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Archive for February, 2009

The Presidents Budget Blueprint

February 28th, 2009 sbrennan No comments

http://online.wsj.com/public/resources/ … 262009.pdf

I will stick to the healthcare part .
You can not raise the tax on venture capital and lower the deductibility of non-profit donations to fund health care .

To learn more about Florida group health insurance, Tampa group health insurance, Sarasota group health insurance, Miami group health insurance, or Orlando group health insurance, visit Grouphealthflorida.com or call 1-800-873-5713.

Stimulus Makes Cobra Coverage a Better Bet

February 21st, 2009 sbrennan No comments

COBRA Provisions in the American Recovery and Reinvestment Act

February 20th, 2009 sbrennan No comments

COBRA Provisions in the American Recovery and Reinvestment Act

RECOVERY AND REINVESTMENT ACT
Congress has passed the American Recovery and Reinvestment Act (“the Act”), and the Act has been signed by President Obama. This alert describes the provisions in the Act that affect COBRA continuation coverage and similar state continuation coverage. These provisions are generally effective immediately or in a relatively short period of time and require prompt attention from employers. The COBRA changes raise numerous questions, particularly from an operational standpoint, that do not yet have answers. Many of the provisions in the law are not entirely clear and there may be additional clarification from the Department of Labor, Treasury or Health and Human Services over the next 30-60 days.

Applicability and Effective Date
The COBRA changes affect both the federal COBRA provisions and the Public Health Service Act program that provides similar extension benefits for public programs. In addition, however, the subsidy provisions apply to state continuation coverage that is comparable to federal COBRA. That would include so-called “mini-COBRA” state laws that cover groups below the 20 employee threshold for COBRA. To be comparable, the state continuation law must allow the individual to continue substantially similar coverage as was provided under the group health plan at a monthly cost that is based on a specified percentage of the group health plan’s cost of providing such coverage. Reference to “COBRA” throughout this memo will also refer to the state programs that meet those requirements.

The Act is effective February 17, 2009, the day that President Obama signed the bill. All of the COBRA provisions that have a timeframe will date from that day. As for calendar monthly billed programs, the effective date is March 1, 2009.

Attention: Employers will need to identify ‘assistance eligible individuals’ as soon as possible to expedite actions. Additional guidance will be forthcoming.

New Subsidy for COBRA Beneficiaries
The Act provides for a new subsidy for certain COBRA beneficiaries. The subsidy is 65% of the COBRA continuation coverage premiums for eligible individuals for up to 9 months. The COBRA beneficiary will pay only 35% of the overall COBRA premium for that period. The period expires on the earlier of (i) nine months, (ii) the date the individual becomes eligible for major medical group coverage or Medicare or (iii) the end of the maximum required period of continuation under COBRA. Further, the beneficiary must notify the employer in writing if they become eligible for coverage under a major medical group health plan or Medicare and is subject to significant penalties (110% of the subsidy amount) for failing to do so.

An individual who does not receive a subsidy that he/she believes appropriate may appeal the plan’s determination to the Department of Labor for private plans or to the Department of Health and Human Services for public plans covered under the Public Health Services Act. The relevant agency must rule on the appeal within 15 business days. Individuals whose appeal is denied may sue under ERISA.

Eligibility for the Subsidy—Timing
The subsidy is available to individuals (and their dependents) who were involuntarily terminated from their employment and became eligible for COBRA beginning September 1, 2008 through December 31, 2009. Persons who elected prior to the enactment of the Act (but on or after September 1, 2008) will be eligible to receive the subsidy prospectively from the date of enactment through the maximum nine-month period. Otherwise eligible persons who did not elect COBRA between September 1, 2008 and the date of enactment will have the opportunity to elect COBRA on a prospective basis with the maximum duration of the coverage dating from the date that they could have first elected COBRA. Employers or plans will have to provide notice to these groups of individuals. In addition, a group health plan or insurer must refund the individuals any COBRA premiums that subsidy-eligible persons paid on or after the date of enactment in excess of 35% of the premium. This may be in the form of a reimbursement payment or credit against future premium payments due.

