HRA BLOG - Health Reimbursement Arrangement

MLM Training Tool

2011-02-17T07:52:00.000-08:00

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New MLM Training

2011-02-17T07:49:00.000-08:00

6 Fig Blueprint Download

GRANDFATHERED HEALTH PLANS?

2010-08-04T10:49:00.000-07:00

Image via Wikipedia

The new law allows plans to be grandfathered i.e. not subject to all the law requires. However, compliance is difficult.

To be grandfathered a plan must have at least one person enrolled as of March 23, 2010 when the law was passed. One person must remain enrolled although it does not have to be the same person.

If a grandfathered plan doesn't make any non-allowed changes, it will remain a grandfathered plan indefinitely. Take a look at what causes the loss of grandfathered status: .

If the grandfathered plan enters into a new policy or contract of insurance. Renewal will cause the loss of grandfathers status.
If an insurer eliminates benefits that are normally covered.
If there is an employee cost share increase by 5% or more.
If the coinsurance provision is increased compared to what was in effect when grandfathered.
If the employee share of out of pocket limits, deductibles etc are increased by more than about 15%.
If the co-pay increases by more than $5.
The imposition of a lifetime or annual limit where one did not exist before, or a reduction in the limit if one did exist.

If a plan loses its grandfathered status, it will become subject to all of the changes of, The Patient Protection and Affordable Care Act.

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Obama Care Knowledge Quiz

2010-06-17T10:24:00.000-07:00

The following quiz is from the National Center for Policy Analysis. I've abbreviated it simply to save space.

1. Under ObamaCare, will your health care coverage be identical to every other American’s?

If you said NO, you are correct. ObamaCare was passed with special deals that treat citizens unequally depending on their geographic status and the nature of their jobs. For example, members of certain labor unions are exempt from requirements other Americans have to meet, and Floridians on Medicare Advantage receive special treatment under the law.

2. Will ObamaCare will save every American money on their health coverage?

If you said NO, you are correct! Some Americans will pay far more. A $30,000-a-year worker with a family will only get a $2000 subsidy. A $60,000-a-year family will get a subsidy twice as large!

3. Under ObamaCare, will you be required to purchase health insurance whether you can afford it or not?

If you said YES, you are correct!
Actually you'll be fined if you don’t purchase health insurance. The Congressional Budget Office (CBO) estimates that by 2016, nearly 4 million Americans will be fined as much as $1,000 per year which the IRS will collect!

4. Will senior citizens pay less for prescription drugs and medical devices?

If you said NO, you are correct. In 2011, new taxes will drive up the cost of prescription drugs. In 2013, higher taxes on medical devices such as pacemakers will similarly increase costs for senior citizens.

5. Do you think you'll NEVER lose your employer provided health insurance?

If you answered NO, you are correct! As many as 35 million Americans could lose their employee-based health coverage and be forced into plans and subsidies provided by the federal or state government exchanges.

HRA - Obama Care & Over 50 employee Groups

2010-06-02T16:45:00.000-07:00

In my last post I stated that the under 50 employee group health plans would be vacated by employers. Since then others have concurred. However I didn't expect that the very large companies, especially those which were Obama supporters would join the fray.

Read the following post concerning large companies. If they are correct, and if I and others are correct the exchange tables are going to be very busy indeed.

"Is Healthcare reform The End Of Employer Medical Insurance coverage?"

You know, I continue to read blogs that think the current law is simply full of errors that the administration did not intend.

I don't agree. I think it is all by design. It is designed to create a single payer government run and controlled take over of the US health care system.

It is definitely time for prayer.

HRA - Obama Care & The Under 50 Employee Group

2010-05-15T07:40:00.000-07:00

Did you know that very soon employers with 50 or less employees will be terminating their current traditional group health insurance for other options like the Health Reimbursement Arrangement (HRA) and the Premium Only Plan (POP).

Why?

IF the average monthly premium for a family is in excess of $600 per month (a conservative estimate); and the cost (fine) for not providing a health care benefit is less about $170 per month per employee; then, why would the employer maintain the traditional health care plans?

Some have said that employers will maintain group plans in order to attract and keep quality employees. Well that is very altruistic.

However, suppose I told you "employers can continue to provide a vehicle for employees to have employee-owned health insurance and still vacate the traditional group plans thus saving lots of money in the process."

It is possible under at least two different plans: The Health Reimbursement Arrangement and the Premium Only Plan. In each of these two plans a method of funding for employee owned health insurance creates a win-win situation for all.

For a consultation to review your business' group health situation contact me via email or phone. tom.markley@paonline.com or 717.574.6009

HRA & Mass Cancellation of Group Health Plans

2010-04-24T13:20:00.000-07:00

Will mass cancellation of employer-sponsored group policies be an "unintended consequence" of Health Care Reform, or will it be an "intended consequence".

Now that Health Care Reform is the law employers small and large are preparing for and actually terminating their employer-sponsored health insurance plan. Why?

The answer lies in cost and protection. The Health Care Reform bill took away some of the negatives for employers. For example, they were rightfully concerned that an employee with a health issue would not be able to get affordable insurance or insurance at all! The bill takes that fear away:

Starting June 23rd 2010, there will be a new federal "risk pool" to guarantee affordable personal coverage to adults with preexisting medical conditions.
Beginning September 23, 2010, all carriers offering personal health policies may not reject or charge more for children with preexisting conditions.
Beginning January 1, 2014, insurance carriers must accept all applicants for personal policies at the same price regardless of their health status.

