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Health Insurance Up 78 Percent Since 2000, Along With Policy Terminations!

Health insurance went up 7.7 percent this year, thats twice the rate of inflation. Premiums have increased by 78 percent since the year 2000 compare that to salary increases of just 20 percent and the real picture starts to have an impact.

Individuals are now averaging a little over $4000 a year in premiums with American families paying out almost $11,500 this year. Companies offering health care benefits now stands at 61 percent this is down from 69 percent in 2000. It’s estimated that over 155 million Americans will get their health care benefits from their employers. To lower the over-all cost of the insurance plans many companies are now offering benefit packages with higher deductibles. It should be noted that this report comes out after a recent Census reported that 1.3 million Americans where added to the ranks of the uninsured during 2005. What becomes clear here is the long term trend towards the decline of coverage supplied by small businesses from their employees.

“To working people and business owners, a reduction in an already very high rate of increase just means you’re still paying more” said Dr Drew Altman, president and chief executive of the Kaiser Foundation.

Insurance companies have been under attack recently for dumping families that build up large medical bills. In an ongoing case in California the state is investigating a claim against Blue Cross who stopped coverage for a family when it’s medical bills reached $20,000. The family have been left with outstanding medical bills of over $60,000. The company have accused the family of failing to disclose in their coverage application an undiagnosed lump on one of the children’s chins. The family say they (or their physician) knew nothing of any tumor when they made the application.

These types of cancellations of coverage have now created a massive backlash towards the insurance companies and resulted in a number of ongoing lawsuits. The policyholders are saying their polices were illegally terminated which resulted in substantial financial hardship. State regulators are investigating and have said they are now preparing to take action against Blue Cross.

Something needs to be done to protect (us) the public against these (insurance) companies. The hardship caused when a family is faced with these medical bills at a time when they really need the most support is nothing short of criminal. Having taken our money every month for years on end they should not have the right to terminate our coverage. They should by law be forced to honor the agreement they wrote and we agreed too.

Health Care Eligibility For Unauthorized Migrants – Moral & Practical Implications

Various organizations and government officials have cited estimates for the number of illegal immigrants at between eight and twenty million. With rising health care costs as a major issue for most Americans, this article considers the moral and practical issues of providing medical care for uninsured immigrants.

According to a research report entitled “The Size and Characteristics of the Unauthorized Migrant Population in the U.S.” {© [2006] Pew Hispanic Center, a Pew Research Center Project}, there are an estimated 11.5 to 12 million unauthorized migrants currently residing within The United States. The report was based on Census 2000 data, as well as the Current Population Survey of March 2005, and the monthly Current Population Surveys through January of 2006. The Pew Hispanic Center uses the term: ‘Unauthorized Migrants’. This term refers to persons residing in The United States who are not U.S. citizens, have not been admitted for permanent residence, and do not have specific authorized temporary status that permits extended residence and work within the United States.

The Pew Hispanic Center report found that the unauthorized population consisted of 5.4 million adult males, 3.9 million adult females, and 1.8 million children. Adult males are in the majority, making up 58% of the unauthorized adult migrants, while females account for 42%.

When discussing the percentage of unauthorized migrants, it is important to consider their labor force participation. Thirty-one percent of unauthorized migrants are employed in service industry jobs, while only sixteen percent of natives work in service. Native workers make up the great majority of white-collar jobs, while unauthorized migrants are underrepresented. Certain occupations have proportionately high concentrations of unauthorized migrant workers: Farming (24%), Cleaning (17%), Construction (14%), Food Preparation (12%), Production (9%), and Transport (7%). This is relevant to the issue of health insurance because the cited industries do not typically provide health insurance coverage.

The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA) addressed eligibility requirements for non-citizens to receive Federal means-tested public benefits. The Act resulted in significant restrictions on immigrants’ eligibility. Such benefits include Medicaid and the State Children’s Health Insurance Program (SCHIP). Certain immigrants are not eligible for Medicaid or SCHIP for five years from the date they enter the United States in a qualified-alien status.

