28. March 2016 · Comments Off on Group Health Insurance · Categories: Health Insurance

Health insurance is a type of insurance policy in which the insurer provides for the cost of any or all of the health care services. Today, there are many types of health insurance such as fee-for-service, managed care, and more. Health insurance is offered to individuals as well as groups. Group health insurance is designed to meet the health care needs of employees of large as well as small companies. Group health insurance policy provides medical expense coverage for many people in a single policy. Under group health insurance, the cost of premium is spread out among the members of the group.

Group health insurance offers health care coverage for student organizations, religious organizations, employers, professional associations, and other groups. Most Americans get group health insurance from their employer. In most cases, employer pays all or part of the health care insurance premium.

Group health insurance benefits both employee as well as employer. Employees covered by group health insurance plan, get medical treatment quickly with little or no cost. Compared to individual health insurance, group health insurance is less expensive. Another advantage is that no medical exam is required to qualify for group health insurance.

A wide range of group health insurance plans are available to choose from. Fully insured employer group, small employer group, large employer group, health maintenance organization (HMO), self-funded ERISA, group managed care, and preferred provider organization are some types of group health insurance.

Getting group health insurance quote through websites is quite easy. In order to qualify for a group health insurance policy, employer must have at least 2 full time employees on the payroll. While purchasing a group health insurance, it is advisable to seek the assistance of group health insurance broker. Golden Rule Insurance Company, UniCare, Aetna Inc., Horizon Blue Cross Blue Shield of New Jersey, Health Net of California, and Time Insurance Company are some of the leading health insurance companies that offer group health insurance.

21. March 2016 · Comments Off on Health Insurance and Health Care Reform in 2014 · Categories: Health Insurance

The most significant changes implemented by health care reform legislation will come into force on January 1st of 2014. These changes will have at least some impact on all individual and family policy holders and will also effect grandfathered policies that were effective on or before March 23, 2010. The positive changes will be for those who have been rated up or declined for health insurance in the past, for those who are currently or plan to become pregnant, and those whose income is less than 400% of the federal poverty level (I will be developing a worksheet to help you determine whether you are eligible for a subsidy). The negative changes will be for those who have an average or better than average health rating and for those on the younger end of the health insurance spectrum (20s-30s).

If You’ve Been Declined or Rated Up

If you have pre-existing conditions, you are now in the sweet spot of health care reform. Starting in October of 2013, health insurance companies will be able to begin accepting applications for policies with a January 1st, 2014 effective date. These policies will not use health status or pre-existing conditions to determine benefits, to decline or charge higher rates. Moving forward, the only factors that will contribute to your health insurance premium is the plan you choose, your age, and tobacco usage. I am not yet aware of how currently effective policies will transition, whether your rating will simply be removed from your existing policy or whether you will need to apply for a new policy to get rid of your rating. I will know more as we get closer to the open enrollment period starting in October 2013.

Maternity Coverage

If you are pregnant or are planning a pregnancy, starting on January 1st, 2014, all new health insurance policies will cover maternity automatically. It has not been made explicitly clear whether women who are currently pregnant will be covered. However, given the language of new policies regarding pre-existing conditions, I am comfortable in speculating that there will not be a waiting period for women who are currently pregnant and whose due date falls in 2014 and beyond. I will give updates as I become aware of definite regulations.

Health Insurance Subsidies

Health insurance policies sold through the NC exchange on or after October 2013, with January 1st effective dates, will be eligible for the subsidy. The subsidy amount will be based on your income and you will be eligible if your income is less than 400% of the federal poverty level. Based on income brackets, the premium you owe for your health insurance policy will be calculated as a percentage of your annual income. As previously stated, I will be creating a calculator to help you predict what percentage of your monthly income a health insurance policy will cost you. Health insurance agents will have the ability to assist you in purchasing a policy through the exchange.

