A recent poll shows that 57% of Americans do not like any of the proposed health care bills, and agree that Congress should start fresh, rather than attempting to piecemeal a model from scrapped ideas. Trying to reach a bipartisan agreement as to what needs to be done is not an easy task, but it is vital to ensure that resolution is achieved. These polls shows interesting trend among voters as to how they feel now, as compared to a year ago in regards to health care reform:
Archive for the ‘Group’ Category
Public Views on Health Care Reform
Tuesday, March 2nd, 2010Is There a Answer for COBRA Subsidies?
Monday, January 18th, 2010Worries grow as those Californians who have been receiving assistance with their COBRA premiums are faced with losing financial assistance. As federal stimulus money dwindles, the 65% of premium formerly covered by this subsidy will expire, leaving many to make a tough choice – pay the premiums or go without coverage. COBRA (the Consolidated Omnibus Budget Reconciliation Act) was passed in 1985, allowing involuntarily terminated employees to keep their current health plan, and take over the payments for their monthly premiums. However, after many years and skyrocketing health care inflation, many people are finding that their COBRA premiums are exceeding their unemployment benefits.
If reports are correct in showing that 40% of newly employed people applied for the COBRA subsidy, these numbers can mean that the number of uninsured people will rise along with the lack of federal support. There are some plans in the works, however, which may bring some much needed relief:
HR 3930 would extend the period of eligibility through June 2010, increase the maximum duration of the subsidy to 15 months and end all subsidies at the end of December 2010.
S 2730 by includes the same provisions as the House bill and would also increase the federal subsidy from 65% of the premium to 75%, as well as expand eligibility to include employed people who lose health coverage because of involuntary reduction of hours.
COBRA Subsidy Laws are changing all the time. We will try and bring you the most updated information as we can. In the meantime, there are many websites to help you keep up with the changes. We are also happy to answer any questions you have!
Enhanced Dental and Vision Benefits for Diabetics with Anthem Blue Cross
Monday, January 11th, 2010Diabetic clients will be finding more comprehensive dental and vision benefits with Anthem Blue Cross starting 1/1/2010. These integrated benefits will help such individuals obtain the care they need to manage their conditions, and prevent diabetes related complications.
Diabetic Retinopathy can be a common occurrence, but is almost 90% preventable with proper vision care. Therefore, members who have the Blue View Vision plan and the 360 degree health program will be enrolled in the ConditionCare for Diabetes program. This program will help clients take a proactive role in managing their condition should a diabetic-related vision diagnosis occur.
Dental benefits will also be extended for diabetic clients, adding one additional dental cleaning or periodontal maintenance procedure every year. High blood glucose levels can help germs to build up on teeth and gums, and increase the probability of gum disease and ultimately tooth loss. Another concern is the fact that dental infections can worsen diabetes by causing hyperglycemia.
Please contact us with any questions regarding these vision and dental enhancements. We want to help you to get the care you need to stay as healthy as possible in 2010.
Expiration Date Nears for COBRA Federal Subsidy
Monday, November 2nd, 2009The federal economic stimulus package which covers 65% of the cost of COBRA premiums is set to end as of December 2009. This reduction was designed to assist those who had an involuntary termination of employment and were eligible for COBRA during the period of September 1, 2008 through December 31, 2009. Though the subsidy is set to end after a period of 9 months, this does not mean you are going to lose your coverage. Instead, you will now be covering the entire cost for the remainder of your 18 months, or longer if your coverage is eligible for extension. The subsidy will end prior to the 9 months in the case of eligibility for coverage under a new group plan, eligibility for Medicare, or in the case of non-payment of the remainder of the COBRA premiums.
Let us help you find alternate coverage before your COBRA expires. There are many options for you and your family, and we are happy to help you determine whether a new plan is the best route, or to stay on COBRA for the remainder of your eligibility period. It is our pleasure to help you determine the best choice for your health insurance coverage.