Eligibility for the Subsidy—Income Test
The subsidy is adjusted based on income. Joint filers with $250,000 or more of modified adjusted gross income and all other filers with $125,000 or more of modified adjusted gross income are not eligible for the full subsidy. The subsidy is phased out completely for persons with modified adjusted gross incomes of $290,000 joint or $145,000 for other filers. The subsidy is not considered income as long as the beneficiary meets the income tests. Excess amounts of subsidy over the amount the person is entitled to by income will be added to the person’s tax on the person’s federal tax return. The employer will not have to be concerned about the taxable effect on COBRA beneficiaries although a COBRA beneficiary may request that the employer not provide any subsidy.

Mechanics of the Premium Subsidy
The Act requires that the relevant entity that is collecting the 35% premium simply not collect the remaining 65% and, instead, obtain reimbursement from the federal government. In cases of a multiemployer plan, a group health plan subject to federal COBRA and/or a self-funded employer, the plan or the employer that is collecting the premium will recoup the subsidy amounts through commensurate reductions in payroll taxes. For insured plans not subject to federal COBRA, where the insurer is collecting the premium, the insurance company will be entitled to the reimbursement through a corresponding credit to its own payroll taxes. In cases where the payroll taxes are not sufficient to cover the subsidy, the additional amount will be provided as a credit to the taxpayer as if it was an overpayment of payroll taxes. There are filings that payers receiving the subsidy must make with the Secretary of the Treasury.

Electing a Different COBRA Option
An employer may allow a COBRA-subsidy eligible individual to change his or her health insurance coverage option when making a COBRA election. The new plan option must be made within 90 days of receipt of the COBRA election notice, must have the same or lower premiums and must be available to non-COBRA active employees under the plan.

Notice Requirements and Election Period
Under the Act employers must provide modified election notices or provide separate supplemental notices to all persons who became entitled to elect COBRA continuation coverage during the period beginning on September 1, 2008 and ending on December 31, 2009.

The new forms would notify the individual about the subsidy and, if applicable, the right to change to different benefits options. DOL, Treasury and HHS are supposed to work together to provide a model notice within 30 days of enactment.

Notices are required to be sent to subsidy-eligible persons who became qualified beneficiaries before the date of enactment within 60 days of enactment. (The Act does not affect the timing of notices sent to individuals who become qualified beneficiaries on or after the date of enactment.) The election period for those beneficiaries who became eligible before the date of enactment will begin on the date of enactment and end 60 days after the date the plan administrator provides the required notice.

Failure to provide the notices would be a COBRA violation and subject to the standard COBRA penalties of up to $110 a day under ERISA. Additionally, there could be adverse tax consequences under the Internal Revenue Code, which can impose excise taxes of $100 per day per notice on the plan administrator.

To learn more about Florida group health insurance, Tampa group health insurance, Sarasota group health insurance, Miami group health insurance, or Orlando group health insurance, visit Grouphealthflorida.com or call 1-800-873-5713.

Group Health Insurance Is Crucial

February 19th, 2009 sbrennan No comments

In most instances, group health insurance is usually fairly affordable, however it does come with some “must do” provisions.

As one may expect, the term “group health insurance” implies that all workers at a certain company must ‘opt in’ for the coverage provided. In most instances as well, the employee is expected to pay the first of their premiums within a 30-day time frame or they will not have automatic coverage.

The other thing an employer would need to know about buying a group health care plan is that there are a couple of choices when it comes to the sponsored Employee Retirement Income Security (ERISA) plans. Those choices are insured and self-insured. There are also non-ERISA plans, but these are more applicable to groups such as church organizations.

Employees will usually find that group insurance is normally the least expensive kind, although many companies do offer a variety of other plans that range from a Preferred Provider Organization (PPO) to a Health Maintenance Organization (HMO). Other companies prefer to just stick with the tried and true group health plan coverage and that is it.

In the case where the employer offers PPO, the worker is expected to pay a monthly premium. However, this type of plan does not allow the choice of a physician for the major reason that they use massive doctor networks that provide medical care. The options here allow choices (from the network) of a primary care doctor. The choice of hospitals is also limited in a PPO to those in the network only. It is highly likely a co-payment will be demanded when services have been rendered.

Basically a PPO is a group of doctors, hospitals and/or other health care service providers that offer services at a lower price. This isn’t to say there is no choice to go to a doctor outside the network. However, the cost to you personally would be much higher than using a PPO network doctor.

