Small business owners need to fully understand how the health care tax credit will affect them this coming year.  For small employers who have less than 25 employees, pay an average wage of less than $50,000 and pay at least half of employee health insurance premiums, a tax credit may be waiting.  A new version of the health care tax credit will be available in 2014, but for the years 2010 through 2013, the maximum credit is 35% for small businesses and 25% for small tax-exempt employers such as charities.

This can equate to large savings so it’s important not to overlook this credit benefit.  Even if you are a small business employer who did not owe any taxes because of other deductions, you can carry the credit back or forward for other years.  Another benefit outlined in the credit is that since the amount of the health insurance premium payments are more than the total credit, eligible small businesses are still able to claim a business expense deduction for premiums more than the actual credit.  Many small business owners may not be aware of this and through appropriate awareness, more small business owners can get the funds they deserve.

Small tax-exempt employers should be aware that the credit is refundable, so even if there is no taxable income, they can be eligible for the credit as a refund as long as it does not exceed the income tax withholding and Medicare tax liability.  Keep in mind that if you can benefit from the health care tax credit this year but forgot to claim it, there is still opportunity to file amended claim.  Talk to a tax expert to determine where savings can be found and to see if you qualify for this useful tax credit available for small-business owners.

For more detailed information visit www.IRS.gov.

By now we all know that the State and Federal Marketplaces offering a side-by-side comparison environment are set to go live October 1st of this year as part of The Patient Protection and Affordable Care Act (PPACA) — better known as Obamacare.

These public marketplaces break down as follows.

1.  16 state based marketplaces (+ DC).

2.  The Federally facilitated exchange — which will administer the online marketplace in 27 states.

2.  A State/Federal partnership exchange in the remaining 7 states.

What people might be less familiar with is the number of private health insurance exchanges that currently exist or will be launching soon that offer a multi-carrier environment similar to what will be offered by the Public exchanges funded by the Government.  What is yet to be determined by these private exchanges is how they will process subsidies that shoppers may qualify for.

A partial list of some private multi-carrier exchanges include

1.  eHealthinsurance.com - National exchange.  Offers health plans from over 180 health insurers.  Has been in operation since 1997.  Is working with Gov’t to be able to process Federal subsidies for customers who enroll through their online marketplace.

2.  Getinsured.com – National exchange, has been in operation since 2005

3.  American Westbrook Insurance Services – Represents 14 insurers in 43 states

4.  FloridaHealthChoices.com – Currently Serves small groups 2-50, but will expand to include plans for individuals and families

5.  HealthPass.com – Offers plans for small businesses & sole proprietors in NY from EmblemHealth, Oxford, and Guardian.

6.  Insurexsolutions.com – Offers health insurance plans in select markets from Blue Cross Blue Shield, Aetna, Assurant & Humana

7.  HSAinsurance.com - In operation since 1969, offers plans in MA & RI

8.  Extendhealth.com – Primary focus on Employers as well as Retirees, Offer plans from many regional Blue Cross Blue Shield plans as well as national carriers.

This is only a partial list, as many multi-carrier marketplaces that focus on group market were excluded as well as others that may have been omitted that serve the individual and family marketplace.

My guess is that some of  these mature private insurance marketplaces, like eHealthinsurance for example, will have  a much more user friendly interface as they are a technology company that has been doing this for more than 15 years.  They also offer a substantial amount of choice.  If these private exchanges are able to process subsidies, and have a deep enough roster of participating health insurers in your state, they should be a great option to continue to purchase individual and family health plans in 2014 and beyond.

Written by Jeff Levy

Follow me on Twitter:  https://twitter.com/jefflevyhis

The Federal and State health insurance marketplaces that will begin enrolling individuals & families in health insurance plans beginning October of this year promise to provide more options than ever before.  However, it will likely not be an easy process if you are not prepared.

There are a handful of things you should research or  think about before you begin shopping for a plan for you and your family

1.  Become familiar with different health insurance types, and what might best fit your needs.

2.  Make sure you understand the basics of  how health insurance works such as deductibles, co-payments, and out-of-pocket maximums etc.

3.  Put together a list of questions that you might require answers for, such as benefits when traveling out of state, or other items that might be specific to your needs.

4.  Know how much you can afford or are willing to budget for your health coverage.  This will determine whether you will be likely be shopping for a Bronze, Silver, Gold or Platinum Plan

5.  Start pulling together tax returns or other documents that might help determine your household income and eligibility for subsidies

6.  If you are currently covered under an employer sponsored plan, attempt to find out whether they plan to continue to offer coverage in 2014.

