Free Supplemental Hospital and Surgical Benefits if you are both Female and Self Employed

If you are both self employed and female you should take a couple of minutes and read this blog post, it will show you how to get valuable benefits for Hospitalization, Surgery, and ER visits for FREE!

These benefits, from Family Life Insurance (a division of Manhattan Life), are paid in addition to any benefits you would receive from your health insurance and are guaranteed issue.  And, after the first 12 months, they cover all pre-existing conditions, including Maternity.

 I’ll describe the benefits in more detail further down the in this post, but first, let’s answer the question, ‘HOW CAN ANY INSURANCE PLAN BE FREE’?

 The answer is simple:

  • Insurance premiums are fully tax deductible so you get a tax deduction for the annual premium if you are self employed or own a business
  • The plan has built-in Wellness benefits for Mammogram and Pap Smear that are paid in cash to you when these tests are performed and you file an on-line claim
  • When you subtract the tax savings and Wellness benefits from the annual premium, the result is less than $0.

 Here is an example, for a 45 year old, self employed female:

  • Monthly premium:  $41.02
  • Less Monthly Deduction::  -$46.66 
    • Tax Deduction (15.2% Self Employment Tax, 15% Income Tax):   -$13,64
    • Annual Mammogram Benefit ($200):  -$16.66
    • Annual Pap Smear Benefit (($200):    -$16.66
  • Net Monthly Premium:  -$5.94

 

This plan isn’t just free, you are being

paid $5.94 per month to have it!

 

The benefits for this plan include:

  • Hospitalization (benefit paid for one admission per year):
    • $500 upon admission
    • $1,000 for the 1st day
    • $4,500 over the next 5 days
    • $100 a day for up to 365 days
  • Surgery:
    • $1,000 per day while hospitalized for a surgical procedure
    • $200 per day for Anesthesia while having surgery
  • Injury/Accident
    • Payments range from $200 to $1,800 for treatment for any injury or accident (similar to an AFLAC Accident plan)
    • Emergency Accident:  $200 for treatment (at ER, Urgent Care, or Doctor’s office

All of these benefits get combined when you have a hospital stay so you may collect, in cash, more than your hospital or surgery bill after your insurance plan deductible.   Who wouldn’t want some cash when you can’t work?

Maternity is also covered under this plan, just subject to the 12 month waiting period for pre-existing conditions.  And, since the policy is free, it doesn’t cost anything to have to wait for these benefits.

This plan is not only guaranteed issue it is also guaranteed renewable up to age 69 and rates haven’t changed in over ten years-this is a plan you can keep up for the long term.

There is also a 30 day free look for this policy and no contracts, you can cancel at any time.

 So in review, the Premier Choice Essential Supplement

  • Costs you less than nothing if you are self employed
  • Pays valuable cash benefits if you are hospitalized, have surgery, or treatment for an accident
  • Covers all pre-existing conditions after 12 months
  • Even covers Maternity after 12 months!
  • Even if you are not self employed the cost of this plan is pennies per day

If you have read this far you will want to know more, here is the link to more to the online, electronic application (click on ‘Premier Choice’):

LINK TO ONLINE APPLICATION

Or call me at (941) 924-3095 for more information.

 

 

 

 

 

 

 

 

Open Enrollment Starts Tomorrow!

The Open Enrollment for 2015 starts on November 15th for coverage that will begin on January 1, 2015.

Everyone has until December 15th to apply for the January 1st date. Open Enrollment will continue until February 15th however the effective dates will change, here are the deadlines:

  • December 15: January 1st
  • December 31: January 15th
  • January 15: February 1st
  • January 31: February 15th
  • February 15: March 1

Once Open Enrollment closes on February 15th the only way you can apply for health insurance is through something called a ‘Qualifying Life Event’.  This creates a Special Enrollment Period to select a new plan.

I encourage everyone to get an early start on your enrollment, there are only 30 days left as of tomorrow.

I have a new, express capability for enrollment where applications for Marketplace plans can be submitted in less than 10 minutes instead of the hours it might take on healthcare.gov, click HERE to visit this site (there is no additional cost to you)

How to Avoid a Mid-Year ‘Deductible’ Penalty in 2014

With 2014 rapidly approaching, consumers are facing a unique situation regarding their health plans that should be addressed before the end of 2013.

Since all health plans will terminate sometime before the end of 2014, everyone who changes plans in mid-year will restart their plan deductible in addition to facing higher premiums.

This ‘deductible’ penalty has never been faced before (almost all plan changes until now were for lower premiums and there was no need to change plans voluntarily if a deductible had been reached) and can easily be avoided by having your plan change in place for a January 1st effective date.