While the various choices of which group health care plan to choose may be confusing, talking to a local health care insurance agent will sort that out quickly and efficiently. The advice is free and their information is tailored to meet the needs of the organization seeking group health care benefits.

To learn more about Florida group health insurance, Tampa group health insurance, Sarasota group health insurance, Miami group health insurance, or Orlando group health insurance, visit Grouphealthflorida.com or call 1-800-873-5713.

End of the Line Health Care Costly

February 19th, 2009 sbrennan No comments

By end of the line, we aren’t referring to palliative care for a terminally ill patient. We are referring to hospital emergency rooms across the nation increasingly being used as a last resort for medical care.

This recession has hit people’s health care in ways no one really thought about. People are getting laid off and with their lay off they lose the health care they once had. Not only is this a significant shock to the system, it may mean the person or family is no longer able to afford health care. Expect the numbers of uninsured Americans to rise while until the recession stabilizes and people are able to go back to work.

This extra burden of more uninsured people really puts a strain on an already overused and abused health care system. What will start to happen, and in fact is already happening, is hospitals becoming the ones who have to absorb unpaid medical bills. These losses will merely translate into higher cost of care for others later, and the cycle will begin again.

Not only will the costs of providing care rise significantly, but also waiting times at urgent care and emergency rooms will get even longer than they happen to be now. The system just has so many people in it that offer health cares services and once their limit has been stretched to the max, it becomes a matter of trying to play catch-up to deal with all the patients who should not be using the hospital as a doctor’s office.

Where does it end? Where did it begin? These are the kinds of questions that plague health care providers and governments as they are trying to find solutions to this nationwide dilemma. At the bottom of this turmoil in the health care system is the fact that the national economy isn’t in great shape. Without a stable economy and a lower debt burden, the health care system will continue to be in the mess it is in today.

It’s also evident that many larger employers are starting to cut back on the kinds of health care perks they offer their employees. It has become an enormous albatross of debt for them to keep up with the rising costs. There is a shift to offering plans that pass more of the costs down to the workers.

This cycle is certainly a destructive one and one that there doesn’t seem to be too much control over. The checks and balances of the economy are out of whack. A recession has to run its course before the nation sees light at the end of the tunnel, an economy starting to recover and a health care system that isn’t overloaded with people who should be doctoring with their family physicians.

To learn more about Florida group health insurance, Tampa group health insurance, Sarasota group health insurance, Miami group health insurance, or Orlando group health insurance, visit Grouphealthflorida.com or call 1-800-873-5713.

The American Recovery and Reinvestment Act

February 17th, 2009 sbrennan No comments

As you are aware, President Obama recently signed into law a $790 billion economic stimulus package – the American Recovery and Reinvestment Act. This plan combines $281 billion in tax cuts with $311 billion in programs funded by appropriation committees and $193 billion for benefits programs.

I would like to take this opportunity to provide you information on how this Law will impact your healthcare benefits and more specifically the effects of the COBRA provisions.

COBRA Components
This plan includes provisions to help eligible jobless workers pay for health insurance under COBRA. Available to employers with 20 or more employees, COBRA allows newly unemployed workers to keep health insurance provided by their former employers. Traditionally, these premiums are prohibitively expensive.

Components include:

• Premium Reduction/Subsidy: For workers who were involuntarily terminated between September 1, 2008 and December 31, 2009, the government will subsidize 65% of their premiums under COBRA for nine months. This subsidy also applies to healthcare continuation coverage if required by the state.
• Special Election Period: For workers who were involuntarily terminated between September 1, 2008 and the day the stimulus Law goes into effect, and who did not sign up for COBRA, will get an additional 60 days to do so and receive the subsidy.
• New Notification Period: Within 60 days of enactment, the Employer or COBRA Administrator shall provide an additional notification to any Assistance Eligible Employee who became entitled to elect COBRA before enactment of this Law.
• Tax Credit for Employers: To offset the employer’s expense, the employer may take a full tax credit for its expenditures out of its payroll taxes including both income tax withholding and FICA.
• High Income Exclusion: If the modified adjusted gross income (AGI) of a participant exceeds $125,000 a year, or a family’s AGI exceeds $250,000, their income tax will be raised by the premium reduction amount – effectively removing the subsidy.
• Plan Enrollment Option: Qualified Beneficiaries (QBs) under the stimulus will have the option to change plans to another product offered by the Employer with the following requirements:
o Employer agrees to allow QBs to enroll in different coverage
o The selected plan does not exceed the premium for coverage in which the individual was enrolled at the time the qualifying event occurred
o Plan cannot be Dental, Vision, Counseling, Referral or FSA
o Coverage is also offered to active employees

