Health Reform: Weighing Up the Employer Mandate

July 26, 2010 – 9:32 pm
Of all the aspects of the new Patient Protection and Affordable Care Act that critics fiercely object to, few generate more ire than the mandates. The health-reform law's individual mandate — requiring every legal U.S. resident to carry Texas health insurance (with some limited exceptions) — has prompted a multistate lawsuit challenging its constitutionality, while the requirement that employers with 50 or more employees provide coverage to workers or pay a stiff fine is despised by business groups. The Chamber of Commerce is warning that the new rule, which will go into effect in 2014, will force companies to drop coverage or go out of business altogether. It's the "job-killing employer mandate," in the words of Republican Senator Orrin Hatch. Critics say the employer mandate will eliminate the flexibility employers have now to structure benefits — the Affordable Care Act sets a minimum baseline of coverage and minimum employer contributions to ...

Coverage of Preventive Health Services- Mandated Changes

July 21, 2010 – 8:04 pm
Texas Individual Health Insurance- On July 14, the Departments of Treasury, Labor, and Health and Human Services jointly released Interim Final Rules (IFRs) for Texas group health plans and Texas health insurance issuers related to coverage of preventive services under the Patient Protection and Affordable Care Act (PPACA). Under the regulations, plans must cover without copay, coinsurance or deductible – certain preventive services that have “strong scientific evidence of their health benefits.” These are interim final rules (IFRs), which means final rules may eventually differ, but these rules are final in the interim. As additional clarification is made available whether through rule-making or otherwise, we’ll share that information with you. General highlights of new regulations: Grandfathered plans are exempt for as long as they remain grandfathered. Non-grandfathered plans (i.e., plans either not in effect on 3/23/10 or that made changes since then resulting in loss of grandfathered status) must comply with the no-cost-sharing requirement ...

Blue Cross and Blue Shield of Texas Announces New Child-Only Coverage Policy

July 21, 2010 – 3:09 pm
Blue Cross and Blue Shield of Texas (BCBSTX) is committed to offering the broadest possible range of products for our members, as well as to maintaining its strong financial position. Thus, on Friday, July 16, 2010, it filed a new policy called Blue Pathway to provide Texas insurance coverage for children age 1 through 18 when the child is the primary insured (commonly called “child-only” policy) with the Texas Department of Insurance (DOI). This new coverage option responds to an Interim Final Rule that was issued by the Department of Health and Human Services (HHS) to implement several provisions of the Patient Protection and Affordability Act of 2010 (PPACA). In this Rule, HHS has determined that provisions limiting the application of pre-existing condition exclusions for children under 19 means that all children under 19 who apply for insurance for which they are eligible on or after Sept. 23, 2010, cannot be ...

Obesity In The U.S. ~ What States are the Fattest?

July 15, 2010 – 3:24 pm
These stats not only majorly effect an individuals health but also the over all rates that the insurance carriers issue for their plans including Texas health insurance plans. Top 5 Fattest States: 1. Mississippi – 70.2% overweight; 35.3 % obese 2. Alabama – 68.1% overweight; 31. 6% obese 3. Tennessee – 68.9% obese; 32.8% obese 4. West Virginia – 67.5% overweight; 31.7% obese 5. Louisiana – 67.6% overweight; 33.9% obese Top 5 Thinnest States: 1. Colorado – 55.6% overweight; 18.9 obese 2. Connecticut – 58.9% overweight; 21% obese 3. District of Columbia – 57.1% overweight; 21.5 obese 4. Massachusetts – 57.4% overweight; 21.8% obese 5. Hawaii – 57.8% overweight; 22.9% obese Looking for the best information and the best rates on Texas Health Insurance--visit www.texashealthandlife.com or give us a call at or 512-246-9955

4 things to know about the tax implications of health care reform

July 14, 2010 – 8:46 pm
Texas Health Insurance - It’s been more than three months since President Obama signed the Patient Protection and Affordable Care Act into law and, whether a person is “for” or “against” health care reform, no one can deny that the system is headed for some changes. Keeping up with the 906-page bill is a job in itself and, as Gunnip & Company Partner James Selsor points out, the reform won’t only affect your Texas health insurance. “It’s been pushed as a health care bill, but a lot of it is a tax bill,” Selsor said, Here are four things Selsor recommends every taxpayer be aware of: 1. Few things will happen overnight. A host of different health care reforms are set to phase in between now and 2018, Selsor said. The controversial everyone-must-have-health-insurance part of the bill doesn’t begin taking effect for three more years, though taxpayers will start seeing boxes on their W-2s ...