The result is that most individuals will be able to purchase their own personal health insurance even if they have a preexisting medical condition. Then they will have their own personal insurance regardless of what happens at their work.

"Under the new rules, virtually every employer with less than 50 employees can switch from group coverage to simply giving employees a reimbursement account so that they can purchase their own personal policy. Most large employers will follow suit once they realize how large of a subsidy their employees receive if the employer does not offer group coverage." Paul Zane Pilser

WHY? With the government set penalty of a maximum of $2000 per employee per year, that calculates to less than $170 per month per employee. That rate would normally be charged for a child in perfect health!

With group rates in PA at or near $1200 per month for a family, that is a major disincentive to maintain the employer-sponsored health benefit. Further, since the employees can get an equal or better plan that becomes a win-win for employers and employees.

Now back to the consequence of group plans being cancelled, I think it is intended so that when more and more people will be in the exchanges. Then a health insurance company crisis will be manufactured so that the government option will "come to the rescue" thus completing the move to single payer government controlled socialistic medicine.

I’m certain that many will disagree with me thinking that I am a conspiratorial whacko. OK. However, simply recall the words of the dems who kept saying "This is like a starter home." That tells me all I need to know.

HRA - HEALTH CARE - THE FUTURE OF IT ALL

2010-04-09T08:53:00.000-07:00

During the campaign to pass Federal Health Care the Obama administration was careful to avoid comparing to Massacheutts plan. Reading the Wall Street Journal today points to one of the reasons why.

PRICE CONTROLS.
According to the WSJ editorial page Mass Governor Deval Patrick (D) passed price controls on the health care industry citing industry greed over rate increases. Since that time nearly all of the health insurers stopped writing policies while the battle moves to the courts.

The editor points out that the four major carriers are non-profits and that three of the four had operating losses in 2009. The price freeze, a form of rationing, will mean an additional $100 million in losses. Thus the battle moved to the courts with a decision due on Monday.

The Patrick administration is demanding that the carriers resume writing policies at the prior levels. "Patrick has made the health insurance business so painful the government actually has to order private companies to sell their products (albeit at sub-market costs)." Doesn't that sound familiar? Well it should and it certainly won't be the last time that you hear that bully tactic.

The best part (or perhaps the worst part) of this situation is that Gov. Patrick's Attorney General and insurance regulators discovered that the losses and the needed rate increases are due to the increased costs of health care....NOT greed or the "supposed industry abuses" that Gov Patrick, Obama, and the dems are so fond of spouting.

HRA and Health Care Reform

2010-03-27T17:08:00.000-07:00

"Finally we have a health care plan written by a committee whose chairman says he doesn't understand it, passed by Congress that hasn't read it and exempted themselves from it, signed by a president who smokes and hasn't read it, administered by a treasury chief who didn't pay his taxes, overseen by a surgeon general who is obese, and financed by a country that's broke. What could go wrong? "......Robert Larsen

Some changes will go into effect this year. Did I mention taxes? However until the new state and federal laws/regulations are created we will not know all that we have received nor will we know exactly how this legislation will affect anyone's specific health plan.

How the Health Care Reform Law affects employers and employees alike can be seen albeit not clearly! Let’s take a look at it based upon employers. There are three groups; (1) Changes affecting all Employers and their Employees, (2) Changes Affecting only Employers with Less than 26 Full-time Employees, and (3) Changes Affecting only Employers with More than 50 Full-time Employees

(1) Changes Affecting all Employers and their Employees

New Temporary High-Risk Pool -In 90 days a temporary national high-risk pool must be established to provide health coverage to individuals with pre-existing medical conditions in 90 days. To be eligible they must have been uninsured for 6 months.

No Lifetime Maximums Allowed - In 6 months, insurance companies can no longer place lifetime limits regardless of whether a group policy or individual policy.

Increased Dependent Coverage - In 6 months, insurance companies must provide dependent coverage for children up to age 26 for individual and group health plans.

No Exclusions for Dependent Coverage Allowed - In 6 months, insurance companies can no longer place pre-existing condition exclusions on children of a policy holder.

Over the Counter Drugs Excluded from HRA/HSA/FSA - Beginning in 2011, non-prescribed over-the-counter drugs can not be reimbursed.

Health FSA Contribution Limit - Beginning in 2013, the amount of contributions to health FSAs is limited to $2,500 per year.

Health Insurance Exchanges - By 2014, each state must create an American Health Benefit Exchange and a Small Business Health Options Program Exchange. The exchanges provide a place where individuals and small businesses can purchase coverage that meets certain requirements.

Insurance Carrier Rating Rules - Beginning in 2014, age rating replaces medical underwriting and pre-existing condition exclusions for individual and small group health insurance plans will be prohibited in all states. Insurers will be prohibited from denying coverage or setting rates based on gender, health status, medical condition, claims or other health-related factors.

Employee Subsidies - Beginning in 2014, the federal government will give tax credits to individuals with incomes between 100 and 400% of the federal poverty line (FPL). Employees offered coverage by their employer will not be eligible for premium credits unless the company's plan does not meet "minimum coverage requirement".

Employee Free Choice Voucher - Beginning in 2014, employers that offer coverage to their employees will be required to provide a "free choice voucher" to employees with incomes less than 400% FPL if they choose to enroll in an exchange plan.

