Further Problems Facing MediCal

As reported in an article from Los Angeles Times by Maura Dolan and Chris Megerian on December 13, 2012 MediCal could be in for more problems.  A three judge panel ruled that the law passed in 2011 which cuts payments to doctors and pharmacies by 10% can be implemented.  There are already a shortage of doctors that accept MediCal and this 10% cut is expected to have detrimental effects on an already fragile system.  Take into consideration that in one year California is expected to add an additional 25% to the number of people on MediCal under the new health care exchange.  To read the full article click on this link http://articles.latimes.com/2012/dec/13/local/la-me-medi-cal-20121214 .
Time will tell what the system will look like in a year or two, but for those that can avoid MediCal by any means should do so.

Mental Health and Health Care

In light of the recent shootings in Connecticut it is a good time to remind people that last year in California the legislation expanded the minimum requirements for mental health services covered under health insurance plans.  People that may have sought help previously may not know that they have expanded coverage.  If you know someone that might need help please share this information with them.  If they are unsure of their coverage simply have them check with their insurance company.  All insurance plans have a phone number listed on the medical ID card that they can call and at least be directed to the proper number to get more information on their specific coverage.

If you need help with this you are welcome to call us at 714-680-5900 or email us at info@ansainsuranceservices.com .  

Good News from Anthem on Preventative Colonoscopies

In Athem's newsletter to brokers they reiterated that colonoscopys done as preventative would be considered preventative even if polyps are found and removed.  This has been a big bone of contention for our clients (with all the carriers). People that were planning on the colonoscopy being covered as preventative and thus having a low or no co-pay for the procedure were often shocked and horrified at the bill that would follow after the procedure.  We hope the other carriers follow in this practice.  Colonoscopies and the removal of polyps can run several thousand dollars.  People that have large deductibles and high out of pocket maximums feel duped when they, unaware of what is taking place while they are under sedation and on the table, get sacked with a huge bill. 

It is very important to talk to your doctor, the billing staff and your carrier to coordinate what will happen when you need a procedure of any kind.  Somethings are not foreseeable, but some situations (like polyp removals during colonoscopys) are.  Do not be afraid to ask your provider how much the procedure will cost and what are some typical situations that may affect those costs.  If we all become better consumers of our health care, we can help drive down costs for everyone.

The Reality of ACA

The link below is to an article published about just one new fee that is set begin in 2014 on individuals with health care.  There are two ways to look at this.  First, why are the people that currently pay into the system getting penalized again by being forced to pay more so other people can participate in the system? The second way to look at it is that to make the system work we all must pay more and hope that it equalizes over time for every one's benefit.  Check the link and make up your own mind.

http://news.yahoo.com/surprise-insurance-fee-health-overhaul-law-185726448.html;_ylt=AgB.16n26aK1Qu4Y71gdsQiZCMZ_;_ylu=X3oDMTJiNXE4ajZtBG1pdANORlUgQnVja2V0IEFydGljbGUgR3Jhdml0eSBORlUgd2l0aG91dCBNb3JlIExpbmsEcG9zAzEEc2VjA25ld3NfZm9yX3lvdQ--;_ylg=X3oDMTNrazhjbWRkBGludGwDdXMEbGFuZwNlbi11cwRwc3RhaWQDZWRiMjhhNTUtMmU1YS0zMDg2LWI0MjctZjE0MDI4Y2ZiYTJiBHBzdGNhdANibG9nc3x0aGVsb29rb3V0BHB0A3N0b3J5cGFnZQR0ZXN0A040VV9HcmF2aXR5;_ylv=3?grcc2=5624594bbdca558306b03a13caaf712a%7E1355167262460%7E494d6e560c95708877ba0eff211c02f3%7E%7E1355167262459%7E597%7E0%7E0%7E0%7E0%7E0%7E0%7E0%7E2%7E35%7E10%7E79%7E-1%7E5014613925465207230%7E%7E%7E

However you feel about the health care law, it is our reality and thus we must learn to work within it and make the best of it.  If you have any questions about the law and how it will affect you, please call us at 714-680-5900.

Dental Coverage Under the PPACA

The PPACA has mandated that plans offered on the exchange, or small group and individual plans all include in them benefits for children's dental services.  There has been much data collected over the years that children that receive regular dental care are healthier than those that do not.  With that said it will be interesting to see how this is played out in the actual world.  Currently, children on Medical have dental coverage.  But there is a continuous cry about accessing that care.  If we add more children to this group, but dentists still resist taking these plans, will the children get more care than they are now?  Or will their coverage merely be on paper and parents that can already afford to take their children to the dentist will continue and those that can not afford it will still not have access to the dentists they need?  We will wait and see.

Dental care is important.  If you would like to find out more about dental insurance and how it works, please contact Angela Gambino or Lisa Boyajain at info@ansainsuranceservices.com or you may call us at (714)680-5900. 

Health and Life Insurance Today: Did You Know that the ACA Created Over 40 Changes...

Health and Life Insurance Today: Did You Know that the ACA Created Over 40 Changes...: Did you know that according to an article in Politico on November 20, 2012 that the Affordable Care Act makes more than 40 changes to the ta...

Did You Know that the ACA Created Over 40 Changes to the Tax Codes?

Did you know that according to an article in Politico on November 20, 2012 that the Affordable Care Act makes more than 40 changes to the tax code?  The IRS has a huge undertaking to make sure this law is implemented and can fund the necessary features to make the law work.  The IRS needs to make sure people and companies get the premium tax credits they deserve (if they qualify).  They need to collect penalties from individuals and businesses that do not purchase insurance.  They will also be the verifiers of income for the subsidies that will be given out through the exchanges.  Because the information will be based on two year old tax returns this could pose many problems at the end of the first year.  In addition to all that, the IRS will need to track individuals personal situations to see if there are changes to qualifying for the subsidies through the exchange.  Some of these situations would be a divorce, the birth of a baby, job loss or if an individual moves to a different state. 

As you can see it is a complex issue with complex rules and results.  If you have any questions about the law and how it may affect you or your business, please call us at (714)680-5900 or find us on the web at www.ansainsuranceservices.com .

One Source of Funding for ACA (Obama Care)

Much of the funding for the Affordable Care Act comes from sources that are currently being used to fund other medical expenses.  The current board working on implementation of the ACA  has begun to try and move the money from one program to the ACA.  This is not a simple task as reported in the Washington Post on November 18, 2012.  The board must figure out how to transfer some $36 billion from a fund that pays hospitals that accept uninsured patients to the Medicaid and subsidised portions of the state exchange program.  The $36 billion would have been distributed to hospitals between 2014 and 2019. 

This is not simple for the fact the board must figure out who will still receive funds and who will be cut first.  Remember the penalties for not obtaining insurance are very small the first few years and the law does nothing to address illegal immigration, so hospitals will still be faced with people coming threw their doors with no ability to pay.  We will see how this affects our local hospitals. 

If you have any questions on this information or would like to get more information on health insurance or life insurance please contact Lisa Boyajian or Angela Gambino at (714)680-5900 or find us on the web at www.ansainsuranceservices.com .

