Insurance Quotes for Groups and Businesses
Federal Health Care Reform
Group Health Insurance Plans for Businesses, we have dedicated an entire website for Group Health Insurance. The New Federal Law mandates insurance changes for All Americans. Our firm is on the issue of change. Click on the link and go directly to the Group Health Insurance website.
Providing your employees with a good cost effective group health insurance plan can help you and your employees stay healthy. We can help you obtain affordable group health insurance and selecting the right health plan for your business. We take into consideration the location of your business, what carriers are available near your business, the doctor networks from the different carriers options and rates available in your area.
Self-Employed or Groups 2-150, we can help. Plans can start at any time of the year.
How much does it cost for a group health insurance plan?
Each and every small business is going to have a different price. There are many factors taken into account for the price.
- Location of the Business
- The type of business industry
- The carrier you choose
- The age of your employees
- Whether or not you will cover dependents
- The health plans you choose to offer
- The amount you as the employer will contribute as a benefit to the employee
The health insurance company has different premiums for different regions in the state. The best way to find out what a group health insurance plan will cost your company is to get a quote.
Low-Cost Group Health Insurance, use Individual Health Insurance with a List Bill
Individual health insurance is generally much cheaper than group health insurance. Using a single list bill for all of your employees, the healthy and part time workers can take advantage of the low rates. Essentially, everyone will have his or her own plan but there will be a single invoice for all plans that can be paid by the business.
Group Health Insurance with a Health Reimbursement Arrangement (HRA)
With an HRA you put money into a spending account for the employee. They use this money to pay for medical expenses. This is entirely employer funded and the unspent money is carried over and not lost. The funds belong to the employer and not the employee.
The HRA is authorized under section 105 of the Internal Revenue Code. The plan is usually set up to reimburse for medical expenses associated with a health plan like doctors visits, prescriptions, etc. The plan can be designed to reimburse for other expenses such as vision tests, dental, orthodontics, and much more. There are many advantages to the employer.
First, you decide what you want to cover and how much you will pay out.
Second, you are not pre-funding an account where unused money goes to the employee.
Third, you can use a higher deductible health insurance plan. The savings in premium is generally much greater than any assistance you provide the employee in the HRA.
Finally, the employee will feel secure with the higher deductible plan knowing that there is some assistance for routine medical expenses.
We can save you money on your group health insurance.
Eligible Employees that can be covered on a Group Health Insurance Plan.
Full Time Employees qualify; the employee must be working at least 30 hours a week on a permanent basis. The full time employee must be paid by the employer (W-2 or 1099).
Owners, Corporate officers, Sole Proprietors, Partners are eligible for coverage on the group health insurance plan, corporate officers, sole proprietors, and partners must put in at least 20 hours of work per week.
Eligible Family members - Dependents
Eligible dependents have one of the following associations with the eligible employee:
ý Husband, Wife, (lawful)
- Domestic partner (must be verified)
- Child under the age of 19 and unmarried (natural or legally adopted) of the employee or the employeeýs enrolled spouse
- Children who are full time students and qualify as a dependent for Federal Income Tax (unmarried).
A husband and wife that both work at the same company can both be covered as employees.
Employees who do not to participate in the group health insurance plan must waive (decline) coverage by completing the appropriate section on the Employee Application when becoming eligible for the group health insurance
Employees not entitled to participate in the group health insurance plan include:
ý Seasonal employees
ý Part Time or Temporary
>> Group Health Insurance Quotes <<
Health Care reform 2010-2014
We may not all be happy about it, but health care reform is the new law and we will work with the hand we have been dealt. The new law will be bring many new changes with government mandates.
Our firm is diligently working on the changes that will come to small business owners with under 50 employees, we will be here to help. In the coming months, there will be a full analysis of current group health plans in place so as to stay in compliance. We also want to make you aware of the tax credits avialble in 2010 and the new mandates that take effect this year.
Effective Immediately Mandates:
1 .Individuals and employer group plans that wish to keep their current policy on a grandfathered basis can only do so if the only plan changes made are to add or delete new employees and any new dependents. In addition, an exception is made for employers that have scheduled plan changes as a result of a collective bargaining agreement. Once a plan loses its grandfathered status, it will be subject to all of the market reforms in the legislation when they take effect, regardless of where coverage is purchased (either through an exchange or outside of an exchange). However, most of the market reform provisions slated to take effect in the next six months will apply to all plans, whether or not they hold grandfathered status.
