The election results are in and the Republicans have retaken the House of Representatives.

Talk about the healthcare bill will once again be brought to the forefront of Congress. The Congress will attempt to change the present Health Care Initiative and this will put the entire Health Care system in turmoil again.

The new initiatives from the first bill have mixed reviews and have caused carriers to increase premiums. Options to employers have minimized while the premiums charged continue to escalate.

My clients ask me what they can do and I try to give them viable options to maintain the healthcare programs for their companies.

There will come a point where the choice will between giving a healthcare program or keep an employee working. The healthcare plan for that company will end. There will be a time when a small employer with less than 50 employees will NOT offer health plans.  It will be simply unaffordable.

So what steps do you take now as an employer?

Get the employees involved!  Either have them all in on the meetings or have them choose an employee representative to hear what the plans and costs are.

Most companies believe that they alone need to choose a plan.

This will not reduce the costs from the carriers but you might be surprised at the input from the employees.

Get the employees involved.

Editor’s note: This is a special post from insurance broker Alan Levenson.

Share

The state of New Jersey has released pricing and plan information about their pre-existing conditions program for uninsured residents.

As you may recall from my original post about the new health insurance exchange, the Patient Protection and Affordable Care Act (PPACA) was started nationwide to provide subsidized insurance for American citizens that do not have insurance due to a pre-existing medical condition.

Each state has the choice to run their own plan or go under the federal plan. The New Jersey Department of Banking and Insurance has decided to run their own plan with Horizon Blue Cross Blue Shield as the sole provider of healthcare.

To be eligible for PPACA coverage an applicant must be a US citizen, a resident of New Jersey, been uninsured for at least six consecutive months, and have a pre-existing medical condition.

The plan in New Jersey will now be called, NJ Protect, and have premiums ranging from $212.63 to $767.95 for a single person depending on the age of the applicant and design of the policy.

Plans offered provide in and out of network benefits similar to a PPO plan. Treatments for pre-existing conditions are covered from the start of the policy and also offer preventive care with no additional cost to the policyholder.

Do you think healthcare reform will continue to provide affordable healthcare for un-insured Americans?

Post a comment or email me at blog@insureyourcompany.com.

Share

Avastin, a popular cancer treatment drug may have its approval revoked by the FDA after studies have found that the drug may not extend patients lives beyond a month, according to The Daily Telegraph. This about face has provoked fears that the FDA is starting a death panel as insurance carriers will likely drop coverage for the costly medication.

The FDA advisory panel has now voted 12-1 to drop the endorsement for breast cancer treatment. The panel unusually cited “effectiveness” grounds for the decision. But it has been claimed that “cost effectiveness” was the real reason ahead of reforms in which the government will extend health insurance to the poorest.

The New York Times has stated that the original trial showed that tumor progression halted for five months, but in new trials that used a combination of different chemotherapy drugs the tumor progression halted for less than a month to three months.

Britain’s National Institute for Health and Clinical Excellence, a pace-setter in evaluating medical advances, issued draft guidance this month against using Avastin for advanced breast cancer patients in the National Health Service. It called the clinical trial data “disappointing” and the cost “too high for the limited and uncertain benefit it may offer patients.”

I don’t believe that this results in Palin death panel rationing as some publications would have you believe.

If a drug does not work as intended, the FDA is within their rights to deny approval for the drug. If someone wants to use a drug that is not approved, then can do so and pay out of their pocket. If someone want to spend $8000 a month on Avastin, then they have every right to do so. I hope this issue is not used as a political weapon by politicians on either side of the aisle in the US.

What do you think? Is the FDA starting a death panel to ration healthcare? Do you think healthcare reform will make the country worse or better off?

Post some comments or email me at blog@insureyourcompany.com. I want to hear your opinion!

Share

I receive tons of spam email, and I’m sure you do too. You may even get email from friends who think they are being helpful and informing you about the current health insurance reform that is taking place.

Unfortunately, one email circulating lately is blatantly not true. The email that is going around claims that your employer’s contributions to your health insurance will be considered income and will become taxable to you. A health insurance premiums tax is not coming to the US. The Huffington Post debunks this email in a recent blog posting on their website.

