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Health Insurance Solutions – Useful News and Information
|HISI WELCOMES FREEDOM ENTERPRISES TO OUR CLIENT LIST|
Posted: 3/28/2013 8:41:24 AM | By: Nanette Poserina
File Under: HISI News
HISI WELCOMES FREEDOM ENTERPRISES TO OUR BENEFITS CLIENT LIST
Health Insurance Solutions welcomes Freedom Enterprise Incorporated, a member of the U.S. Green Building Council, to our client benefits list.
Located in East Norriton, Pennsylvania, Freedom Enterprise, Inc. (FEI) is an experienced construction service company dedicated to quality construction and efficient management of resources. Their track record of major projects - including new construction, renovation and restoration - has earned them a reputation for being creative, technologically advanced and extremely responsive to their customers.
Their two greatest assets are their people and their integrity. Freedom Enterprise employees are experienced, well-educated professionals. Their competitive advantage stems from the atmosphere of mutual trust and respect that permeates the company. The care and concern that they have for their employees and subcontractors greatly enhance their ability to deliver quality projects on time and within budget.
Above all, they are dedicated to their customers and their projects.
|HISI WELCOMES SALEM COUNTY AS OUR NEWEST CLIENT|
Posted: 3/28/2013 8:26:24 AM | By: Nanette Poserina
File Under: HISI News
HISI WELCOMES SALEM COUNTY AS OUR NEWEST CLIENT
Health Insurance Solutions welcomes Salem County located in New Jersey as our newest client effective March 1, 2013!
Salem, which means “peace,” is a place steeped in history and tradition. The county is the site of the first Quaker Colony in North America established in 1675. The majestic Salem Oak, which still stands today, is said to be the site where John Fenwick, a member of the Religious Society of Friends, entered into a treaty with the Lenni-Lenape tribe for the land that is Salem County today.
Salem County has partnered with HISI to receive substantial savings for their Employees Benefits based on HISI's innovative solutions. Their more than 950 employees and families will "see the difference" including employee contributions, custom benefit design, and the deep savings in premiums based on HISI's purchasing power.
Welcome to Salem County!
|EMPLOYMENT-BASED HEALTH INSURANCE IN U.S. DECREASED IN LAST DECADE|
Posted: 3/5/2013 1:30:57 AM | By: Nanette Poserina
File Under: HISI News
EMPLOYMENT-BASED HEALTH INSURANCE IN U.S. DECREASED IN LAST DECADE
By IFAwebnews Staff
Posted: March 4, 2013
The rate of employment-based health insurance coverage declined from 64.4% in 1997 to 56.5% in 2010, according to a U.S. Census Bureau report, Employment-Based Health Insurance: 2010.
Among employed individuals, employment-based coverage declined from 76.0% in 1997 to 70.2% in 2010. During this time period, the employment-based coverage rate for those not in the labor force declined from 45.4% to 38.6% and for unemployed individuals declined from 33.5% to 30.8%. Individuals not in the labor force are people without jobs who are not currently looking for work, while unemployed individuals are people without jobs who are actively seeking employment.
During the same period, among employed individuals without coverage the rate increased from 14.7% to 18.0%, and the rate for those not in the labor force increased from 12.4% to 14.4%. A higher proportion of unemployed individuals were uninsured in 2010 (46.2%) than in 2005 (39.8%) and 2002 (43.1%).
“The report highlights the prevalence of employment-based health coverage among various socio-economic groups including coverage obtained outside the workplace,” said Hubert Janicki, an economist with the Census Bureau’s Health and Disability Statistics Branch. “Unemployed and individuals not in the labor force with employment-based coverage were generally covered by a previous employer’s plan or someone else’s, such as a spouse’s or a parent’s employer.”
The report uses data from the Survey of Income and Program Participation to examine the characteristics of people with employer-provided health insurance coverage as well as the characteristics of employers that offer health insurance. The economic and demographic characteristics studied in this report include sex, race and ethnicity, age, family income and insurance status.
Likelihood of coverage increased with income
The report finds that the likelihood of working for an employer that offers any health insurance benefits increased with family income. Individuals with family income less than 138% of the federal poverty level were the least likely to work for an employer that offered health insurance benefits. Among these low-income workers, 43.3% were employed in firms that offered health insurance benefits. In comparison, workers with family income 401% and above of the federal poverty level were the most likely to work for an employer that offered health benefits (80.9%). For reference, 100% of the federal poverty level for a family of four was $22,113 in 2010.