Young and/or Favorable Health Rating

If you are young and/or have a favorable health insurance rating, in almost all cases, you can expect rate increases in 2014. This rate increase is due to required pre-existing coverage and to rate variance shrinking from young to old subscribers. The purpose of coverage penalties for currently uninsured individuals is an attempt to bring in healthy policy holders and temper this increase. There will be high deductible plans available to those who want to satisfy the health insurance mandate while minimizing monthly premium expenses.

There is a danger however, that individuals with low health care expenses will be driven to companies that have high complaint ratios, but offer coverage that fulfills the mandate, because those with poor health are likely to gravitate towards the health insurance companies that most reliably pay claims. If a scenario like this occurs, the reliable health insurance company’s premiums will be driven very high, which may even cause them to go bankrupt if they are unable to attract healthy subscribers. The tragedy of this type of scenario would be that the bargain basement health insurance company would come out on top for the very fact that they don’t do a good job of paying claims.

Grandfathered Versus Non-Grandfathered

If your health insurance policy was effective on or before March 23, 2010, and you have not made changes to your benefit level since then, you have a grandfathered plan. Grandfathered plans are not subject to many of the health care reform requirements, so if you are one of those who expects to see rate increases due to coming changes, it makes sense for you to stick with your current plan for now. If you are in your 20s or 30s, and/or have a very good health rating with your current plan then you probably fall in this category. However, in several years, up to 40% taxes will be applied to grandfathered plans that will cause them to lose their appeal. When these taxes are applied, then in almost all cases it will make sense to roll into a non-grandfathered plan.

When to Enroll (Open Enrollment)

Starting in October of 2013, you will be eligible to begin applying for a policy that falls under the new health care regulations. The initial open enrollment period will last for 6 months. After this time, there will be an annual open enrollment period at the end of each year (October 15th-December 7th) in which you may switch your benefit level or apply for a policy with a new company. Outside of open enrollment periods, you may change your policy during special enrollment periods created by certain life events such as moving your residence, losing group coverage, getting married, or having a baby.

How to Enroll

The enrollment process for policies sold outside the exchange likely remain much the same as they are today with two major exceptions. Medical underwriting will no longer be a part of applications and enrollment periods will be restricted as described above. Policies sold inside the exchange will have the same type of applications as outside except there will be required proof of income if you are eligible for a subsidized policy. It is not yet clear what specific documentation or tax form will be required to substantiate claims of income.

Current Policies

If you currently have a health insurance policy that you are happy with and plan to keep your policy beyond the open enrollment period, your policy will likely transition on January 1st of 2014 and be automatically modified to accommodate the new regulations coming into force. As previously stated, I am not aware of how ratings on current policies will be handled. They might stay on, in which case you would need to apply for a new policy without a rating to shed your old health rating. The more likely scenario is that non-grandfathered policies will automatically shed their health rating and transition into the new rating pool for that specific policy.

What Should You Do?!

There’s nothing to do immediately. As October moves closer and the NC health insurance exchange is up and running, I will be able to provide more specific details and directions in navigating the coming changes. I wish you well and invite you to contact me with questions or concerns.

07. March 2016 · Comments Off on Changes in Big Health Insurance for 2013 College Grads · Categories: Health Insurance

With all the fuss about the new policy, open enrollment period, the subsidies given by government and the necessity to have a health cover has created new choices and issues at the same time for the new college grads.

Some of the choices they make are; Mom & Dad’s plan, individually purchased coverage, short-term coverage, etc., but there is a whole new lot of options coming on for them.

How will health insurance options of today change for graduates when the last big provisions of the health reform law come into effect from January?

Here’s How!

Mom & Dad’s health insurance plan – A parent health insurance plan is best for you if you are thinking of moving back to your parent’s place, and you are looking for quality coverage or employer-based coverage is not available at the moment. With the help of the Affordable Care Act (ACA) now a person graduating from college can stay insured under his parent’s health insurance plan till the age of 26. This is a very nice option for some of the graduates. But there are negative sides of this, like increased premium for the parents, or if you are not in the state then it is not possible to get the assistance of network doctor at the time of requirement. So these are the things that can hamper the benefits of your coverage.

