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Health Facts

Denied Health Insurance – What to Do If You Are Denied

You never think about it until it happens to you. You apply for health care coverage fully expecting that you will be covered. Instead, you get a letter or an email informing you that you have been denied health insurance. There are a number of reasons why an insurance provider would deny you coverage. Possibly the top reason is because of a preexisting condition. However, other reasons, such as being overweight and even poor credit, can cause a provider to reject your application. Being denied insurance is not the end of the world. You have several recourses available to you that can help you get the insurance you need.
Talk to the health insurance provider to see why they rejected your application for insurance. Generally, the insurance carrier will tell you why you were denied health insurance. If it is something you can fix, such as being overweight then work on correcting the issue. However, if it due to a preexisting condition, then you will need to take other action. Ask the insurance company if they will insure you based on a contingency, such as a waiting period before they cover the medical bills for your condition.
Another option is to check with other health insurance providers. Each insurance company has their own guidelines when it comes to underwriting a policy. Even though one company may have rejected your application does not mean you will be denied health insurance at all of them. A good way to find out who is willing to extend coverage to you is to visit a website that allows you to get quotes from multiple insurance companies at the same time. Instead of wasting time filling out several applications, you will only have to enter information once and the insurance companies will advise you of their answer. This will save you a lot of time.
If you are still having trouble getting standard insurance from carrier, see if you will qualify under a different type of plan. There are several types of insurance plans you can sign up for including HMO, PPO, Point of Sale, Fee for Service, High Deductible Health Plans, and Catastrophic insurance. You may not get the exact coverage you need but having some coverage is better than being completely uninsured. Lastly, if you continue to be denied health insurance from private insurers, contact your local government assistance office to see if you qualify for a government funded program.
If you need assistance in locating particular coverages at a pre-determined price, we can help you find a reduce health insurance premium today.…

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Health Food

Health Care Reform For Small Business – Professional Employer Organizations (PEOs) To the Rescue

Professional Employer Organizations offer a one-stop solution for companies averaging 5 to 100 employees. They provide HR consulting, employee benefits, payroll, workers comp insurance, and many other employer-related services. As more regulations are created, and managing them becomes more difficult for employers, the PEO value proposition become more attractive.
2010
A� Small business tax credit – This tax credit is applicable for businesses with less than 25 full-time employees with an average wage below $50,000. The maximum credit equals 35 percent of the employer’s contribution to health insurance premiums, but it is unlikely the maximum credit will be applied. Calculating exactly what an employer qualifies for is an extremely sensitive process.
How PEOs help:
PEOs proactively consider whether their clients qualify for the credit and pass the total amount directly to the client. Since most PEOs manage their clients’ payroll and insurance plans, calculating the credit amount is much easier.
2011
A� W-2 provision – Employers must report the aggregate cost of employer-provided coverage on employees’ W-2s for informational purposes.
How PEOs help:
PEOs manage all aspects of their clients; payroll and benefits, so complying with this provision is synergistically efficient – the amount will be shown on all PEO work-site employees’ paychecks.
A� Wellness Grants are available for businesses with fewer than 100 employees to assist in implementing employee wellness programs. There is $200 million dollars that will be distributed over a five year period.
How PEOs help:
Since many PEOs partially self-insure their health insurance policies, they have always had a vested interest in proving their clients’ employee easy access to wellness programs. Most PEOs have long offered robust wellness programs that help employees live healthier lives, and consequently, make less medical claims – which is cheaper for everyone.
In 2013
A� FSA limits – all employee contributions to the FSA or Flexible Spending Account are limited to $2,500 per year. The penalty for using Flexible Spending Accounts incorrectly will be an increase from 10 percent to 20 percent.
How PEOs help:
PEOs manage all aspects of FSA administration for their clients – all FSAs offered to client employees will be adjusted seamlessly to comply with this provision.
A� Tax increases – Medicare payroll tax increase of 0.9% on self-employed individuals and employees with respect to earnings and wages received during the year above $200,000 for individuals above $250,000 for joint filers will go into effect. The new tax does not change the employer’s tax obligations, but self-employed individuals are not permitted to deduct any portion of the additional tax. In addition, there will be a new 3.8% Medicare contribution on certain unearned income from individuals with AGI over $200,000 ($250,000 for joint filers).
How PEOs help:
Professional Employer Organizations are responsible for deducting and filing all payroll taxes to the appropriate governing body. Unlike a payroll service, PEOs are often responsible and liable for calculating and deducting the proper amounts.
A� Notices & Fines
1. Plan sponsors must supply participants at enrollment or re-enrollment a new form of plan summary that must include information on benefits, exclusions, and cost-sharing requirements. Those that do not comply with this provision are subject to a noncompliance fee of $1,000 for each failure.
2. Employers must provide a written notice regarding the existence of the Insurance Exchange and that the employee might qualify for subsidies by March 1, 2013.
3. Plan sponsors will be required to provide an annual statement to the government and covered individuals reflecting the months during the calendar year for which the individual had “minimum essential coverage”. Those that do not comply with this are subjected to a noncompliance penalty of $50 for each missed statement to an employee to a maximum of $100,000.
How PEOs help:
PEOs are often the plan sponsor for all their clients’ healthcare, unless they “carve out” benefits, which would mean they are not the plan sponsor, and the client maintains their own health insurance. Should a client be receiving healthcare through a PEO sponsored plan, each of these mandates falls squarely on the shoulders of the PEO. Notice the trend, due to co-employment, many of the additional requirements put forth by health care reform are burdens for the PEO.
2014
A� State-based insurance exchanges open – State-based insurance exchanges are planned to pool employers together into one large group much like PEOs have done for years in order to reduce overall premiums. However the exchange program has been attempted in other states and has not had the same success that PEOs have had. As with many public programs, cost-efficiency and timely service is inferior to that offered by private entities. We don’t foresee this principle changing.
How PEOs help:
PEOs have long pooled employers together for cooperative purchases of many items including health insurance, the result is lower cost. There is …