http://healthpayerintelligence.com/news/major-health-insurance-mergers-may-leave-consumers-worse-off
If You Miss the Obamacare Deadline, Temporary Health Insurance Plans Are Available.
March 3, 2016 by
Missing the deadline to purchase health insurance does not mean consumers have to forego coverage for nearly a year until the next open enrollment season starts.
Short-term health insurance plans are one method to manage not having health coverage. After all, one trip to the ER can be an expensive one that can set you back for months or longer since unpaid medical bills is one of the top reasons consumers file for bankruptcy.
Although neither short-term, accident or critical illness insurance will meet the requirement for health insurance coverage under the Affordable Care Act and consumers are still subject to the tax penalty for being uninsured for two consecutive months or longer, these plans will put a cap on your financial liabilities. There are many qualifying life events that could make you eligible for buying health insurance under the special enrollment period such as moving to another state, getting married or divorced or turning 26 and aging out of your parent’s plan.
The short-term plans usually do not include coverage for preventive care like an annual physical or pre-existing medical conditions or prescription drugs. They can be a good option so that your expenses do not wind up insurmountable in case you are injured or wind up sick.
The short-term plans are often “significantly more affordable” than standard health insurance plans, he said. The monthly premiums can range from $50 to $150.
The coverage typically does not last longer than 6 to 12 months, but you can usually apply again at the end of that period. While this option can serve as a backup plan, also ask your doctor for their “cash” value of a visit, which is often affordable if you need a checkup or have a minor illness.
Six states currently do not allow the sale of short-term insurance – Minnesota, New York, Vermont, Massachusetts, Rhode Island, New Jersey and Maryland, said Noah Lang, CEO of Stride Health, the San Francisco health insurance exchange company. Other states such as California limit the length of the policy and consumers can only be covered for up to six months.
Accident insurance is designed to help consumers if they have a qualifying injury. The money is paid directly to consumers rather than to the doctor, which means you can do what you want with the payout such as paying medical bills or for your rent, said Purpura.
Critical illness insurance plans work similar to accident plans because consumers receive a payment if you are diagnosed with a qualifying illness such as cancer or heart disease.
It seems like a no-brainer to simply purchase a temporary plan and use it year-round if you are young and healthy, since you can save money each month, but there are a few catches: you are still liable for the tax penalty, they do not cover any pre-existing conditions and have payout limits of usually $1 million to $2 million, said Jack Hooper, CEO of Take Command Health, an online health insurance exchange based in Dallas.
“In the eyes of Obamacare, temporary insurance counts as being uninsured, meaning you’re liable for penalties and taxes,” he said. The tax penalty for not having health insurance coverage rose for 2016 and now consumers are liable for $695 or 2.5% of their income, whichever is greater.
Two more Obamacare health insurance plans collapse.
October 17, 2015 by
https://www.washingtonpost.com/national/health-science/two-more-obamacare-health-insurance-plans-collapse/2015/10/16/cc324fd0-7449-11e5-8d93-0af317ed58c9_story.html
Tardy tax filers at risk of losing health insurance subsidies.
August 25, 2015 by
http://www.jsonline.com/business/tardy-tax-filers-at-risk-of-losing-health-insurance-subsidies-b99563280z1-322743301.html
6 “Benefits” to Having Group Employee Benefits.
June 8, 2015 by
As a small business owner, you may be thinking about providing group employee benefits for your employees. There are many “benefits” (no pun intended) to providing this kind of service for your employees. There are many different insurance companies with many different programs. Generally speaking, there are six types of benefits you should at least consider when selecting which to include in your package.
1) Health Insurance: Health insurance protects against the risk of medical expenses. There are many health insurance companies with many different types of programs and options. It is best to do some research to see which insurance company is best for your company and employee’s needs. Two very popular insurance programs are HMOs and PPOs.
- HMOs, or health maintenance organizations, provide managed care for insurance companies. HMOs cover services of doctors who agree to treat patients under HMO guidelines. Under HMOs, individuals usually select a primary care physician and need to obtain referrals in order to see other doctors or specialists. These referrals are only given when the HMO plan deems the services necessary.
- PPOs, or preferred provider organizations, are subscription based and the employee can visit a network doctor without going to a primary care physician for a referral. Doctors and hospitals work with insurance plans in order to provide care at reduced rates. Most PPO plans also allow you to visit a non-network doctor, but you pay a higher deductible and/or Co Pay.