Employee Requirement to Purchase Insurance - Phasing in from 2014-2016, individuals will have to purchase coverage or pay a penalty of the greater of $650 per year up to a maximum of three times that amount per family or 2.5% of household income. Beginning in 2017, the penalty will be increased annually by the cost-of-living adjustment.

(2) Changes Affecting Employers with Less than 26 Full-time Employees

Employer Subsidies - Provide small employers with no more than 25 employees and average annual wages of less than $50,000 that purchase health insurance for employees with a tax credit.
Phase I : Beginning in the 2010 tax year Phase 1 of this subsidy provides a tax credit of up to 35% of the employer’s contribution toward the employee’s health insurance premium if the employer contributes 50% or more of the total premium cost (or 50% of a to-be-established benchmark premium). For employers of less than 10 employees the full credit will be available.

Phase II : Beginning in 2014 and available for 2 years, small companies that purchase coverage through the state exchanges will be eligible for a tax credit of up to 50% of the company's contribution toward an employee’s health insurance premium if the company contributes at least 50% of the total premium cost. Tax-exempt businesses are eligible for tax credits of up to 35% of the company's contribution toward the employee’s health insurance premium.

(3) Changes Affecting Employers with More than 50 Full-time Employees

Employer Penalties for Not Offering Any Coverage - Beginning in 2014, a company with more than 50 full-time employees that does not offer coverage must pay an annual penalty of $2,000 per full-time employee, excluding 30 employees from the assessment. For example, an employer with 51 full-time employees that does not offer health coverage will pay an annual penalty of $42,000 ($2,000 per employee for 21 employees).

[Blogger Note: If the average monthly health benefit cost per employee is $600 that equals $7200 per year. Let’s see! Which is the better economic decision for the employer? Paying $7200 per year for health insurance or paying a $2000 per year penalty per employee. Can you see that this will reduce group benefit plans, reducing revenue to insurance companies, which in turn will put them out of business. This will then become the basis for single payer which is the Obama goal anyway.]

Employer Penalties for Offering "Unaffordable" or "Unqualified" Coverage - Beginning in 2014, a company with more than 50 employees that offers coverage that is "unaffordable" or does not meet the "minimum coverage requirement" (i.e. the coverage is "unqualified") will pay the lesser of $3,000 per year for each employee receiving a credit or $2,000 per year for each full-time employee, excluding 30 employees from the assessment. The "minimum coverage requirement" requires a qualified plan cover 60% of the benefit costs of the plan, with an out-of-pocket limit equal to the Health Savings Account (HSA) current law limit ($5,950 for individuals and $11,900 for families in 2010.

Thank you Rick Lindquist for the analysis which I have abridged.

So What is the Bottom Line?
What I write next is self-serving however employers must research and then act on implementing an HRA, a POP, an HRA with the HSA. This week I’ll post brief discussions of each of these plans with pros and cons on my blog and website. However, please know that each employer situation is different which leads to one solution over another. My partner and I are available for consultations.

IRS Audit Alert.
If you have a Section 125 Cafeteria Plan and you have been allowing reimbursement for some health related expenses, you could be receiving a greetings and salutation letter from the IRS.

OBAMA HEALTH & HRA

2010-03-09T10:03:00.000-08:00

Image by Steve Rhodes via Flickr

WHY
Why does President Obama want national health insurance? Well, at least why he says he wants it. The reasons touted are: Protect the Uninsured; Stop Companies Which Ration by Reneging on benefits; Reduce Costs.

UNINSURED.
The UNINSURED fall into three categories: 1. Those who lost insurance and have health issues (Portability Issue #1); 2. Those who relocated to another state for employment or domicile (Portability Issue #2); 3. Those who don't want it or can't get it due cost issues, preexisting health issues, age issues, or alternative use issues.

Portability Issue #1 Solution:
When individuals own their health insurance policies like the auto or homeowners policy then portability due to health issues is no longer a problem. Regardless of why they change employment they can go to any new job or retire and still own their policy. This is available now under the congress law signed by President Bush. It is called the Health Reimbursement Arrangement (HRA). More on this later.

Portability Issue #2 Solution:
Under an HRA where an employee owns the health insurance policy it makes no difference if the move from one state to another is do to an employment opportunity, retirement, or simply a domicile change. The policy is owned and the coverage remains in force. What may pose a difficulty would be the process of reimbursement or payment for medical services rendered. However, that situation now exists in an auto insurance policy when on is injured out of state so I don't imagine it a difficult problem with which to deal. Certainly not a deal breaker.

THOSE WHO DON'T WANT HEALTH INSURANCE:
This is quite misleading. What they really mean is that they don't want to pay for health insurance! This group can be comprised of the wealthy who desire to pay for their health needs from their own assets, or it can be those who would rather spend the premium dollars on something else thinking or gambling that they won't get sick or be injured. Regardless of their reasoning the fact remains that when a significant medical treatment has and equally significant expense other people will end up paying for the treatment.

For the wealthy a solution could be an option to purchase insurance with an extremely high deductible which would be collateralized with a bond or a CD or some other equity instrument.

For those who want to gamble or who are unable to purchase due to a citizenship issue a solution would be a requirement for a basic policy in order to obtain a job or a drivers license or automobile. I have to admit that this idea ruffles my libertarian feathers but so does the idea of having to pay for the irresponsibility of another person. Besides, it is more reasonable than debtors prison!