The IRS will require employers to list their contribution amounts on your W-2 starting in 2012, but current law excludes health insurance premiums from taxable income. The reason for the new reporting, is due to the new individual mandates, requiring individuals to have health insurance coverage. There are also employer mandates to offer coverage and fines to individuals who have “Cadillac plans.” These are all reasons why your employer’s contributions will appear on your w-2.

Rest assured, there will be no taxes on the money your employer contributes to your health insurance premiums.

Share

An explanation of why health insurance is expensive in America and an overview of current health care reform and other possible fixes that may alleviate high prices.

Share

Last week Healthcare.gov launched as a portal for U.S. citizens to explore the American health insurance market in an easily navigated and concise website. The website includes ways to find insurance coverage options, learn about preventive care, compare quality care, and ways to understand the new insurance laws.

First of all, finding insurance coverage options is a very easy process of selecting options that apply to your unique situation. Whether you are a small employer, an individual with an illness, unable to get health insurance, or a young adult under 26, the website directs to state specific resources for finding coverage.

For example, for a small IT consulting firm in New Jersey, I was informed that New Jersey is a guaranteed issue state for health insurance. An insurance carrier cannot turn a small business down for coverage if it meets the qualifications of small employer. I was then directed to Department of Banking And Insurance where I could read their online New Jersey small employer’s buyers guide to health insurance.

The preventive care section of the website partners with healthfinder.gov where you can enter your age and gender and recommended tests, immunizations, and other health tips tailored to your information is presented. This is a great feature to include in the website and I found it very helpful.

Next, the U.S. Department of Health and Human Services’ hospital compare tool allows users to search hospitals by zip code and offers the ability to compare hospitals in your area by patient care surveys, care outcomes, medical imaging statistics, their Medicare coverage, and volume. This tool is an excellent addition to healthcare.gov and provides an easy way to compare hospitals.

Lastly, the website includes information about the Patient Protection and Affordable Care Act in an easy to understand format. A timeline for establishment of reform changes is included to easily reference when certain provisions of the bill will go into effect.

Share

Many Americans without health insurance coverage due to pre-existing conditions may find themselves with health insurance coverage due to the newly established Pre-Existing Condition Insurance Plan (PCIP.)

Starting today, July 1st, 2010 many states will start accepting applications for the new plan with coverage likely beginning on August 1st. You can check to see if your state is running their own program at the following website.

This temporary high risk pool of coverage for Americans with pre-existing conditions will expire on 2014 when denying individuals insurance based on pre-existing conditions will be outlawed.

The congress has already allocated $5 billion to the program, so if you fit the description, you are urged to apply immediately, just in case the program runs out of money if a higher number of people than anticipated enroll in the plan.

In New Jersey, for example, the department of banking and insurance has decided to run their own program under guidance from the Department of Health and Human Services.

General rules for the program are as follows:

  • You must be un-insured for over 6 months
  • You must be unable to get insurance due to a pre-existing medical condition
  • You must be a United States citizen or a national

Premiums will vary from state to state, but the coverage cannot be higher due to your medical conditions or age.

According to healthcare.gov typical premium for the federally run program for a 50 year old will be between $320-$570.  To get an estimate of premiums, check out the details at the website for the PCIP.

The Pre-Existing Condition Insurance Plan will cover a broad range of health benefits, including primary and specialty care, hospital care, and prescription drugs. All covered benefits are available for you, even if it’s to treat a pre-existing condition.

Most plans will have a deductible for major medical services such as hospital visits and surgery and a maximum out pocket to limit the patient’s liability.

Share

Many small businesses and tax-exempt organizations that provide health insurance coverage to their employees now qualify for a special tax credit under the Obama health reform legislation that just passed. This credit is designed to encourage small employers to offer health coverage for the first time or maintain coverage they already have. If you pay at least half the cost of the health insurance (employee only) you might be entitled to a 35 percent credit of those premiums. This credit is effective now (2010). The credit increases to 50 percent in 2014. The IRS has all the information on how to apply for the credit on your 2010 tax return. This is a great opportunity to use your health plan to recruit and retain the best people for your positions. You can structure multiple plan designs and with the credit pay an affordable amount for coverage. Contact me for more info. alan@cgbins.com.

Share