On August 1, 2011, Major changes have been made for Woman regarding their preventive services for the better. Beginning on or after August 1, 2012, woman will no longer have a co-pay for many services and have many additional benefits including counseling for Preventive Care Services that are now very costly. 

Since not every woman can’t afford Health Insurance and even if they do have it can’t pay for the Co-Pays that come with the costly tests many go without. Finally us Woman will have help and get the medical attention we need to stay on top of our Health. 

Below is a list of the services that will have no Co-Pay starting August 1, 2012:

• Well Woman Visits Annually (some plans already have coverage)
• HPV testing, woman 30 years up
• DNA testing, woman 30 years up
• Gestational Diabetes Screening
• HIV screening
• Counseling for HIV
• Sexually transmitted infection
• Counseling for Sexually transmitted infections
• Contraception methods (FDA approved)
• Counseling for Contraception methods
• Breastfeeding supplies/Support /Counseling
• Domestic Violence Screenings
• Counselling for Domestic Violence

The services will help insure that women receive a comprehensive set of preventive services without having to pay  their deductible, a co-payment,  or any co-insurance to have proper care.

This is a huge step forward in helping all woman get the care they need and try and keep all women on top of their Health Care for no charge to them. 

If you have any questions please give me a call, (818) 709-8442. Looking for a New Health Insurance Plan, get free quotes www.health-insurancecalifornia.com

Looking for a Individual dental plan? CIGNA of California  now offers Dental Insurance! If you are a current CIGNA member or are looking for a medical plan for you and your family you can now add a dental PPO plan to your coverage for as low as $1.15 a day, depending on your County. 

Looking for a new Tax Credit?

 There is a new Small Business Tax Credit for providing Health Insurance to your employees. You may not realize the tax credits that you can claim on your federal income tax filing due to the Patient Protection and Affordable Care Act. If you provide Health Insurance to your employees or have been wanting to start, you can take advantage of this credit. Please give our office a call with any questions you may have or for a Free Group Health Insurance Quote, (818) 709-8442.

Is your Business Eligible?

You must meet the following guidelines to be eligible for this federal income tax credit:

• Company Size:

A qualifying employer must have less then the equivalent of 25 full time workers when totaling all the individuals’ hours of employment.

• Provide Health Coverage:

Employer must confirm they cover at least 50% of the cost of the Health Insurance coverage for their employees. The employer must know the cost they pay to cover a single full time employee’s insurance premium.

• Wages Paid:

Employers with 10 or fewer full time equivalent employees, paying annual average wages of $25,000 or less will receive the max credit of 35%.

Employers with greater then 10 and fewer then 25 full time equivalent employees, paying annual average wages of less then $50,000 will also receive the minimum credit of 35% of the premiums paid.

All tax exempt organizations that meet either of the above criteria can only claim the minimum credit of 25% of premiums paid.

• Credit Amount & Years Available:

Stated by the IRS “Small Businesses can claim the credit for 2010 through 2013 and for any 2 years after that. Tax years 2010-2013, the maximum credit is 35% of the premiums paid by small businesses and 25% of premiums.

Beginning in 2014, maximum tax credit will increase to 50% of premiums paid by eligible small business employers and 35% of premiums paid by eligible tax exempt organizations.

For any Health Insurance quote you can always go to our website:

www.health-insurancecalifornia.com

Call us anytime, 818-709-8442

Most people are very confused and over whelmed by Health Care Reform, wondering what changes are happening and when. Below is a timeline on the changes from now through 2018. I thought it would be easier to just take you year by year, starting with the present and what has changed so far. Each change will fit into a category of New Programs, Insurance Reform Changes, Coverage Mandates, Subsidies, Medicare Reforms and other info.

