Well there have been a lot of changes or at least a lot of talk about changes in health insurance and coverage this year. With the passage of the health care reform signed by President Obama, March 23, 2010 you get extra choices, some good, some bad and some unknown. As you consider your renewal options this year, you have one more thing to think about: how your decisions will affect your benefits and costs in the future?

The recently passed federal health reform law includes special rules for plans that were in effect before March 23, 2010. These plans are called “grandfathered” plans. Even a simple change to your deductible could exempt you from the “grandfathered” status. So what do you do? Is a “grandfathered” plan in your favor?  If you keep it then:

• You won’t be affected by some post-reform changes. For example, if premiums go up for plans sold after reform due to requirements in the law, these increases won’t apply to your plan.
• You’ll still be eligible for some of the consumer protections and health plan changes mandated by the reform law.

Only you can make a change that would cause you to lose this important status, by changing plans.  So should you or not?  Call us 817-898-1301 or click here for a quote and see what the new plans look like.

Here is a summary of some ways that you CAN lose your ‘grandfathered’ status.

• You switch to a plan that pays a lower percentage of your costs — that percentage is called “coinsurance” — compared to the plan you had on March 23, 2010. For example, if you move from a plan that covers in-network services at 80 percent to a plan that covers these services at 70 percent, you could lose grandfathered status.
• You increase your deductible by more than 18 percent compared to the deductible you had as of March 23, 2010. For example, moving from a $1,000 deductible to a $2,500 deductible would cause a loss of grandfathered status.
• You choose a plan with higher copayments. If your copayment for any service goes up by a certain amount — generally speaking, by more than $5 or 15 percent — you could lose grandfathered status.
• You choose a plan that eliminates all or most benefits for a particular condition. For example, if you move to a plan that doesn’t cover mental health, you could lose your grandfathered status.
• You enroll in a new plan with an effective date anytime after March 23, 2010. This would apply whether it’s a new plan or a plan from a different insurance company.

What WON’T cause you to lose grandfathered status.  As long as these changes aren’t associated with one of the items above, they won’t affect your status:

• You add or remove coverage for a family member.
• You increase your benefits — for example, by moving to a plan with a lower deductible or higher coinsurance.
• Your insurance company makes a change to comply with state or federal law, including the health care reform law.
• Your insurance company changes the premium for your current plan.

On March 23, 2010, President Obama signed the Patient Protection & Affordable Care Act (P.L. 111-148) into law. The Act contains a provision (Sec. 1101) for a new federal high risk health insurance pool program to be established (the Federal Pool). To qualify, an individual must be a citizen or national of the United States, or lawfully present, must have a preexisting medical condition and must have been uninsured for at least 6 months before applying for the federal program. An enrollee in the Federal Pool will pay a premium rate equal to standard market rates. Moreover, Federal Pool coverage will not be subject to any preexisting condition exclusion.

According to the U.S. Dept. of Health & Human Services (HHS), August 1, 2010 is now the target date for coverage to be available through the Federal Pool, known as the Preexisting Condition Insurance Plan (PCIP). Go to www.pcip.gov or call 866-717-5826 for information on the Federal Pool if you have been without coverage for at least 6 months.

Texas also has a risk pool www.txhealthpool.org here is a link to the application and rates Click Here for Application and here are the Click Here for the Rates.

The premium rates for the PCIP Federal Pool will be approximately half the rates that Texas law requires for the State Pool. The Federal Pool will not impose a preexisting condition exclusion waiting period on a new enrollee. The State Pool, in contrast, must impose a 12-month preexisting condition exclusion waiting period on new enrollees who did not have creditable coverage in place during the 12 months prior to enrollment. This State Pool exclusion period is, however, reduced by the number of months the enrollee did have coverage in force during the year immediately prior to enrollment in the State Pool, and it is fully waived if the enrollee had creditable coverage in place during the full year prior to enrollment.

As mentioned above, the PCIP Federal Pool will be available only to individuals who have been uninsured throughout the 6-month period prior to their application to the Federal Pool.

You should determine which risk pool program–state or federal–best serves your needs, based on your individual circumstances. If you have any questions about the State Pool, or the information contained in this Notice, please call our Customer Service Unit at 1-888-398-3927.