Medical Devise Excise Tax

In an article from the Washington Post (November 18, 2012) by Jordan Raw it was reported that begining January 2013 the Medical Devise Excise Tax will kick in.  It is a 2.3% tax on all medical devises.  But there are still many unresolved issues that need to be addressed.  The first and biggest issue is what gets taxed and how that tax is applied and collected.  An example of what is in front of the board working on the ACA would be latex gloves.  At what point  does the tax get applied.  Is it from the first sale - manufacturer to wholesaler?  Or is it from the point of last sale - a person purchases a box from Rite Aid.  Another example would be taxes on kits that doctors and hospitals use.  Would those kits be taxed on the parts purchased for the kits or at the point of sale?  In addition to those questions the board needs to figure out who gets taxed for instruments that have uses outside of the medical profession.  Do veterinarians and dentist get taxed on medical devises that doctors use.  That was not the intent of the law, but how do you enforce it? 

In other news, if you are a business looking at carrier options in Southern California Kaiser Permanete is offering a special on locked in rates for 15 months.  If you would like more information on that or any other health or life related issues you can reach Lisa Boyajian or Angela Gambino at (714)680-5900 or find us on the web at www.ansainsuranceservices.com .

Premium Tax

What is a Premium Tax?  It currently does not exist, but it is possible that it is only a short distance down the road.  Basically, a premium tax is a sales tax on health care paid by employers and individuals buying health insurance.  It was written in the health care law as a way of keeping down costs for Medicaid (or MediCal for those in California).  How would it work?  Everyone that buys health insurance from a source other than Medicaid or MediCal would pay a tax on the cost of their premiums.  This revenue would then be used to offset the cost of Medicaid and MediCal. 

Will it be implemented?  That depends.  Right now there is a huge push to keep premiums down, but there are more factors and stresses pushing those premiums up then ever before.  Congress would be crazy to implement this tax now, when in affect, the tax would be an additional cost on those premiums. Is Congress crazy?  We will just have to wait and see.  But when we find out we will share it with you.

Employer Mandate

Much has been made of the "Employer Mandate" in the Affordable Care Act, but few details have been available for employers to see.  In a nut shell, and leaving out many of the individual nuances, the Mandate goes as follows:

1. Starts January 1, 2014
2. Pertains to Employer with over 50 or more Full-Time Equivalent Employees (How an employer figures out what "equivalent" means is best left up to your tax advisers and accountants - there is a complicated formula to follow and many different rules to be sure you are considering.)
3. Employers with over 50 Employees must offer plans that meet the minimum essential coverage rule.
4. Employers with over 50 Employees must be sure that the cost of these plans does not  exceed 9.5% of what the lowest wage earners earn in a year.

What happens if an employer with over 50 employees does not offer minimal essential benefits at an affordable price?  Well it depends.  If no employee elects to get coverage through the exchange and receive premium tax credit than no penalty will be accessed on the employer.  But if an employee joins the exchange and gets premium assistance the penalty can be either $2,000 or $3,000 per employee of that company.  There are nuances to these rules and we will address these nuances in future blogs.

The burden of these new rules fall squarely on the employer, but know that the carriers are doing their best to educate their clients.  Your broker should be keeping up on these rules as well.  If you do not have a working relationship with your broker you need to get one.

Lisa Boyajian and Angela Gambino work with all the major carriers (Aetna, Anthem B.C., Blue Shield, Cigna, HealthNet, Kaiser, United Health, CalChoice and SeaChange).  If you would like to get more information or reach us you can call us at (714)680-5900 or find us on the web at www.ansainsuranceservices.com .

"Covered California"

Today California's Exchange Board will be meeting to vote on submitting an establishment grant to the Federal Government.  This board has already moved California to the forefront of State Exchanges in the U.S. and it is looking as if it may be one of only a few that are set up and running by the goal date of January 1, 2014.  The Exchange in California will be known as "Covered California".   At this same meeting they will be busy  working on setting regulations for "qualified" health plans.  We should know quite soon what to expect out of such "qualified health plans" and who already meets that criteria to be considered as having a "qualified" health plan.

In addition to the Exchange Board meeting Governor Brown has requested that the State Legislature meet back early to discuss health care in the state.  No dates have been set, but it is looking as if the normal month off in December will be drastically cut short.  There are many agenda items that need to be moved forward now that the election is over and the Affordable Care Act will stand as is.

What we know now is that for those already covered under most carriers in California (Anthem Blue Cross, Blue Shield, Aetna, Kaiser, Cigna, HealthNet and United HealthCare) very little will change.  For those of you on discount plans, you will need to make a substantial change.  Discount plans will in now way be considered "qualified" and thus you will need to move plans or face penalties.  If you have questions about your plan (and it is not from one of the carriers listed above) you can call us and we can help you sort through what you have and find out if you are in good standing. 

You can reach either Lisa Boyajian or Angela Gambino at (714)680-5900 or find us on the web at www.ansainsuranceservices.com .

Medicare and Open Enrollment

It is that time again to talk Medicare Advantage.  October 15th through December 7th is the open enrollment period for Medicare Advantage Plans.  If you are Medicare eligible (or know someone that is) this is your opportunity to find out more.  In Orange and Los Angeles Counties most Medicare Advantage Plans have a $0 premium and include $0 office visits and many more additional benefits at no cost or a very low cost.  Medicare Advantage Plans are not for everyone.  If you reside in multiple locations or want freedom to chose any Medicare Accepting physician than you will probably wish to stay on a standard Medicare Supplement.  The only way to find out for sure is to schedule an appointment with an authorized agent to go over your situation.  Of course Ansa Insurance Services is authorized to offer Medicare Supplemental and Advantage plans. 

If you receive your health insurance through a group plan and your renewal is this January you should have or should very soon, be receiving your SBC's.  SBC stands for Summary of Benefits and Coverage.  It is a new standardized way to look at available plans.  Your employer should be making the SBC's available to you and your dependants.  If you are the employer, be sure to get those out.  If you have an individual plan you should be receiving them soon.  I do know for a fact that Kaiser sent out their individual SBC's already. 

If you have questions about SBC's or Medicare please contact us at (714)680-5900 or email me at angela@ansainsuranceservices.com .  You can also get more information about us on the web at www.ansainsuranceservices.com .

"Covered California" is the New Name of Our Exchange

California Exchange - that's the new branded name of our health exchange here in California.  It was chosen from a field of other submitted names and run by a focus group to find the name that would best suit the exchange in California.  Those same oofficials are expected to pick which insurers, of the nearly 30 that are applying,  that will ultimately be a part of the exchange.  Kaiser, Anthem, Blue Shield and HealthNet are a few of those that officials will be looking at.  Some others that are applying are small companies and hospital groups that are looking to be regional players in the exchange.  As we find out more we will continue to update you.

Today is Election Day.  Did you vote?  Polls are open till 8:00 pm so be sure to do your civic duty and vote.  When you vote be an informed voter.  Look into the candidates and the measures and propositions to be sure you truly know what you are voting for.  There is nothing worse than finding out after the fact that your "yes" vote for a proposition meant no or the other way, you voted "no" and by voting "no" it meant that the act you thought you were stopping was now going to happen.  Be informed, be informed, be informed.

If you would like to get information on health insurance or life insurance be sure to call us at (888)800-5855 or find us on the web www.ansainsuranceservices.com .

Almost Election Day

November 6th is almost upon us.  For those of you that are voting with absentee ballots be sure to have them mailed off by this weekend.  If you are planning on voting at the polls, be sure to spend a few hours looking over your propositions and local issues before you enter the booth.  By now it is safe to say that we all (except for a tiny few) have made up our minds on the big issues and the presidential race.  But the local issues and candidates often get put off until the last minute.  Now is the time to research those issues and people.  It is our civic duty - not just to vote but to be informed voters. 