2. Eligible small businesses (those that have no more than 25 FTEs, pay average annual wages of less than $50,000 and provide qualified coverage) are eligible for phase one of the small business premium tax credit. Small employers will receive a maximum credit, based on number of employees, of up to 50% of premiums for up to two years if the employer contributes at least 50% of the total premium cost. 3. Employers that provide a Medicare Part D subsidy to retirees will have to account for the future loss of the deductibility of this subsidy in 2013 on liability and income statements. While the elimination of the deductibility does not take effect until 2013, there could be an immediate accounting impact. If you are a client of the firm and we do not currently manage your group health insurance account, please contact us immediately so we may email you the BOAR approval process form. We will actively monitor all clients accounts and our service offerrings will expand over the years to keep your business in federal and state compliance.
Eligibility Rules Credit Amount
Employer Notification/Support Materials I will send you future email updates with detail explanations of each mandate and change as it is explained by the administration. I have been attending almost daily webinars and meetings in regards to these changes so our firm can be at the forefront of these historic changes.
For-profit and tax-exempt employers may qualify. However, all three of the following criteria must be met:
The IRS is informing potentially eligible small business groups about this tax credit. Visit the IRS site for additional support materials, including a video and frequently asked questions
If you are a client of the firm and we do not currently manage your group health insurance account, please contact us immediately so we may email you the BOAR approval process form. We will actively monitor all clients accounts and our service offerings will expand over the years to keep your business in federal and state compliance.
HEALTH CARE
REFORM LAW
In March 2010, Congress passed and the President signed a new health
care reform package into law. We understand you may have questions
about the new health care reform law, and how it may affect your
HumanaOne health plan.
That’s why we’ve put together this information. We hope it will answer some of your basic questions about the new law, what to expect, and which changes may affect you and your family.
Change Takes Time
The health care reform law is thousands of pages, with hundreds of
provisions that insurers will implement over the next several years.
There were no immediate changes to your HumanaOne health plan
when the new law was enacted in March 2010.
Starting in late September 2010, you may see some changes in your
health plan when it renews. Humana will let you know about any
changes before your plan renews.
It’s important to keep a few things in mind. Many of the law’s provisions
are general in nature. Legislative and regulatory bodies will pass additional
laws and issue rules, regulations, and guidance that explain how health
plans must comply. Not all of the rules and regulations have been released,
so it’s difficult to understand the full impact of health care reform on any
member’s specific health coverage. In the meantime, we can share what
we do know.
What It Means for You
GCA096VHH 7/10
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Q: When will I start to see changes to my health plan because
of health care reform?
A: Many of the provisions in the new law will not take effect for several
years. At the earliest, provisions that affect individual health plans will take effect six months from the date of enactment — in late September. Even then, most of those early provisions will not affect your plan until it renews. Humana will let you know about any changes before your plan renews.
Q: Do I need to do anything differently, now that health care
reform is law?
A: No, you can use your health plan as you normally would.
Q: Will my premium change due to health care reform? Will more
services be covered?
A: It’s hard to say how your plan’s benefit design and premium rates
might change until we know more about the law and how state and federal regulatory agencies will apply its provisions.
Q: What about “grandfathered” health plans?
A: Under the new law, the plan you had as of March 23, 2010, is
considered a “grandfathered” plan. Such plans are exempt from many — but not all — reforms. New plans, effective after March 23, 2010, are not “grandfathered” and will be subject to changes that could cause premiums to rise higher than they otherwise would. For example, the new law will eventually eliminate annual limits on certain key health benefits and require plans to include a mandatory package of “essential benefits.” While such benefits may appear attractive, they also can make premiums more expensive. (See the timeline on page 5 for more.)
You may lose your rights to a “grandfathered” plan if you make changes
to your existing health plan. Humana won’t make any changes that will
affect your “grandfathered” status. However, you could make changes that cause you to lose this status, such as:
• You switch to a plan that pays a lower coinsurance percentage
• You increase your deductible by more than 18 percent
• You choose a plan with higher copayments
(Continued on next page.)
Q QUESTIONS & ANSWERS
A
The U.S. Department
of Health and Human
Services (HHS)
warned consumers
about people selling
fraudulent health
insurance policies
— sometimes referred
to as “Obama Care.”
If you think you were
approached about a
fraudulent health
plan, please contact
your state department
of insurance, or the
agency that regulates
health insurance in
your state.