Does prevention improve health care outcomes and lower costs?

July 7, 2010 – 8:27 pm
The eighth paragraph of the modern Hippocratic Oath reads: “I will prevent disease whenever I can, for prevention is preferable to cure.” Support and encouragement of prevention are deeply rooted among physicians. Intuitively, to prevent a deadly or disabling disease from occurring or stop it at an early stage seems like a bread-and-butter concept with obvious Texas health benefits. But it should also accrue cost savings by avoiding the treatment of the disease and its complications. Indeed, prevention has been the mantra of many pundits and politicians during the past year’s debate on health care reform. Many have held out prevention as the touchstone of Texas health care reform that would bring improved health care outcomes at lower costs.   Health care reform prominently promotes prevention by requiring preventive services to be included in every health plan offered through the Texas health insurance exchange, and by eliminating co-pays for obtaining preventive services. What could ...

Health Care and Early Retirement

July 7, 2010 – 8:07 pm
Texas Health Insurance~Early retirement was once a popular option for older workers. Some chose to leave the workforce early due to declining health, while others felt financially secure and were ready to experience the freedom of retirement. But today, early retirement has become a less viable option for many. One of the most prevalent concerns of those who consider early retirement is health care. Medicare is not available to them until the standard retirement age, so they are likely to end up uninsured. If you’re in excellent health, this may not affect you very much. But those who are nearing retirement age often have ailments that require them to make regular trips to the doctor and take expensive prescription drugs. What many would-be early retirees don’t realize is that they do have some health care options. They may be more expensive than insurance plans available through an employer, but they can be ...

Healthcare Reform a Positive?

July 7, 2010 – 7:28 pm
Posted from National Underwriter Online News Service, June 6, 1:20 p.m. EDT The new federal Affordable Care Act could potentially have a positive effect with Texas Health insurance when it comes to medical malpractice liability, actuaries were told at a recent Casualty Actuarial Society (CAS) Seminar on Reinsurance. According to a CAS statement, John Mize, consulting actuary at Towers Watson, told attendees that some provisions of the law emphasize value-based compensation programs. Since hospitals will get penalized if they have a large proportion of re-admissions, this may motivate them to provide better care, which would result in more favorable outcomes and fewer claims, Mr. Mize said. Paul Fields, vice president, underwriting at Odyssey Re, said that accountable care coordinating programs that are jointly managed by hospitals and physicians have the potential to create a “smoother continuum of care.” In addition, panelists noted some factors that have improved medical malpractice loss experience in recent years. ...

Government unveils Pre-existing Condition Insurance Plan

July 2, 2010 – 8:47 pm
Consumers unable to get Texas health insurance because of a pre-existing medical condition now have a new option. The federal government on Thursday began accepting applications for its new Pre-existing Condition Insurance Plan, which was authorized by the health care overhaul signed into law this year by President Barack Obama. To be eligible, people must be uninsured for at least six months and have been turned down for coverage by a private insurer because of a medical problem. Applications for the insurance are available online at www.HealthCare.gov. Coverage starts Aug. 1. The Pre-existing Condition Insurance Plan is a separate program from Texas' high-risk pool, the Texas Health Insurance Pool. In the existing Texas Health Insurance Pool, premiums are set by state law at twice the standard individual market rates. But in the new Pre-existing Condition Insurance Plan, premiums will be similar to average individual market premiums charged to healthy people in Texas. Estimates on HealthCare.gov ...

Need savings on your Prescriptions?

July 2, 2010 – 5:28 am
Do have medications that you fill on a monthly basis? Most individual Texas health insurance plans these days have deductibles that you must meet for any brand name prescriptions. We came across a company that can help if you have a health insurance plan or if you pay for your prescriptions out of your own pocket.  The company is called Medco and is actually used by some Texas health insurance carriers. Please feel free to contact Texas Health & Life if you have questions.  Looking for the best information and the best rates on Texas Health Insurance--visit www.texashealthandlife.com or give us a call at or 512-246-9955