The election could quite possibly bring changes to this industry, either directly or indirectly.  As we find out what these implications are we will share them with you.  The health  carriers (Aetna, Cigna, Kaiser, Anthem, Blue Shield, and Health Net - just to name a few) have been looking at the many possibilities that are ahead of us.  As they communicate their changes we will add them to this blog.  If you have any other questions regarding health insurance or life insurance please do not hesitate to call us at (714)680-5900 or email us at info@ansainsuranceservices.com .  As always, you can find us on the web at www.ansainsuranceservices.com .  REMEMBER TO BE AN INFORMED VOTER AND GO VOTE!

Immigrants and the Affordable Care Act

Under the Affordable Care Act, undocumented immigrants and lawful immigrants who have lived in the U.S. for less than five years are excluded from new coverage opportunities, including state health insurance exchanges and Medicaid expansions.

A recent report by the UC-Berkeley Center for Labor Research and Education and the UCLA Center for Health Policy Research on California residents who will remain uninsured after the ACA takes effect found that:
•66% of the remaining uninsured will be Latino;
•60% of the remaining uninsured will have limited English proficiency; and
•62% of the remaining uninsured will live in Southern California.

So what are we going to do about this?  There are some small organizations and groups looking at this and trying to find solutions for this population.  The people in this group are not just going to disappear in 2014 when most of the mandates in the law are implemented.  Our State and Federal Governments are not addressing this at all.  If you live in Southern California you should be extra concerned.  We will have the potential for a humanitarian crisis on our hands.

If you are concerned about this or about anything else relating to health or life insurance please feel free to call us at (888)800-5855 or find us on the web at www.ansainsuranceservices.com .

The Move is on Toward More ACO's

Last week both Cigna and Aetna announced that they are expanding their ACO network.  ACO's are Accountable Care Organizations.  Essentially they are little networks set up in larger networks.  Think of them as your local public school.  You belong to a larger school group called your school district and it belongs to a larger group either from your county and/or state.  But what matters to the individual is which school they are going to.  Their first choice is the local neighborhood school.  But some people chose to move to another school still within the district.   ACO's are the same.  You belong to a carrier and in that carrier there are networks of Preferred Providers.  If you stay within the preferred provider network you pay less than if you go outside that network.  Now we are seeing even smaller groups forming from these preferred provider networks - they are the ACO's. 

Be on the lookout for more of these smaller networks coming to your plan.  If you would like to get more information on these plans or any other health or life insurance plans please call us at (714)680-5900 or email us at info@ansainsuranceservices.com .  You can always find us on the web at www.ansainsuranceservices.com .

Reuter Article on Employer Survey Done by Adecco

This article sums up much of what we have seen with our clients.  Read on...

Reuters, by Nick Zieminski -

October 22, 2012:

U.S. corporate executives are more worried about providing healthcare benefits to their employees than about issues like wages, taxes or attracting qualified workers, according to a survey by the world's No. 1 staffing company, Adecco SA.

In Adecco's poll of senior executives, 55 percent named healthcare benefits as their biggest current business challenge, and about a third say they are holding back hiring because of healthcare reforms introduced by U.S. President Barack Obama.

Obama's 2010 healthcare law, upheld this year by the U.S. Supreme Court, is expected to raise insurance costs for employers because it calls for wider coverage of more people, including those with pre-existing medical conditions.

"A lot of firms just don't know how the (law) is going to impact them financially," said Senior Vice President Janette Marx. "If it does increase costs, it causes executives to question whether they can hire more."

Obama is not doing enough to help businesses grow, executives say, and they favor Republican challenger Mitt Romney in the November 6 Presidential election by nearly 3-to-1.

Fewer than half of those polled expect their businesses to grow profits in the next year. Those who run small businesses are more optimistic than those running large ones.

More respondents also reported lower profits over the past year than said their companies grew earnings. They cited government regulation, consumer confidence and commodity prices as the biggest headwinds to growth.

Healthcare's prominence as an issue has risen since the 2008-2009 recession, Adecco found: in 2007, only 35 percent called healthcare their top worry.

U.S. hiring could pick up after the election, regardless of who wins, because employers will have one less area of uncertainty to keep them on the sidelines. Adecco is seeing pent-up demand for workers among clients in manufacturing, retail, e-commerce and in the car industry.

"Companies have been waiting until after the election to make hires they need to make," Marx said.

Adecco is the world's largest staffing company measured by revenues and is the third-largest employer in the United States, behind Wal-Mart Stores Inc and the postal service. Its poll was conducted in early October and included responses from 501 CEOs, owners, managing directors and other senior executives.

If you would like to get information on health insurance or contact  us you can call us at (714)680-5900 or find us on the web at www.ansainsuranceservices.com .

Halloween - The Perfect Time to Talk Dental Insurance

Halloween reminds us all of chewy, sticky and oh so yummy candy.  As our little ones begin to dawn their new costumes and plan for the yearly ritual of door to door extortion it becomes apparent we need to make sure they have good teeth!  Routine dental care is more important than most people know.  Many of us think that dental care is only important once our teeth begin to hurt.  But studies have shown over and over again that good routine dental care keeps your body healthier. 

With the economy being what it is, many have put off their dental care even though they know it is important.  Those with dental insurance are much more likely to continue with care even when times are hard.  Not all dental insurance is the same and what plans work for some may not work for others at all.  Finding the right plan for you is a group effort between your doctor, you broker and you.  When all three work in accordance with one another their is grater satisfaction with the dental plan. If you do not have a dental plan and would like to get information about dental insurance please call us at (714)680-5900 or email us at info@ansainsuranceservices.com .  If you would just like to get some general information on dental insurance go to www.ansainsuranceservices.com and click the individual insurance tab from their click on to either the Anthem Blue Cross tab or the Blue Shield tab to get more information. 

California's Move Away from Healthy Families

This is an important topic underway in California.  Nearly 1 million children are in Healthy Families and we are about to see a major change for these children.  The article does not address the lack of doctors that accept Medi-Cal.  It only addresses the pay reduction that these doctors will take. 

Associated Press -

October 16, 2012:

Sacramento — California lawmakers will begin hearings this week into how the state will end a health program serving more than 860,000 children without disrupting care.

The state budget enacted this year eliminates Healthy Families to save $73 million a year. Its participants will be moved to Medi-Cal, California’s version of the Medicaid program for the poor.

Healthy Families benefits low-income families who did not qualify for Medi-Cal.

A top concerns is whether health care providers will be willing to accept the new patients because they were reimbursed at a higher rate under Healthy Families. They could receive 15 percent less under Medi-Cal.

California Health and Human Services Secretary Diana Dooley says she believes enough health providers will be willing to care for the children at the reduced rates.

If you have questions about the above article please do not hesitate to call us at (714)680-5900 or find us on the web at www.AnsaInsuranceServices.com .

Wellness Programs - Are They Worth It?

Health Net has published information on wellness programs and has sited that more employers are implementing wellness programs in their work places.  As a result of this implementation employees are reporting a reduction in their personal health care costs.  Some wellness programs are tide to the company's health plans (Kaiser is one example).  In these models, the insurance company makes wellness plans available to all it's members.  The other option available are independent wellness companies that come into the workplace in addition to the companies health insurance. 