In 2014: You will be treated as a holder of a health plan with your parents till the time you turn 26, but after that you are supposed to purchase a health cover of your own, in order to fit in the requirements of ACA.

Traditional individual health insurance plan -if you are looking for quality coverage and do not have an option of employer-based coverage at the moment, or you have an ambition of being financially independent, then you should go for a traditional major health insurance plan for yourself. A person with good health has many good and affordable options to choose from.You can get the best for you by getting the best information about your plan from an online marketplace. It is to be kept in mind that this is possible to decline coverage based on pre-existing conditions until 2014

In 2014: by the start of 2014, most of the people who are not covered under employer-based insurance will have to purchase these individual insurance plans. It will be a good thing if you will purchase one now. There is a chance of you getting the benefit of subsidies in 2014.

High-deductible health insurance plan – if you are not covered under any employer-based health insurance and want quality coverage, but do not have the need of it, as you are in a good health conditions and are not taking any kind of medical drug regularly, then you should go for a high deductible insurance plan. These are the traditional insurance plans with higher deductible. Here the meaning of higher deductibles is lower monthly premiums. Some of the higher deductible plans can be used in the health saving accounts, by which you will be getting some tax advantage and saving a considerable amount of money.

In 2014: At this time also the high-deductible plans and Health Savings Accounts will be available. Apart from these there will be plans available for everyone which are now a days only there for the people below 30 years of age.

Short-term health insurance plan – If all you want is the basic emergency coverage, or your employer-based coverage is not enough for you, then a short term health insurance will be a good option for you. The short term health insurance plans are easy to qualify and quite affordable. But it should be kept in mind that the short term plans do not cover the pre-existing conditions, preventive care or prescription drugs. You can easily purchase a short term health insurance plan.

In 2014: the short term health insurance will not be complying with the requirements of the health reform law in 2014. So you will be subject to a tax penalty on the federal taxes if you stay uncovered from a qualifying health plans for more than 90 days.

Going uninsured – It is a matter of concern that most of the young Americans are uninsured these days. The idea of health insurance sounds foolish at the time you are young and healthy. But a single medical emergency can cost to more than you can ever think with all the medical expenses these days. the success of the health reform will be vague without the involvement of young and healthy individuals.

In 2014: it is going to impact your finances if you are uninsured in 2014. Most of the uninsured people will face a tax penalty of 1% of their income or $95 (whichever is greater) and the penalty will keep increasing in the coming years.

23. February 2016 · Comments Off on Know More About Types of Health Insurance Plans in Florida · Categories: Health Insurance

Individual, families, groups, and businesses need customized health insurance plans to ensure that they have to spend minimum out-of-the-pocket money for their healthcare needs. With the implementation of healthcare reforms, the options for buying health insurance are widened.

With the advent of internet technology, the concept of transparency of price is gaining momentum. Insurers in Florida health insurance are facing a compelling need of price transparency when they offer health insurance quotes to their clients. At the same time, application time and waiting time for health insurance has reduced significantly as compared to earlier times.

Types of health insurance plans offered in Florida
Apart from State and Federal governments’ sponsored program including Medicare, Medicaid, etc., there is an option of buying health insurance from private companies. Like many other states, health insurance plans in Florida are offered to the residents in traditional format. These could be classified as:

1. Individual health coverage
2. Family health coverage
3. Group insurance
4. Student health coverage
5. Dental health insurance
6. Low cost insurance
7. Low-income families insurance
8. Short-term insurance
9. Small business insurance

Companies offering health insurance Florida
Below is the list of health insurance companies offering health insurance to the residents of Florida:
• Aetna
• AMS
• Assurant
• Avalon Healthcare
• AvMed Health Plans
• Blue Cross and Blue Shield
• Celtic
• Cigna
• Coventry
• Golden Rule
• Humana One
• IAC
• Solera Dental
• Vista

Types of health plans offered in Florida

A lot of consumer end up having discount coupons, which sometimes are termed as health plans; however, it needs to be understood that these discount coupons are not insurance. To buy affordable health plans in Florida, consumers need to equip themselves with proper knowledge about the same.