The Uninsurable - Preexisting Conditions
The solution for the uninsurable due to preexisting conditions again would fall under the HRA model. When a family owns its own policy their children are covered up to a certain age. If they have a preexisting condition at the age when they leave the parents policy, they could go into a pool much like the assigned risk pool for auto insurance. The pool would be funded by all insurance companies based upon a prorated share of their premium compared to the whole nationwide. Thus the cost could be determined by actuaries so a small premium would be included in every policy written.

The Uninsured due to Disability.
Another situation exists should one be sick or injured thus preventing their ability to earn a living. Well, life insurance has an answer to that which is a 'disability income endorsement or rider'. This simply provides payment for the premium should the insured become disabled and unable to pay the premium.

Companies That Renege on Claims.
Regardless of how and why insurance companies renege on claims based upon some medical history of the past, or how and why a claims adjuster attempts to get out of paying a claim with thin or nonexistent reasoning such practices could be handled with two provisions.

1. Bad Faith Laws. When a claim is denied and it is a result of bad faith then the penalty would be treble the reserves established for the particular medical procedure or situation from which they are trying to avoid payment. The amounts would go to the uninsured pool.

2. Further, like life insurance underwriters, medical insurance underwriters should have access to the Medical Information Bureau (MIB) records and the attending physician records. The underwriters must do due diligence in underwriting the case up front. Perhaps we could give them one year for discovery during which time they could change the rates or cancel their offer of insurance.

WHAT ABOUT COST SAVINGS?
Unlike what President Obama said, "cost for individuals are three times the costs for a large group", the HRA solution typically saves an employer health benefits package between 20% to 60%. Read the following to understand why.

THE HEALTH REIMBURSEMENT ARRANGEMENT (HRA)

1. An employer establishes the Health Reimbursement Arrangement (HRA) which is a legal document required by the IRS. It provides for reimbursement for specified medical expenses.
2. It provides for reimbursement for health insurance premiums.
3. Each employee reviews the options available in the health insurance policy and selects only those which apply. This provides cost savings. For example a 60 year old employee may choose to exclude maternity benefits.
4. After selecting, designing and paying for the policy the employee then submits a request for reimbursement.
5. After receiving medical services the employee submits the expenses to the insurance company. Those things not covered by the policy like co-pays or deductibles are then submitted for reimbursement.
6. After verifying the expense, the employer is instructed by a Third Party Administrator to provide the reimbursement.
7. The expense is tax deductible to the business.
8. The reimbursement to the employee is NOT taxable income.
9. The HRA can reduce an employers health care benefits program from 20% to 60%.
10. The premiums cannot be increased because of paid claims or health issues.
11. The policies cannot be cancelled except for non-payment of the premium.
12. The HRA works for large companies down to one employee.

Since early 1940's self employed persons could deduct medical expenses as long as a spouse was a formal employee. Since 2002 now insurance premiums can also be deducted. It is more than a great deal. Contact us to check it out.

CONSTITUTION AND OBAMA HEALTH

2010-02-26T08:53:00.000-08:00

WELCOME BACK. I've waited and waited for the nearly-final idea of what Obama planned for health care reform. I've reviewed the outline and will comment on it in future blogs. The first comment is relative to the constitutionality of the law.

MICHAEL CONNELLY. Permit me to introduce the comments of a retired constitutional lawyer. He address the constitutionality issue as follows:

SEPARATION OF POWERS. The law provides that congress give over to the executive certain powers rightfully positioned with the legislation body not the executive. The law would cease the separation of powers which the founders so deftly crafted.

General Violations. Mandating health care, rationing health care, free provision to illegals, free or subsidized abortions, and mandating performance by health care providers.

4th Amendment. By requiring access to personal health and financial information to the federal government the 4th amendment violates the protection against unreasonable search and seizure.

5th Amendment. By providing for a "tax" against those who don't obtain the health insurance they get around the Due Process provision that would exist if the levy were called what it is...a fine.

9th Amendment. The enumerated powers are those which the constitution specifically grants to the federal government. No where is the provision of health care an enumerated power.

10th Amendment. Powers not so enumerated and nor prohibited by the states belong to the states and/or the people. In other words, it cannot be usurped by the federal government. There is no provision for eminent domain relative to the power of the fed.

6th Amendment. I've saved this one until last because I want it to remain in your thoughts until the November elections.

This amendment provides that each member of congress, whether a representative or senator, makes and takes a solemn oath to protect the constitution. Given the above anyone who votes for this legislation is violating his/her oath to protect the constitution. That alone is worthy of losing the right to represent us! Keep that in mind whether republican, democrat, or independent.

Finally, don't take my interpretations or those of Mr. Connelly. Obtain your own copy of the US Constitution and the Bill of Rights. You can do so by going to the website www.askheritage.org. Know your country's foundation and teach your family, friends, and neighbors.

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HRA & The President's Plan

2009-09-22T16:28:00.000-07:00

I don't know if you recall, but during the President's joint session comments concerning his health plan he made the statement that he'd love to have a plan where all employees could own their own health insurance policies and have the employer help out a little.

BAM!! That's is exactly what the HRA does. I wonder why he won't respond to my messages?

Oh well, hang in there, sooner or later we'll have a written document about which there can be no misrepresentations.