Impacts on Your COBRA Compliance
This Law will have a direct impact on your company with regard to the administration of your healthcare benefits. In compliance with the Law, you will be required to:

• Send a notice to involuntarily terminated employees since September 1, 2008 with a description of their rights and obligations regarding the subsidy.
• Update all COBRA forms and enrollment materials to reflect the changes.
• Or, if you currently work with a COBRA Administrator, coordinate with the Administrator to send notices and update forms.
• Take a full tax credit out of your payroll taxes for your expenditures associated with the subsidy.

As you navigate your way through these legislative changes, if I can be of assistance to you in any way please do not hesitate to call. For those of you not already working with a COBRA Administrator, I can provide recommendations and walk you through your options.

www.grouphealthflorida.com

To learn more about Florida group health insurance, Tampa group health insurance, Sarasota group health insurance, Miami group health insurance, or Orlando group health insurance, visit Grouphealthflorida.com or call 1-800-873-5713.

President Obama missing the point

February 11th, 2009 sbrennan No comments

We would like President Obama to tie in loss of job benefits with continuation of health insurance benefits . Many people lose their jobs because of their health problems and can not pay Cobra .

We like any expansion of children health programs via a national childrens coverage in the administered in the schools with Rx dispensed onsite .

We dont like Daschles technology insert because the burden is on the physician (again)

To learn more about Florida group health insurance, Tampa group health insurance, Sarasota group health insurance, Miami group health insurance, or Orlando group health insurance, visit Grouphealthflorida.com or call 1-800-873-5713.

The Obama Recovery Bill & TARP

February 10th, 2009 sbrennan No comments

We are going to try and leave politics out of this . Obama is our Commander in Chief and the people have spoken , a milestone has been achieved . There are more milestones , Woman , Asians , ect .

Now past the party its time to talk business .

I do not know who can be happy with the cost of the Bill , the secrecy surrounding the Bill , and the broad scope of the agenda including disgraced appointee Tom Daschles portable medical records technology proposal although it is contradictory to HIPAA and not always in the patients best interest to know every medical deviation and degeneration of their own body , nor is encryption fool proof . There are many new burdons expenses and penalties to be incurred by Medical Providers , Insurance carriers , and Insurance Agents and Agencies .

At first review everything and anything is considered a component of economic recovery which strikes me as deceitful and dishonest . It is too big and arrogant in its complexity .

We will break it down over the coming weeks here on our Group Health Insurance Blog .

We now have 117,000 RSS Readers in Florida and expatriates as far away as the island of Tobaga offshore from The Republic of Panama Central America .

http://thomas.loc.gov/cgi-bin/query/z?c111:H.R.+1:

**** Update We are going to applaud the Obama administration for taking a stab at the Cobra problem . We will detail it when we can , but frankly we do not know where the 65% subsidy comes from or much about how it works . There is an old saying about assumption so when we get it black and white we will post it .

To learn more about Florida group health insurance, Tampa group health insurance, Sarasota group health insurance, Miami group health insurance, or Orlando group health insurance, visit Grouphealthflorida.com or call 1-800-873-5713.

Ruin Your Health With the Obama Stimulus Plan

February 10th, 2009 sbrennan No comments

Ruin Your Health With the Obama Stimulus Plan: Betsy McCaughey

Commentary by Betsy McCaughey

Feb. 9 (Bloomberg) — Republican Senators are questioning whether President Barack Obama’s stimulus bill contains the right mix of tax breaks and cash infusions to jump-start the economy.

Tragically, no one from either party is objecting to the health provisions slipped in without discussion. These provisions reflect the handiwork of Tom Daschle, until recently the nominee to head the Health and Human Services Department.

Senators should read these provisions and vote against them because they are dangerous to your health. (Page numbers refer to H.R. 1 EH, pdf version).

The bill’s health rules will affect “every individual in the United States” (445, 454, 479). Your medical treatments will be tracked electronically by a federal system. Having electronic medical records at your fingertips, easily transferred to a hospital, is beneficial. It will help avoid duplicate tests and errors.