- High deductible HSA plans are also gaining popularity. The premiums can be significantly lower than a PPO and this option allows the employee to set up a qualifying bank account and make contributions from which they pay the expenses that fall within the deductible. The contributions to the HSA that are not used in the calendar year roll over to the next year.
2) Vision Plans: Usually offered as an addition to a general health insurance plan, but can be purchased stand alone, vision plans provide reimbursement for vision services. This insurance would be used when visiting an optometrist or ophthalmologist for services such as eye exams, eye glasses or contact lenses.
3) Dental Coverage: Generally offered in addition to a general health insurance plan, dental insurance provides individuals with insurance for dental care. Dental plans vary, but generally speaking they cover (partially or in total): basic cleanings, fillings, x-rays, periodontics, endodontics. Some plans may even cover parts of oral surgery, crowns, implants or dentures. Some carriers offer HMO and PPO dental options.
4) Group Life: Life Insurance can be purchased on the group with a set limit for the group or set limits by job/class. The coverage is term, is reasonably priced and is available while the individual is employed by the company. While a Group Life program can be purchased stand alone, most employers will combine as part of the overall benefits package.
5) 401K : 401K plans are a great way for employers and the owners to provide a vehicle to create a retirement income pool. Individuals contribute a percentage of pre-tax income into a qualified plan while they are working and later receive funds from the plan upon their retirement. The investment income accumulates tax free and the recipient pays income taxes as the funds are distributed, usually at a lower rate. Individuals can start withdrawals without penalty upon turning 59 ½. Many employers will provide a matching contribution based on a formula that may include company profitability.
6) Disability (Short and Long Term): this type of insurance protects those who become disabled and are unable to work. Short-term disability insurance generally pays a percentage of a disabled employee’s salary for a certain amount of time after a short waiting period of 7-14 days. Each state has different guidelines and rules regarding short-term disability; some states require benefits be provided for up to 26 weeks. Long-term disability insurance is more popular among employers. If an employee is unable to work for a long period of time due to disability, this coverage will pay a part of the employee’s salary. The amount of money that an individual will receive often depends on their position and how much coverage their company provides. Many employers will provide both STD and LTD as complimentary products.
California Immigration 2016: Senate Approves Health Insurance For Undocumented Immigrants.
June 8, 2015 by
A proposal to expand health care to Californians in the country illegally cleared the Senate on June 2nd, passing on a 28-11 vote and heading to the Assembly.
Senate Bill 4 would allow undocumented immigrants to purchase health insurance on the state exchange, pending a federal waiver, and enroll eligible people under the age of 19 in Medi-Cal, the state’s insurance program for the poor. A capped number of undocumented adults would also be allowed participate, if additional funding is appropriated in the state budget.
“We are talking about our friends, we are talking about our neighbors and our families who are denied basic health care in the richest state of this union,” said Sen. Ricardo Lara, D-Bell Gardens, the measure’s author. “Ensuring that every child in California grows up healthy and with an opportunity to thrive and succeed is simply the right thing to do.”
The debate frequently turned to other intersecting issues, including Medi-Cal reimbursement rates. An effort to reverse a 10 percent cut to the payments from 2011 has been front and center at the Capitol during final budget negotiations, with many lawmakers arguing that doctors simply cannot afford to accept new Medi-Cal patients.
“If this bill were to be signed into law, it would only serve to exacerbate the problem and not fix it,” said Sen. Jeff Stone, R-Temecula. “This bill would only add hundreds of thousands of more patients to the roll with no one to care for them.”
As the discussion shifted to stalled federal efforts to overhaul the country’s immigration laws, it got increasingly contentious. Sen. Isadore Hall, D-Compton, baited his Republican colleagues – who supported a resolution in April calling for comprehensive immigration reform – to vote for SB 4, calling their “excuses” to oppose the measure “tools of the weak and incompetent.”
“If excuses are the tools of the weak and incompetent, then we have a weak and incompetent president,” retorted Sen. Bob Huff, R-Diamond Bar.
Republican Sens. Andy Vidak of Hanford and Anthony Cannella of Modesto, who both represent swing agricultural districts, joined Democrats in voting yes on the bill.
