A pre-existing condition is simply a health concern that you have before you start looking for insurance. This can be a chronic condition, such as diabetes or multiple sclerosis, or may be an acute health concern, such as a pregnancy or a serious injury. Health insurance options for people with pre-existing conditions can be harder to find, because the health insurance companies know ahead of time that you will be collecting benefits. Rather than paying monthly premiums and rarely is ever visiting a doctor, you will be paying your monthly premiums and visiting a doctor regularly.
Finding health insurance options for people with pre-existing conditions is possible, if you know where to look. There are a number of health insurance companies in Texas that offer plans to people that suffer from chronic conditions. Enlisting the help of a health insurance agency can be extremely helpful in finding a health insurance option. Your agent will be able to quickly direct you to the companies that cover people suffering from your particular condition and can then advise you on the best plans for your situation.
If you need help finding health insurance options for people with pre-existing conditions, you should visit http://www.texashealthcarespecialists.com/ today. The trained insurance professionals that you will find there are experts on health insurance in Texas, and can help you find the best health insurance plan for you and your family, regardless of pre-existing conditions.
Monday, July 19, 2010
Wednesday, July 7, 2010
Legislative Alert: Health Reform Reporting Requirements
One of the major goals of the Patient Protection and Affordable Care Act (PPACA) is to insure millions of new Americans. To accomplish this goal, the government is expanding Medicaid to 133% of the federal poverty level, providing premium subsidies and tax credits to individuals up to 400% of poverty, and requiring employers with more than 50 full-time employees to provide health insurance coverage or face stiff penalties. There are also penalties for individuals who choose to remain uninsured.
To make sure people know about all of their options, determine who has the required coverage, and enforce any applicable penalties, the government will need to collect all sorts of additional information – information that your clients will be asked to provide in a number of new required reports. Here are just a few:
Summary of Coverage Requirement (2010)
Beginning with the first plan year on or after September 23, 2010, health plans must provide a new Summary of Coverage to all employees. There are very specific criteria for this new summary –it must be no more than four pages in length, can be no smaller than 22pt font, and must be written in a “culturally linguistically appropriate manner.” The summary must be distributed to employees at the time of enrollment in either a paper or electronic form, and a notice of material changes must be provided to employees at least 60 days prior to the effective date. While this requirement is effective beginning this year, required regulations have not been issued yet, and the government has 12 months to identify all of the criteria for the new Summary of Coverage.
Value of Coverage Reporting (2011)
Beginning in January of 2012, employers will be required to calculate and report the value of their employer-sponsored coverage on their employees’ W-2 forms. This rule is generally effective for coverage offered beginning January 1, 2011 and includes the value of major medical coverage, executive physicals, HSA contributions, on-site medical clinics (only if they provide more than minimum care), Employee Assistance Programs, Medicare supplemental policy, and employer contributions to health care FSAs. Interestingly, health FS salary reductions are not included in this report, even though they will be included in the “Cadillac tax” calculation beginning in 2018.
TIP: In calculating the value of benefits, both the employer and employee cost portions must be included. To make this easy, employers can use their COBRA rate calculations with little modification – simply remode the 2% administrative surcharge from the COBRA premium to determine the overall value to report to the IRS.
Exchange Related Reporting (2013)
Starting in 2013, employers must provide a new notice to employees at the time of hiring and to all of their existing employees no later than March 1, 2013. This notice will inform employees about the new health insurance exchange that will be available
January 1, 2014, tell them how to qualify for a premium subsidy through the exchange, and warn them that they will lose the employer’s contribution for health coverage if they enroll in a plan through the exchange and do not qualify for a “free choice voucher.”
Play or Pay Reporting (2014)
Beginning in 2014, “applicable large employers; will be required to provide a report to the Secretary of Treasury and to each full-time employee by January 31st of each year.
This report must identify the employer, include the number of full-time employees for each month during the year, and provide a certification as to whether the employer offers minimum essential coverage as defined by the statute to its full-time employees. If the employer does provide minimum essential coverage the report must also include the length of any waiting period, the months of the year that coverage was offered, the monthly premium for the lowest most option in each enrollment category, and the employer’s share of total allowable costs of benefits. Here’s where it gets tricky: if the employee contribution exceeds 8% of any employee’s applicable house old income, the report must also include the option for which the employer pays the largest portion of the premium along with the portion paid.