Under the health care bill passed in March, tax credits will be granted to some small employers for a part of the health insurance premiums the employer pays. The purpose of this credit is to encourage employers to offer their employees health care coverage for the first time, and to encourage those who do currently offer it, to continue to do so.

Effective 2010 through 2013, the IRS will provide a tax credit of up to 35% for small businesses and 25% for tax-exempt organizations that provide health insurance for their employees. A small business is eligible for this tax credit if the employer:

Employs 25 or fewer “full-time equivalent” employees (FTE Full Time Equivilent)

Pays average annual wages of less than $50,000 per FTE

Contributes a uniform percentage of the premium cost of coverage which must not be less than 50%, based upon the premium rates for single coverage

In 2014, the tax credit for small businesses will increase to 50% and 35% for taxexempt organizations. This tax credit is designed to help small businesses afford health care coverage, specifically those who employ low to medium income workers. Employers can claim this 2010 tax credit when they file their income taxes in 2011. In order to determine the total 2010 tax credit, there are specific qualifications that must be met.

Here is a link to IRS website to see how this impacts your business

Some key highlights which you will need to discuss with your accountant:

• If an employer only pays a portion of the cost of the premiums, only the employer-paid portion of the premiums is counted towards the credit, and premiums paid through a salary reduction arrangement are not treated as paid by the employer for this purpose.
• employer will not receive a tax deduction for the health insurance premiums it pays for which it receives this tax credit. Thus, an employer will not receive both a tax credit and a tax deduction for the same premiums it pays.
• When determining the average number of FTE’s and the average annual wages, the following persons are excluded: sole proprietors, partners in a partnership, two percent or greater shareholders in an S corporation and all owners of more than five percent of a business. In addition to excluding these persons for purposes of determining the number of FTEs and average wages, the premiums paid on their behalf are excluded when determining the tax credit.

Example
The credit is calculated as follows:
For 2010, a qualified employer has 12 FTEs and average annual wages of $30,000. The employer pays $96,000 in health care premiums for those employees (which does not exceed the average premium for the small group market in the employer’s state) and otherwise meets the requirements for the credit.

(1) Initial amount of credit determined before any reduction: (35% x $96,000) = $33,600
(2) Credit reduction for FTEs in excess of 10: ($33,600 x 2/15) = $4,480
(3) Credit reduction for average annual wages in excess of $25,000: ($33,600 x $5,000/$25,000) = $6,720
(4) Total credit reduction: ($4,480 + $6,720) = $11,200
(5) Total 2010 tax credit: ($33,600 – $11,200) = $22,400

Qualifying employers will claim the tax credit on their 2010 tax return. In early April 2010, the IRS published a series of FAQs on the new tax credit.
Check the IRS website for a copy of the FAQs: http://irs.gov/newsroom/article/O,,id=220839,00.html.

Support Erodes for another COBRA Subsidy Extension

Congressional support for a fourth extension of the COBRA subsidy eligibility period has diminished over the past few weeks, as lawmakers continue to shift their focus to fiscal responsibility.

The eligibility period for the federal COBRA health care premium subsidies under the American Recovery and Reinvestment Act of 2009 (ARRA) ended on May 31, 2010.

Individuals who were involuntarily laid off on or after June 1 are not eligible to receive the 65 percent COBRA premium subsidy and will have to bear the full cost of their COBRA coverage if they elect it. Those assistance-eligible individuals who are already receiving the premium reduction, and are eligible to continue to receive the subsidy for up to 15 months, are not affected.

“Information about ARRA is not being included in notifications for any qualifying event that occurs after May 31, 2010,” said compliance manager Jim Trimble with Ceridian’s Finance & Regulatory Management department.

Although there has been voiced support for providing further financial aid to help involuntarily terminated workers continue their health care coverage, many party leaders feel there’s not enough backing in Congress to pass another COBRA extension.

Some Congressional leaders have even considered reducing the tax subsidy or shortening the 15-month coverage period to make the provision less expensive.

“Forced to make budget choices by their newfound concern about government spending, it looks like Congressional democrats and their union allies favor an extension of unemployment insurance and aid to states to pay teachers over an extension of the COBRA subsidy,” said Jim O’Connell, Ceridian’s legislative affairs consultant.

This info is provide by Ceridian

here is the link for the department of labor info

This bill will:

* Mandate that everyone must have insurance.

* Result in more than 30 million additional people becoming insured.

