Recent studies show an alarming trend in California. General Practice physicians are in dwindling supply, and at the lower end of “per capita need”. As fewer and fewer younger physicians enter this field, the inadequacies will become even more dire. On the other hand, specialists seem to be in abundance, but are not distributed throughout the state in an equal manner. Both Specialists and General Practice doctors tend to congregate more in the urban areas, leaving the rural areas without the medical care they need. Add to that the insult of few new general practice recruits, and their current provider population getting older, these individuals can be in real trouble.
Hopes for getting a quick and long term recovery would mean a few things from the state. The first step, of course, would be to get more physicians to study in the field of primary care. This can be done with the help of grants, financial support, and better residency training programs in all fields of general medicine. Providing financial compensation to these new primary care providers would also help to establish care where we most need it. By making it easier to practice in the hard hit areas will ensure that no Californian is without the physicians they need. The only way to achieve this, however, is to make sure that both the patient and doctor are adequately taken care of.
Archive for the ‘Employees’ Category
Reduced General Practice Physicians in California
Monday, July 6th, 2009Educating the Patient With a Chronic Disease
Saturday, June 20th, 2009Once you or your loved one has been diagnosed with a chronic health condition, the most important thing is to become self-aware and gain the ability to manage the impact that this illness will have on your life. The first step is to understand your illness. In doing so you will gain the upper hand in preventing further complications.
Most insurance carriers offer nurse lines specific to your illness and access to support groups. Such groups can be vital for both physical and emotional support, resulting in overall improved health. Subjects covered include:
• Communicating well with your family, friends, and health care providers
• Exploring the possibility of new techniques and treatment options.
• Learning ways to deal with problems such as frustration, low energy, pain management, etc.
• Utilizing exercise to maintain and improving strength and flexibility, and increase endurance
• The proper use of medications
• The role nutrition plays in your healing process
Studies have proven that individual with chronic conditions who take an active role in their treatment plans and take proactive steps to improve their lifestyle have achieved significant advances in their healing process, and fewer hospital, emergency room, and outpatient visits.
Call us with any questions, or access your insurance carrier website to get more information on the management of chronic illnesses.
Medicare Made Easy
Friday, May 29th, 2009For those individuals who are turning 65, the world of Medicare may seem overwhelming. We are here to help you understand the four parts to Medicare Health Insurance. Original Medicare is the federal health insurance program available to people 65 years of age or older. Medicare is also available to younger people with certain disabilities and people with end-stage renal disease – permanent kidney failure living with dialysis or a transplant; it’s sometimes called ESRD.
Part A is Hospital Insurance. This pays for inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
Part B is Medical Insurance. This helps pay for doctors’ services, outpatient hospital care, durable medical equipment and some medical services that aren’t covered by Medicare Part A.
Medicare supplemental insurance is designed to cover the “gaps” in Medicare coverage, such as deductible and coinsurance.
Part D is Prescription Drug Coverage – Like a Medicare Advantage plan, Medicare Part D is available only from private insurers through contracts with Medicare. Joining a Medicare prescription drug plan (Part D) is voluntary, and you pay an additional monthly premium for the coverage. You are eligible to enroll if you are entitled to Medicare hospital insurance (Part A) and/or enrolled in Medicare medical insurance (Part B).
What Does Concierge Medicine Mean?
Friday, May 22nd, 2009 These days you are probably hearing a lot about “concierge medicine”. This is where physicians charge patients an annual fee of several hundred to several thousand dollars a year to ensure benefits like longer appointments, shorter waiting times and the ability to call your provider directly. It has been reported that there are over a thousand physician groups nationwide who are currently operating concierge practices.
Critics claim that these practices result in many patients being driven to emergency rooms and family doctors who remain independent, resulting in overcrowding and long stays in the waiting room. Since there are fewer doctors going into primary care, this too will only add to an already strained system.
However, providers within these systems claim that it can only benefit their patients. The doctor will be able to see fewer patients, allowing more detailed time and services to those they take on. They say that this style of patient care will result in overall improved health of their patients, as they are better able to monitor wellness screens, as well as solidify the doctor/patient relationship.
There are still many providers out there who practice independently, and do not require even more money out of your pocket. Check out the Provider Search on our website to ensure that you are getting the best care for your money.
Assembly Bill 1672 & What it means for Small Business Plans
Monday, May 18th, 2009Small business owners in California received extra protection under the law for their rights with group health insurance when the law AB 1672 was passed in 1992. This new requirement required that group health insurance carriers provide coverage for employees covered under a group health plan, even if they have a pre-existing condition. This new law meant that insurance companies may not deny coverage, and if there is an exclusion period for a pre-existing condition, it must be kept to six months to one year. If an employee was covered by a health plan before joining the group health plan offered by their new employer, this coverage must count towards this exclusion period, as long as the employee’s coverage was enacted within 62 days of losing the previous policy.
Under law AB 1672, a group health insurance provider must renew a group health plan for a small business, as long as two conditions are met: there has been no fraud with the policy and all the premiums have been paid. This prevents insurance companies from offering a small business a group health plan and then arbitrarily canceling it later on.
What Qualifies as a Tax-Deductible Medical Expense?