Starting October 2010:

-Dependent coverage up to age 26. – Mandated
-National Risk Pool- New Program
-$250 rebate for Medicare Members who reach the “donut hole”. – New Program
-No lifetime dollar limits. – Insurance Reform Change
Restricted yearly limits on the dollar value of certain benefits. – Insurance Reform Change
-No coverage Cancellations, except for Fraud or misrepresentation.- Insurance Reform Change
-No pre-existing exclusions for enrollees up to age 19. – Insurance Reform Change
-No cost-sharing obligations for preventive services in network.- Insurance Reform Change
2011:

-Start of Medicare Advantage cost-sharing limits.- Medicare Reform
-Medicare Advantage plans begin restructure of payments. – Medicare Reform
-Once Donut hole reached to get a 50% discount on Brand Name drugs. – Medicare Reform
-General Surgeons & Primary Care Doctors practicing in inner cities & rural areas get a 10% Medicare bonus. – Medicare Reform
-Increased funding for community Health Centers to provide care for many low-income/uninsured people. – New Program
-Excludes over-the-counter drug reimbursement through HSA & FSA plans. – Insurance Reform Change
-Employers can report the value of Health Care on employees W2 tax statements. – Insurance Reform Change

 
2012:
-New annual fees on pharmaceutical manufacturing sector.- Insurance Reform Change
-Hospitals with high rates of preventable readmissions face reduced Medicare Payments. – Health Reform Change
2013:
-Medical device manufacturers to have a 2.9% sales tax on devices, exemptions for some. Insurance Reform Change
-Individuals making $200k a year or couples making $250k will have higher Medicare Payroll tax of 2.35% on earned income, currently 1.45%. – Insurance Reform Change
-No more deductions for expenses allocable to Medicare Part D subsidy for employers who maintain prescription drug plans for their Medicare Part D Eligible retirees. – Insurance Reform Change
-Contributions to FSA limited to $2,500 a year.- Insurance Reform Change

2014
-New Taxes on Health Insurers. - Insurance Reform Change
-Pre-exsisting condition exclusions are prohibited. – Insurance Reform Change
-State individual & small group health insurance exchanges operational. – Insurance Reform Change
-No Lifetime or annual dollar limits for essential benefits. – Insurance Reform Change
-Individual affordability tax credits. – Coverage Mandate
-Expanded Small Business tax credits. - Coverage Mandate
2018:

New tax on employer-sponsored health plans that offer policies with generous coverage levels.

For any questions or comments please contact me.

http://www.health-insurancecalifornia.com

On August 25th Anthem Blue Cross was approved for a proposal they submitted for a Rate Increase for the state of California. The average of the rate increase is to be 14% to individual policy holders. Blue Cross is the state of California’s largest insurer. Effective October 1, 2010, some increases will be as much as 20% for some policy holders.

Last April, Anthem Blue Cross had a request for premium increase to take effective May 1, 2010 which they withdrew. The increase would have been as high as 39% for some policy holders. Anthem withdrew their proposal after there was an investigation report by external actuaries regarding the high increase. The investigation was found to have discovered significant errors with their proposal.

Another Insurer has been approved for a Rate Increase proposal they submitted as well. Blue Shield’s request has was also approved by regulators. The proposal shows a raise in premiums for some Blue Shield members of an average of 18.2%.

There are requirements and rules that the Insurance Carriers have to follow when raising trying insurance premiums. Steve Poizner, CA Insurance Commissioner can and ordered an independent reviews which he did for Blue Shield and Anthem Blue Cross as well as other state insurers. The review makes sure the Insurance carrier is in compliance with state law that does require to spend at least 70% of premiums on Medical Care.

Both Anthem Blue Cross and Blue Shield were in compliance with the state’s medical loss ratio requirements, which is why the rate increases will be coming soon.

Insurance companies will be notifying their members of the rate increases in the next week.

If you are with Anthem Blue Cross or Blue Shield and would like a Free review of your policy and to see other options for you or your family, please give me a call. I will place you with another carrier or plan that works for you and price range.

For Free Health Insurance Quotes:

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Health Care Reform Bill has made changes being made, Dependent Coverage Extended until age 26:

Starting January 1, 2011 the provision must go into effect for individual and family plans as well, Allowing any dependent age 26 or younger to be able to be on their parents Health Insurance Plan, no matter Health condition.