Whether you plan to switch to a 2013 plan that will continue through the end of 2014 or a new 2014 plan don’t make the mistake of waiting until your plan termination to do so.  I don’t want any of my clients to satisfy their plan deductible in the first few months of 2014 and then have to start all over again, it could mean an extra $5,000-$10,000 of costs during the year.

An Open Letter to President Obama-How to Fix the Affordable Care Act

Dear Mr. President,

I am 66 years old, have an BS in Chemistry and an MBA, and had a successful engineering, marketing, and executive management career in both the microelectronics and environmental industries.

I have also taken on several corporate turnarounds (on a smaller scale, up to $15M in revenue) and made them successes.

Since 2007 I have been an independent health insurance broker so have spent about 10,000 hours of my time learning about health insurance and helping my clients save money on their premiums without giving up coverage.  Since 2007 I have worked with almost 1,000 clients and my efforts resulted in, to date, over $3,000,000 in lowered premiums.  My services have not cost my clients anything as broker compensation is built into Administrative costs that are now subject to the MLR regulations of the Affordable Care Act.

I am now a Medicare recipient and have helped over 150 other Medicare recipients make the right choice for their supplemental benefits.

Those are my qualifications that should allow me to offer a critique of the final introduction of the Affordable Care Act and how you can fix it without changing the law, just the implementation.

I am also a lifelong Democrat who chose not to vote for you in 2012 because of the funding aspects of the Affordable Care Act (primarily the cost of the premium subsidies).

As someone who has been through hundreds of hours of preparation for this introduction,  let me say that I am appalled.  I really expected that the introduction would be based on the Medicare system and the Medicare.gov website, where you can find out everything you need to enroll in a plan in less than 10 minutes and either choose to enroll directly through Medicare or go through another channel (directly with an insurance company or working with a broker like myself).

That system has worked for many years, I am dumbfounded as to why it was not used as the base of the new ACA system.

That all being said, there are several simple things you can do to fix this very quickly.  Here they are:

  • Allow everyone to keep their current plan, whether grandfathered or not, through the end of 2014.  Many of the large insurance companies already offer this extension, it’s just that people don’t know about it.
  • Start educating the public about how health insurance works-99% don’t understand it and don’t realize that 2014 ACA plans are much better than the current plans, for a variety of reasons.  I can give you a laundry list of reasons why the new plans are better and real life stories of how my clients are purchasing new plans off the exchange (and paying full price) because they see value in these plans.  Allowing them to keep their plans through 2014 provides the time needed to do this education.
  • Change the way the enrollment system functions-stop all the identity proofing and Subsidy Eligibility upfront and allow consumers to submit applications, based on a subsidy calculator, either through the insurance companies (and their agents) or through healthcare.gov.  That’s how the Medicare system works and millions of applications are processed during the AEP in 2 1/2 months each year.  Allow the review process to approve the applications in a manner similar to today’s medical underwriting process-people are used to applications taking from 1-4 weeks to approve so the only thing that changes is the type of underwriting (from medical to financial).

You are stuck with a system that puts all of the work upfront and isn’t mature enough to handle it.  Most experienced agents (like myself) have given up even trying to process enrollments and are focusing on the Off Exchange market (where the new plan designs and benefits are saving many of my clients significant amounts of money, thank you).

We are a nation of innovation and creativity-I worked for 25 years in an industry (microelectronics) that changed the world forever and am personally embarrassed at what has happened in the past month.

We are better than this, you are better than this, I really hope that you will take the advice of those who are used to making things work in the corporate world and fix this and fix it soon.

Very truly yours,

Michael Golden

Avoiding Obamacare Rate Increases in 2014

Many people are getting notices from their insurance company about large premium increases in January because their plan is being terminated and replaced by a new 2014 plan that includes all of the mandates being introduced next year.

What most of them don’t know is that there is a very simple way to avoid these rate increases-you can enroll in many plans now (up until December 28th) that offer excellent benefits and low rates and these plans will be automatically extended until December 31, 2014 with no rate increases.

By doing so, you will avoid both the large rate increases in January and any penalty for not having coverage-all of these plans are fully compliant with the current law.

You will have to answer some health questions before approval but most of the insurance companies have become more lenient in approving these applications because there is only one year of risk for them.

Here is a real life example for a 40 year old living in Tampa, Florida:

  • 2014 Bronze plan:  $229 per month
  • 2013 Plan (Bronze equivalent):  $124 per month
  • 2013 Plan (Catastrophic):  $79 per month

Another example, a 30 year old female in Atlanta, Georgia:

  • 2014 Bronze plan:  $229 per month (same as Tampa)
  • 2013 Plan (Bronze Equivalent):  $99 per month
  • 2013 Plan (Catastrophic):   $53 per month

The only difference between the 2013 Bronze and Catastrophic plans is the Maximum Annual Out of Pocket-Bronze is $5.000 and Catastrophic is $10,000, after which the plan pays 100% (Catastrophic deductible is $5,000).