! BUYER
BE AWARE
3
• You choose a plan that eliminates all or most benefits for a
particular condition
• You enroll in a new plan — with the same insurance company or a
different one — that has an effective date anytime after March 23, 2010 Other changes, such as increasing your benefits or adding coverage for a family member, will not cause you to lose “grandfathered” status.
Q: I’ve read that reform is supposed to lower health care costs.
Will HumanaOne members be eligible for any rebates?
A: Any premium changes — up or down — due to health care reform
will occur in the future. Not all of the law’s rules and regulations have been released, so it’s difficult to understand the full impact of health care reform on any member’s specific premiums.
Q: Does the new health care reform law provide me with free
health care coverage?
A: No. The new law does not mean that you’re now covered under a
free government health plan. Such a change is not part of the new health care reform law. One of the goals of health care reform is to create additional health insurance options, whether from private health insurers or expanded public programs like Medicaid. The new law includes additional provisions designed to help low- and moderate-income people afford health care coverage. Under the new law, in 2014 premium assistance for uninsured individuals with incomes between 133 – 400 percent of the federal poverty level will be available for plans purchased through new, state-run exchanges. The amount of assistance will depend on your income. The lower your income, the more assistance you can expect. Also in 2014, Medicaid will expand to cover people with annual incomes at or below 133 percent of the federal poverty level. That’s $29,327 for a family of four. If you think you qualify, the agency that oversees Medicaid in your state can likely give you more information. As always, you should carefully evaluate your personal situation and insurance options before making any decisions about your health care coverage. Only you can make sure you have the health insurance coverage that you and your family need and want.
Q
A
4
Q: I currently have a HumanaOne health plan and would like to
continue coverage for my child who is over 21. Can I do that?
A: A provision of the new health care reform law allows adult children to
remain on their parents’ plan until their 26th birthday. Although this provision takes effect on September 23, 2010, Humana agreed to make this change earlier to eliminate what otherwise could have produced a gap in coverage for adult children who are already on their parents’ HumanaOne medical plan.
Beginning in July 2010, adult children may stay on their parents’ HumanaOne medical plan until age 31 if coverage isn’t available through
their work and they are not married. If the adult child is married, coverage will be available until they reach at least their 26th birthday. In some states, married dependents can remain on their parents’ policy beyond their 26th birthday. If you have questions or want information about your specific state, call HumanaOne customer service at the
toll-free number on the back of your HumanaOne insurance ID card.
Remember that this change only applies to adult children who are currently covered by their parents’ HumanaOne plan. By making this
change earlier than required, we hope it provides not just extended health insurance coverage, but also peace of mind for families with HumanaOne.
Q: I currently have a HumanaOne health plan and I’d like to add
my 21-year-old child to my plan. Can I do that?
A: Yes. HumanaOne offers coverage for adult children until their 25th
birthday in most states, and beginning September 23, 2010, HumanaOne
will cover adult children up until they reach at least their 26th birthday,
as required by the new health care reform law. In some states, adult
children can be covered by their parents’ HumanaOne policy beyond
their 26th birthday. Like all applicants for a new policy, the adult child’s health history would be reviewed by HumanaOne to determine if they qualify for coverage.
Q: I do not currently have a HumanaOne health plan, but I’m
interested in purchasing a HumanaOne policy. Would I be able to
cover my child who is older than 21 on my HumanaOne plan?
A: Yes. HumanaOne offers coverage for adult children until their 25th
birthday in most states, and beginning September 23, 2010, HumanaOne
will cover adult children up until they reach at least their 26th birthday, as
required by the new health care reform law. In some states, adult children
can be covered by their parents’ HumanaOne policy beyond their 26th birthday.
(Continued on next page.)
Q
A
5
Like all applicants for a new policy, the adult child’s health history would
be reviewed by HumanaOne to determine if they qualify for coverage.
Q: My family member has a pre-existing condition and isn’t
eligible for coverage right now. When will they be able to get coverage?
A: We know that many people are eager to obtain coverage.
The new law says that starting in 2014, health plans cannot have pre-existing condition limits and will be guaranteed. The new law also ends pre-existing condition limits for dependent children under the age of 19 under certain plans sooner than 2014. When this goes into effect, insurance companies won’t be able to:
• Deny coverage to a child because of a pre-existing condition
• Deny payment for a child’s treatment because the treatment is related
to a pre-existing condition These rules will apply to all types of health insurance, except for individual policies that are “grandfathered.” Not all of the rules and regulations have been released, so it’s difficult to understand the full impact of health care reform on any specific person’s coverage. Here is when some of the health care reform law’s provisions take effect. Remember, some details of the law are likely to change.