On September 23, 2010 Group plans (employer sponsored) will give the option of letting dependents stay on their parents plan until age 26 regardless of student, resident, employed or marital status. Most health plans (currently) imposed a limit of age 19 years old for Non Full Time students and age 23 for Full Time Students.

Some Health Insurance Carriers that are starting to implement the provision early for its members. Dependents will have to re-enroll on their parents plan during their open enrollment period for Group plans. Re-enrollment is NOT automatic, members must take actions on or after October 1, 2010 to have their dependent back on their plan if not already.

For Individual and family plans, the dependent will have to be added before January 1, 2011. Dependents only have until January 31, 2011 to be added on the plan without underwriting. Once 1/31/11 is passed, normal underwriting policies will be enforced.

Be sure to get yourself or dependent added on during the time frame. Once the time has passed dependent may not be approved due to normal underwriting guidelines.

Check with your current Health Insurance to see if you are able to add your dependent this soon or at least get your forms lined up.

On Wednesday July 14th, White House unveiled new requirements for Health Insurance Carriers to provide preventive care services without copays. Obama Administration put together rules to follow, allowing people with Health Insurance to receive certain preventive care services with no cost to them, waiving deductible and any out-of-Pocket charges.

The new rule was created under the Federal Health Reform Law. The preventive care will be lab tests and screens that are recommended by government advisory boards. Insurers will be required to cover routine vaccinations, cancer screenings, well baby care, prenatal care and other preventive care services.

This all will take effect in September of this year. All new health plans that are effective after September 23rd will be required to have the new coverage inforce. Anyone with a current Health Insurance plan will also benefit from the rule.

It is being said, this new requirement will increase premiums by 1.5% on average.

If you have any questions please give us a call anytime.
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Finally decideing you are ready for a baby there are millions of things going through your mind of what you need to do to get ready, a major item to think about is if your current Health Insurance is the right plan for you when you give birth? Does your Insurance Plan have maternity coverage? A few important questions any one should ask before they get pregnant and preparing for a baby.

1. Does Your Current Insurance Plan have maternity coverage?
Seems like a dumb and obvious question but not all Health Insurance Plans cover maternity coverage, espically individual plans. If your current plan does not cover maternity coverage that means it will not pay for any doctors visit, ultra sound, prenatal visits, prenatal testing, giving birth etc. Anything that has to do with your pregnancy and baby. One should check their current plan.

2. Is your OBGYN In-Network?
Most woman already have an OBGYN or have figured out who will deliver your baby, you need to make sure that your doctor and the hospital your doctor is affiliated with are In-Network with your Health Insurance Carrier.
If you have a PPO, you will have the option of going in and Out-of-Network, which is nice because you do have flexibility but when you do go Out-Of-Network your percent of the cost is much higher then staying In-Network.
My advise is to always try and stay with doctors and facilities that are In-Network to pay the least amount possible.

If you have an HMO, no need to worry. Your PCP will have referred you to a OBGYN that is in your Network.

3. What is your total Cost of Birth?
The total cost of the birth does differs from plan, person and kind of birth.
Every Health Insurance Plan has a Out-of-Pocket Maximum. That is the most one will spend in one calendar year on all medical bills. Once this amount is met, you will not longer be charged for any service and the Insurance Carrier will pay 100%.

The Out-of-Pocket max can be as low as $2,500 on PPO plans to $10,000. On HMO plans they tend to be less.
When you think about all the doctors visits, ultra sounds and tests you have before you even give birth you may already hit your Out-of-Pocket MAX.

4. Be sure you have Maternity Coverage!
If you do get pregnant and do not have maternity coverage, you will not be able to get your own individual plan. Being pregnant is a pre-existing condition. Another option would be to join group coverage (from an employer) or to try Medical depending on your income.

