Going to Kaiser

Are you one of the people that have moved to KAISER insurance?  I'm hearing so many good things about getting appointments, successful surgeries, and I want to hear about your experience! Why did you move to Kaiser from other health insurance carriers?  IF it was financial or through an employee benefits change I'm curious as to how you would compare old and new.  Thanks!

Life Insurance Basics

Life Insurance is unique in that other financial planning tools simply can't provide what Life Insurance does. . . Here are the basics things Life Insurance can do for you:

• Paying Final Expenses - Bills, Medical Costs, Funeral Needs
• Ensuring the mortgage(s) will be paid off
• Ensuring your Spouse, Partner, Children will be able to use the monies to replace income
• Estate Planning to cover taxes as well as providing monies to heirs
• Permanent Life Insurance can be used as an emergency fund
• Term Insurance provides a benefit but does not build cash value and is less costly then Permanent

Health-Care Reform--Fact vs. Fiction

The health-care reform legislation that passed earlier this year was incredibly broad in scope, so it's probably not surprising that there's a good deal of confusion, and a number of false or misleading claims being circulated. Here's the truth behind two of the claims that have gained the most traction lately.

The claim: Beginning in 2011, you'll be taxed on the value of your employer-provided health insurance

There are several e-mail campaigns making their way around right now claiming that, beginning in 2011, taxable income on Forms W-2 will be increased to reflect the value of employer-provided health insurance. A typical e-mail warns: "You will be required to pay taxes on a large sum of money that you have never seen. Take your last tax form and see what $15,000 or $20,000 additional gross does to your tax debt. That's what you'll pay next year. For many it also puts you into a new higher bracket so it's even worse. This is how the government is going to buy insurance for the 15% who don't have insurance and it's only part of the tax increases."

The facts:

While it's true that, beginning in 2011, the health-care reform legislation requires employers to begin reporting the cost of employer-provided health-care coverage on an employee's Form W-2, the cost is included for informational purposes only, to show employees the value of their health-care benefits. The amount reported is not included in income, and will not affect your tax liability.

The claim: Beginning in 2013, a new federal sales tax will apply to the sale of a home

The claim is that, beginning in 2013, all real estate sales will be subject to a new 3.8% federal sales tax. The e-mails making this claim generally contain some variation of the following text: "Under the new health-care bill--did you know that all real estate transactions are now subject to a 3.8% sales tax? The bulk of these new taxes don't kick in until 2013 … If you sell your $400,000 home, there will be a $15,200 tax."

The facts:

This claim, though inaccurate, has a basis in fact. There's no federal sales tax being imposed on the sale of homes. But, beginning in 2013, the health-care reform legislation does impose a new 3.8% Medicare contribution tax on the net investment income of high-income taxpayers (individuals with adjusted gross income (AGI) exceeding $200,000, and married couples filing joint returns with AGI exceeding $250,000). Net investment income will include gain on the sale of a home. However, the tax will not apply to any gain from the sale of a principal residence that is excluded from income (individuals, if they qualify, can generally exclude the first $250,000 in gain from the sale of a principal residence; married couples filing joint returns can generally exclude up to $500,000). That means that in most cases, at least where a principal residence is concerned, the 3.8% tax would kick in only if your AGI exceeds the threshold above, and only if profit on the sale of the home exceeds $250,000 ($500,000 for married couples filing jointly).