The report details reasons for nonparticipation in an employer’s health insurance plan. The report finds that the fraction of workers that reference “ineligibility” as the main reason for nonparticipation in an employer’s health insurance plan decreased from 37.1% in 1997 to 32.2% in 2010. Nonparticipating employees were not eligible to participate in the employer’s health insurance plan typically because they were temporary, worked part time or had not completed their probationary period.
• In 2010, 71.1% of employed individuals age 15 and older worked for an employer that offered health insurance benefits to any of its employees.
• 42.9% of individuals who did not complete high school worked for an employer that offered health insurance to any of its employees, compared with 78.9% for individuals with a college degree.
• 75.7% of workers age 45 to 64 worked for an employer that offered health insurance benefits, compared with 60% for workers 19 to 25.
• Among married couples with only one member employed in a firm that offered health insurance benefits, 68.7% of married couples provided coverage for the spouse.
• While 37.6% of firms with zero to 24 employees offered more than one health insurance plan, 65.6% of firms with 1,000 or more employees offered more than one plan.
• About 1.1% of nonparticipating workers whose employer offered health insurance benefits were not insured by their employer because they were denied coverage.
• Among nonparticipating workers whose employer offered health insurance benefits, approximately half (50.4%) declined coverage by choice.
• The two most common reasons among workers who chose not to obtain health insurance coverage through their employer were health insurance obtained through another source (66.4%) and cost (27.4%).
© 2013 New Horizon Group, Inc. :: Insurance & Financial Advisor : IFAwebnews.com ::
|REPORT: SHIFT IN HOW EMPLOYERS WILL DELIVER FUTURE HEALTH BENEFITS|
Posted: 3/5/2013 1:23:15 AM | By: Nanette Poserina
File Under: HISI News
REPORT: SHIFT IN HOW EMPLOYERS WILL DELIVER FUTURE HEALTH BENEFITS
By IFAwebnews Staff
Posted: March 4, 2013
In the wake of unprecedented health care market changes and rising health care costs, new survey findings from Aon Hewitt reveal that the way U.S. employers offer, manage and deliver health care benefits to employees is likely to change significantly in the coming years.
According to Aon Hewitt, the amount employers spend on health care has increased by 40% in the past six years to about $8,800 per employee. Over this same period, employee premium and out-of-pocket costs have increased 64% to almost $5,000 per year. Aon Hewitt estimates that health care costs for both employers and employees will continue to rise 8% to 9% per year for the foreseeable future. Worsening population health issues, including obesity, smoking and failure to comply with medications, are expected to significantly contribute to the rapid rise in health care costs.
Despite these challenges, Aon Hewitt’s survey of nearly 800 large and mid-size U.S. employers covering more than 7 million employees found that 94% of those surveyed will continue to offer health benefits to their employees in the next three-to-five years. However, of those employers, almost two-thirds plan to move away from a traditional “managed trend” approach to one that requires participants to take a more active role in their health care planning.
“The health care marketplace is becoming increasingly complex. New models of delivery, new approaches to managing health, and new compliance requirements are challenging employers to think differently about their role in ‘owning’ health insurance responsibilities for employees and their dependents,” said John Zern, executive vice president and the Americas Health & Benefits practice director for Aon Hewitt. “Employers are staying in the game, but they are taking bold and assertive steps to achieve more effective results—and they are doing so at a faster pace than we’ve seen in prior years.”
Adopting “pay for performance” philosophies
Aon Hewitt’s survey found that in the next three-to-five years, almost 40% of employers expect to migrate toward a “house money/house rules” approach. Under this model, employers may reserve a portion of their health care dollars for those employees who exhibit good health behaviors or who can show measurable progress toward their health goals. For example, participants who take health risk questionnaires and biometric screenings may be rewarded in the form of lower premiums or access to broader health coverage. Other employers may waive prescription drug co-pays if an employee demonstrates they are following their doctor’s orders with regard to a chronic condition. Lastly, some leading-edge employers are working with health plans to incentivize participants to use a small provider network of high quality, cost-efficient providers.