2010, immediately:
• The U.S. Department of Health and Human Services (HHS) will
establish a process for federal review of rate increases.
2010, July:
• An Internet portal will be created for consumers and small businesses
to shop for health insurance.
2010, September:
• Health plans may not impose lifetime limits on the dollar value of
essential benefits.
• Annual dollar-value limits on benefits are restricted. (Does not apply
to “grandfathered” individual plans.)
TIMELINE
Q
A
6
• Insurers may not rescind (void) health insurance policies, except in
cases of fraud or intentional misrepresentation.
• Adult children who are currently on their parents’ policies and unable
to get insurance through their jobs may stay on their parents’ policies until age 26, regardless of their marital status.
• Plans may no longer impose pre-existing condition exclusions on
children under 19. (Does not apply to “grandfathered” individual plans.)
• New policies must cover the full cost of preventive care. (Does not
apply to “grandfathered” individual plans.)
2011:
• Health savings accounts and flexible spending accounts may no
longer be used for over-the-counter purchases unless those purchases have been prescribed by a doctor.
• Insurers must spend 80 percent of individual health insurance
premiums on medical services or provide rebate payments to enrollees.
• A national, voluntary insurance program is established for purchasing
long-term care services (CLASS — Community Living Assistance Services and Supports — program).
2012:
• A new fee is imposed on health insurance companies to fund
comparative effectiveness research (research to determine the most effective regimens, drugs, supplies, and therapies for various diseases and conditions): $1 per participant through 2013; $2 per participant through 2019.
2013:
• Contributions to flexible spending accounts are limited to $2,500
per year.
• Medicare payroll tax increases by 0.9 percent for individuals
who make more than $200,000 and couples that make more than $250,000.
• A new 3.8 percent tax will be added on income from interest, dividends,
annuities, royalties, and rents for those at the same income threshold.
7
2014:
• Health insurers must accept every individual who applies for coverage.
• Health plans can no longer impose pre-existing condition exclusions
for any person of any age. (Does not apply to “grandfathered”
individual plans.)
• No annual limits on health insurance benefits. (Does not apply to
“grandfathered” individual plans.)
• State health insurance exchanges introduced for individuals to
buy insurance.
• Rating restrictions go into effect: Insurance companies cannot charge
women more than men, old people more than three times what young people pay, or smokers more than 1.5 times more than what non-smokers pay.
• Essential benefit plan is created, which mandates the level of benefits
that must be included in individual health insurance plans. (Does not
apply to “grandfathered” individual plans.)
• A temporary reinsurance program is established in the individual
market and funded by individual and group health plans assessments ($25 billion in 2014 – 2016).
• Families and individuals between 133 and 400 percent of the Federal
Poverty Level get subsidies — on a sliding scale — to purchase insurance.
• Medicaid program is expanded to cover everyone under 65 with an
income less than 133 percent of the Federal Poverty Level.
• A non-deductible premium tax is imposed on insurers ($8 billion in
2014, rising to $14.3 billion in 2018, and increasing proportional to overall premium growth after that).
2016:
• States can form health choice compacts to allow insurers to sell
individual policies in any state participating in the compact.
Humana believes all Americans deserve affordable, quality
health care coverage.
Our company has said for a long time that we must enact
comprehensive, bipartisan reform that guarantees coverage, with
everyone participating in the system, and that makes pre-existing
conditions a thing of the past.
The new health care reform law contains many positive, important
reforms that we support, but it also contains provisions that we are
concerned may result in much higher costs for young adults as well
as seniors and disabled Americans who get their Medicare through a
Medicare Advantage plan. Humana also believes that more needs to
be done to control the underlying cause of our health care crisis —
rising health care costs.
WHAT WE BELIEVE
IMPORTANT: The information in this brochure applies to health plans only. Humana designed this brochure
to provide a general overview of the new health care reform law. It does not attempt to cover all of the law’s
provisions and should not be used as legal advice.
The HumanaOne brand of individual products are insured by subsidiaries of Humana, Inc.
Insured by Humana Insurance Company, Humana Health Plan, Inc., Humana Health Insurance Company of Florida, Inc., Humana Employers Health Plan of Georgia, Inc. and Humana Insurance Company, Humana GCA096VHH 7/10 Health Benefit Plan of Louisiana, Inc. For residents of Arizona and Texas: Insured by Humana Insurance Company.