HRA - The Health Insurance Solution

2009-09-01T16:04:00.000-07:00

I know.......I know. It's been nearly a month since I posted. I haven't been vacationing. I've been researching or trying to research the "new" words that will be used to try and fool us about the health care/insurance reform.

Unfortunately I haven't been able to get confirmation on the things that I've been told are in the works. So...... until I have that confirmation I'm not going to bolster rumors.

Instead, let me tell you about a call I had with two local radio personalities. They were hoping that some day employees would be able to buy their own health insurance policies and find a way for employers to assist in that pursuit.

I called the station and told them that it already exists! It is called the HRA. (Health Reimbursement Arrangement) I then made the analogy that it is like reimbursement of on the road sales people i.e. reimbursing for gas, parking, car wash, motel, entertainment etc. Unfortunately I was unable to complete the explanation probably because of the need for a break or for a more entertaining caller! The two gentlemen said such a thing wouldn't work. That's too bad because it already is! They felt it wouldn't work for a big company. Well before Obama took over GM I'd guess that one is pretty large. (Reference: Paul Pilser in his TV interview - see prior post for the link)

I'm going to email their station when I have a chance and upload that interview along with all the other support information. Perhaps, they will then inform business in their listening area about the HRA.

HRA & Congress's August Break

2009-08-06T09:28:00.000-07:00

Now is the time to get involved with your senator & representative relative to National Health Care. Should they have a town hall meeting get there and speak up.... not act up!

Pennsylvania

Rep. Kathy Dahlkemper

• 08/08 09:00 AM - 11:00 AM: Hike and Bike/Congress in the Community - Presque Isle State Park, 301 Peninsula Drive # 1, Erie, PA, 16505

• 08/15 11:00 AM - 01:00 AM: Hike and Bike/Congress in the Community - Buhl Farm Park, 730 Forker Boulevard, Sharon, PA, 16146

• 08/19 10:00 AM: Seniors Walk with the Congresswoman - Warren Senior Center, 800 Pennsylvania Avenue W., Warren, PA, 16365

• 08/20 06:30 PM - 08:00 PM: Hike and Bike/Congress in the Community - Armstrong Trail, Armstrong Road, Armstrong, PA, 16041

• 09/26 11:00 AM - 01:00 PM: Hike and Bike/Congress in the Community - Allegheny River Trail, 6297 Emlenton Clintonville Road, Emlenton, PA, 16373

Sen. Arlen Specter

Image by eshm via Flickr

• 08/11 09:30 AM: Town Meeting - HACC - Lebanon Campus Multipurpose Room, 735 Cumberland Street, Lebanon, PA, 17042

• 08/11 03:45 PM: Town Meeting - Bucknell University Trout Auditorium, 701 Moore Avenue, Lewisburg, PA, 17837

• 08/12 08:30 AM: Town Meeting - The Penn Stater President's Hall 4, 215 Innovation Boulevard, State College, PA, 16803

• 08/13 03:30 PM: Town Meeting - Belmont Complex, 415 Butler Road, Kittanning, PA, 16201

Arm your self with the facts you wish to debate:
•Page 15: Lose individual policy if any change is made.... must go to government/public plan
•Page 22: Mandates audits of all employers that self-insure!
• Page 29: Admission: your health care will be rationed!
• Page 30: A government committee will decide what treatments and benefits you get (and, unlike an insurer, there will be no appeals process)
• Page 42: The “Health Choices Commissioner” will decide health benefits for you. You will have no choice. None.
• Page 50: All non-US citizens, illegal or not, will be provided with free healthcare services.
• Page 58: Every person will be issued a National ID Health card.
• Page 59: The federal government will have direct, real-time access to all individual bank accounts for electronic funds transfer.
• Page 65: Taxpayers will subsidize all union retiree and community organizer health plans (SEIU, UAW and ACORN)
• Page 72: All private healthcare plans must conform to government rules to participate in a Healthcare Exchange.
• Page 84: All private healthcare plans must participate in the Healthcare Exchange (i.e., total government control of private plans)
• Page 91: Government mandates linguistic infrastructure for services; translation: illegal aliens
• Page 95: The Government will pay ACORN and Americorps to sign up individuals for Government-run Health Care plan.
• Page 102: Those eligible for Medicaid will be automatically enrolled: you have no choice in the matter.
• Page 124: No company can sue the government for price-fixing. No “judicial review” is permitted against the government monopoly. Put simply, private insurers will be crushed.