Traditional categorization of health coverage in Florida offers indemnity and managed care health plans. Indemnity health plans have the insured file claims for reimbursement. While managed care health plans allow the providers to file claims for the insured person.

Managed care health plans are further categorized as HMO, PPO, and POS.

Impact of the Affordable Care Act on insurance in Florida
• 290,000 small businesses in Florida will be offered tax credits for offering health coverage to their employees.
• Medicare beneficiaries in Florida will be automatically mailed a check of $250 to defray the cost of their prescription drugs.
• Early retirees will be offered reinsurance options.
• Uninsured Floridians with pre-existing condition will have a huge boost with $351 million federal dollars made available to Florida starting July 1 to provide coverage.
• Like many other states, for the first time ever, Florida will have the option of Federal Medicaid funding for coverage for all low-income populations, irrespective of age, disability, or family status.
• 8.8 million Floridians will no longer have to worry about lifetime limits on the coverage.
• Around 1.1 million individuals will not have to worry about getting dropped from coverage when they get sick.
• Children in Florida will be able to stay with their family insurance policy till the age of 26 years.

Costs involved in a health coverage plan in Florida

It is important to understand types of costs involved in a health coverage plan to make sure that Floridians have assessed everything before they finalize a health plan. We talk about the types of costs involved in a health coverage plan:

Premium-premium is the amount of money to be paid on monthly basis. Premium is the main cost that a health plan constitutes. It could vary from person to person and in plan to plan. It mainly depends on the age, gender, and health status of a consumer applying to get health coverage.

Deductible-deductible is the second major cost involved in a health plan. It is the amount of money that a consumer pays before the insurer actually begins to pay for the coverage. With higher deductibles, premium costs are reduced.

Coinsurance – coinsurance, as the name explains itself, is the amount of money that the consumer agrees to pay in percentage of the total cost of medical service after the deductible has been paid. Generally, it is usually 80/20 of the total value where 80% of the cost is paid by the insurance companies while the 20% is by the consumer.

Copay – copay is like coinsurance but it is not represented in percentage but in real value. Moreover, there is no consideration of deductibles in copays. Supposing a consumer needs to pay $70 per visit for the doctor: with copay, consumer will be paying $40 and the remaining $30 will be paid by the insurer. However, this copay facility will have some impact on the premium costs.

26. January 2016 · Comments Off on Florida Health Insurance · Categories: Health Insurance

Florida health insurance that meets your health care needs is very essential. Over the past few years, the cost of Florida health insurance is on the rise. Because of the high cost, the number of uninsured in Florida continues to rise. The state government and certain non-profit organizations in Florida have taken efforts to reduce the cost of health insurance so as to provide medical care to those people who need it most.

Florida health insurance is for individuals as well as groups. It not only protects you, but also provides access to quality heath care services. Health insurance in Florida provides medical coverage to children up to age of 19, pregnant women, self employed individuals, and families. In Florida, the rate for health insurance varies significantly from one insurance company to another. You can save time as well as money by comparing the different health insurance plans in Florida.

In Florida, a wide range of health insurance plans are available to choose from. Most of them provide benefits such as the cost of medicine, prescriptions, doctor visits and hospital stays. The types of health insurance plans available in Florida include individual health insurance, small group health insurance including health savings accounts (HSA) and health reimbursement accounts (HRA); large group health insurance, and temporary health insurance.

To qualify for individual health insurance in Florida, you have to undergo a medical exam. If you qualify for a health insurance plan, then you have to pay the premium, based on your age and medical history. Individual health insurance plan in Florida is cheaper than group health insurance.

Finding an affordable Florida health insurance is time consuming. To find one seek the help of an insurance agent or an insurance broker. There are several websites that help to find the best health insurance plan in Florida. Florida-health-insurance.com and eHealthinsurance.com are some websites. Vista, Blue Cross and Blue Shield of Florida, Inc., United Healthcare, and Humana Health Insurance Company are some of the leading companies that offer health insurance in Florida.

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