The Mental Health Parity and Addiction Equity Act of 2008
Wednesday, September 2nd, 2009In October of 2008, the President signed the Mental Health Parity and Addiction Equity Act (MHPAEA), which provided some vital changes in the way group mental health and addiction benefits are to be covered. This ensures that those needing such coverage will not be denied or restricted in their ability to seek treatment.
The MHPAEA applies to Large Group plans; both self-funded and fully insured, and works to prevent the placement of dollar limits on mental health care. Instead, it ensures that mental health benefits and substance use disorders are covered just as any other medical or surgical benefits.
The MHPAEA applies to Large Group plans; both self-funded and fully insured, and works to prevent the placement of dollar limits on mental health care. Instead, it ensures that mental health benefits and substance use disorders are covered just as any other medical or surgical benefits.
However, there are some snags. If the group plan does not currently have mental health benefits on their plan, they will not be required to add them to their current benefit package. Also, the number of covered visits may be limited, even if there is no visit limit imposed on regular medical visits. Cost sharing may be higher for mental health or substance abuse visits as well.
Though this law may only apply to large group plans, those individuals who are on small group or an individual/family plan will find the same protection under “Mental Health Parity”. You can click on www.ncsl.org to see state specific laws regarding mental health benefits.
Ancillary Benefits Equals Happy Employees
Friday, August 14th, 2009Small Businesses are definitely hit the hardest when it comes to premium rates. However, recent studies have shown that incorporating ancillary benefits, such as life, disability, and dental benefits, ensures employees are not only healthy and happy – but loyal as well. A MetLife study showed that 73% of employees who felt adequately covered were happy with their job. On the other hand, those employees who felt that their coverage left them too exposed, were not. Only 22% of such employees stated that they were satisfied with their job.
Productivity is also greatly affected by health benefits. If an employee knows that the coverage is there when they need it, they will push further for their employer. With economic times at their tightest, knowing that they will not incur large medical or dental bills, or leave their family without protection if something should happen to them, means employees can focus on the task at hand. In these cases, everyone benefits!
Though the economy is in tough shape right now, Employers may find that a bit more out of pocket costs for their employees will result in a return of happy, healthy, and productive workers in the end.
Reduced General Practice Physicians in California
Monday, July 6th, 2009Recent 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.
How Agents and Brokers Make a Difference
Friday, June 12th, 2009Many people may still not quite understand what role an agent or broker plays when it comes to your health insurance plan. You don’t pay fees to work with an agent or broker, and the return in services in invaluable.
Most importantly, we serve to help you understand the complex world of health insurance. Whether you are an individual or family shopping for coverage or an Employer looking to cover their employees, we provide you with access to multiple insurance companies and plans, thereby ensuring you have all the information necessary to make your decision.
Agents also work to negotiate the best rates for you. We work with the carriers to make certain your rates are the lowest they can be. They serve as your underwriting liaison to contest declines, or work with rated policies. This is the case for all plans – individual/family plans and small/large businesses as well.
When it comes to group plans, we work to take the burden of administering your plan off of you. We will walk you through the plan options, negotiate your rates when it comes to renewal time, and help your employees complete all of their paperwork. When it comes to new hires, terminations, or COBRA enrollments, again we step in to facilitate the necessary paperwork.
Once your plan is issued, we continually work to help you. Whether it is obtaining medical records for claims processing, assisting your pharmacy in getting a medication authorized, or explain detailed claims benefits, you can always count on us to be there to assist.
Health Reform concerns often bring up the concept of removing agents from the picture. This would destroy the personalized service you have received from us for years.
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.
Savings with a Premium Only Plan (Section 125)
Friday, May 8th, 2009The IRS has instituted a provision in Section 125 of their code. This provision allows for a simple change in your company’s payroll process that reduces your taxable payroll. Every premium contribution your employees make will be deducted from your overall taxable payroll amount. Here’s what you and your employees can expect with a Premium Only Plan or POP.