Which one has a better outcome can be debated.  What is most important  to note is that when an employee can reduce it's out of pocket costs related to their own health they will be happier and more likely to stay on a course of well being.  That well being translates into a more productive worker for the employer.  It is a win win situation.   I'm sure we will only see growth in this area as other health care costs continue to rise.

If you would like more information on wellness programs within a given carrier or you would like more information on a specific plan, please contact us at (714)680-5900 or you can find us on the web at www.ansainsuranceservices.com .

Employer Responsibilities Under the ACA

As many of you have heard, employers that have over 50 employees may be fined under the Affordable Care Act if any employee goes to the exchange and is subsidised for premiums.  But the practicality of this is very different than the simple statement.  For starters 50 employees is not what most employers believe it is.  The law states that it is 50 full time equivalent employees that trigger the fines.  What is an equivalent employee? Part-time and seasonal employees are counted toward the 50 mark and the mathematics behind it is confusing to say the least.  Employers will need to be aware that even though they may only have 20  full-time employees at any given time that they will need to figure out the equivalents for part-time and seasonal employees.  Seasonal employees are not simply employees that come in and work a season or two and move on.  Seasonal employees can be any employee that works full time hours but not necessarily every day.  An example of this would be an employee that works an 8 hour shift one day a week for most of the year.  If you simply added up their hours they would appear to be part-time, but because they always work a full day they would be considered seasonal. 

What does this mean for your business?  It means that as we move closer to 2014 you need to be in constant communication with your insurance broker and carrier.  They will be the ones making sure you are compliant with the law.  There will be much to consider at any given time and a good broker will help you sort through all this.  If you are not working with a broker and would like us to preform a market analysis, please contact us at (714)680-5900 or you can email us at info@ansainsuranceservices.com .  As always you can find out more about us and what we offer on the web at www.ansainsuranceservices.com .

What's New?

As we move into our last quarter of the year it is important to pay attention to the new rules coming on health care.  One of these rules is the requirement to include health insurance premiums on your employee's W2 forms.  If you have filed less than 250 W2's last year you may be exempt this year.  Eventually you will need to add it to any W2's even if you are a small business.  Consult your tax account or payroll specialist for more information.

For North Orange County residents:  Kaiser Permanete opened it's new facility (Anaheim Medical Center) off the 91 Freeway on La Palma Ave in Anaheim on September 12th.  If you are interested in joining in on a tour please call us or email us and we will help set up the tour.  You can contact us at (714)680-5900 or find us on the web at www.ansainsuranceservices.com .

Medicare Advantage

It is about that time of year again.  The Annual Election Period (AEP) for Medicare Advantage plans.  This is the time when individuals can either elect to sign up an Advantage Plan or Change from one Advantage plan to another or to move from an Advantage Plan back to a Supplemental Plan.  This time period runs from October 15th through December 7th.  If you have a family member that is eligible for these plans they are currently being bombarded with advertising materials.  It can be quite confusing and a bit overwhelming.  Now is a good time to check in with your loved ones and make sure they understand what they are or are not purchasing. 

If you would like to gather information for yourself or someone you know you may call us at (714)680-5900 or email us at info@ansainsuranceservices.com .  As always you may find us on the web at www.ansainsuranceservices.com .

Governor Brown Strikes Down SB961 and AB1461

On October 2, 2012 the Sacramento Bee reported that Governor Brown vetoed the Senate Bill 961 and Assembly Bill 1461.  Those bills were the requirement for California's "Guaranteed Issue" laws that would require health insurance carriers to take every applicant regardless of past and current health conditions.   Governor Brown wrote...



"Without the strong foundation that federal law provides, a state-level mandate on insurers alone could encourage healthy people to wait until they got sick or injured before purchasing coverage," Brown wrote in his veto message. "This would lead to skyrocketing premiums, making coverage more unaffordable."
The issue is not dead.  The State Senate and Assembly will need to come together and rewrite the laws so that they are more closely tied to the Federal Mandate. Be on the lookout for those new laws with the improved language within the next two months.

If you have any further comments or questions you may contact us at 714-680-5900 or you can find us on the web at www.ansainsuranceservices.com.

What Percentage of Population Is Uninsured?

What percentage of the population is uninsured?  This seems like a simple question, but it is in fact quite complex.  The Sacramento Bee reported on September 12, 2012 that it depends upon where you are.  Nationally the medically uninsured rate is 15.7%.  This is actually down from 16.3% in 2010.  But what state you live in makes a big difference.  Massachusetts has a medically uninsured rate of 3.4% (Due to what is known as Romney Care - they have a forced mandate to purchase health insurance).  In Texas they have an uninsured rate of 23.8%.  Here in California we have seen an increase in our uninsured population.  We were at 19.4% in 2010 and have moved up to 19.7% in 2011.  This is mainly due to the economy while rates have simultaneously increased over that same time.

What will happen in 2014?  So much remains to be seen.  We will see what happens here in California.  We have moved faster than any other state to set up our exchange and our mandates that we already have in place are further than most states.  Stay tuned, we will update you as we receive more information.  If you would like to get specific information, you can reach us at 714-680-5900 or find us on the web at www.ansainsuranceservices.com .

Relay for Life - Santa Fe Springs

Let the count down begin.  Santa Fe Springs Relay for Life is only 11 days away.  If you have never been a part of a Relay for Life event - let us say it is a beautiful and inspiring weekend.  For those of you that don't know what it is, it is a 24 hour fundraiser where teams of people walk to support the American Cancer Society.  There is live entertainment, booths, food and inspiring people and inspiring stories.  Some people stay for all 24 hours while others come for a few hours.  If you have never seen the luminaria you should.  Anyone that has ever watched a friend or loved one battle cancer will be especially touched. 

To get information on a Relay for Life event in your area or to get more information on the Santa Fe Springs Relay for Life go to relayforlife.org .  Lisa Boyajian is co-chairing this event once again with Paul Hesse. If you would like to contact Lisa regarding the SFS RFL you can reach her at (714)680-5900 or email her at lisa@ansainsuranceservices.com . 

If you would like to get more information on Ansa Insurance Services please see our website at www.ansainsuranceservices.com .

Communicating with Your Doctor's Office Staff

With all the new preventive care benefits out there it is more important than ever to maintain a line of communication with the staff in your doctors office.  When making appointments that are for preventative benefits you need to be extremely specific and exact.  Have the appointment setter read back to you the reason for the appointment and make sure they repeat that it is for preventative care.  When getting any test done, be sure that the doctor is clear with you and his staff if it will be covered as preventative care.  Many test are, but if they are lumped with some that are not covered then the whole group may not be covered. 
We have seen an uptick in complaints regarding this topic.  It is all in the coding.  If the doctors office staff miss codes you will be billed differently than you anticipated.  If the doctors staff explains to you that what you are doing is not covered then you will need to decide if it is necessary and worth the added expense.  You are your biggest health advocate, do not be afraid to call on staff and the insurance carrier to find out what your benefits are and at what level you will be covered for the care you receive.
If you would like to find out more about your specific health plan or get information on another plan, please contact us at (714)680-5900 or email us at www.ansainsuranceservices.com .