For more information on this subject contact an agent at Texas Healthcare Specialists. Visit them on the web at http://www.texasheatlhcarespecialists.com/
To make sure people know about all of their options, determine who has the required coverage, and enforce any applicable penalties, the government will need to collect all sorts of additional information – information that your clients will be asked to provide in a number of new required reports. Here are just a few:
Summary of Coverage Requirement (2010)
Beginning with the first plan year on or after September 23, 2010, health plans must provide a new Summary of Coverage to all employees. There are very specific criteria for this new summary –it must be no more than four pages in length, can be no smaller than 22pt font, and must be written in a “culturally linguistically appropriate manner.” The summary must be distributed to employees at the time of enrollment in either a paper or electronic form, and a notice of material changes must be provided to employees at least 60 days prior to the effective date. While this requirement is effective beginning this year, required regulations have not been issued yet, and the government has 12 months to identify all of the criteria for the new Summary of Coverage.
Value of Coverage Reporting (2011)
Beginning in January of 2012, employers will be required to calculate and report the value of their employer-sponsored coverage on their employees’ W-2 forms. This rule is generally effective for coverage offered beginning January 1, 2011 and includes the value of major medical coverage, executive physicals, HSA contributions, on-site medical clinics (only if they provide more than minimum care), Employee Assistance Programs, Medicare supplemental policy, and employer contributions to health care FSAs. Interestingly, health FS salary reductions are not included in this report, even though they will be included in the “Cadillac tax” calculation beginning in 2018.
TIP: In calculating the value of benefits, both the employer and employee cost portions must be included. To make this easy, employers can use their COBRA rate calculations with little modification – simply remode the 2% administrative surcharge from the COBRA premium to determine the overall value to report to the IRS.
Exchange Related Reporting (2013)
Starting in 2013, employers must provide a new notice to employees at the time of hiring and to all of their existing employees no later than March 1, 2013. This notice will inform employees about the new health insurance exchange that will be available
January 1, 2014, tell them how to qualify for a premium subsidy through the exchange, and warn them that they will lose the employer’s contribution for health coverage if they enroll in a plan through the exchange and do not qualify for a “free choice voucher.”
Play or Pay Reporting (2014)
Beginning in 2014, “applicable large employers; will be required to provide a report to the Secretary of Treasury and to each full-time employee by January 31st of each year.
This report must identify the employer, include the number of full-time employees for each month during the year, and provide a certification as to whether the employer offers minimum essential coverage as defined by the statute to its full-time employees. If the employer does provide minimum essential coverage the report must also include the length of any waiting period, the months of the year that coverage was offered, the monthly premium for the lowest most option in each enrollment category, and the employer’s share of total allowable costs of benefits. Here’s where it gets tricky: if the employee contribution exceeds 8% of any employee’s applicable house old income, the report must also include the option for which the employer pays the largest portion of the premium along with the portion paid.
For more information on this subject contact an agent at Texas Healthcare Specialists. Visit them on the web at http://www.texasheatlhcarespecialists.com/
Thursday, July 1, 2010
Why You Need a Texas Health Insurance Agent
Nowadays so many people run to the internet to do shopping for all different types of things, including health insurance. Being one of the most important things you buy for our family, shopping on the internet can be a mistake. Having an agent you can call on at any time is so important especially if you find your self or a family member sick or in a hospital. Not knowing exactly what your coverage is can leave you at a loss.
Understanding your coverage is your best defense against being inadequately covered, and a Texas health insurance agency and health insurance agent can help you do just that. These dedicated professionals understand all of the insurance jargon and terminology that the health insurance companies use when you get health insurance quotes, and can translate them into language that you can understand.
Visit us at www.texashealthcarespecialists.com where you will find a direct phone number to our office. We will answer any and all of your questions at any time. Give us a call and we will review which options are best for you when shopping for health insurance. After we find you the right policy, feel free to call us at any time with questions you might have.
Understanding your coverage is your best defense against being inadequately covered, and a Texas health insurance agency and health insurance agent can help you do just that. These dedicated professionals understand all of the insurance jargon and terminology that the health insurance companies use when you get health insurance quotes, and can translate them into language that you can understand.
Visit us at www.texashealthcarespecialists.com where you will find a direct phone number to our office. We will answer any and all of your questions at any time. Give us a call and we will review which options are best for you when shopping for health insurance. After we find you the right policy, feel free to call us at any time with questions you might have.
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