Generally, only “qualified aliens” are eligible for coverage. Who is considered a qualified alien? There are nine basic types of qualified aliens: Aliens lawfully admitted for permanent residence under the Immigration and Nationality Act (INA), 8 USC 1101 et seq.; Refugees admitted under §207 of the INA; Aliens granted asylum under §208 of the INA; Cuban and Haitian Entrants, as defined in §501(e) of the Refugee Education Assistance Act of 1980; Aliens granted parole for at least one year under §212(d)(5) of the INA; Aliens whose deportation is being withheld under (1) §243(h) of the INA as in effect prior to April 1, 1997, or, (2) §241(b)(3) of the INA, as amended; Aliens granted conditional entry under §203(a)(7) of the INA in effect before April 1, 1980; Battered aliens, who meet the conditions set forth in §431(c) of PRWORA, as added by §501 of the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, P.L. 104-208 (IIRIRA), and amended by §5571 of the Balanced Budget Act of 1997, P.L. 105-33 (BBA), and §1508 of the Violence Against Women Act of 2000, P.L. 106-386. Section 431(c) of PRWORA, as amended is codified at 8 USC 1641(c).1; Victims of a severe form of trafficking, in accordance with §107(b)(1) of the Trafficking Victims Protection Act of 2000, P.L. 106-386.2.

Unauthorized migrants will be denied health care with the exception of emergency situations. This policy creates a problem for paramedics and other medical professionals, who will be forced to determine whether the individual’s life is at risk and what constitutes a medical emergency. How emergency health care workers are expected to enforce this policy is unclear. The Department of Health and Human Services is currently working on the terms, with the start date set for less than three months from now.

To receive health care, individuals will be required to provide proof of citizenship or proof that they are eligible as qualified aliens. This requirement creates potential problems for United States citizens, as well as immigrants. The homeless are perhaps the most obvious example of individuals who are eligible for care but may not have the proper documentation. Another, lesser known, example may be African-American senior citizens. African-Americans from the South were not allowed to be born in hospitals and therefore do not have proper birth certificates.

Another issue that needs to be addressed is the potential spread of disease. Testing for Tuberculosis, for example, is something that Americans take for granted. Those initiating and enforcing these policies should consider whether basic medical testing will be provided. Regardless of the apparent moral implications, denying health care services to individuals residing within the United States can easily result in more tangible problems.

Health Care Exchange information

What will the Healthcare Exchange be?  What does it mean?

The Pacific Business Group on Health yesterday released the third and final installment of its comprehensive report on how to ensure that the people joining a health benefit exchange end up with the plan that works best for them.

“The whole notion of the Affordable Care Act and the establishment of the exchange is to improve the overall health care marketplace,” said Ted von Glahn, a senior director at PBGH, a not-for-profit business coalition focused on health care issues.

“If you don’t get it right when people are making those choices,” von Glahn said, “that would defeat the whole purpose of it.”

That’s one of the points of yesterday’s report, that health officials need to make sure that the choice of a health plan for consumers in the exchange becomes both a simple and well-informed decision.

The report, done in three installments, is based on a series of 2,100 interviews overall, conducted in 2012 with low-income participants chosen to mirror the demographic makeup of expected enrollees in the exchange in 2014.

Outside of premium cost, one of the most important factors to increase enrollment among participants is to make the process a simple one. The first recommendation of the report is to offer shortcuts to the choice of a health plan. That simple approach — basically nudging participants to consider common concerns — must be balanced by the flexibility to also present consumers with more detailed and in-depth information about their choices, von Glahn said. Basically, the approach is to simplify choices, but to be able to lay out the more complex components to choosing a plan, such as the level of varying deductible levels a consumer would pay, for instance.

“Because we know there are half a dozen things that stand out, that matter to people, so you want to nudge them to consider certain aspects,” von Glahn said. “But you don’t want to curtail their opinions or needs. You have to give people choices of what they want to choose.”

The cost calculator, for instance, will be an important component of the health plan selection process, von Glahn said.

 

The New Health Care Reform Act Gives Consumer Protections While Strengthen Medicare Benefits

The Affordable Care Act is a new health reform law created in March 2010 to help Americans who are struggling to obtain health insurance. It gives consumers many protections against the abusive practices of the insurance companies. The Act also protects the benefits of Medicare for millions of American elderly who receive this type of health care.