But the bill goes further. One new bureaucracy, the National Coordinator of Health Information Technology, will monitor treatments to make sure your doctor is doing what the federal government deems appropriate and cost effective. The goal is to reduce costs and “guide” your doctor’s decisions (442, 446). These provisions in the stimulus bill are virtually identical to what Daschle prescribed in his 2008 book, “Critical: What We Can Do About the Health-Care Crisis.” According to Daschle, doctors have to give up autonomy and “learn to operate less like solo practitioners.”

Keeping doctors informed of the newest medical findings is important, but enforcing uniformity goes too far.

New Penalties

Hospitals and doctors that are not “meaningful users” of the new system will face penalties. “Meaningful user” isn’t defined in the bill. That will be left to the HHS secretary, who will be empowered to impose “more stringent measures of meaningful use over time” (511, 518, 540-541)

What penalties will deter your doctor from going beyond the electronically delivered protocols when your condition is atypical or you need an experimental treatment? The vagueness is intentional. In his book, Daschle proposed an appointed body with vast powers to make the “tough” decisions elected politicians won’t make.

The stimulus bill does that, and calls it the Federal Coordinating Council for Comparative Effectiveness Research (190-192). The goal, Daschle’s book explained, is to slow the development and use of new medications and technologies because they are driving up costs. He praises Europeans for being more willing to accept “hopeless diagnoses” and “forgo experimental treatments,” and he chastises Americans for expecting too much from the health-care system.

Elderly Hardest Hit

Daschle says health-care reform “will not be pain free.” Seniors should be more accepting of the conditions that come with age instead of treating them. That means the elderly will bear the brunt.

Medicare now pays for treatments deemed safe and effective. The stimulus bill would change that and apply a cost- effectiveness standard set by the Federal Council (464).

The Federal Council is modeled after a U.K. board discussed in Daschle’s book. This board approves or rejects treatments using a formula that divides the cost of the treatment by the number of years the patient is likely to benefit. Treatments for younger patients are more often approved than treatments for diseases that affect the elderly, such as osteoporosis.

In 2006, a U.K. health board decreed that elderly patients with macular degeneration had to wait until they went blind in one eye before they could get a costly new drug to save the other eye. It took almost three years of public protests before the board reversed its decision.

Hidden Provisions

If the Obama administration’s economic stimulus bill passes the Senate in its current form, seniors in the U.S. will face similar rationing. Defenders of the system say that individuals benefit in younger years and sacrifice later.

The stimulus bill will affect every part of health care, from medical and nursing education, to how patients are treated and how much hospitals get paid. The bill allocates more funding for this bureaucracy than for the Army, Navy, Marines, and Air Force combined (90-92, 174-177, 181).

Hiding health legislation in a stimulus bill is intentional. Daschle supported the Clinton administration’s health-care overhaul in 1994, and attributed its failure to debate and delay. A year ago, Daschle wrote that the next president should act quickly before critics mount an opposition. “If that means attaching a health-care plan to the federal budget, so be it,” he said. “The issue is too important to be stalled by Senate protocol.”

More Scrutiny Needed

On Friday, President Obama called it “inexcusable and irresponsible” for senators to delay passing the stimulus bill. In truth, this bill needs more scrutiny.

The health-care industry is the largest employer in the U.S. It produces almost 17 percent of the nation’s gross domestic product. Yet the bill treats health care the way European governments do: as a cost problem instead of a growth industry. Imagine limiting growth and innovation in the electronics or auto industry during this downturn. This stimulus is dangerous to your health and the economy.

(Betsy McCaughey is former lieutenant governor of New York and is an adjunct senior fellow at the Hudson Institute. The opinions expressed are her own.)

To contact the writer of this column: Betsy McCaughey at Betsymross@aol.com

Last Updated: February 9, 2009 00:01 EST

***** We got pounded for not liking this bill , lets us be more clear , we like technology and a better health insurance and prescription service . We are insurance agents after all . We just dont think think Medical Providers and agents should get stuck with the huge expense of keeping medical data secure , portable , and updated . Consumerism means responsiblity of the consumer .

To learn more about Florida group health insurance, Tampa group health insurance, Sarasota group health insurance, Miami group health insurance, or Orlando group health insurance, visit Grouphealthflorida.com or call 1-800-873-5713.