Thursday, September 26, 2013

In Most Cases Premiums Will Be State Specific


Posted:  |  Updated: 09/26/13 EDT

What Will You Pay For Obamacare? Depends On Where You Live (MAP)


The cost of enrollment in the health care exchanges that open Oct. 1 will depend on a person's age,
family size, tobacco use, income — and geographic location, with significant variation among cities and states.
The average nationwide price of basic coverage was $249 a month, not including tax credits that could
reduce the cost for many Americans, according to a report the Obama administration released Wednesday.
Why is the cheapest "bronze" plan just $144 in Minnesota and $425 on average in Wyoming?
Prices hinge on many factors, including how much health care services cost in the region.
Premiums on the health insurance exchanges also depend in part on how many insurers are
competing in the local market.
Story continues with map => go to story - 
http://www.huffingtonpost.com/2013/09/25/obamacare-map-_n_3990491.html?1380138426&ncid=edlinkusaolp00000009

Infographic by Jan Diehm for The Huffington Post.


Saturday, September 21, 2013

A Simple Breakdown of the Obamacare Plans

My comments: This is a great summary of what the overview of the plan structure is going to look like. This is where it's important to note affordable premium does not equal affordable care. For example, the Bronze program has a lower premium but a 60/40 co-insurance.  For those of us use to a standard 80/20 or even 90/10 - 60/40 on a major illness takes my breath away and would probably devastate the finances of most families.

How do I choose Marketplace insurance?




There are 4 categories of Marketplace insurance plans: Bronze, Silver, Gold, and Platinum. The categories help you choose a plan that’s right for you.

4 categories of Marketplace insurance plans

When you compare Marketplace insurance plans, they're put into 4 categories based on how you and the plan can expect to share the costs of care:
  • Bronze
  • Silver
  • Gold
  • Platinum
All Marketplace insurance plan categories offer the same set of essential health benefits.The categories do not reflect the quality or amount of care the plans provide.
The category you choose affects how much your premium costs each month and what portion of the bill you pay for things like hospital visits or prescription medications. It also affects your total out-of-pocket costs —the total amount you’ll spend for the year if you need lots of care.
Note: The Marketplace also offers "catastrophic" plans to people under 30 years old and to some people with very low incomes. Learn more about catastrophic plans.

Balancing monthly premiums with out-of-pocket costs

As with all health plans, you'll have to pay a monthly premium. But it's also important to know how much you have to pay out-of-pocket for services when you get care.
  • Premiums are usually higher for plans that pay more of your out-of-pocket medical costs when you get care. For example, if you have a Gold plan, you'll likely pay a higher premium, but may have lower costs when you go to the doctor or use another medical service.
  • With a Bronze plan, you'll likely pay a lower premium, but you'll pay a higher share of costs when you get care.
  • Platinum plans will likely have the highest monthly premiums and lowest out-of-pocket costs. The plan will pay more of the costs if you need a lot of medical care.
  • In general, when choosing your health plan, keep this in mind: the lower the premium, the higher the out-of-pocket costs when you need care; the higher the premium, the lower the out-of-pocket costs when you need care.

What to consider when choosing your plan

Think about the health care needs of your household when considering which Marketplace insurance plan to buy.
Do you expect a lot of doctor visits or need regular prescriptions?
  • If you do, you may want a Gold or Platinum plan.
  • If you don't, you may prefer a Bronze or Silver plan. But keep in mind that if you get in a serious accident or have an unexpected health problem, Bronze and Silver plans will require you to pay more of the costs.

Explaining The Affordable Care Act

Comments:  One of the reasons I started this blog was to provide independent -- nonpartisan information regarding The Affordable Care Act.  I know as a former insurance salesperson and corporate benefits manager, insurance for anyone can be difficult to understand. Now throw is the clanging sound of partisan commentary and it becomes an increasing fog, making understanding it that much more difficult.

The News Hour (PBS) has set up a section of their website for Q&A and to follow is an interview I saw which answered some basic questions, which I'll add commentary to later.


SUMMARY

Even as Republicans are trying to shut off funding for the law, the Obama administration and some states are preparing for implementation of the Affordable Care Act. Julie Rovner of NPR joins Ray Suarez to answer some of your frequently asked questions on tax credits and subsidies, as well as penalties for not having insurance.