Effects On Medicare

The Affordable Care Act ensures that older Americans will still see reductions on prescription care medications. The Act strengthens Medicare benefits while reducing the amount of fraud that wastes money as the law helps to ensure that recipients receive improved health care.

Better Care Access

With the passing of the Affordable Care Act, millions of Americans can receive free preventative care services without having to pay additional out-of-pocket expenses. People who have pre-existing medical conditions — especially children — cannot be denied health coverage, and young adults can remain on their parent’s health insurance plans up to the age of 26.

People also can shop for the right private health insurance plan that fits into their particular health needs. Through Affordable Insurance Exchanges, a healthcare marketplace, people will be able to compare different health choices that many members of Congress have access to.

Consumer Protections

Millions of Americans were given consumer protections due to the Affordable Care Act. This Act prevents anyone from being denied health insurance, being dropped from their health insurance due to a medical condition and a mistake is found on the insurance application, or having their rates be increased for no reason. Insurance companies will also no longer be able to place lifetime caps on the amount of coverage they give to people who have chronic conditions.

Supreme Court Claims The Affordable Care Act As Constitutional

On June 28, 2012, The Supreme Court ruled that The Affordable Care Act created by President Obama was deemed constitutional. This health reform act would be the first of its kind to affect all Americans across the nation. The health reform act specifically targets insurance companies who have abused consumer rights in several different ways for many years. The Affordable Care Act will also help businesses when it comes to paying insurance premiums for employees.

Consumer Protections

The Affordable Care Act stops insurance companies from canceling your policy or raising your rates without a legitimate cause. The insurance company cannot deny a person coverage if they have a pre-existing medical condition, such as chronic issues like asthma or diseases like cancer. Women will no longer pay higher premiums than men while seniors will continue to save on prescription medication costs.

In August of 2012, many Americans will see a rebate check in their mailboxes. This rebate check will be from insurance companies who spent customers’ premiums toward administrative expenses or for CEO bonuses instead of going toward the healthcare of Americans.

People who are on Medicare will continue to receive their health benefits, wellness visits, and free preventative care as this law takes effect. The only changes to Medicare is to cut down on overspending, fraud, and abuse of the Medicare system.

Benefits To Businesses

Businesses will see more benefits in offering health insurance to employees due to the Affordable Care Act. This healthcare reform will give tax credits to small businesses who offer health insurance, allowing the employers to save on premium costs. The Act will also lower the premium costs, creating more competition between insurance companies obtaining new clients. This benefits business owners who can shop insurance companies and receive the best rates.

With smaller businesses now able to offer health insurance to employees, talented workers are no longer locked in their current jobs to keep their medical benefits. Workers with expertise can chose to give their professional talents toward start-up and small businesses, creating more competition in the workplace and stimulating job growth.

The Future Of The Affordable Care Act

Nobody knows what the benefits and restrictions of this Act will create in the future. Only time will tell if insurance companies will begin to play by the rules or find loopholes to again raise premiums, and if all Americans will truly have better healthcare due to this new health reform law.

The New Health Care Reform Act Debunking Myths And Giving Facts

Unless you’ve been living in a cave, you’ve heard about the new health reform law, The Affordable Care Act, as the law now applies to all Americans. With so much political maneuvering, different political parties vying for the next presidency, and media hoopla, there is a lot of conflicting statements concerning this new Act. What is the truth? What are the myths?

Here is a straightforward breakdown of 5 myths you may have heard and the real facts concerning The Affordable Care Act.

Myth #1: The Affordable Care Act Will Raise The Cost Of Health Care

Fact: Most people are under the impression that this new reform act will cost Americans billions, if not trillions, of dollars. The truth is, The Affordable Care Act will reduce the national deficit by over $3 trillion over the next 10 years as a regular family of four will save over $2,300 on their insurance premiums.