• Page 126: Employers MUST pay healthcare bills for part-time employees AND their families.
• Page 127: The AMA sold doctors out: the government will set wages.
• Page 145: An employer MUST auto-enroll employees into the government-run public plan. No alternatives.
• Page 149: Any employer with a payroll of $400K or more, who does not offer the public option, pays an 8% tax on payroll
• Page 150: Any employer with a payroll of $250K-400K or more, who does not offer the public option, pays a 2 to 6% tax on payroll
• Page 167: Any individual who doesn’t have acceptable healthcare (according to the government) will be taxed 2.5% of income.
• Page 170: Any NON-RESIDENT alien is exempt from individual taxes (Americans will pay for them).
• Page 195: Officers and employees of Government Healthcare Bureaucracy will have access to ALL American financial and personal records.
• Page 203: “The tax imposed under this section shall not be treated as tax.” Yes, it really says that.
• Page 239: Bill will reduce physician services for Medicaid. Seniors and the poor most affected.”
• Page 241: Doctors: no matter what specialty you have, you’ll all be paid the same (thanks, AMA!)
• Page 253: Government sets value of doctors’ time, their professional judgment, etc.
• Page 265: Government mandates and controls productivity for private healthcare industries.
• Page 268: Government regulates rental and purchase of power-driven wheelchairs.
• Page 272: Cancer patients: welcome to the wonderful world of rationing!
• Page 280: Hospitals will be penalized for what the government deems preventable re-admissions.
• Page 298: Doctors: if you treat a patient during an initial admission that results in a readmission, you will be penalized by the government.
• Page 317: Doctors: you are now prohibited for owning and investing in healthcare companies!
• Page 318: Prohibition on hospital expansion. Hospitals cannot expand without government approval.
• Page 321: Hospital expansion hinges on “community” input: in other words, yet another payoff for ACORN.
Page 335: Government mandates establishment of outcome-based measures: i.e., rationing.
• Page 341: Government has authority to disqualify Medicare Advantage Plans, HMOs, etc.
• Page 354: Government will restrict enrollment of SPECIAL NEEDS individuals.
• Page 379: More bureaucracy: Tele-health Advisory Committee (healthcare by phone).
• Page 425: More bureaucracy: Advance Care Planning Consult: Senior Citizens, assisted suicide, euthanasia?
• Page 425: Government will instruct and consult regarding living wills, durable powers of attorney, etc. Mandatory. Appears to lock in estate taxes ahead of time.
• Page 425: Government provides approved list of end-of-life resources, guiding you in death.
• Page 427: Government mandates program that orders end-of-life treatment; government dictates how your life ends.
• Page 429: Advance Care Planning Consult will be used to dictate treatment as patient’s health deteriorates. This can include an ORDER for end-of-life plans. An ORDER from the GOVERNMENT.
• Page 430: Government will decide what level of treatments you may have at end-of-life.
• Page 469: Community-based Home Medical Services: more payoffs for SEIU and ACORN.
• Page 472: Payments to Community-based organizations: more payoffs for SEIU and ACORN.
• Page 489: Government will cover marriage and family therapy. Government intervenes in your marriage.
• Page 494: Government will cover mental health services: defining, creating and rationing those services.

DEMAND your senator & representatives read and know the bill..... especially pages of contention.

Sorry, got to go to lunch.... if I can keep it down. I'm going to need health care because Obama Care makes me sick. Special Thanks to www.romanticpoet.wordpress.com

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HRA & National Health Care Revisited - Costs

2009-07-24T14:37:00.000-07:00

OK. Let's continue the evaluation based on following some money:

►The bill includes a new tax starting at $280,000 of income. If that tax doesn’t generate enough revenue to cover the government’s costs by 2013, the tax automatically doubles. Don't you wish you could do that with your income?

►This tax is negative to small biz because their biz income is their personal income.
Will higher taxes force job loss, less capital investment, or perhaps shutting down the business?

► If you make less than $280,000 per year, section 401 of the bill includes a tax on individuals without acceptable health care coverage. Don't have ‘approved’ health insurance? Shut up and pay the tax!

►The bill also includes a new “fair share” tax to pay for a federal health board. These political appointees will be deciding if you need the new hip or knee or heart valve or… you fill in the blank. Oh yes, it will not be your doctor! Far fetched? Ask a Brit.

► The bill requires individuals to buy health insurance. That’s when you find out the definition of 'approved' health insurance!

►Big business must buy the government-approved insurance for their employees. At over $11,000 per year, that may be the straw that breaks the business financial backbone. If not, you know those ‘evil business owners' will figure some way to save money to pay the bill. Layoffs? Oh yeah...if they don’t buy then they will pay a new payroll tax of 8%.

►The bill establishes a government-run health plan that will undercut the private market and force people to lose their private health insurance. It would be like medicare for everybody and would not operate on the same legal and economic basis as private health insurance companies must.

►Could employers see that as their way out? Could they simply cancel the current group plan and send all employees to the government plan? Isn't that the real motivation of the national health plan?

►Oh yes, lest I forget, you need to know that it won’t apply to members of Congress, who will keep their top of the line health plan.

All right. That’s enough. I’ve just ruined my weekend… I don’t want to ruin yours!

HRA & National Health Care Bill Analysis

2009-07-22T06:49:00.000-07:00

Problems in Health Care Bill HR3200-

Although I’ll continue my analysis of the health care bill, for this entry I am restricting my comments to:

Any provisions that would effectively eliminate our freedom to choose health insurance coverage, cost sharing (deductible, co-pays, and co-insurance). President Obama has said and is still saying that “you can keep the coverage that you have.” However, what he is not saying is for how long we can keep it.

Well….. let’s just check that out!

SEC. 102. PROTECTING THE CHOICE TO KEEP CURRENT COVERAGE.

(a) Grandfathered Health Insurance Coverage Defined- Subject …the term `grandfathered health insurance coverage' means individual health insurance coverage that is offered and in force and effect before the first day of Y1 (first year after passage of the law) if the following conditions are met:

(1) LIMITATION ON NEW ENROLLMENT-

(A) IN GENERAL- Except as provided in this paragraph, the individual health insurance issuer offering such coverage does not enroll any individual in such coverage if the first effective date of coverage is on or after the first day of Y1.