News from Anthem

Anthem released an update that some members were mistakenly sent post cards notifying them they would be receiving a rebate under the new rules from the PPAC regarding the MLR (medical loss ratio).  But in fact, their plans were not eligible for a rebate.  They are working to get new letters out clarifying the mistake.  If you are an Anthem member and have questions regarding the MLR you can call Anthem directly or if you are a current client of ours please call us directly.

You may reach Lisa and Angela at (714)680-5900 or find us on the web at www.ansainsuranceservices.com .

September 23rd Is Right Around the Corner

September 23, 2012 is right around the corner.  What is the significance of September 23, 2012?  It is the last day that the health insurance carriers have to release their SBC's (Summary of Benefits and Coverage) to all it's members.  If you are on a group plan your employer is responsible to make sure you have access to the SBC.  If you are on an individual plan, your carrier should let you know how to retrieve it online if they do not send you a hard copy.

Why is the SBC important?  It details the plans so that they can be compared to other plans on an apples to apples basis.  In other words, it is to help the insured understand what they have and what it covers.  All SBC's must include the cost of childbirth and type 2 diabetes.

Putting together and getting out these SBC's have costs the insurance carriers $188 million so far. It is important to understand the value of the SBC's and not let this important tool go unnoticed and put in the pile of papers to never be seen again.  Consumers need this information to be informed. 

If you have questions about you SBC from any insurance carrier, please call us at (714)680-5900 or you can email us at info@ansainsuranceservices.com .  We work with all major carriers including Aetna, Anthem, Blue Shield, Cigna, Kaiser, United and CalChoice.  You can find out more about us at www.ansainsuranceservices.com .

Latest News on California's Exchange

On August 23rd the California Health Benefit Exchange received it's third installment of federal funds to the amount of $196 million for a total of $236 million.  The money is to be used to set up the information system of the Exchange.  In other words, the federal government has already spent $236 million dollars just in California to set up the computer software to run the exchange here in California alone. 
On August 24th the exchange failed to reach a decision on the choices small business and their employees would have if using the exchange.  It has been deferred to a later meeting. 

For more information on individual insurance plans as they are right now, please check out our website at www.ansainsuranceservices.com or call us at (714)680-5900.

Washington Post - Part 5

The final and last factors, according to the Washington Post's article on August 10, 2012, that would cause premiums to rise due to the health care law are the taxes and fees associated with it.  It is presumed that the costs associated with these fees would be passed down to the purchasers.  The more fees attached to the carriers, the more the rates will increase.

What the article does not mention are the costs associated with caring out this law.  The bureaucracy associated with the law is enormous and will be passed on from the top to the very bottom.  Compliance on every end of the service chain will be tested and possible fined.  It is a law like no other and the unknown costs could be enormous.  Time will tell and we hope we are wrong, but what we see at this point is 16,000 newly hired IRS agents to look for people and companies not complying.  Yet people and companies do not even know what the laws are yet.

We will continue to update you as we get more information.  If you would like to reach either Lisa Boyajian or Angela Gambino you can either call us at (714)680-5900 or find us on the web at www.ansainsuranceservices.com .

Washington Post - Part 4

As you have read in our past three posts, the Washington Post on August 10, 2012 published an article on the five factors that may lead to increased premiums due to the passage of the healthcare law.  The fourth factor they wrote about is that insurers must offer an "essential health benefits" package.  The essential benefits provide coverage in ten areas.  These ten areas are:

1)ambulatory patient services 2)emergency services; hospitalization 3)maternity and newborn care 4)mental health and substance use disorder services, including behavioral health treatment 5)prescription drugs 6)rehabilitative and habilitative services and devices 7)laboratory services 8)preventive and wellness services and chronic disease management9)and pediatric services, including oral and 10)vision care.

They are great benefits, but are more than what most individuals and groups purchase and as we all know, the more you get the more you pay.  If you would like to find out more about these plans or current plans you can call us at (714)680-5900 or find us on the web at www.ansainsuranceservices.com .

Washington Post - Part 3

Part 3
If you have read the past two posts you would know that the Washington Post on August 10 had an article on the effect of the health care law on premiums and noted five factors that could/would raise premiums for most individuals.

The third factor is closely related to the second factor but often gets confused as being the same thing, yet it is quite different.  Factor 2 relates to what is known as community rating.  Everyone within a age band pays the same rate.  Factor 3 is the part of the law that forces health carriers to accept  everyone regardless of preexisting conditions.  What this means is that carriers can not turn down anyone and their premiums must be the same as all the healthy individuals.

The end result is that those healthy individual will need to make up the cost difference for all the unhealthy individuals that the carriers were forced to accept.

We will continue to update you on the factors that will increase premiums in future posts so be on the lookout.  If you have any questions or would like to get more information you can reach us at (714)680-5900 or find us at www.ansainsuranceservices.com .

Washington Post - Part 2

On August 10, 2012 the Washington Post reported on five factors that may increase health care premiums with passage of the Affordable Care Act.  We have already written on the first factor.  The second factor that may increase premiums is Community Rating.

Community Rating is the practice of one rate for all in that particular age band.  Carriers can no longer charge more if someone has a problematic health history.  Starting in 2014 everyone will pay the same premium in a given age band.  If a individual, for example,  has diabetes, COPD, or any other chronic disability he or she will pay the same rate as a perfectly healthy individual with out a single health issue.  This will be very good for those that did have health issues, but it means that every healthy individual will now pay more for those that are not healthy.

Look for the next posting to find out more about the ACA and it's impact on premiums.  If you have any questions or would like to get information on health or life insurance please give us a call at (714)680-5900 or check us out at www.ansainsuranceservices.com .

Washington Post - Impact of Health Reform Law on Premium

On August 10 the Washington Post examined the ACA and it's effect on health care premiums.  For the next five posts we will examine the five factors that could lead to higher premiums for some/many/all depending which category you fall into.

Factor One:  Premiums could increase for some and decrease for others because of what is known as age banding.  Currently most states (including California) band on a 5:1 ratio.  This means that older individuals pay 5 times more than younger individuals.  Starting in 2014 the new age band ratio will be 3:1 meaning that older individuals will pay 3 times more than younger individual.  In a practical sense younger individuals will pay more for the same insurance and older individuals will pay less.

Look for more information on the health care laws impact to come.  If you would like to reach us at Ansa Insurance Services, you can either call us at (714)680-5900 or find us on the web at www.ansainsuranceservices.com .

Relay for Life - American Cancer Society

It's time again for the Santa Fe Springs Relay for Life.  This wonderful 24 hour event will take place at  Lake Center Athletic Park in Santa Fe Springs on September 28th and 29th.  Just like last year, Lisa Boyajian, will be co-chairing the event. 

If you have never attended a Relay it is a beautiful event and you should take a little time to come and check it out. If you have and are interested in either attending or supporting check out the website at www.relayforlife.org and put in Santa Fe Springs, CA  under Find Event.  You can sign up or just donate, but all proceeds go to The American Cancer Society.  We all have been touched in one way or another by cancer, come do something about it.

To get more information on the Relay for Life, you can contact Lisa Boyajian at (714)680-5900 or email her at lisa@ansainsuranceservices.com .  At Ansa Insurance Services we are committed to doing all we can to make this world a healthier place for all.  Check us out at www.ansainsuranceservices.com .