“Over the past decade, employers have reserved an increasing portion of their cash compensation program to pay-for-performance bonus programs,” said Zern. “We see similar approaches emerging with health benefits, which reward those employees who actively participate to achieve improved health outcomes.”
Growing interest in private health care exchanges
While still an emerging trend, private health care exchanges are quickly generating interest among employers. In this model, employers continue to financially support health insurance, but enable employees to choose from multiple plan options and insurance carriers via a competitive, fully insured health insurance marketplace. The exchange model assumes many of the health benefits responsibilities that employers historically manage—including plan design, insurance carrier selection and management, user experience and behind-the-scenes administration.
“Private health care exchanges allow employers to re-create a competitive marketplace for health insurance based on consumer choice, which will encourage insurance companies to drive the system toward greater efficiency,” said Jim Winkler, chief innovation officer for the U.S. Health & Benefits practice at Aon Hewitt. “While this option may not be a fit for every employer, it is increasingly attractive to those organizations that want to offer employees health care choice while lowering future cost trends and lessening the administrative burden associated with sponsoring a health plan.”
According to Aon Hewitt’s survey, about 28% plan to move into a private health care exchange over the next three-to-five years. In January 2013, for example, more than 100,000 U.S. employees enrolled in their health benefits through Aon Hewitt’s Corporate Health Exchange, the nation’s first and only operational fully insured, multi-carrier health care exchange.
Exiting health care completely
Aon Hewitt’s survey shows the vast majority of employers do not view the emerging individual insurance market as a replacement for the employer-based system in place today. Just 6% of employers said they plan to exit health care completely in the next three-to-five years.
“The allure of exiting completely is strong until you look at the numbers,” said Winkler. “Between the Affordable Care Act penalties for failing to offer coverage and the ensuing talent flight risk, most employers believe they need to continue to play a role in employee health, but want a different and better outcome.”
“Regardless of the role the employer plays in managing health benefit plans, every organization needs to be committed to maintaining a healthy, high performing workforce that is engaged and ready to work every day,” added Zern. “This is increasingly true in the global, mobile workforce of tomorrow.”
© 2013 New Horizon Group, Inc. :: Insurance & Financial Advisor : IFAwebnews.com
|AFFORDABLE CARE UPDATE - TAXES AND FEES AND HOW THEY MAY AFFECT YOU|
Posted: 10/26/2012 8:05:53 AM | By: Nanette Poserina
File Under: HISI News
Taxes and fees — and how they may impact you
Affordable Care Act update for insured and self-funded plan sponsors
The Affordable Care Act (ACA) includes a number of provisions that affect both insured and self-funded plans. Those provisions include four new taxes and fees, which we expect to impact the cost of plans going forward. The responsibility for paying the new taxes and fees will fall on both health insurers and plan sponsors. This flyer discusses these four new taxes and fees. While we are still awaiting final regulatory rules and guidance on how each of these taxes and fees will be calculated and paid, we want to help you stay up to date based on what we know at this time. We will provide you with updated information about how we expect them to impact your health plan as additional regulatory guidance becomes available.
New taxes and fees coming soon These four ACA-mandated taxes and fees are expected to impact health plan(s):
* Health Insurer Fee
* Transitional Reinsurance Program Contribution
* Patient-Centered Outcomes Research Fee (also known as the Comparative Effectiveness Fee)
* High-Value Plan Tax (also known as the “Cadillac Tax”)
Because the new federal fees will impact the cost of plans going forward, we feel it’s important for you to understand each fee. By doing so, you can better anticipate and plan for the expected impacts. Research conducted by the National Federation of Independent Businesses (NFIB) in November 2011 suggests that insured premiums will increase by at least 2-3 percent as a result of the Health Insurer Fee alone. A study published by Oliver Wyman in October of 2011 1 found that the combination of the Health Insurer Fee and Reinsurance Contribution will, when fully implemented, increase the average cost of family coverage by $530 in the small group market, and $550 in the large group market. For 2014 this works out to approximately 4 percent of premiums. The chart offers a summary for each of the four fees.
Other ACA taxes are expected to impact health plans indirectly
In addition to taxes and fees on health plans, the ACA also imposed new annual taxes on pharmaceutical companies with more than $5 million in sales, beginning in 2011. Between 2012 and 2019 the aggregate tax ranges from $2.8 to $4.1 billion, and continues thereafter. Beginning in 2013, the ACA also imposes an excise tax of 2.3 percent on the sale of any taxable medical device. To the extent that the pharmaceutical and medical device companies incorporate the impact of these taxes into the cost of drugs or medical devices, they will affect your premiums and/or claim costs.
