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10 Benefits Every Plan Must Offer Under Health Care Reform 

8/27/2013

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Health care reform requires that all individual and small group health plans offer these 10 essential benefits starting in January 2014. Many of the benefits weren't provided or fully covered in the past, so including them means more benefits with more protection for you.

Ambulatory patient services - Care you receive without being admitted to a hospital - such as at a clinic, physician's office or same-day surgery center.

Emergency services - Care for conditions which, if not immediately treated, could lead to serious disability or death.

Hospitalization - Care you receive as a patient in a hospital, such as room and board, care from doctors and nurses, and tests and drugs administered during your stay.

Maternity and newborn care - Care provided to women during pregnancy and during and after labor; care for newly born children.

Mental health and substance abuse disorder services - Care to evaluate, diagnose and treat mental health and substance abuse issues.

Prescription drug coverage - Drugs prescribed by a doctor to treat an acute illness, like an infection, or an ongoing condition, like high blood pressure.

Rehabilitation and habilitation services and devices - Services and devices to help people with injuries, disabilities or chronic conditions gain or recover mental and physical skills.

Laboratory services - Testing blood, tissues, etc., from a patient to help a doctor diagnose a medical condition and monitor the effectiveness of treatment.

Preventive and wellness services and chronic disease management - These services include routine physicals, screening and immunizations. Chronic disease management is an integrated approach to manage an ongoing condition, like asthma or diabetes.

Pediatric services - The other nine essential benefits are provided to children along with dental and vision care.

Resources For Health Care Reform Updates - Websites To Check In With
www.KFF.org

www.AHIP.com  

www.HHS.gov

www.CBO.gov  

www.NAIC.org  

www.statereforum.org/states  

www.ncpa.org       



Jeanine Kinzie is a Licensed Health Insurance Agent, Licensed Life Insurance Agent and a Federally Facilitated Marketplace Enroller from Grand Rapids, Michigan.
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Important Dates Coming Regarding The Health Care Reform Law That Impact You

8/23/2013

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Important Health Care Reform Dates
Under the new health care reform laws, there will be some changes coming in the way you pick, purchase and pay for your plan. Here are some of the upcoming steps and dates to remember:

October 1 The Health Insurance Marketplace opens for business for coverage effective Jan. 1, 2014. It is optional for you to participate if you already have coverage.  Most carriers are not forcing any changes to current coverage until 1/1/15 for individual plans.  Group insurance benefits must upgrade to the new benefit requirements effective the renewal date next year.  The enrollment form does not include health status with the exception of tobacco use. 

Plans will be more uniform since they must conform to Essential Health Benefits of the "metal" plans: Bronze (60%), Silver (70%), Gold (80%), Platinum (90%), and Catastrophic (available to those in certain situations, under age 30).  We encourage you use our services for comparing your options an enrolling in a new plan if it is a better option for you.

Open enrollment starts Oct. 1, 2013.
We will be able to enroll you in a non-medically underwritten plan for 1/1/14.  For the initial year only, open enrollment lasts from 10/1/13 to 3/31/14.  Coverage begins wither 1/1/14, or the 1st of the following month (for next year only), to ensure no gap in coverage.  If you do not purchase insurance, most will have to pay 1% of their adjusted gross income as a penalty.  We can assist you in calculating your subsidy so you know what your net cost is anticipated to be.  You have an option of having the insurance carrier receive monthly payments from the government, or you can get a refundable tax credit if you do not receive a monthly subsidy.  In most cases, subsidies are not available for those with group insurance options.

January 1 Tax credits (or subsidies) become available. Go to http://kff.org/interactive/subsidy-calculator/ and use theSubsidy Calculator Tool to see if you qualify.

Be forewarned, there are a lot of moving parts to this and it's getting more complicated than ever.  Your accountant may have recommendations for your situation due to income projections changing for 2014.  Keep in mind that open enrollment ending means that you won't be able to purchase coverage anytime during the year, without a qualifying condition.  A qualifying condition would be loss of group coverage due to job loss or change of family status (birth, divorce, adoption, marriage).  The next open enrollment would be October 1st, 2014 for January 1, 2015 effective date.

Jeanine Kinzie is a Licensed Health Insurance Agent, Licensed Life Insurance Agent and a Federally Facilitated Marketplace Enroller from Grand Rapids, Michigan.
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Getting Ready For Obamacare

8/16/2013

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If you have questions about the Affordable Care Act, here's a short video overview on how it works. It is the law and it is being implemented. You will be affected, no matter who you are. This is the largest social change in our country since Medicare started in 1965. Take a few minutes to watch this from Kaiser Family Foundation, then let me know if you have any questions.
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    I love to work one-on-one with my clients to provide safe investment choices which will contribute to the financial success and security of individuals and families. 

    As a health and life insurance agent since 2004, I have been active in educating clients and the public about Healthcare Reform benefits and issues. I am also a small business advocate for current tax law and healthcare issues.

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