“Taxpayers are already paying high health care costs for the undocumented Californians when they show up in our emergency rooms,” Vidak said.
While support for SB 4 is strong in the Assembly, a signature from Gov. Jerry Brown is not guaranteed. Brown has expressed skepticism over the bill because of its cost, which was estimated to be as much as $740 million annually in an earlier incarnation.
Lara scaled back the bill last week to help it get past the Senate Appropriations Committee, where a similar proposal was held last year. In addition to limiting the Medi-Cal enrollment guarantee to children only, the amendments eliminated a proposal to establish a secondary insurance market for undocumented immigrants if the federal waiver is not approved.
Because SB 4 aims to expand the scope of the federal Affordable Care Act, which prohibited undocumented immigrants from participating in any of the health insurance exchanges it established, California would be required to apply for a waiver allowing individuals to buy plans on the state exchange regardless of immigration status, though they would not be eligible for subsidies to help pay for the coverage.
Obamacare is About to Bankrupt a Whole Bunch of Small Businesses.
April 8, 2015 by
The crushing costs of compliance with the regulatory burdens of Obamacare have already been well documented, especially as they pertain to small businesses. But as small businesses prepare their corporate tax returns next year, many accountants are warning that, based on Department of Labor guidelines issued after the election, countless small businesses are about to be hit with a huge tax penalty that they simply cannot afford.
The issue here is somewhat complex, and is exactly the sort of issue that most small business owners trust to professionals to handle for them. When these businesses were notified that the health plans they offered their employees were not compliant with Obamacare, many of them sought to avoid dumping their employees on the exchanges. At the time, insurance vendors, based on a colorable reading of the law, encouraged many small businesses to work with them to either provide so-called section 105 plans where the employer would reimburse a broker for the cost of coverage bought by the employees, or to encourage their employees to buy their health insurance directly from brokers and to reimburse them for the purchase of this healthcare coverage. All year long, the Department of Labor allowed this practice to continue, only to declare at the 11th hour that this arrangement would be treated as noncompliant with Obamacare and thus subject employers to a penalty. The reasons for this decision are obvious and disgustingly political: the Obama administration wants to boast of larger numbers of people enrolled in the exchanges for political reasons:
This answer is very clear that ANY reimbursement of health insurance payments by an employer for an employee is subject to the ACA rules and therefore are subject to possible penalties under Section 4980D of the Code. These penalties can be substantial (up to $100 per day per employee). Therefore, it is extremely important to make sure that any payment of premiums for employees is as a direct result of payments withheld from an employee’s paycheck and then directly transmitted to the health insurance provider. Any gross of up wages directly related to payment of premiums may be problematic.
Additionally based on this Q & A, it is probably better for the employer not to pay any health insurance premiums (unless a qualified group plan or for only one employee employers). It appears that the DOL and the Administration is pushing all non-qualified premiums onto the exchange and those premiums are usually paid directly by the employee (and may not be reimbursed). This will increase the number of persons covered by the exchange which is the primary goal of the administration (this last part is strictly my opinion).
If you can do basic math, you can probably figure out that many small businesses are about to get hit with a penalty of $36,500 per employee through no fault of their own. If you have any familiarity with small businesses, you know that the overwhelming majority of them are simply not going to be able to pay an unforeseen penalty of $36,500 per employee and are going to be forced to simply shut their doors. As a result, who knows how many employees are about to have no health coverage at all or be forced onto the subsidies (provided that they aren’t eliminated in most states via King v. Burwell). It’s yet another example of the twisted incentive created by Obamacare where the government would actually prefer that taxpayers be on the hook for these people’s health insurance than their own employer, just because they oppose the specific payment mechanism for political reasons.
And the saddest thing of all is that many small businesses are going to get caught in the crossfire of this political fight and snuffed out. The monstrosity that is Obamacare must be repealed, and fast, no matter the political cost, or the damage it wreaks on our economy might well be permanent.
Small Businesses and the Affordable Care Act at Five Years.
April 8, 2015 by
Small businesses were promised lower costs and more choices once the Affordable Care Act (Obamacare) was implemented. Five years after being signed into law, small businesses have not seen many of the benefits they were promised.