* Provide for subsidized coverage for people that can’t afford it and increase the number of people that will qualify for Medicaid.

* Make cuts to Medicare Advantage Plans and change their payment formula.

* Increase taxes and fees to many individual Americans and Corporations.

* Make many changes to the way Insurance Companies do business from not allowing them to use pre-existing conditions to limiting their rates based on medical loss ratios.

Many of these elements do not phase in for many years. Those that are most immediate and are expected to occur in 2010 are:

* Tax credits for certain small businesses. (After September 2010)

* Elimination of pre-existing conditions (Click Here for plans available Now through state pool) Not mandatory until 2014 for insurance companies)

* Increase in dependant coverage to age 26.(already available on many plans) Click here

* Creation of a temporary reinsurance program to provide coverage for retirees over 55 who are not eligible for Medicare. (After September 2010 – data available unknown)

* The further creation of a temporary national high risk insurance pool. (After September 2010)

* The prohibition of lifetime limits on benefit payments. (After September 2010)

* Closing the so called “doughnut hole” by providing immediate tax credits for Medicare patients who face a gap in prescription drug coverage.

The real impact in the health insurance system won’t occur until the year 2014. During the interim, there will be the phase-in of additional new taxes that will provide added government revenue to pay for these changes. The four most significant changes occurring in 2014 are:

* Insurers will be required to take all applicants.

* Insurance will be mandated for all Americans.

* Tax credits to help pay premiums will start flowing to middle-class working families.

o The most aid – including help with copayments and deductibles – will be made available for those individuals and families on the lower end of the income scale.

* Insurance exchanges will be created to help administer subsidies for those individuals that require them.

When fully implemented, I believe that the majority of working-age Americans and their families will continue to have employer-sponsored coverage as they do today. In addition, through mandates and other subsidies, the number of people insured can grow by more than 30 million.

People using Health Savings Accounts (HSAs) and HSA-qualified health plans say they are satisfied with their coverage, spend less and are more involved in managing health benefits and costs.   So says a survey by Buck Consultants and independent research firm, hired to study the use, benefits and management of HSA’s by the insureds and their employers.

HSA’s are designed to help customers participate in the management of their on health insurance and save them money on their health coverage.  An HSA (Health Savings Account) is a health insurance plan with a higher deductible (some as low at $1,500), that allow a person with a qualified HSA plan to put money into a savings account and get tax benefits for doing so and then use that money to pay for health care costs, while meeting the deductible of their plan.

Click Here to go to our insurance terms glossary

Please contact us if you would like to know more about an HSA.  888-528-0700 or contact@5280700.com

Oklahoma’s Governor signed into law House Bill 2470 which raised Oklahoma’s minimum compulsory automotive liability limits from $10,000 per person/$20,000 per accident (medical)/$10,000 for damaged property per accident (10/20/10) to 25/50/25.

This law went to effect April 1, 2005 amending Title 36 (Oklahoma Insurance Code) and Title 47 (Oklahoma Motor Vehicle Code) of the Oklahoma Statutes. Now all Oklahoma drivers and vehicle owners are required by law to carry the 25/50/25 minimum limits of liability insurance at all times if their vehicle is operational.

If you do not have the legally required liability insurance you may be subject to a fine of up to $250, 30 days in jail, or both.  In addition, you will face license suspension and suspension of your vehicle registration if you are convicted of failure to comply with the minimum Compulsory Insurance Law or if you fail to produce proof of insurance to a law enforcement officer or Public Safety Representative upon request. 

We can help with all of these problems, click here for more information or call us.

At the time of a collision or a traffic stop, the driver must show a current security verification form (proof of liability insurance) to the law enforcement officer. The vehicle owner’s insurance company or an individual’s non-owner insurance policy will provide the proper security verification form.

With Texas cracking down on uninsured motorists with $350 fines, impounding your card, license issues, and more buying insurance is a lot better deal.  Chances are your insurance will be $350 or less for liability only and you can pay that monthly and the bonus is not only are you legal, but if something happens you actually have insurance to pay instead of it coming out of your own pocket.  Click Here for a FREE no obligation quote.

News Story

It is now going to be harder to forge, fake and falsify your way to a new car license plate.  Counties and the Department of Public Safety are now linking in with Insurance Companies in Texas to crack down on the approximately 4 million uninsured drivers.  Read the Story