Friday, May 15th, 2009When it comes to Health Savings Account health plans, one of most common questions we hear is what is a qualified medical expense? As you know, you can use your savings account to cover expenses that are not covered by your health plan, though there are limitations as to what does and does not fall under the definition of eligible medical expense. According to the IRS Publication 502, Medical and Dental Expenses, the general purpose of the health savings account is to cover “Medical expenses are the costs of diagnosis, cure, mitigation, treatment, or prevention of disease, and the costs for treatments affecting any part or function of the body.” Such items that would fall under this category include:
•• Fees paid to medical practitioners
•• Costs of hospitalization or inpatient treatment
•• Dental Expenses
•• Surgery
•• Medical examinations
•• Medications
•• Medical aids
•• Transportation
•• Adding handrails or grab bars anywhere (whether or not in bathrooms)
•• Modifying hardware on doors.
•• Constructing entrance and exit ramps or modifying the areas in front of entrance and exit doorways
Since the definition of what could fall under each category is open to interpretation means that additional clarification is needed in Publication 502. Therefore, the text continues to state “”Medical care expenses must be primarily to alleviate or prevent a physical or mental defect or illness. They do not include expenses that are merely beneficial to general health…”. This means though a much needed vacation can do a world of good, it is not yet a qualified medical expense. Vitamins are also not considered deductible unless they are recommended by a medical practitioner for a specific medical condition diagnosed by a physician.
However, there are many beneficial deductions that will be considered a qualifying medical expense, such as smoking cessation programs (though nicotine gum and/or patches are not) as well as weight loss programs, as long as they are part of a treatment plan prescribed by a physician for a specific disease. You can even deduct health club fees as long as they are part of a physician’s recommended treatment plan.
Please let us know if you have any questions about HSA plans, or click on the link below to read more.
Changes to Federal COBRA for 2009
Wednesday, May 6th, 2009In February of 2009, President Obama signed into law the American Recovery and Reinvestment Act. Designed as part of the economic stimulus bill, this also provides some major assistance to COBRA coverage for certain individuals. Some of the major points to this bill are:
- Will provide for a federal subsidyon the COBRA continuation coverage premiums for qualified beneficiaries due to involuntary termination of employment between Sept. 1, 2008 and Dec. 31, 2009 (Assistance Eligible Individuals)
- Qualified beneficiaries will include the covered employee, the covered employee’s spouse, and covered employee’s dependent children. This means that the spouse or dependents of the involuntarily terminated employee will be eligible for benefits even if the employee does not elect COBRA.
- There will be a federally provided COBRA subsidy of 65% of the amount owed by the Assistance Eligible Individual (AEI). A payment of 35% made by the AEI is considered payment in full. The remaining amount will be covered by the plan, insurer, or employer and will be reimbursed by the government via payroll tax credits. Note – this subsidy is not offered to health flexible spending account plans.
- Those qualified beneficiaries that experienced involuntary termination of employment between September 1, 2008 and February 17, 2009 who did not elect COBRA during the initial 60 day period will now be provided another 60 day election period during which to elect COBRA coverage.
Please call or email us with any questions!
Saving Money on Small Group Plans
Thursday, April 30th, 2009Businesses, especially those with fewer than 5 employees, are really bearing the brunt of the rate increases. However, there are still options out there to save you and your employee’s money.
Carriers are constantly revising their portfolios to meet your needs. For example, Anthem Blue Cross expanded its portfolio to include four new HMO options.
Other ways to save on your Group Health Coverage may be to consider adding on the Section 125 Premium Only Plan. This allows employees to pay certain medical expenses (i.e. their portion of the premium) before taxes are deducted from your paycheck. This increases the employee’s take home pay, and reduces Employer taxes.
Carriers are also offering programs to rival their competitors. For example, small businesses with a lower “Risk Adjustment Factor” may qualify for substantial rate reductions by changing to another carrier. Sometimes even just adding dental and life plans to your current group coverage can also aid in reducing your overall premium.
Please call us today to discuss your current group coverage and ways we can help you to save!
Keeping Employees Aware of Benefit Packages
Monday, April 27th, 2009One of the most important things you need to do as an Employer offering health insurance is to make sure that your employees understand their benefit packages.
Here are some frequently asked questions that employees may have about their group health insurance plan:
How much do they have to pay?
As the employer in a group health insurance policy, it is your responsibility to provide at least some payment for monthly premiums for the policy.
It is important that your employees know exactly how much you will provide and what they will have to pay on the policy. Ideally, this should be answered before an employee signs up for your group health plan to avoid any confusion.
How high is their deductible?
In addition to their monthly premium amounts, your employees should have a clear idea of what their annual deductible will be.
This will help them decide on which plan will best suit their needs, and will be necessary if they plan on using a health savings account to help pay for their premiums.
Is the insurance plan HSA eligible?
With the popularity of health savings accounts growing, your employees will need to know if your group health policy is HSA eligible.
Are there any exclusions in the policy?
Group health insurance is just like any other type of insurance. There will be specific exclusions in your group health plan that your employees will need to know about.
For example, dental care may be excluded from coverage, or preventative screenings may be excluded. It is important to get a list of exclusions for your policy from your health insurance provider.
Will they have coverage for a pre-existing condition?
If your employees have pre-existing conditions, this can affect their group health coverage. They will need to discuss this with your insurance company representative to make sure that they will have the kind of coverage that they need.
These are just some of the important topics you will need to address. As your agent, we will also be happy to answer such questions on your behalf.