My Opinion: This means that the insurance company cannot add new clients to its list of customers. The result of this provision would be that the insurance company would have an increasing group of clients who are aging and whose medical costs increase year by year. With no new client premiums it would crash. Sounds like medicare’s future doesn’t it?

The dirty truth is that an insurance company faced with that future would liquidate while they still have assets to distribute to their stockholders thus forcing all policy holders into the national health plan. So much for keeping what you have!

Competition and choice would be further eliminated because an individual policy holder could not shop around for a better plan in terms of coverage or premium or both! Again, not a good deal.

(2) LIMITATION ON CHANGES IN TERMS OR CONDITIONS- Subject to paragraph (3) and except as required by law, the issuer does not change any of its terms or conditions, including benefits and cost-sharing, from those in effect as of the day before the first day of Y1.

My Opinion: This mean that all changes would invalidate the ‘grandfathering’. Not a good deal. For example take a single male who did not buy maternity coverage for obvious reasons then got married and wanted that coverage. Or, take a young family whose budget was stressed and took a low deductible and 100% coverage. Then later in life when they prospered and were healthy wanted to save premium dollars by selecting a higher deductible and 80% coinsurance. That change would invalidate 'grandfathering'.

(3) RESTRICTIONS ON PREMIUM INCREASES- The issuer cannot vary the percentage increase in the premium for a risk group of enrollees in specific grandfathered health insurance coverage without changing the premium for all enrollees in the same risk group at the same rate, as specified by the Commissioner.

My Opinion: This provision was written by someone who thinks all health insurance benefit plans are exactly the same. That isn’t even close to being factual. It would be nearly impossible for an insurance company to comply with this restriction because of the variation of benefits within a specified risk group. Policies do not have the same coverage benefits (some include maternity, dental, vision, and some have special care for heart attack, cancer, …etc).

Finally, what makes our current distribution system great is that a healthy family can shop each and every year for the best rate and coverage selection available to them by multiple insurance companies.

This option is fully available for individual policy holders under the HRA.

Wow, I'm now through page 16 or so! Obviously more next time.

Uninsured Statistics & the HRA

2009-07-13T16:42:00.000-07:00

A few posts prior I mentioned that of the 47 million uninsured 18 million were between 18 and 34 years of age, aka, young healthy adults who chose not to buy health insurance. Well here are some more stats with citations:

1. 17 million lived in households earning $50,000 or more…. obviously could buy health
insurance if they chose to do so and,
2. 50% of non-elderly people who were uninsured regained their health insurance within
four months and,
3. 30% remained uninsured for more than 12 months.

References:
1. (http://www.census.gov/prod/2006pubs/p60-231.pdf )
2. (http://www.aspe.hhs.gov/health/reports/05/uninsured-cps/ib.pdf)
3. (http://www.heartland.org/policybot/results.html?artID=16014)

The second reference also found:
1. 21% are below age 18
2. 63% are under age 34
3. 21% are non-citizens

Prior to believing any stats that the proponents of national health care put forth, it makes sense to verify their usage.

Are they intended to inform or mislead?

Within the HRA nearly 52% of those uninsured could easily obtain their own health insurance. Why? Because the individual health policy is rated on age and health. A young person looking at the costs under the employer-paid benefit sees a premium cost of nearly $500 per month. That is disposable income. How would spending that money for health insurance stack up against… renting a BMW or payments on a 51 inch high def flat screen tv?

The average cost for an individual health policy under the HRA for the 18-34 demographic would be about $200. An employer is a lot more likely to participate at that level but even if not it is still less expensive precisely because it is age rated not marital status rated!

Once again the HRA is a winner!

HRA Benefits Chiropractic

2009-07-09T10:47:00.000-07:00

A couple weeks ago I shared the HRA concept with Dr. Jason Fullmer a fellow member of NExT (Network Exchange Team) and a Chiropractor. As I shared the HRA idea with him he was very interested but cautious. It seems that many of his patients' medical insurance plans cap the benefits for chiropractic service.

When he learned that the HRA reimbursement could be used for approved medical expenses including chiropractic he quickly saw that the insurance company cap wouldn't prevent the patient from using the balance of the HRA reimbursement for chiropractic treatment modalities. Since Dr Fullmer is also deeply involved in natural treatment modalities he saw how the HRA could benefit his patients there too.

Indeed the HRA flexibility is one of its best features. This same flexibility also places the buying power in the hand of the patient. This indeed will reduce costs since the patient is now part of the medical decision-making loop.

For more information on the HRA visit our website http://www.pahealthteam.com

Tire Kicking, Brain Picking, Time Wasters

2009-07-08T09:37:00.000-07:00

Image by alles-schlumpf via Flickr

Yesterday I read a blog by Catherine Lockey “Business Predators”. (http://www.cyclonemarketing.info/?p=169). It is an insightful presentation well reasoned and well said. It was especially poignant for me as I recalled an appointment with one of her characters. His name, Mr. Terrible McMiserable.

He was controlling. His desk sat on a platform whereas my chair did not! So he literally towered over me by at least 12 inches. Talk about a power trip. He fired questions like a prosecuting attorney going for the kill. His questions were well rehearsed and random both in topic and volume. For example he quietly asked about my service and then immediately followed with a bellowed, “Why are you wasting my time?” Since he’d invited me to visit with him I wondered whose time was being wasted.