Health Insurer Fee Insured plans only
Description: Health insurers will have to pay an annual fee to offset at least a portion of the expense related to premium subsidies and tax credits to be made available to qualifying individuals purchasing health insurance coverage on the exchanges beginning in 2014.
Fee: Industry fee of $8 billion in 2014, increasing to $14.3 billion in 2018, and increasing each year thereafter at the rate of premium growth.
Impacted products: All medical, dental and vision plans except: Medicare Supplement; coverage for specific diseases; hospital/fixed indemnity coverage; Accident/Disability-only overages; Long-term care; and Stop Loss.*
YEARS: Ongoing 2014 and beyond.
Transitional Reinsurance Contribution Program Insured and self-funded plans
Description: Used to fund state non-profit reinsurance entities to help finance the cost of high-risk individuals in the individual market.
Fee: Aggregate fee of $25 billion over the three-year period.
Impacted products: All medical plans except: Medicare, Medicare Supplement, Medicaid, SCHIP; excepted benefit plans (i.e., standalone vision and dental plans); and Stop Loss.*
YEARS: Temporary 2014 to 2016.
Patient-Centered Outcomes Research Fee Insured and self-funded plans
Description: Will be used to fund clinical outcomes effectiveness research.
Fee: $1/covered life in the plan’s first year that ends on or after October 1, 2012, and before October 1, 2013; $2/covered life for plan/policy years ending on or after October 1, 2013, and before October 1, 2014. Fee subject to adjustment for increases in National Health Expenditures in future years. The fee is set to end in 2019.
YEARS: Temporary 2012 to 2019
High-Value Plan Tax Insured and self-funded plans
Description: Fee assessed on high-premium health plans.
Fee: Plans that annually cost more than $10,200 (single) or $27,500 (family) are subject to a 40% excise tax on the amount above those costs. The amounts are adjusted for cost of living, age and gender, and increases in 2019 and beyond by CPI + 1%.
YEARS: Ongoing2 018 and beyond
Learn more about ACA. Visit our website for more about the ACA, its many requirements, and how we are preparing for the changes ahead. Go to www.HealthReformConnection.com.
1 Carlson, C, FSA, MAAA. 2011. Estimated Premium Impacts of Annual Fees Assessed on Health Insurance Plans.
Available at: www.ahipcoverage.com/wp-content/uploads/2011/11/Insurer-Fees-report-final.pdf. Accessed September 19, 2012. Aetna is the brand name used for products and services provided by one or more of the Aetna group of subsidiary companies, including Aetna Life Insurance Company and its affiliates (Aetna). The content of this brochure is not intended to be legal or tax advice and should not be construed as such. The intent is to provide information only. We encourage you to consult with your legal counsel and tax experts for legal and tax advice. Benefits and insurance plans contain exclusions and limitations. Information is believed to be accurate as of the production date; however, it is subject to change. For more information about Aetna plans, refer to www.aetna.com.
|BROKERS & EMPLOYERS: CONSIDER A MEDICARE CARVE-OUT OPTION FOR BENEFIT COST REDUCTION.|
Posted: 12/5/2011 9:14:06 AM | By: Nanette Poserina
File Under: HISI News
Express Scripts — your smart choice for Medicare.re Solutions 2
As a plan sponsor trying to determine the best Medicare program to offer your retirees, you may find it difficult to decipher all the complexities. Medicare comprises many moving pieces. There are a lot details to understand and manage. On the plus side, you have a varietyof options available, and we have the expertise to help you implement the optimum solution.
Express Scripts is an industry-leading pharmacy benefit manager (PBM) with extensive knowledge of Medicare programs and requirements. Our experience, clinical insight and operational strength are delivered through a dedicated team of experts. At Express Scripts, we are always in alignment with you. That means your best interests are our best interests.
And because we are on the same side, we develop your Medicare offering as if our own dollars and beneficiaries were at stake.