In both of these real life cases, enrolling in a plan now results in a premium that is between 40-70% LOWER than waiting until January (2013 plans will no longer be available after December 28th).  All of these 2013 plans will be terminated on December 31, 2014 but there is no guarantee that the law will still be in force without changes by then.  One change might be to allow everyone to keep their current plan, regardless of when it was issued.

These rates can be instantly be quoted online for your own situation at INSTANT QUOTES

Not every state allows 2013 plans to be extended (California and Illinois are among those who aren’t, it’s OK in Florida, Georgia, and many other states) but, if you are reasonably healthy, this is an easy way to avoid a huge rate increase in January while keeping excellent coverage.

 

A Tale of Two Exchanges

The difficulties in ‘shopping’ on the Federal Exchange for new health plans is well documented.

I signed up personally on October 1st and until today, have been unable to view a single health plan, that nightmare ended today although I still do not have a completed ‘Identity Proofing’ and can’t download the ‘Eligibility Determination’, all I get is an error message when clicking the button to do so.

I have clients in some of the individual states exchanges so, at the request of one today, I created an account for the Maryland Health Connection, the state exchange for, you guessed it, Maryland.

The experience on the Maryland Health Connection was a completely different experience from the Federal site.  Within 13 minutes I had created an account, logged in, entered my each of my clients ages and home zip, and could review each plan offered under this exchange.

I have now added Maryland to my very short list of exchanges (actually, it is the only one so far) where I will attempt to do an enrollment On Exchange.

Maybe Washington should look up the road a little and find out why Maryland was able to implement a clean, working system when our Federal government, with far more extensive resources, has this mess called healthcare.gov.

Added Benefits for Children under ACA

One of the best improvements under the Affordable Care Act is the opportunity to cover children under their own policy and not only receive enhanced benefits (Dental and Vision are now Essential Health Benefits under ACA plans and provide coverage at no extra cost) but allow parents to upgrade children’s coverage without changing their own-this can save thousands of dollars in both premiums and out of pocket cost for a family of 4.

The ability to put children under their own plan under ACA is something that should be considered by every parent.   The rates for Children’s Platinum plans are about 50% higher than a Bronze plan (in most states) and exchanging deductibles in the $5000 range to $0 makes much sense because of the extra benefits available.

Here is a real life example-a single dad with two teen aged children, ages 17 and 15.

  • The dad is healthy and rarely goes to a doctor outside of an annual physical
  • One of his children has seasonal asthma and allergies and takes a daily medication,  it is a brand name and costs about $150 retail
  • The other child is very healthy but needs some dental work, the estimate from their dentist was about $2,000.

The dad now has a family HSA with a $3,000 deductible and 100% coverage after that, his premium is $750 per month.  Under his plan, his sons’ med is only covered after the $3,000 deductible is reached while his other childs’ dental is only covered as a deductible expense from the HSA account.

While the dad liked having the $3,000 maximum family out of pocket, he didn’t like the premium or the lack of benefits for his children.  His expected total cost of healthcare for this year was $14,000 (total annual premium plus out of pocket costs).  While his son’s prescription costs count against the plan deductible there is still an additional $1200 to reach before the family maximum out of pocket is satisfied, so his maximum out of pocket (no including dental for his children) is $15,200.

The new 2014 ACA plans provided an excellent solution:

  • The dad will have a Silver Metal HSA Plan, deductible $3500, premium $377
  • Each child will have a Platinum Metal Plan, $0 deductible, copays for all out of pocket, including dental, $2,000 maximum out of pocket, premium for both children combined is $420 per month ($210 per child).

Under this new combination of plans, his expected cost of healthcare is $10,340 ($9600 annual premium, $360 for his son’s prescriptions and $400 for his other child’s dental).  That represents a reduction of $3,660 next year in the cost of the family healthcare due to known treatment.

Additionally, since the dad is keeping his HSA eligible plan, all of the family’s out of pocket can be taken from the existing HSA account on a pre-tax basis.

With these new plans, the remaining maximum out of pocket for the family is $3500 (dad), $1660 (son), and $1600 (daughter).

While the maximum cost of healthcare for the family is slightly higher under the new set of plans it still made sense because both children’s plans have small copays for all routine care, 75% coinsurance for all other medical care up to the annual maximum, and any additional dental treatment for either child (including Orthodontics, if needed) would be covered under the plan, making the annual maximum for either difficult to reach.

 

 

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