He didn’t want to learn about me or what I could provide his business. He only wanted my materials. Why? To give to my competitor! He arrogantly said so. “If you want my business you’ll do it on my terms. I want a friend to review your materials with an unbiased eye. By the way he is your competitor.”

While I don’t mind competition, I do mind educating my competition… unless there is a substantial matriculation fee. Thanks Catherine for a needed reminder.

HRA - Another Independence Day

2009-07-04T09:23:00.000-07:00

Image via Wikipedia

The more I 'work' at this HRA solution to health insurance, the more I like it. Not since the 80's have I received more satisfaction from my work.

Group health insurance has frustrated small business because it just keeps presenting more and more problems. Oh sure, the cost is nearly preventing profits but what is even more pressing is the feeling that "nothing can be done".

The HRA solution not only creates the profit possibility but it provides a much needed alternative to employer-sponsored-group health insurance. It is an alternative that is so flexible that the power resides with the employees relative to their own health care.

The many different coverage options, deductibles, co-pays, and costs are in the hands of the employee. Additionally, the choices of medical service providers will definitely generate competition which will lower costs and improve results.

Yep.... I like this work. I just quoted a trucking company. The HRA saves over $6000 per month in premium costs.

That makes it very worthwhile.

HAPPY INDEPENDENCE DAY!! Re-read your Declaration of Independence and your constitution. Also, read what our founding fathers said and did. Inspiration is a word... but it does not due them justice.

Health debate: A little clarity, please - Jun. 19, 2009

2009-06-24T12:08:00.000-07:00

Health debate: A little clarity, please - Jun. 19, 2009: "But President Obama has set a tight deadline. He wants both the House and Senate to pass their health reform bills by Aug. 1."

The Rush to What?

2009-06-24T11:39:00.000-07:00

According to our federal officials in Sep 08 we needed to save our banks and loosen credit. The bailout did neither. But we did it in a rush.

Then the stimulus bill had to be passed in such a rush that no one read it! Now, four months later only about 10% has been released. What did we rush to?

Now the newest need to rush is the rush is nationalized health care. How is it justified. Mystical stats. For example: "There are 47 Million uninsured." Well that begs the question, "How many of those could afford health insurance but choose not to buy?"

As it turn out between the ages of 18-64, over 43% or 18 Million could afford health insurance but choose to spend their money elsewhere. See complete article at http://www.medicalnewstoday.com/articles/155093.php - "New EPI Healthcare Study".

Another study shows that the rush is still on. However there is no consensus. So the rush must be to limit or eliminate a complete and vigorous debate that should take place. The debate and required time for same is needed so that the phony stats and emotional fear generating tactics are exposed for what they are....... A rush to deceive.

Health debate: A little clarity, please - Jun. 19, 2009: "But President Obama has set a tight deadline. He wants both the House and Senate to pass their health reform bills by Aug. 1."

HRA & the Sole Propietor

2009-06-22T09:28:00.000-07:00

It seems that only the big get the breaks. Not so with the HRA. A qualifying Sole Proprietor can save a bundle with an HRA.

How? The HRA allows reimbursement for lots of health related expenses: health insurance premiums, glasses, dental work, deductibles, co-pays... and this is only a partial list (see IRS Pub 502 - Health & Medical Expenses)

In a prior blog I mentioned that my wife and I paid over $1200 per month in health insurance premiums. Under an HRA that would be a deductible expense for my business. That would save Federal, State, Local, and self employment taxes. Plus it would not be income to me personally. That's $1200 per month and only a start. It's not a raise but it does save taxes!

That is a good deal. Save money and get health insurance!

Paul Zane Pilser

2009-06-18T10:02:00.000-07:00

Cover via Amazon

A friend ask about the author I referenced, Paul Zane Pilser. I've read two of his books but only after reading the one titled "The New Health Insurance Solution".

For a synopsis of that work check out this you-tube link where he is interviewed and discusses his book.

http://www.youtube.com/watch?v=mh_MGyx9tgc

He'll give more than enough reasons for not seeing government health insurance as a solution.

Bankruptcy by Medical Costs

2009-06-15T08:19:00.000-07:00

Cited as a reason for National Health Insurance, proponents stipulate the millions of Americans who go bankrupt each year due to health-care costs.

What they don't say is that nearly 70% have or had health insurance.

What's missing? The snake still deceives! COBRA just does not do the job.

The dirty little secret is that employees covered by employer-paid-health insurance remain covered only as long as they can work. (For the moment forget about auto workers) Once one is too sick to work, group health insurance stops even if one can afford COBRA. Thus subsequent medical bills accumulate at an alarming rate with no chance of stopping short of death.

A solution pointed out by Paul Zane Pilser in "The New Health Insurance Solution" is for individuals to purchase and own their health insurance policies. That provides complete portability thus eliminating the need for the snake.

What about affordability? In my area of Pennsylvania coverage for my wife and I is over $1200 per month. It includes maternity. In our 60s that isn't high on our list of coverages. However, that same rate applies to a married couple in their 20s.

The same rate for an individual health policy for a couple in their 20s is about $300 per month. The rate goes up as they age but can't be increased due to illness. It can't be canceled due to medical expenses either.

But, young people won't spend money on health insurance. Hey, they'll buy 52 inch High Def TV.
The right incentive isn't in place... "no health insurance no driver license". Too radical? Maybe.

But not compared to National Health Care!