Higher Insurance Costs
Very little has changed for small businesses and the self-employed when it comes to costs. They keep going up. Yes, there are exceptions here and there, but for the most part, the promise of lower costs has been an empty one for small businesses.
According to a National Small Business Association survey in 2014, “91 percent of small businesses reported increases in their health plan at their most recent renewal while 96 percent reported increased health insurance costs over the past five years. The majority expect to continue seeing cost increases in the coming year.” Indeed, that has been the case for 2015.
You can’t load up health insurance plans and the health care system with mandates, regulations and taxes (like Obamacare does) and expect lower costs. Let’s make this clear: The law has not produced lower costs. President Obama promised a $2,500 decrease in insurance costs per family. This did not happen.
Choice and Access Have Not Improved
The performance and effectiveness of the health insurance exchanges for small businesses have been underwhelming, to say the least. In most states, the exchanges have been a sad and wasteful disaster. “One year in, the new small-business insurance marketplaces born out of the new federal health-care law have fallen short of their promise in nearly every state, both in terms of functionality and enrollment,” reads an October 2014 Washington Post article.
For 2015, small businesses have been promised bigger and better. The federal Small-Employer Health Option Program (SHOP) was delayed until this year and is now open. One of the original selling points was the offering of many plan choices that the employees of small businesses could select from. This feature will not be available nationwide until 2016, but some state exchanges do provide this option (albeit with limited choices). Exchange website “glitches” and lack of insurer participation have slowed SHOP down, and it remains a question mark as to whether small businesses will actually use the government exchanges. It’s a question mark as to whether more insurance companies will actually want to participate on the SHOP exchanges, thus undermining their whole purpose.
Obamacare stripped existing health care plans from many small businesses and the self-employed – most have not been (or will not be) able to keep the health care plans they liked. We knew this was going to happen, despite promises stating otherwise. Obamacare is upending Health Reimbursement Accounts (HRAs) as well, which are used by many small businesses. While the federal government announced it would delay the imposition of financial penalties on companies that use HRAs until July of this year, stripping this choice from small employers is going to hurt.
The bottom line is that small businesses and the self-employed are losing, not gaining, health insurance choices under Obamacare.
Obamacare controls the market; therefore health insurance choices are limited by government’s control, and dictates on plans. Obamacare has eliminated many preferred and affordable choices. The government exchanges are not real markets. These markets are not appealing for most small businesses, or insurers. That is probably why the federal government (HHS) will not fully release the data on the number of small businesses that are using the exchanges (despite repeated requests by former House Small Business Committee Chairman Sam Graves in 2014, and those shortly following the launch of the new HealthCare.gov.) The total numbers would be embarrassing, but we know the truth. Small business participation is abysmal.
Small Business Tax Credit a Dud
During debate on Obamacare, most members of the small business community did not see how the plan would lower costs or improve access. So the White House kept talking up the benefits of the health care exchanges (see how that worked out above?) combined with the small business tax credit. Unfortunately, and as predicted, the tax credit remains a big dud.
The tax credit is so measly and complex that only a tiny fraction of the small business sector qualifies for it, or dares to sift through the morass. To make matters worse, the tax credit is only temporary. As noted by the Government Accountability Office last year, “the credit may be too small and administratively complex to motivate many employers to enroll.” Indeed, another reason why small business participation in the health exchanges is so low.
The credit needs to be much more robust to minimally harmonize with the high cost of Obamacare and the reality of small business pay scales. Moreover, simplification, permanency and allowing more small business employees to qualify, could yield a higher adoption rate.
New Burdens, Uncertainty and Complexity
Remember when President Obama boldly claimed that buying health insurance on the exchanges would be easy peasy – as simple as purchasing something on Amazon.com? Well, it did not turn out that way. There was the dreadful launch of HealthCare.gov, but bad websites are only one aspect of Obamacare’s false starts, complexity, confusion, and the burdens impacting small businesses.
Obamacare’s incessant changes and delays have been confusing for many small businesses. According to the Galen Institute, “more than 49 significant changes already have been made to the Patient Protection and Affordable Care Act: at least 30 that President Obama has made unilaterally, 17 that Congress has passed and the president has signed, and 2 by the Supreme Court.”