We understand your goals are to provide a quality benefit, simplify plan management and get the best value for your plan dollar. Our best practices focus on evidence-based clinical solutions and member satisfaction, while maximizing cost effectiveness. Since no two situations are identical, we first evaluate your specific circumstances and then define the optimal strategy. The result is an effective and appropriate plan tailored to your unique needs.
Put your best option in play. Avoid leaving money on the table. Express Scripts has demonstrated expertise in reducing both operational costs and drug spend while maximizing Centers for Medicare & Medicaid Services (CMS) reimbursement. More than 400 plan sponsors who have opted for retiree programs through Express Scripts have received over $1.5 billion in federal subsidies or savings on retiree prescription drugs. We will work with you to determine which type of Medicare program yields the optimum benefit for your plan and your retirees. Our proprietary analytics and savings modeling allow us to compare options and develop a solution that saves your plan the most money and best meets the needs of your retiree population. In addition, a well-run Medicare program can help reduce your total healthcare spend. Through cost-effective, clinically appropriate programs and targeted, behavioral science-based messaging, beneficiary claims can be managed to the lowest possible cost.
Your Medicare prescription benefit options include:
Prescription-Drug Plan (PDP)
Retiree Drug Subsidy (RDS)
Medicare Part B plan paired with either of the PDPs or an RDS plan
The Express Scripts Medicare Part B program is both a complement to your other Medicare programs as well as a stand-alone option. It is a “complete solution” because we handle virtually everything for you.
|PAHU HEALTH REFORM: RESOURCES|
Posted: 10/27/2011 10:17:53 PM | By: Nanette Poserina
File Under: HISI News
PAHU’S PATH TO CONSTRUCTIVE HEALTH REFORM: RESOURCES
PAHUs Letter to Congress on Health Reform
<<< Click Here >>>
** NAHU's Magazine**
The Health Insurance Underwriter!
We believe all Americans deserve a health care system that delivers both world-class medical care and financial security. Americans deserve a system that is responsible, accessible and affordable. This system should boost the health of our people and our country's economy. Americans also deserve a system that is realistic. An American Solution—NAHU's Vision for Affordable and Responsible Health Care Reform
is a comprehensive approach to meeting this challenge, and a yardstick for evaluating other proposals.
NAHU believes the following issues to be critical when maintaining a responsible, accessible, and affordable healthcare system for all Americans.
Value of Agents, Brokers and Consultants
As implementation of the Patient Protection and Affordable Care Act (PPACA) progresses, NAHU is dedicated to ensuring continued access to the crucial services of state-licensed health insurance agents, brokers and consultants who work on a daily basis to help individuals and employers of all sizes purchase health insurance, use their coverage effectively and make sure they get the most out of the benefits they have purchased. Consumers' need for help from a licensed professional will only increase as the new health reform law is fully implemented and the compliance demands on employers and individuals increase.
Learn more about this issue
Containing Health Care Costs
By far, the greatest access barrier to health insurance coverage in America today is cost. Constraining skyrocketing medical costs is the most critical—and vexing—aspect of health care reform. The cost of health care delivery is the key driver in rising health insurance premiums and it is putting the cost of health insurance coverage beyond the reach of many Americans.
Learn more about this issue
The establishment of health insurance exchanges is one of the most far-reaching aspects of the private health insurance reforms contained in PPACA. Exchanges will transform our nation's private health care marketplace for individuals and small businesses buying coverage. Since it is the professional role of health insurance agents and brokers to provide consumers with accurate information about their health coverage options, exchange participation is a natural fit.
Learn more about this issue
Great care needs to be taken when implementing health insurance market reforms to prevent cost increases in the existing private market system. No matter how fair a market reform idea might seem on its surface, it's not at all fair if it also prices people out of coverage options.
Learn more about this issue
Many Americans would be caught completely unprepared if they or a loved one were faced with a medical crisis that required long-term care. This lack of preparation has led many to either self-finance their care or rely on the over-burdened Medicaid system when faced with a long-term care crisis. But now that the baby boom generation is aging, the Medicaid program is becoming increasingly financially strapped. NAHU believes policymakers should take additional steps to encourage Americans to make the financially responsible decision to purchase private long-term care insurance. If more individuals were able to privately finance their long-term care needs, the cost savings to both the federal government and the states in reduced Medicaid expenditures would be enormous. In addition, Congress needs to review the long-term financial stability of the new government-sponsored Community Living Assistance Services and Support Act (CLASS Act) long-term care program and how it could impact the private long-term care insurance marketplace.