One in Three Adults in the U.S. South Are Obese

In an article from AFP published August 14, 2012 on a new study, the rates for adult obesity reach as high as 1 in 3 in Mississippi, Louisiana, West Virginia, and Alabama.  In fact, there are 12 states that have an obesity rate of 30% or higher.  On a sadder note, even in the leanest states 1 in 5 adults are obese. 

So what does all this mean?  Who does it effect?  It means that chronic diseases associated with obesity are on the rise as well, thus affecting the cost of health care across the board for everyone.  It is not simply a matter of it hurting individuals, it hurts us as a nation, it hurts us as a people.  No one wants to send out food police to watch our every bite.  But we do need to work on making better choices over the long run.  It is in our best interest to try and live healthier lives.  We all know what needs to be done - it's on T.V., it's on the web and it's in almost every magazine you pass in the checkout  line.

Insurance companies are working hard to promote healthy lifestyles in classes and programs.  If you are interested in some of these programs call your carrier and get information.  There is an abundance of help out there if you search for it.  We all may not look like fashion models, but we will feel better!

If you would like to get specific information on health plans that offer support and classes for healthy lifestyle, please feel free to call us at (714)680-5900 or find us on the web at www.ansainsuranceservices.com .

More Good News if You Have Blue Shield

The contract has been finalized!  Starting September 1, 2012 UCLA is back in the network.  If you are currently on Blue Shield and would like to make an appointment with a doctor in the UCLA group, you can make the appointment, just make it for after September 1st.  If you are not sure if your plan allows it, check with member services at Blue Shield.

If you have specific questions on your plan or general questions about health insurance, please feel free to give us a call today at (714)680-5900 or email us at info@ansainsuranceservices.com .  You can always find us on the web at www.ansainsruanceservices.com .

Transitional Re-Insurance Program

So what is the Transitional Re-Insurance Program?  In a nut shell it is a bureaucracy set up to essentially rob Peter to pay Paul.  It is a program that will be run by either HHS or a given state (if the state so chooses), that administers taking funds from private group insurance plans to compensate individual private plans that are run through the exchanges, but have very high costs associated with them.  How much will this cost private group insurance, who knows at this point?  It will costs though and with the added level of bureaucracy attached to it, it could cost substantially more.  When will this be in place and running?  It is to be up and running when the exchanges come on line in 2014. 

If you would like to get more information on changes coming with the health care law, please continue to follow our blog.  If you have a specific question and would like to get information on either a health plan or life insurance please call us at (714)680-5900 or find us at our website at www.ansainsuranceservices.com .

News from Kaiser Permanente OC

Big news from Kaiser Permantente in Orange County.  September 12, 2012 is the opening of the Anaheim Medical Center campus for all services including emergency medical care.  Other services that will be provided at the new center include:

• 262 beds in all private rooms
• 10 operating rooms
• Outpatient SurgiCenter
• Cancer Care Center
• Women's Health Center
• 20 private beds in the neonatal intensive care unit (NICU)
• Pharmacy, radiology, and lab services
• 3-acre healing garden

If you would like more information on this Kaiser Medical Center or any other medical centers please contact us at (714)680-5900 or you can email us at info@ansainsuranceservices.com .

We are brokers with all major carriers in California, if you want to find out more about Lisa Boyajian or Angela Gambino please check out our website at www.ansainsruanceservices.com .

Health Carrier News

What's new with the carriers?  Well for starters (and it's big) Blue Shield is about to finalize it's contracts with the UC campuses.  In the mean time they have extended existing contracts to allow continued in-network services in some cases until August 8th all the way through till December 31, 2012 for some.  UCLA still remains outside of network, but when these current contracts are finalized they will be back in the network!!

For groups, CalChoice has new Anthem Blue Cross plans in their offerings.  Call to check out
what is available.

Lastly Aetna has published it's new individual and family rates for October 1, 2012 effective dates.

As always, we are here to help answer your questions.  If you would like to reach us you may do so at 714-680-5900 or email us at info@ansainsuranceservices.com .   For quotes go to our website at www.ansainsuranceservices.com .

News from Anthem Blue Cross

From time to time we will be updating you on news that is specific to certain carriers.  Today we are writing about Anthem Blue Cross and what is new for them. 

1. Walgreens returns to In-Network status on September 15, 2012.
2. Anthem purchased Amerigroup - this will help service those Dual-Eligible individuals and the Medicaid markets in general
3. Priority Select HMO is here.  It provides a smaller network of providers, while still offering rich benefits to the insured.

Look for future articles on what's new with the other carriers.  If you would like more information on Anthem or any other insurance carrier please call us at (714)680-5900 or check out our website at www.ansainsuranceservices.com .  We are at your service!

Special Hearing for Dual Enrollies

A little over a week ago the Senate Special Committee on Aging (Chaired by Senator Bob Corker) held a hearing on Medicare and Medicaid coordination of benefits for Dual -Eligible.  The Director of CMS Medicare-Medicaid Coordination Office, Melanie Bella testified that CMS hopes to get up to 2 million beneficiaries to participate in its demonstration program for dual eligibles.  The hope is to reduce costs through better management of benefits. Many Senators on the committee worry about  the Medicare Advantage plans.  They note that those plans are very popular in their home states.  They view this coordination as a possible threat to those plans.  The CMS expressed its desire not to harm those plans at this point. 

At Ansa Insurance Services we work with all major carriers to provide a comprehensive look at health insurance benefits.  As you change and age your needs change.  Income levels and lifestyle changes can create more or less need for health insurance benefits.  We work with you to make these adjustments.  If you would like to find out more about us look us up on our website at www.ansainsuranceservices.com or you can email us at info@ansainsuranceservices.com .

Illegal Immigrants: Issue Not Addressed in PPACA

His came from Yahoo.News...

Hospital leaders told The New York Times they're wary of terms in the health care reform law that will eventually halve the amount of money they receive for caring for uninsured people without addressing the estimated 11 million illegal immigrants in the country, most of them lacking insurance.

Emergency rooms are required to take in all patients, insured or uninsured, under a federal law signed by President Ronald Reagan. The government used a pot of about $20 billion to reimburse hospitals each year for this care. But that pot is going to be cut in half by 2019, under the reasoning that the health care law will dramatically cut the number of people who don't have insurance, thus saving hospitals money. The calculation leaves out one key group of uninsured people: illegal immigrants, who will not be required to buy health insurance or be eligible for Medicaid, or be allowed to purchase insurance on state-run exchanges under the law.

Earlier proposals that addressed illegal immigrants were scrapped during the health care debate after they drew controversy.

In New York City public hospitals, an estimated 40 percent of all uninsured patients treated are undocumented, and other hospital systems have an even larger share. Experts estimate that about 6 million of the nation's uninsured are illegal immigrants.

There is still so much to be worked out with the ACA let's hope our officials (whether appointed or elected) can do more something to help fix this.  If we want to have hospitals in our neighborhood to stay open we need to address this in a reasonable fashion.  If we bury our heads in the sand we will look up someday when it is too late. 

If you would like information on health care or life insurance please contact us at www.ansainsuranceservices.com or call us at (714)680-5900.

One out of Eleven Employers May Drop Health Benefits

Yes this is the second time I have just attached an entire article to our blog, but it is a very simple yet telling article of what is to come in this industry and in your work environment.  Though this article is overly simplistic and optimistic the trend seems to be about right.  What it does not address is the shear amount of compliance administration that will go along with the new law for every employer, regardless of whether they offer insurance benefits or not.  This is where having a knowledgeable broker will be helpful.  If you would like to get more information on insurance benefits, please call us at 714-680-5900 or email us at info@ansainsuranceservices.com .  You can also find us at our website www.ansainsuranceservices.com .