Obamacare’s administrative and compliance burdens are not insignificant either. They are imposing hefty costs on top of general frustration for small businesses. In February, we also learned the Department of Health and Human Services (HHS) sent faulty tax information to 800,000 taxpayers – presumably many of these are small businesses and the self-employed. (House Small Business Chairman Steve Chabot has multiple requests into HHS about the incident.) Moreover, the complexity of Obamacare’s employer mandate (where, for example, a 30-hour work week is considered full time) and its sheer costs have forced small businesses to cut hours, wages and jobs.
The Struggle Continues for Small Businesses
From the small business perspective, Obamacare has exacerbated their 20-plus year struggle with health insurance – costs are too high and keep increasing, innovative choices are lacking, and buying coverage and administering health insurance is a burdensome hassle.
Obamacare supporters point to those getting insurance (though not all are newly insured) as the key measure of its success. Yet, those meager achievements could have easily been reached without disrupting the lives and health plans of millions of people, and without spending $1.7 trillion of taxpayer dollars, including the wasted billions on bad exchanges, consultants, technology and who knows what else
Employers cutting worker hours to avoid PPACA.
March 24, 2015 by
About one in five U.S. employers either have reduced hours for workers they consider to be part-time, or will do so, in response to requirements of the Patient Protection and Affordable Care Act. That’s what a survey of some 740 human resources professionals conducted by the Society for Human Resource Management found.
The vast majority — nearly three-quarters — of respondents haven’t altered schedules to avoid providing health insurance for part-timers working 30 or more hours a week on average. But 14 percent have, and another 6 percent told SHRM they intend to.
It’s still a significant number as some previous studies have found that most large employers will not circumvent coverage extension by reducing full-time workers’ hours. SHRM’s survey results come as PPACA marks its 5th anniversary this week.
PPACA mandates large employers offer health care coverage to employees working 30 hours or more per week or face a penalty.
When it comes to trying to reduce full-time worker hours or reducing the number of full-time employees to duck under the requirement, SHRM reported that only about 10 percent have considered going down that road.
“As organizations learned more about the law, they found that their coverage levels were already the same or more than what the law required, minimizing the adjustments that some anticipated employers would need to make when the ACA was created,” said Evren Esen, director of SHRM’s survey programs.
Among other outcomes:
- 54 percent of employers require employees to work 30 hours a week to be eligible for coverage, an increase from 44 percent in 2014 and 39 percent in 2013. Another 26 percent require employees to work more than 30 hours a week to be eligible.
- 66 percent said their organization offered the same level of health care benefits as before PPACA was enacted.
- 77 percent said that their health care coverage costs increased from 2014 to 2015, and 6 percent saw a decrease.
Health Insurance: It’s Not Too Late To Get Covered.
March 24, 2015 by
Health Insurance: It’s Not Too Late to Get Covered – Special Enrollment Period Now Open
(Fremont County, Wyo.) – Up to six million Americans are expected to pay a tax penalty this year for not having health insurance coverage in 2014. To help families avoid future penalties, a special enrollment period for the Health Insurance Marketplace opened on March 15 and will close April 30.
This special enrollment period is an additional time outside of open enrollment during which you and your family can sign up for health coverage. This will be your last chance this year to receive health coverage through the Health Insurance Marketplace and avoid a tax penalty for next year.
Why is health coverage important?
Health coverage helps cover the cost of medical services, tests and treatments that assist you in getting and staying healthy. The required basic level of coverage includes preventive care, health screenings, well woman and prenatal care, immunizations for adults and children, treatment for pre-existing conditions, and the cost of some prescription medications.
What fees might I owe if I’m not covered?
Surveys have shown that nearly half of uninsured adults are unaware of the penalty associated with not having health coverage. In 2014, the penalty for not having the required minimum level of health coverage was up to $95 per uninsured person or 1% of a household’s income. For 2015, this amount will more than double, with the penalty per uninsured person reaching $325 or 2% of a household’s income.
There are exemptions available to those who cannot afford coverage or who have experienced hardship. Consult Healthcare.gov or a certified application counselor to see if you qualify for an exemption.
Who’s eligible for the special enrollment session?
The special enrollment period is designed for the following:
- Those who don’t currently have health coverage for 2015;
- Those who paid a penalty as part of their 2014 federal income tax returns for not having health insurance in 2014; and
- Those who became aware of the individual mandate penalty after the regular 2015 enrollment window closed.