Archive for the ‘Laws’ Category
Sunday, February 14th, 2010
Recently, the California Department of Managed Care has released some new guidelines for HMO patients, in order to create a more efficient and comprehensive level of care for these patients. Among the new rules:
• A physician appointment within 10 business days of a request Read more...
Tags: health insurance, HMO plan, network provider
Posted in Employees, Employers, Family, General, Individual, Laws, Resources, State | No Comments »
Tuesday, February 2nd, 2010
Health Care reform faced yet another setback as Massachusetts State Senator Scott Brown received 51.9% of the vote needed to fill late Senator Kennedy’s seat in the US Senate. This now makes the Republican head count 41, thereby bringing the 60-count Democrats were relying on to pass the health care reform legislation to an end. Brown’s strong statements regarding the negative portions of the bill, such as higher taxes and the destruction of jobs, played a major role in his political success. However, ironic that he fills the seat of a major proponent of universal health care, many are breathing a sigh of relief as the thought is while health care reform is much needed, it is something that needs to be dealt with carefully – not a “fix it later” attitude. Read more...
Tags: health insurance, individual health, Universal Health Care
Posted in Federal, Government Run Health Plan, Laws, State | No Comments »
Monday, January 18th, 2010
Worries 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!
Tags: COBRA, group health, health care costs, premiums
Posted in Employees, Employers, Federal, Group, Laws, Resources | No Comments »
Monday, November 2nd, 2009
The 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.
Tags: COBRA, health insurance, premiums
Posted in Employees, Employers, Federal, Group, Laws, Resources | 3 Comments »
Monday, September 28th, 2009
For the 42 million seniors and people with disabilities who are currently enrolled in Medicare Part B, a recent vote has ensured that there will be no premium increase for Part B. The standard premium is currently $96.40; slightly higher for those with incomes over $85,000 for individuals or $170,000 for couples. This premium is calculated annually to cover around 25% of the Medicare program. For 2010, this would mean the premiums would be at about $103 (and up!) per month. However, there is a “hold harmless” policy which eliminates this rate hike, by utilizing $2.8 billion from a 2008 fund to improve Medicare.
Due to the economic recession, Social Security’s cost-of-living adjustment is expected to be zero, and therefore the checks will not increase. Therefore, if the Part B premium increase is projected to be more than the increase in Social Security, most current Medicare enrollees are ensured no premium hikes. As with any law, however, there are loopholes and if Congress did not step in, there would have been some enrollees who would have not fallen under the hold harmless policy (i.e. new Medicare enrollments, and those whose premiums are not deducted from the Social Security checks). With the implementation of this act, all Medicare enrollees will be spared any rate increases for their Part B premiums.
Tags: heath insurance, medicare
Posted in Federal, Laws, Resources, Seniors | 2 Comments »
Wednesday, September 23rd, 2009
California children will not be losing their Healthy Families coverage thanks to the implementation of Assembly Bill 1422. Over 600,000 children were going to be disenrolled starting October 1st, due to a lack of funding. Currently, there are 71,000 children on the waiting list since enrollment was frozen in Mid-July. Parents and guardians can breathe a sigh of relief, however, as this affordable medical, dental, and vision coverage will remain in place. Read more...
Tags: children's health, health insurance, preventative care
Posted in Family, Individual, Laws, Resources, State | No Comments »
Tuesday, September 8th, 2009
The State of California has been in financial crisis as of late and now is going to hit home for many families whose children are enrolled on the Healthy Families program. This is a low cost state run plan that offers affordable medical, dental, and vision coverage for California children. Unfortunately, due to a lack of financial support from the state, they are planning on disenrolling children from the program starting October 1, 2009.
Budget cuts that totaled over $128 million dollars caused a major financial strain, and further enrollments were halted this July. This resulted in a waiting list of over 55,000 children, and a prediction of the removal of nearly 670,000 children having to be removed from coverage.
It is important to keep updated on these proposals, to ensure that California’s children maintain comprehensive medical, dental, and vision care. With too many children already forgoing vital preventative care, we have to find a way to keep our future healthy. Please visit the California Major Risk Medical Board for updated information and ways to become involved.
Tags: health insurance, preventative care
Posted in Family, General, Individual, Resources, State | No Comments »
Wednesday, September 2nd, 2009
In 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.
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.
Tags: Add new tag, group health, mental health, pre-existing
Posted in Federal, Group, Laws, Resources | No Comments »
Wednesday, July 1st, 2009
Senate Bill 810, the Universal Health Care Act, proposes methods to provide affordable and attainable healthcare to all Californians. In a time where there are more uninsured individuals than ever before, and more stringent medical underwriting requirements (leaving those with pre-existing conditions ineligible for coverage), this bill could bring some much needed relief to our strained economy.
Under SB 810, eligibility would be based on residency. All residents would be covered, regardless of health status, employment status, or income level. Would this mean an increase in taxes? Well, theory states that over $200 billion dollars were spent in California on healthcare last year. By utilizing this enormous cash flow already being spent on healthcare by Federal, State, and County funds, such a plan is possible. By changing the way the funds are directed, such as purchasing prescription medication and durable medical equipment in bulk, California can save billions in the first year alone.
Ensuring fair reimbursements to providers, allowing consumers to choose their own doctors, and relying on a shared source of financial support, may be the answer to one of the biggest issues facing our State and Nation as whole.
Tags: health insurance, pre-existing, Universal Health Care
Posted in General, Laws, Resources, State | No Comments »
Sunday, June 14th, 2009
While many people think the answer lies in a Government run health insurance plan, but there is also a negative side to the theory. While the idea of health coverage for all is a dream worth pursuing, we need to make sure the quality of coverage is not sacrificed in doing so.
Currently, there are state and government run plans in place, such as Medicaid and children’s health insurance. While these programs benefit many people who would normally not have any coverage at all, concerns lie in the fact that there are lower reimbursement rates to providers, thus resulting in less access to doctors.
Obama’s plan is to allow those who have a plan they already like to keep their current coverage. However, should Employers have the choice between current higher premiums, or a lower cost option of the Government run plan, the lesser of the two would be elected. Therefore, employees would now be subject to a plan with more limited access to providers, and could possibly lose their current doctors altogether.
In terms of the doctor’s themselves, they may refuse the low reimbursement rates altogether and decide not to accept any insurance. Lower compensation would also means cuts in care and staff at your doctor’s office. Would-be physicians may decide to pursue more lucrative careers, instead of dealing with the red-tape of a government dictated medicine.
Tags: health insurance, Universal Health Care
Posted in Federal, General, Laws, State | No Comments »