Myth #2: The Affordable Care Act Will Hurt Small Businesses

Fact: The Affordable Care Act will instead lower health insurance premiums so that small businesses can offer health insurance to their employees. Small businesses could see a drop in insurance premiums of up to 4-percent, which saves employers $2,000 per person on health care costs.

Myth #3: Businesses Will Stop Offering Health Insurance To Employees

Fact: If businesses are saving anywhere from 3-to-4 percent on premiums per person on health insurance due to this health care reform act, then employers have no reason to take health insurance away from their employees. It is the hope of many economists that businesses that did not offer health insurance before will now find it affordable enough to offer it to their employees now.

Myth #4: Preventive Services Will Be Restricted On Many Health Care Plans

Fact: The Affordable Care Act will not restrict preventive care. Instead, many Americans have found that their preventive care coverage has improved, with seniors on Medicare obtaining several preventive care services for free.

Myth #5: The Affordable Care Act Will Have The Government Control My Choices For Healthcare

Fact: This has been the biggest fear in most Americans — that their freedom of choice will be taken away. But what this law does is give people more of a choice in their health care instead of having the insurance companies decide on who is covered. The Affordable Care Act allows more people who couldn’t afford health insurance before to obtain it now with the help of tax credits. It also increases consumer health care protections.

While there are still many myths and facts floating around, you now have a clearer picture concerning several debunked myths and the truths concerning the Affordable Care Act.

All of this information was taken directly from the White House web page.

Health Care Reform changes

Here are some changes that are now in effect:

· Require co-pays or co-insurance for preventive services.

· Cap lifetime benefits. (Caps of $1 million to $2 million are now common.)

· Cancel or rescind a policy, except in cases of fraud.

· Refuse to cover pre-existing conditions in children.

In addition, parents in many health plans can keep their young-adult children covered until the age of 26, unless the child gets a job that offers health coverage.

The scope and timing of the changes, however, depends on the type of plan. Some of these changes don’t take effect until Jan. 1, 2011. Other plans are grandfathered, and exempt from the changes. For up-to-date information on the new reforms, go to www.insurance.wa.gov and click on the health reform icon.

Gov Schwarzenegger signs health care bill

The governor signed a bill on Thursday that will establish a web-based insurance exchange that will allow consumers to comparison shop for health insurance coverage.  This legislation makes California the first state to implement an oversight board for insurance exchange marketplaces since the federal health care laws were approved.

“For national reform to succeed, it will be up to the states to make it work, and California is moving forward on reforms that will provide affordable and quality health care insurance,” Schwarzenegger said in a statement.

The two bills, SB900 and AB1602 are said to promote competition in the health insurance marketplace, according to Assembly speaker John Perez of Los Angeles.

Edwin Garcia, a spokesman for Kaiser Permanente, called the exchange “a promising and important part of health care reform” that would make coverage more affordable for millions of low- and middle-income Californians and small business owners. Kaiser insures about 6.5 million people in the state, Garcia said.

The exchange is said to be active by 2014.

Health Care Update – August 20th, 2010

Removing lifetime and annual dollar limits for essential health benefits

As part of the health care reform law, health insurance companies must remove lifetime and annual dollar limits on covered services (in network and out of network) that the U.S. Department of Health and Human Services (HHS) considers “essential health benefits.” This change goes into effect September 23, 2010, although certain annual limits can be removed in phases over the next four years.

HHS has not given us the final definition of “essential health benefits” yet, but based on the information and examples it has released, as well as our own research of current state and federal mandates, we have come up with a list of approximately 26 services we believe will be affected. There may be variations in certain states. The services still may be subject to copays and other cost shares.

This provision of the health care reform law also restricts annual or lifetime dollar limits at the plan level except transitional annual dollar limits as defined in the legislation.

A waiver program will be available for certain types of plans like mini-med and limited benefit plans so they can retain annual plan limits. We are waiting for more information on this program from HHS.

Administrative services only (ASO) plans also are required to comply with the health care reform law lifetime and annual limits provision for plan years that start on or after September 23, 2010. We will provide guidance to ASO clients, but the final decision on how they choose to comply is theirs.