For Free Health Insurance Quotes go to:

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Most people don’t know that you can add a term life insurance policy to their current Individual Health Insurance Plan. Most major Carriers in California give their memebers the option to add a Term Life Insurance plan or dental with no underwriting. A member is guaranteed coverage on approval of their individual plan. There is no additonal applications or medical exams to take, its simple you just choose the amount of benefit that would fit your families needs.

If one were to add Life Policy to their current Medical Plan it would usually range from $15,000 to $100,000 benefit. These are aviable to all individual memebers (which makes one under 65).

A member at the age of 32 could pay as low as $6.50 per month for a $30,000 benefit, for example. This extra policy can added to your current medical insurance bill, all you need to do is make one payment.

Adding this Life Policy is an inexpensive and great way to protect your family in their time of need. Make it easier and less stressful worrying about finances.

Memebers also have the option to add a dental plan to most carriers as well. Your dental insurance can range from as low as $8-$55 per month per person. All plans would give you the option to go have your teeth cleaned 2 times a year, which is always nice. Depending on which dental plan you go with, there are services that range from X-Rays, fillings and major services.

Each company has number of different plans. The two most popular are the PPO and HMO plans.

HMO dental plans are similar to an HMO medical plan in the sense that you will chose one dentist/dental office and that will be your Primary Care office. You will go to that dentist/dental office for all services needed. If you need to see say a specialist your PCP will refer to one also in network.The best part regarding the HMO dental is there is no maximum per year, it is unlimited.

PPO dental plans are opened to go to any dental office at anytime, but will see the best price when staying in-network. A PPO plan does have a maximum per year depending on the plan. Ranging from $500 to $2,000. Once you meet your maximum the the carrier will no longer pay any claims.

To inquire about adding a Term Life Policy or Dental plan to your current Medical Insurance, give your Carrier or Broker a call.

For Free Health, Dental and Life Insurance quotes please give me a call toll free, 877-707-9898.

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I am a huge believer in Preventive Care. Anyone that has ever discussed Health Insurance or Health Insurance Plans with me most likely heard me discussing it two or more times.

Today I thought I would give everyone a clear understanding on some preventive care services that are recommended by the American Cancer Society, the Advisory Committee on Immunization Practices and U.S. Preventive Services Tasks Force.

More of the plans that have come out in the past 3 years will either pay 100% or waive a members deductible for their Preventive Care services (please see your current Health Plan). It is a great coverage to have on your Health Insurance policy and one should take full advantage of, if you can.

The two main categories for Preventive Care are Screening Tests and Immunizations. There is also different preventive care guidelines for Children and Adults.

Screening Tests:

For Adults what is included/recommend depending on the plan:

Cholesterol level screening
Blood glucose test to screen for diabetes
Mammography screening and Breast Exam
Routine blood and urine screenings
Hearing Screening
PAP, contraceptive and pelvic exam for females
Bone density test
Cancer Screenings:
-Prostate Cancer, may include PSA test and Rectal Exam
-Colorectal Cancer, may include blood test and colonscopy screening
Screening for STD’s

For Children they include/recommend depending on the plan:

Vision screening
Hearing screening
Pelvic exam, PAP and Contraceptive management

Immunizations:

For Adults what is included/recommend depending on the plan:

Hepatitis A & B
Chicken Pox (Varicella)
HPV (Human Papilloma Virus)
Tetanus, Diphtheria
Shingles (Herpes Zoster)
Measles
Mumps
Rubella

Immunizations for Children:

Hepatitis A & B
Rotavirus
Meningococcal Polysaccharide
Rubella
Mumps
Measles
Polio
HPA (Human Papilloma Virus)
Pneumonia
Flu Shot (Infuenza)
Chicken Pox (Varicella)
Dipheria, Tetanus, Pertussis

Most Carriers that offer Preventive Care coverage will give their member the option to use these services once a year during their annual physical by their In-Network Physician.

Please let me know if you have any questions or would like info on which plans or carriers give you 100% coverage when it comes to Preventive Care.

Politi Insurance Agents & Brokers
http://www.health-insurancecalifornia.com
818-709-8442

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