Top Questions answered about your Health Insurance

The new legislation does not affect Medicare's guaranteed benefits. A goal of the new health-care legislation is to slow the increasing cost of Medicare premiums paid by beneficiaries, and to ensure that Medicare will not run out of funds. Cuts in Medicare spending will occur over a ten-year period, beginning in 2011, particularly targeting Medicare Advantage programs––Medicare programs provided through private insurers but subsidized by the federal government. These cuts could reduce or eliminate some of the extra benefits Medicare Advantage plans may offer, such as dental or vision care, and some insurers may choose to increase premiums. Medicare Advantage plans cannot reduce primary Medicare benefits, nor can they impose deductibles and co-payments that are greater than what is allowed under the traditional Medicare program for comparable benefits. Some of the federal funds previously earmarked for Medicare will be reallocated to doctors and surgeons as an incentive to treat Medicare patients.  Medicare Part D beneficiaries are surprised to find that they have to pay for the entire cost of prescription drugs out-of-pocket after reaching a gap in their annual coverage, referred to as the "donut hole." Currently, if you're a Medicare Part D beneficiary, you may pay up to an additional $3,610, out-of-pocket, for medicines after reaching an initial threshold of $2,830 in total prescription drug costs (including Part D payments, beneficiary co-pays, and deductibles). Beginning in 2010, beneficiaries who fall in the donut hole will receive a $250 rebate, and, in 2011, they will receive a 50% discount on brand-name drugs. By 2020, a combination of federal subsidies and a reduction in co-payments will completely eliminate the donut hole. However, individuals with annual incomes greater than $85,000, and couples with incomes exceeding $170,000, will see their Part D premiums increase as the federal subsidy offsetting some of the cost of Medicare Part D premiums is reduced. Benefits added to Medicare Medicare beneficiaries will receive free wellness and preventive care beginning in 2011.  Increased access to home-based care The new health-care reform law provides for programs and incentives for greater access to in-home care. The Community Living Assistance Services and Support program (CLASS) will be established sometime after 2011 (depending on when final regulations are published) as a voluntary insurance program, financed through payroll deductions and available to all working adults who choose to participate. This national program allows participants with functional limitations to maintain their personal and financial independence and live in the community by providing a cash benefit of at least $50 per day (after a five-year vesting period) for nonmedical services, such as home-care services, family caregiver support, and adult day-care or residential-care services. In order to qualify, a participant must need help with at least two activities of daily living, such as eating, toileting, transferring, bathing, dressing, or continence. The Independence at Home demonstration program, available in 2012. This test program will  provide Medicare beneficiaries with chronic conditions the opportunity to receive primary care services at home. This is intended to reduce costs associated with emergency room visits and hospital re-admissions, and generally improve the efficiency of care. Community First Choice Option will be available in 2011 to states to add to their Medicaid programs. This option will provide benefits to Medicaid-eligible individuals for community-based care instead of placement in a nursing home. In addition, the State Balancing Incentive Program, to be established in 2011, will provide increased federal funds to qualifying states that offer Medicaid benefits to disabled individuals seeking long-term care services at home, or in the community, instead of in a nursing home.

 

*None of these program fully replace or can possibly pay for all of your future needs. I design specific Critical Care, Long Term Care, Annuity or Health Insurance programs for you and yours.  

Health Insurance - Aetna Child Only Policies

Aetna will discontinue new business sales of our child-only policies to applicants (under the age of 19) for Aetna Advantage Plans for Individuals, Families and the Self Employed after the 11/1/10 effective date.


This change will allow Aetna to deal with upcoming changes from healthcare reform reguarding guaranteed issue (GI) of coverage for individuals under the age of 19 and no corresponding coverage requirement.
No impact to existing child-only policies.

Discontinuation of child-only coverage in the following states for Aetna Advantage Plans for Individuals, Families and the Self Employed: CT and OH will occur on 11/1/10. The implementation date for the following states MD, and OK is still being established. We will notify you once dates are confirmed for these states. The following states discontinued sales of child-only coverage for Aetna Advantage Plans for Individuals, Families and the Self Employed on 10/1/10: AK, AR, AZ, CA, CO, DC, DE, FL, GA, IL, IN, KS, KY, LA, MI, MO, MS, NC, NE, NV, PA, SC, TN, TX, VA, WV, and WY.

Options:  Other health insurance options available for individuals under age 19:  Be added as a dependent to a parent's plan.

Need More help?  Just email or call me.

Have a Great DAY!

Removing lifetime and annual dollar limits for essential health benefits

As part of the health care reform law, health insurance companies must remove lifetime and annual dollar limits on covered services (in network and out of network) that the U.S. Department of Health and Human Services (HHS) considers "essential health benefits." This change goes into effect September 23, 2010, although certain annual limits can be removed in phases over the next four years.  

Anthem Blue Cross California:

HHS has not given the final definition of "essential health benefits" yet, but based on the information and examples it has released, as well as our own research of current state and federal mandates, we have come up with a list of approximately 26 services we believe will be affected. There may be variations in certain states. The services still may be subject to copays and other cost shares. 

This provision of the health care reform law also restricts annual or lifetime dollar limits at the plan level except transitional annual dollar limits as defined in the legislation.  

A waiver program will be available for certain types of plans like mini-med and limited benefit plans so they can retain annual plan limits. 

Need Help? Email me today!