Update on Health Care Reform

Here are some updates on Health Care Reform and how it can affect you or your business.   Remember, you can also visit http://www.healthcare.gov/ to get information.

Unions/collectively bargained plans

Whether fully insured or self-insured, unions must implement the same provisions as other grandfathered plans for plan years beginning on or after September 23, 2010. However, fully insured plans get some special treatment in the interim final grandfathering rules. The following allowances are given to collectively bargained agreements (for the life of the agreement) that were ratified before March 23, 2010:

· The plans may change carriers and remain grandfathered.

· The plans may make benefit plan changes (such as plan design) or change employer/employee organization contribution amounts and remain grandfathered.

· The interim final rules on grandfathering are silent as to whether grandfathered health insurance coverage is exempt from the anti-abuse rules.

When the last of the collectively bargained agreements expires, the special allowances end as well. From that point on, the grandfathered status of fully insured plans will be determined as it is for any other health plan.

Self-funded plans that are kept as collectively bargained agreements are treated like any other plan. For self-funded plans, whether or not they are kept as collectively bargained agreements, a change in third-party administrators will not result in the loss of grandfathered status.

If a group customer requests that we implement health care reform changes earlier or later than its renewal date because its ERISA plan year differs from the renewal date, we will honor the request.

60-day notice of plan changes

Another health care reform law provision requires plans to create a uniform summary of benefits. And any material modifications to the terms of the plan must be communicated to members 60 days before those changes go into effect. Based on our review, we believe that the 60-day notice provision will not go into effect right away; however, it must be implemented before March 23, 2012 (two years after the law was enacted). The U.S. Department of Health and Human Services will be giving us more guidance on this provision. When it does, we will let you know.

No discrimination based on compensation

Benefits cannot be based on wages

The health care reform law notes that, effective September 23, 2010, plans may not discriminate in favor of highly compensated employees. This means that group health plans cannot base eligibility or the level of benefits on an employee’s wage. The group can offer different levels of benefits as long as they comply with ERISA and are not tied to the amount an employee makes. The legislation defines a highly compensated employee is someone who is:

· One of the five highest paid officers.

· A shareholder who owns more than 10% in value of the employer’s stock.

· Among the highest paid 25% of all employees (exceptions apply).

Waiting periods

We do not believe we will need to change our approach to allowing groups to offer different waiting periods to different employee levels. The health care reform law "nondiscrimination by compensation" provision is specific to the benefit offerings of a medical plan and not the waiting periods established by a company.

Grandfathered vs. non-grandfathered plans

No matter how a plan is structured, in order for it to be a grandfathered plan, it must have been in effect when the health care reform law was passed on March 23, 2010, and no changes are made to the benefits or the benefit plan. For non-grandfathered plans, the plan sponsor of a group health plan (other than a self-insured plan) may not set up rules about health insurance coverage eligibility (including continued eligibility) for any full-time employees based on the total hourly or annual salary of the employees. Nor can the sponsor set up rules that in any way favor employees who receive more compensation.

Offering benefits only to currently eligible employees

A group can retain grandfathering status by continuing to offer benefits only to currently eligible employees (instead of all employees), as long as the benefits are not tied to how much those employees make. In addition, the health care reform law notes that the plan sponsor of a group health plan (other than a self-insured plan) may not set up rules about health insurance coverage eligibility (including continued eligibility) for any full-time employees based on the total hourly or annual salary of the employees. Nor can the sponsor set up rules that in any way favor employees who receive more compensation.

Executive physicals

Because this health care reform law provision is specific to plans and not to benefits, executive physicals (and similar benefits) are not affected.

Getting to the bottom of your health care costs

Did you know: Health care fraud and abuse accounts for 3% of health care spending?

The National Health Care Anti-fraud Association estimates conservatively that 3% of all health care spending, or $68 billion, is lost to health care fraud each year – that’s more than $180 million per day.

This content is provided solely for informational purposes: it is not intended as and does not constitute legal advice. The information contained herein should not be relied upon or used as a substitute for consultation with legal, accounting, tax and/or other professional advisers.  We’re just passing along information we are getting in hopes of assisting you in navigating the new rules and regulations as they come.