Learn more about this issue
Preserving Private Medicare Choices
All Americans, including Medicare beneficiaries, need to have a wide range of health plan choices available to them and the ability to pick the policies that best suit their individual needs. Congress should not limit the ability of seniors to access any Medicare coverage option, including Medicare Advantage plans, nor should they restrict senior access to the services of licensed professional health insurance producers. Preserving the financial stability of the Medicare program, and its private option counterparts, is also critical
|SELF-INSURING CALLED 'MOST COST EFFECTIVE WAY' TO CUT HEALTH COSTS. |
Posted: 5/8/2011 8:43:38 AM | By: Nanette Poserina
File Under: HISI News
SELF-INSURING CALLED 'MOST COST EFFECTIVE WAY' TO CUT HEALTH COSTS.
By Bob Graham
Posted: May 5, 2011
The nation’s homepage for insurance industry news
The “most cost-effective way” for employers to rein in soaring health care costs is to self-insure, according to a research organization focused on using business technology and management principles to control health care costs.
In a white paper, the Healthcare Performance Management Institute suggests that the exemptions from state insurance mandates and premium taxes granted to self-insured health plans enables self-insured companies to develop more customized plans and devote more resources to their employees.
Opting to self-insure could allow employers to “regain control over their health benefits,” George Pantos, executive director of the HPM Institute and a former under secretary of the U.S. Commerce Department, said in a statement.
The white paper suggests that self-insuring allows employers to control cost by enabling them to:
- Obtain more specific information about their actual healthcare expenditures.
- Control costs because they pay for routine expenses such as doctor visits, procedures and prescription drugs through a self-insured plan, obtaining lower-cost catastrophic or “stop-loss” policies to cover major medical events.
- Enable better “human capital management” by recognizing in advance what types of health events are emerging in their covered population in time to help employees avoid a catastrophic event.
The Bethesda, Md.-based group describes itself as a research and education organization dedicated to promoting the use of business technology and management principles that deliver better and more cost-effective health care benefits for employers who cover their employees.
© 2011 New Horizon Group, Inc. :: Insurance & Financial Advisor : IFAwebnews.com :: NS 27 queries. 0.646 seconds
|HEALTH REFORM SUMMARY & LEGISLATION OVERVIEW|
Posted: 4/13/2010 8:18:55 PM | By: Nanette Poserina
File Under: HISI News
LEGISLATION OVERVIEW OF HEALTHCARE REFORMS MARCH 23, 2010
On March 23, 2010, President Obama signed H.R. 3590, the Patient Protection and Affordable Care Act and on March 30, 2010, H.R. 4872, the Health Care and Education Affordability Reconciliation Act of 2010, a companion package of "fixes" to H.R. 3590, was signed into law. These two measures make the most profound changes to our country's private-market health care system in 50 years. Many provisions of the new health reform law impact American employers and private health insurance consumers immediately, while others take effect over the course of the next eight years. Below is pertinent information that will assist you in understanding all the reforms and changes:
Text of H.R. 3590, the Patient Protection and Affordable Care Act.
Text of H.R. 4872, the Health Care and Education Affordability Reconciliation Act of 2010.
View NAHU's side-by-side comparison chart outlining what was contained in each bill.
View NAHU's side-by-side comparison chart of all four pieces of legislation considered by the 111th Congress.
Read the Q & A from NAHU's health reform webinars.
The two final pieces of legislation total nearly 1,000 pages and contain market reforms, an individual mandate, the creation of exchanges, new taxes and more.
Detailed timelime on health care reforms and their effective dates.
Simplified timeline of implementation that outlines how the health care reform legislation will impact your individual and employer clients.
New tax timeline that gives an overview of the taxes created by the health care legislation and when they go into effect.
One page summaries of the need-to-know facts on some of the major provisions in H.R. 3590.
The new Small Business Tax Credit
Medical Loss Ratio Requirements
Establishing SIMPLE Cafeteria Plans for Small Businesses
Grandfathered Health Plans
Reinsurance Program for Early Retirees
Detailed PowerPoint presentation on health care reform implementation.
Simplified PowerPoint presentation on health care reform implementation targeted for use with your employer clients.