 

Part-Timers Losing Health Insurance May Want To Thank Their Companies

How terrible. Home Depot (HD) and Trader Joe’s have decided to stop offering health insurance for part-time employees, moving them over to Obamacare instead. More companies seem sure to follow. And more wailing about greedy, heartless corporations is sure to follow that. Some workers may start to drop dead from sheer anxiety before Obamacare even goes into effect on January 1.
Once the new health law has been in place for a few months, however, Part-Time America may issue a collective sigh of relief. Nobody ever held up today’s part-time "mini-med" plans as model coverage. The majority of part-time workers don’t even get health insurance, and those who do typically get diluted plans with limited benefits they still have to pay something for. “You have to question whether that’s really insurance,” says Paul Fronstin, director of the health research program at the Employee Benefits Research institute. “They may not cover prescription drugs, and if you get cancer or end up in the hospital, they probably won’t help you a whole lot.”

Insurance offered under the Affordable Care Act, by contrast, could end up being a much better deal. Obamacare is complicated, and it will require many people to do detailed research on their insurance options instead of having an employer do it for them. There have also been elaborate efforts by foes of the program to depict it as The Ruination of Everything. So it’s not surprising that part-timers being told their employer is cutting them loose and sending them over to Obamacare are a little jumpy.

Actually enrolling could calm them down, however. Obamacare was designed to make decent health insurance affordable for people who otherwise can’t afford it, and whether you love or hate the program, it seems likely to succeed at that basic mission. That’s because the program subsidizes the cost of insurance based on your income, with the largest subsidies going to those with the lowest incomes.

Lots of confusion

There are many insurance choices under Obamacare that vary by state and apply to different income levels, which adds to the confusion. But the nonprofit Kaiser Family Foundation has built ahelpful calculator that lets you enter your income and a few other basic details to get an idea of how much insurance would cost you under the program.

A single parent with three kids and an annual income of $25,000, for instance, could get an $8,800 insurance plan for a total out-of-pocket cost of $500 per year. Subsidies, in other words, cover 94% of the cost. Try to beat that on part-time pay.

A two-parent family with two kids and a $50,000 income could get a $10,000 plan for $3,365, with subsidies covering 66% of the cost. There’s one catch: You only qualify for such deals if you’re not able to get coverage through your employer. So if you’re a part-timer whose company canceled your watered-down insurance coverage, it may have actually done you a favor.

Trader Joe’s is one employer known for offering generous health care benefits, even for part-timers (until now). But even those workers could end up better off under Obamacare. In an internal email published by the Washington Post, a Trader Joe’s exec provided some calculations for a part-time employee who earns about $24,000 per year and has been paying about $167 per month as her share of a Trader Joe’s policy similar to a “silver” plan under the ACA. If she enrolls in Obamacare, the subsidized cost would fall to about $70 per month for nearly identical coverage. And that’s before a $500 annual stipend Trader Joe’s plan to offer part-timers to help them pay for insurance.

Some will pay more

Without a doubt, there will be some people who end up paying more for insurance as their employers offer less. Mostly, they will be higher-income workers who lose employer-provided coverage and have to buy it through Obamacare. Subsidies are phased out at 400% of the poverty line, which this year is $45,960 for an individual and $94,200 for a family of 4. Above that, people have to pay the full cost of coverage.

Other companies have been changing their health care coverage in ways that sound like they’re related to Obamacare but aren’t. Walgreens (WAG), for instance, will begin requiring employeesto choose an insurance plan from a private “exchange” that offers at least 25 choices, instead of the three or four Walgreen’s has been offering. The concept is similar to the public exchanges that will be up and running under Obamacare, beginning October 1, with coverage beginning January 1. But the government plays no role and offers no subsidies in the exchange Walgreen’s is joining.

Walgreen’s will still bear much of the cost of its employees’ coverage, through fixed stipends it grants employees to help pay for care. But workers will now have to educate themselves more, choose coverage from a wide range of options, and pay the difference if they choose Cadillac coverage that costs more than the subsidy covers. The idea is to give employees a stronger incentive to control health care spending, by requiring them to pay more of their own money as costs rise.

IBM (IBM), Time-Warner (TWX) and General Electric (GE) have enacted similar plans for retirees, and companies in general are getting more aggressive about finding new ways to control health care spending as it become more and more of a burden. Obamacare may be part of the solution, but many companies would be doing this even without the health reform law. If the scaremongering over Obamacare ever stops, weathering changes in health care benefits may no longer require hypertension medication.