Read On...

1-0 of nullprev next

Survey: One in 11 employers plan to drop health coverage

By Parija Kavilanz | CNNMoney.com – 21 hours ago

One in 11 employers is planning to drop health insurance coverage for workers over the next three years because of the high expense, according to a report from consulting firm Deloitte.

While Deloitte's 2012 survey of employers -- conducted before the Supreme Court's ruling in June to uphold health reform -- showed that 9% of them planned to stop offering health care coverage, 81% of companies polled said they would continue providing the benefit as a means to attract and retain employees.

That's good news for more than 160 million people -- more than half the U.S. population -- who currently get health insurance directly through their employers.

[Related: $1 Billion in Health Insurance Rebates: Taxable or Tax-free?]

Another 10% of employers polled in the Deloitte survey indicated that they hadn't yet made up their mind.

Among those employers who indicated that they wouldn't dump health coverage, most plan to make workers pick up more of the cost associated with it through higher premiums, co-pays and deductibles.


The survey also showed that smaller businesses -- those with fewer than 50 employers -- view health insurance exchanges more favorably than bigger companies.

Under health reform, states are mandated to set up health insurance exchanges -- online marketplaces where consumers can buy subsidized health plans -- by 2014.

These exchanges are geared toward making health insurance affordable to underinsured and uninsured individuals.

By 2014, companies with 50 or more full-time employees must start providing health insurance or face penalties.

Related: Demise of the solo doctor

For most small businesses, that means a new way to shop for less-expensive health insurance on the exchanges where they can buy plans for their workers.

Deloitte's online survey, conducted between February and April, polled 560 randomly selected companies with 50 or more workers that offer health.

3 Ingredients for a Successful Business Article

I thought this was an interesting article.  It back's up a lot of what and why we do what we do at Ansa Insurance Services  We just didn't think about it in terms of the 3P's.  To learn more about Ansa Insurance Services check out our website at www.ansainsuranceservices.com .  If you need to contact us you can reach us at (714)680-5900.

3 Ingredients for a Successful Business

By CNBC | CNBC – 6 hours ago

@cnbc on Twitter

• Email
• Share3
• Print

When my husband Jonas and I started Auntie Anne's in 1988, we never expected or anticipated building an international pretzel franchise. It was the farthest thing from our minds.

In fact, the only dream I ever had was to be a stay-at-home mom and wife. For many years, I had the chance to live out that dream, but the tragic death of our 19-month-old daughter changed all that.
The path our life took led us to some of the darkest times in our lives and nearly caused us to end our marriage. Had that been the end of our story, it would be categorized as a sad saga. But our story didn't end there.
[More From CNBC: 10 Ideas That Made $100 Million]
We continued to push through and eventually found ourselves as the leaders of a fresh, new franchise that was growing beyond our wildest imagination. By the world's standards, we shouldn't have made it.
In the beginning, we had no education, no capital, and no business plan. However, rather than focusing on what we didn't have, we focused on what we did have: purpose, product, people. I've come to call these "The Three P's." I believe that if you have these three P's, they ultimately lead to the fourth "P" - profit.
Purpose
When we started Auntie Anne's, I had a purpose. It was simply to provide for my family and give back to our community. Jonas had a desire to counsel others free of charge, and so we needed an income. Our purpose has always been about giving back. It's the foundation that Auntie Anne's was built on and thrived at during my years at the company.
It's so important for business leaders to discover what their purpose is. In the days when the business seems overwhelming or you aren't certain you can continue, it is your purpose that will compel you to push through.
[More From CNBC: People Who Quit Their Jobs and Made Millions]
Discovering your purpose doesn't have to be complicated. Look at what you do and why you do it. Is it to support your family? That's your purpose. Is it to make a difference in your customer's life? That's your purpose. For us, it was giving. Maybe your purpose is to give back as well.
Product
I think this goes without saying but if we didn't have a "better than the best" product, Auntie Anne's wouldn't have been successful. Our product, the pretzel, was why we had lines all day long. Customers would buy the pretzel, take a bite, and want to know how they can sell these in their own town.
When we started Auntie Anne's, our pretzel recipe was terrible. The product was bad. I was ready to give up. When you have a product you're proud of, it will sell itself. What is your "better than the best" product? I encourage you to take a look at what you offer, whether it's a product or service, and strive to make it the best out there.

People
I didn't build Auntie Anne's alone. That would have been impossible. From the very beginning we had a team around us that was exceptional. Our company was successful because of the dedicated people who worked for us.

As we grew, we knew it was important to surround ourselves with those that had experience and expertise in the areas we lacked. We looked for people who understood our culture, our philosophy, and worked hard. The employees built the company.
[More From CNBC: Surprising Million-Dollar Ideas]
Bringing in the right people is so important to overall health of your organization. Surround yourself with a team of dedicated, purpose driven, employees. Don't settle for mediocrity. There are plenty of willing and able people out there that can help take a business to the next level.
The combination of these three ingredients is what made Auntie Anne's successful and I believe that if you apply the Three P methodology to what you're doing, both in business and your personal life, you will be successful. In business, that means more profit.
Did we always do it right? Absolutely not! However, our passion carried us through. Our product kept us going, and the people we had on board worked hard to be successful.
Watch the full story of Auntie Anne's on "How I Made My Millions" Monday, July 23 at 9 p.m. ET, with a re-air at 12 a.m. ET.
________________________

Summary of Benefits and Coverage Rule (SBC)

Blue Shield just announced how it will be handling the Summary of Benefits and Coverage Rule (SBC) under the Affordable Care Act (ACA).  By September 23, 2012 carriers are to distribute the SBC to all members.  Blue Shield has announced that for group coverage they will be electronically sending the SBC to the policy holder (the owner/administration of the business) and that they will then be responsible to distribute it out to the members/employees. 

As for Individual and Family Plans the SBC will be available online at www.blueshieldca.com .  Members will be able to go online and get it.  If they can not go online, they can call Blue Shield and request it. 

It is reasonable to conclude that the other carriers will be handling this the same way.  By August the carriers will be sending out information to the policy holders on their exact implementation of this rule.  If your carrier is planning something different they will notify you of this.  If you have any questions about this or any other item relating to health insurance or life insurance you may reach us at (714)680-5900 or email us at angela@ansainsuranceservices.com.  You can also look us up at our website at www.ansainsuranceservices.com .

Costs of Care

Anthem Blue Cross just published a fantastic brochure explaining the costs of care and why health care premiums have risen so much over the past few years and what the projected costs will be in coming years.  Here is one statistic that stands out and that we have written about in the past.  By 2019 it is expected that the U.S. will spend $4.4 trillion on health care.  That amount represents 1/5 of the economy and is almost twice as much as what was spent on health care in the year 2007!  The brochure also goes on to detail many other aspects of the rising health care costs and what is being done to curb some of these costs. 

Although this brochure is intended for small businesses we think it would be a helpful  and informative tool for everyone.  If you would like for us to send you a copy of it or email it to you please contact us at (714)680-5900 or you may email us at info@ansainsuranceservices.com .  You can also find us on our website at www.ansainsuranceservices.com .  We believe that it is important that everyone be informed and educated as to what and why health insurance is changing and what it will mean to them personally. 