Recording of Health Care Reform: Changes You Need to Know by NAHU CEO Janet Trautwein
The IRS has created three new resources on the small business tax credit:
Joint Committee on Taxation (JCX-18-10): Technical Explanation of the Revenue Provisions of the Reconciliation Act of 2010, as amended, in Combination with the Patient Protection and Affordable Care Act.
SIMPLE Cafeteria Plans for Small Businesses (brief from the American Society of Pension Professionals and Actuaries).
Summary of Potential Employer Penalties Under PPACA (P.L. 111-148) - Congressional Research Service report, April 5, 2010.
Grandfathered Health Plans Under PPACA (P.L. 111-148) - Congressional Research Service report, April 7, 2010
PPACA Grandfather Rule Chart (courtesy of Groom Law Group)
Insurance Coverage of Adult Children up to Age 26 (CRS Memorandum)
Summary of Small Business Health Insurance Tax Credit Under PPACA (P.L. 111-148) - Congressional Research Service
|IMPORTANT QUESTIONS TO ASK BEFORE YOU PURCHASE HEALTH BENEFITS|
Posted: 12/22/2008 7:43:10 PM | By: Nanette Poserina
File Under: HISI News
IMPORTANT QUESTIONS TO ASK BEFORE YOU PURCHASE HEALTH BENEFITS
When purchasing health insurance, is important to ask your insurance agent or consultant the right questions to make sure that you understand what your health plan does and does not cover. Read all of the "fine print" in your health plan brochure. When you receive your policy, take time to read through your policy. You usually have a 10-day free look period.
In order to make an educated decision, we have provided a list of ten important questions you should ask your Insurance Agent, Broker, or Consultant BEFORE deciding to purchase health insurance.
4What insurance companies do you represent?
n We have the largest selection of insurance plans available anywhere. We represent all the top insurance carriers. We will compare the plans for you and find the best match.
4Are you a Captive Agent or Independent Agent/Broker/Consultant?
n A Captive Agent usually represents ONE insurance company and can usually only sell that company's insurance products. An Independent Agent or Insurance Broker usually represents many insurance carriers and can sell a variety of insurance products. We are an Independent Consultant.
4What is the plan calendar year deductible?
n Most health plans have a per person calendar year deductible. Typically, they range from $250, $500, $1,000, or $2,500.
4Will I have to pay a separate deductible for each family member if everyone in my family became ill at the same time?
n Some plans will only require you to pay a two person maximum deductible each calendar year, even if everyone in your family needed extensive medical care.
4What is the plan's maximum out of pocket expenses per year?
n This expense is a total of all deductibles plus all coinsurance percentages plus all applicable "access fees" or other fees.
4What is the plan's coinsurance percentage and what dollar amount is this percentage based on?
n A plan with 80/20 coverage means you pay 20% of some dollar amount. This dollar amount is also known as a stop loss and can vary based on the type of policy purchased. Stop loss can be as little as $5,000 or as much as $20,000. Some policies have NO stop loss.
4What is lifetime maximum benefit if I have a serious illness?
n One of the provisions of the health care reform bill that goes into effect immediately is the removal of lifetime caps on insurance. Many don't pay attention to these existing caps -- which range from $1 million to $8 million -- but they can be devastating to the few who reach them and lose coverage during a catastrophic or chronic illness. By 2014 no annual limits will be allowed.
4Does the plan have unlimited doctor co-pays or is there a limited number of doctor co-pay visits per year?
n Many plans have a limit of how many times you can go to the doctor per year for a co-pay. Usually the limit is 2-4 visits.
4Does the plan offer prescription drug coverage?
n Some plans offer prescription benefits immediately. Other plans require you to pay a separate drug deductible before you can receive prescription medication for a co-pay. Today, many plans offer no outpatient prescription drug co-pay options and only provide you with a discount prescription card that gives you a 10-20% discount on all prescription medications.
4What if I have questions about my policy plan or a medical bill that is not processed?
n HISI is your insurance advocate and partner. Our staff will get answers for questions you may have about coverage or benefits. We will not redirect you to the insurance carrier. We will get the information you need. You will speak to a live person and after hours we have a toll-free hotline that is active 24/7.
Health Insurance Solutions is committed to assisting you with your health insurance choices by simplifying the decision-making process, explaining your options in simple understandable terms, and providing exceptional service to your account long after you have chosen your plan.