform, that coverage gap will grow to more than $7,000 by 2019. Senate leaders and President Obama have promised that the final bill will include a phase-out of the coverage gap by 2019, which is already part of the House health reform bill.
Medicare provides coverage for the treatment of illness and injury, but it falls short in providing affordable coverage of preventive care. Both the House and Senate bills eliminate deductibles and coinsurance for preventive benefits, and the Senate bill would provide 100 percent coverage for an annual health assessment.
One in five people with Medicare who are discharged from the hospital are readmitted within 30 days. Preventable readmissions cost Medicare $12 billion every year. Both the House and Senate bills provide incentives to hospitals to improve care after discharge and for specialists and primary care doctors to improve the coordination of care.
People with Medicare aren’t the biggest losers if Congress gives up on health reform. Over 20,000 people in the U.S. die each year because they lack health insurance, according to the Urban Institute. There are now 50 million people with no health insurance in our country. If we give up on health reform, that number will grow to 54 million in ten years, according to the Congressional Budget Office. Both the House and Senate bills would cover more than 90 percent of U.S. residents.
People who can’t get health benefits through their jobs, or who lose their insurance when they lose their jobs, can now be denied coverage if they have a pre-existing condition. Both the House and Senate bills would make this practice illegal. If we give up on health reform, insurance companies will be able to continue to deny coverage to the people who need it most—those with illnesses needing treatment.
These are the essential elements of health reform: covering the uninsured, prohibiting unfair insurance company practices and improving Medicare. We can’t give up now. We have too much to lose.
11.11.09Medicare Supplement (Medigap) Standards Are Changing in 2010
As you may know, all Medicare Supplements are standardized by the Federal Government. There are currently twelve plans, lettered A through L. No matter what company you go to, a plan with the same letter designation is exactly the same. CMS has recently announced changes to the these standards. These changes will apply to plans that are effective on or after June 1, 2010. Here is an overview of the changes.
1. They have added Hospice coverage as a Basic ''Core'' benefit to all plans. This coverage had already been added as a basic benefit in plans ''K'' and ''L''.
2. They removed coverage for "Preventive Care NOT Covered by Medicare" (as in plans E and J). CMS came to the conclusion that Medicare Part B has changed to cover many more preventive services, and the usefulness of this benefit was greatly reduced, covering only part of an annual physical after Medicare covered the initial physical. They also removed the "At-Home Recovery" (as in plans D, G, I and J). They said that this benefit was confusing and difficult to understand and administer, and changes to Medicare had made this benefit less meaningful.
3. They created a new plan D, which is the same as the current plan D except that the "At-Home Recovery" benefit was taken out.
4. They created a new plan G, which is the same as the current plan G except that the 80% "Medicare Part B Excess" benefit is being replaced by a 100% "Medicare Part B Excess" benefit, and the "At-Home Recovery" benefit was taken out.
5. They eliminated the current E, H, I and J plans as they now duplicated existing Plans.
6. They created a new plan M, which is the same as plan D but with a 50% coinsurance on the Part A deductible.
7. They created a new plan N which is the same as plan D with the Part B coinsurance being paid at 100%, minus a $20.00 copay per doctor visit and a co-pay of $50.00 for an emergency room visit, unless the person is admitted to the hospital.
These changes to the Standardized Plans are only for plans with an effective date after June 1, 2010. If you currently have a plan, or purchase one before that date, your plan will remain the same.
-- David Hecker, Longview TX Insurance AgentBack to Top
The number of individual health insurance policies that do not include maternity coverage has risen dramatically in recent years, prompting concern among consumers and a legislative effort to require California insurers to include the benefit.
About 805,000 Californians have insurance policies that specifically exclude maternity coverage - a number that has more than quadrupled from 192,000 in 2004, according to the California Health Benefits Review Program, which provides independent analysis of proposed health insurance benefits mandates.
"You see this tremendous jump in just a few years. That's where we're going with this," said Assemblyman Hector De La Torre, D-South Gate (Los Angeles County), whose bill to require maternity coverage is headed to the Assembly Health Committee today. Insurance companies are "pushing these policies clearly onto people, and people are making their decisions based solely on dollars and cents."