Rick Newman’s latest book is Rebounders: How Winners Pivot From Setback To Success. Follow him on Twitter: @rickjnewman.

Thursday, September 19, 2013

Obamacare Implementation Gets Messy for Small Business Owners


19 Apr 13Posted by: Kathleen C Lanza
in Feature Articles
obamacare-logo_full
Recent developments in the Obamacare (aka the Affordable Care Act) implementation process are confirming what many agreed from the outset was a foregone conclusion: This is going to get messier before it gets better. More specifically, the way the law is currently written is forcing some small business owners to make some pretty tough decisions.

Case in point? Over the last month or so, the mainstream press has cited a number of unsettling firsthand accounts by small-business owners who hover around the 50-employee threshold where offering health insurance to their workers becomes mandatory in 2014. And by mandatory, we mean they have to get on board or pay a penalty.

Here’s the issue, for many of them—even those who want to provide coverage—the math just isn’t working out the way they had hoped. Paying the penalty for non-compliance, they say, is far cheaper than it would be to continue or begin providing their employees with the opportunity to purchase health insurance, so many of them are planning to opt out and pay up. And for those who don’t want to have to make such a seemingly lose-lose call in the first place, the decisions they’re making in order to steer clear of the 50-worker-level mandates altogether don’t look much better.

To avoid even hitting the threshold for compliance, many small business owners report they are having to take some pretty bold steps. Some of them are cutting their employees’ hours or letting them go, while others are deciding not to hire any additional staff or upping the portion of the premium their employees currently pay for healthcare benefits. The fear is that, taken as a whole, these kinds of coping strategies may result in potentially negative consequences for an economy that is still struggling to recover.

Complicating matters even further is the fact that the health insurance exchanges*—which are supposed to make insurance premiums more affordable for both individuals and small businesses because they operate on the principle of pooled risk—may now be delayed in coming online for another year or so. This most recent development even has those organizations that represent small business and that also supportObamacare somewhat concerned.

In his recent testimony before the South Carolina Senate, Frank Knapp, Jr., president and CEO of the South Carolina Small Business Chamber of Commerce asserted that while the new law does offer a solid compromise to meet the demands of businesses who want to provide health insurance to their employees and rein in healthcare costs, any delay in the healthcare exchanges poses a challenge. Competitive state-based exchanges, he said, are “something that we are selling as a benefit of the Affordable Care Act,” so not having them in place sooner rather than later really limits small business owners’ options at a time when they need them the most.

As for small businesses with less than 50 employees, while they are not required under the new law to provide their employees with health insurance, the healthcare exchanges are designed to create a free and competitive marketplace that entices and enables them to do so. Of course,self-employed individuals will also be required to purchase health insurance or risk paying a penalty, which also makes the healthcare-exchange piece of the current law and its effects on implementation so important.

The really good news? And yes, there is some… To help everyone obtain coverage starting next year, health insurers will no longer be able to deny coverage to anyone based on their gender, health status or whether or not they have a pre-existing condition, addressing an ugly reality that has left far too many small business owners, sole proprietors and other individuals in need of health insurance out of luck in the past. Furthermore, insurers will be unable to charge higher premiums based on anyone’s specific health status or circumstances.

Although complicated, Obamacare does provide significant tax incentivesfor small business owners to provide their employees with health insurance benefits, even now. And for those self-employed individuals who qualify as low-income, tax credits will be available for them as implementation unfolds as well.

*more formally known as the Small Business Health Options Program, or SHOP Exchange
For more information on the very complex issue of Obamacare and its effects on small business owners in particular, we recommend the following resources:
“Some Small Businesses Opt for the Healthcare Penalty” (Wall Street Journal)
“Small Business Obamacare Delay Means Fewer Choices for Workers”(Huffington Post)
“Small Businesses Opt to Pay Obamacare Penalty Instead of Offering Health Insurance” (Huffington Post)
“Some Small Businesses See Obamacare as Welcome Relief”(Entrepreneur)
“Businesses Could Shum Obamacare Exchanges” (CNN Money)
“No Big Deal? Small Business Groups Shrug Off Delays to Obamacare’s Healthcare Exchanges” (Washington Post)
“What Obamacare Means for All Entrepreneurs” ( Fox Business News)
And finally, for a great webinar on how to prepare for Obamacare’s implementation and what it means for the self-employed and those with 50 or less employees more specifically, go to the National Federation of Independent Business (NFIB) now!