PPACA New Rules for Women's Preventative Care

The new requirements for women’s preventative services are listed below.

•  Well-woman visits
•  Screening for gestational diabetes
• Testing for human papillomavirus (HPV)
•  Counseling for sexually transmitted infections
• Screening and counseling for human immunodeficiency virus (HIV)
•            FDA-approved contraception methods and contraceptive counseling
• Breastfeeding support, supplies and counseling
•        Screening and counseling for interpersonal and domestic violence  

For some people these benefits are not that different from what they already had.  For others, these benefits are very different.  Remember these benefits are to be provided at “no cost sharing” for the subscriber.  There are some exceptions (we will discuss religious exemptions at a later time) though.  Contraceptive benefits are for prescriptions only.  Over the counter contraceptives are not covered under this ruling.  As for prescriptions, the generic form is covered as well as the brand if no generic is available.  If a generic is available and the patient wants the brand name then they would have to pay a co-pay.

So when do these benefits start?  As with everything attached to the PPACA it depends.  If you are under an old “grandfathered plan” (either individual or group) than these rules and added benefits do not apply to you.  If you have group coverage through an employer it must start the first plan year after August 1, 2012.  If you have an existing individual plan benefits must be expanded no later than January 1, 2013.  For new individual plans the benefits start August 1, 2012.

You should be receiving information from your carrier if you will be getting these extra benefits.  If you have an older plan and would like to see about changing plans to now get these benefits you can check out our website and see if the cost savings would make sense for you.  Our website can be found at www.ansainsuranceservices.com or you can contact Lisa Boyajian or Angela Gambino at 714-680-5900.

Rate Reduction for Some Small Businesses

State Insurance Commissioner, Dave Jones, announced on July 7^th that Anthem Blue Cross, Blue Shield, and Aetna are going to modify their small group rate hikes that went into effect on July 1^st.  The collective savings to small business is estimated to be $48 million on their health insurance premiums.

The actual savings are as follows.  Anthem Blue Cross withdrew a 2.5% rate hike saving $25 million for their 45,000 policy holders.  Blue Shield will reduce their rates by $15 million for some 58,000 policy holders and Aetna will reduce its rates by 1.3% saving $8 million for 9,200 policy holders.

Another Example of Uncertainty with the ACA

Here is another example of the unintended consequences of the ACA.  Businesses are beginning to get checks back from carriers to distribute to their employees.  This sounds great, and in time it will be.  But for now it has caused a huge can of worms.  The checks are rebates from the carriers for not spending (in these cases) 80%  of the money they bring in on health care related items.  When the checks are issued they are issued with a statement that says that the money must be distributed, but does not let the employer know the formula to figure out how much goes to each employee.  Because these are small businesses with less than 50 employees, the amount that each employee contributes is different.  The rates are based, in most cases, on employee age and home zip code.  Then factor in some employees add dependents.  The cost the dependents is based on the employees age and home zip code as well, plus the cost for the dependents is based on 1) employee plus spouse 2) employee plus children 3) employee plus family. 

So when the rebates come in and a company has to figure out how much goes back to each employee it is not as simple as it sounds.  To add insult to injury, the check comes with an email address for the Department of Labor that is no longer active.  This is another case of the cart before the horse.  The carriers were under the gun to get the checks out to their clients or face penalties, but no clear distribution process has been set up. 

Will the employers face penalties if they distribute wrong?  Maybe, like we have written before, much of the practical aspects of this law have yet to be seen.  We at Ansa will continue to work on this until we have a definitive answer for you.  If you or your company are faced with any of these types of issues, please write and let us know.  You can reach us at info@ansainsuranceservices.com or find us on the web at www.ansainsuranceservices.com .  We believe that if we work together we can work through the issues that come up.

Autism Resources

On July 1, 2012 in California the new regulations for carriers to expand coverage for children with Autism went into effect.  The insurance carriers are working hard to get everything in place but they are still behind in the provider area.  If you need services, please contact your carrier.  If they are short of providers in your area and you know of providers, be the go between to get them hooked up. 

If you are not sure if your child has autism or you just found out that they do, be sure to educate yourself on the condition.  It is vitally important to your child that you do.  There are numerous sources on the internet to help you.  Below are just a few of the sources we have used.

www.ninds.gov

www.autism.com

www.autismspeaks.org

www.mayoclinic.com/health/autism/do00348

Don’t let autism remain a mystery.  There are tools out there to help the children.  If you are insured and have questions on your coverage, you should call your provider.  If you need help with this or other questions regarding health insurance please feel free to contact us at 888-800-5855 or check us out on our website at www.ansainsuranceservices.com .  In California all children have guaranteed issue, if your child was previously declined due to autism (or anything else), you can get them insured.  Don’t let this go untreated.

Regulations, Regulations, Regulations!

Regulations, regulations, regulations! The Affordable Care Act set up the provisions for the new health care law.  Now administrators (not elected officials) write the interim rules that will eventually lead to the regulations.  The interim rules are set to give a “heads up” to all involved so they can begin to plan, adopt and coordinate these rules into practice.  The interim rules can be changed if there is enough pressure on those writing the rules.  That is why so much of the actual law is still an unknown. 

Over the next couple of years, while all these laws start as interim rules and then become regulation, business owners need to pay attention and begin implementing these regulations as they arise.  Staying on top of these rules from the onset will make the transition so much easier.  Waiting until the last minute to comply will cause much undue stress.  Owners of businesses will find that they need to spend much more of their time (or hiring someone to do it for them) to keep up on all the new rules.

Reporting, reporting, reporting, this will be the name of the game.  All these new regulations, for practical purposes, mean that everything needs to be reported.  More of every company’s income (time and money) will go to set up and implement the reporting of their data so as to be compliant with the regulations.  Like it or not this is what we all face.  We might as well come to terms with it so we can move on.  Resisting will waste even more of your time, talent and profit. 

If you are worried about the future and what is ahead for you, do not be afraid to contact us.  We are here to help you work through these times.  No one knows the details of what is ahead, but as we find out we will continue to share it with you.  If you would like to talk to either Lisa Boyajian or Angela Gambino you may reach us at (714)680-5900 or check out our website at www.ansainsuranceservices.com .  We work with all major health carriers (Aetna, Anthem, Blue Shield, Health Net, Kaiser, United, and Sea Change) and will continue to stay up to date with them as these regulations come to fruition. 

Funding for California Health Benefits Exchange

Before the Supreme Court had made its ruling on the ACA, California had already sent in its request for more funding from the Federal Government to the tune of $190 million.  According to Peter Lee, the executive director of the California Health Benefits Exchange, the money is slated to be used for the setting up of the enrollment system. The system needs to be up and ready to enroll individuals by October of 2013. 

Within a month or so the carriers should start finding out what the exact requirements for health plans that wish to be sold on the exchange will be.  At that point it will become clearer on just how the exchange will look and feel.  Right now there is only speculation, once the interim rules are set there will be even more clarity.

Continue to check this blog for more changes on the way.  If you wish to get information on a specific topic or you wish to look into your current plan and compare it to other plans, please feel free to call us at (714)680-5900 or find us on the web at www.ansainsuranceservices.com .  We are continuing to educate ourselves so we can guide you through this massive law and all that goes with it.