As more people lose their jobs - and along with that, their health insurance benefits - an increasing number are expected to turn to the individual health insurance market for coverage, an option that is usually less expensive than paying to stay on their former employers' health plans.
De La Torre's bill, AB98, would require all health insurance products regulated by the state Department of Insurance to include maternity benefits. Gov. Arnold Schwarzenegger vetoed a similar bill authored by De La Torre last year as well as one introduced in 2004 by then-Sen. Jackie Speier, D-Hillsborough.
Health insurers and consumers who support the right to buy a policy that excludes maternity benefits say they shouldn't have to pay for a service they have no intention of using. They say requiring such coverage would increase premiums and force more people to go without insurance.
"Clearly there are a number of people out there who don't think they need or want a maternity benefit at this point in their lives and recognize there is a significant reduction in costs associated with this," said Ben Singer, spokesman for Anthem Blue Cross, which covers about half of the individual policyholders in the state who do not have maternity coverage. Singer said requiring the benefit could increase premiums by as much as 107 percent for some members.
Supporters of the mandate, however, argue that denying coverage is unfair to women and that, in exchange for an average $7.17, or 4.24 percent, increase in monthly premium price per individual policyholder, society would save money if fewer women were on government-supported programs.
De La Torre argued that excluding maternity flies in the face of the insurance philosophy of shared risk. "Why do women pay for prostate cancer? Why do men pay for breast cancer? Because that's the whole point of insurance," he said.
The controversy is limited to individual insurance coverage because group policies, those provided by an employer or group, include maternity benefits. Health maintenance organizations, or HMO plans, are required by the state to have maternity coverage, but preferred provider organization, or PPO, service plans are free to exclude the benefit.
People who buy individual plans typically do not have access to group coverage. They can be self-employed, work for an employer that does not provide health insurance or simply choose such policies as the most affordable options.
But with the growing popularity of such policies without maternity coverage - such as Anthem Blue Cross' low-cost Tonik plans, which are geared toward young adults - finding an affordable individual plan with the coverage can prove to be a daunting task.
When Wendy Root Askew of Monterey started looking for a doctor she hoped would be her gynecologist as well as deliver her future children, she was shocked to discover her health insurance policy didn't include a single OB/GYN in her county.
The 31-year-old considered changing health plans. But then she learned that while 85 percent of the plans available in Monterey County offered maternity coverage five years ago, just 15 percent offer it now.
She found only two individual policies that included maternity, but they were three to five times as much as the policy she already had and came with annual deductibles of up to $15,000.
"Who's going to be buying policy with a $10,000 or $15,000 deductible? Clearly only those women who are intending to use the service," said Askew, who went from running her own business to working for an employer that offers group health insurance. She said she made the decision in part because the job offered comprehensive health benefits.
Health insurers are not uniformly against mandating maternity benefits. Kaiser Permanente, which as an HMO is required to include maternity, has supported maternity mandates along with Blue Shield of California, which has come out in favor of De La Torre's bill. The California Association of Health Plans has not taken a position, while another insurance trade group, the Association of California Life & Health Insurance Companies, publicly opposes the bill.
Several states, including Massachusetts, New Jersey and New York, already have laws in place requiring plans to pay for maternity services.
Anthem Blue Cross' Singer said that those states have much higher rates for individual insurance coverage than California.
"The point of insurance is to insure against catastrophic care costs. That's what you're trying to aggregate and pool for such things as heart attacks and cancer," he said. "Having a child is a matter of choice. Dealing with an adult onset illness, such as diabetes, heart disease breast or prostate cancer, is not a matter of choice."
Patricia Bellasalma, president of the California National Organization for Women, noted that not all pregnancies are planned. She said some insurance companies are discriminating against women.
"The philosophy of the insurance company on maternity coverage - the only pool of risk takers are women - is that all of the obligations to pay for child bearing is born solely on the woman and not on the man and not on society, which is just outrageous," she said.
Women in California pay an estimated 39 percent more than men for coverage in the individual market. San Francisco City Attorney Dennis Herrera filed a lawsuit against the state in January over the issue. Legislation also has been introduced by state Sen. Mark Leno, D-San Francisco, and Assemblyman Dave Jones, D-Sacramento, to forbid gender rating.