7.  Get health insurance quotes from top health insurers in your state now.  If yous are young and healthy and might not be eligible for federal subsidies, your health insurance premiums will likely rise dramatically effective January 2014 according to most experts.  However, some national carriers offer a 12 month rate lock when you enroll, so if you are able to secure a policy in advance, you may be able to enjoy significant saving for 6 months or more.

Some states are getting way more federal funds than others to put towards customer assistance which could ultimately affect how many people get properly enrolled in health insurance under the new exchanges.  Florida plans on spending about $6 million to reach about 4 million uninsured residents as they help them enroll for coverage in the federal health law’s marketplace in a few months.  Maryland will be spending significantly more than this, about $24.8 million on their 730,000 uninsured residents.  This is a very wide variation and it seems that it will likely affect how many uninsured people obtain coverage through these exchanges.

Some states with the highest rates of uninsured residents such as Florida and Texas are getting far less money per uninsured person from the federal government.  Some states with lower rates of uninsured residents are getting more money such as Maryland, Vermont and Rhode Island based on an analysis from Kaiser Health News.  This is because states using the federal government to run their marketplaces are getting less funds than the states who are choosing to set them up themselves.  States like Maryland are also using state funds to support their customer assistance efforts and this is furthering the gap even more.

Jon Kingsdale, a consultant who assisted with the Massachusetts health insurance exchange in 2006, says this spending difference will have a huge impact on enrollment.  Consumer assistance is very important in getting people to understand and navigate effectively the online health insurance exchanges.  Many polls show that most Americans are unfamiliar with the health law and everything that goes into it.  The online marketplaces open October 1st, and the federal government is hoping they will be easy to use and help get more people insured.  But adequate customer assistance is key to ensuring people understand how to use and understand the website.  Many people have never applied for health insurance and many will not be internet savvy.  Quality assistance could make a big difference in which states see higher insured rates and which ones do not.

Earlier this month, the Obama administration scrapped plans to cut by 2.2% the rates paid to health insurance companies that are taking part in the Medicare Advantage program.  There were many people who opposed the cuts including over 100 members of Congress and the health insurance companies themselves.  Insurers put together a convincing campaign to convince lawmakers that the cuts did not make sense.

The Centers for Medicare and Medicaid (CMS) announced that it will be changing the way they calculate reimbursement rates and payments for Medicare Advantage will actually increase by 3.3%.  The CMS’s acting principal deputy administrator, Jonathon Blum, said the policies announced furthers the agency’s goal of improving payment processes and helps ensure the programs stability over time.  It also proves to preserve beneficiary choice which many have felt has been at risk.

The Kaiser Family Foundation states that 27% of Medicare beneficiaries get their benefits from private health insurers that make up the Medicare Advantage program according to Sandhya Somashekhar’s article on The Washington Post’s website.  If the original cut would have been approved it would have been one of several cuts aimed at Medicare Advantage.  The plans could still face further reductions under the 2010 health law.

Senator Orrin G. Hatch, R-Utah, said in a statement that CMS made the right choice to reverse their course and implement a rate that will keep choices and ensure continued and consistent access to top quality plans.  It will allow for more affordable care for beneficiaries throughout the nation enrolled in these popular plans.  Medicare Advantage is an important part of the health care industry and many feel it needs to be protected for further budget cuts.

It was the broken leg heard throughout the stadium.  Kevin Ware brutally broke his leg while playing basketball for the University of Louisville in a big NCAA Tournament game last week.  As he was rushed to the hospital there was already a debate stirring about the treatment of unpaid college students who generate millions of dollars for their schools through sports and the risk they put themselves in daily.  Do they all have adequate health insurance coverage?

The good news for Ware was that the university had a secondary policy on its varsity athletes, and Ware also has his family’s primary insurance so he will be paying no out-of-pocket costs for his rehabilitation.  But not all student athletes are as well-covered.  It is possible Ware will be responsible for any health care expenses related to the injury after he leaves Louisville.  Injuries sustained while the student is in school are not generally covered by the school’s medical insurance once an athlete has left college.

According to the New York Times article by Bill Pennington, if Ware’s medical claims exceed $90,000 he will also qualify for the NCAA’s catastrophic insurance program.  The NCAA also has additional supplemental insurance for injuries that occur during certain championship events which is good news for students who are not eligible for workers comp since they are not employees.  Is this adequate enough student health insurance coverage for these athletes, or could some be left with mounting bills?

There is some concern over the fact that in general schools offer their student athletes the same type of health insurance coverage as a regular student even though the athlete put themselves at much more physical risk to the benefit of the university.  These universities are making a lot of money off of their athletes and a more comprehensive plan seems to make sense.  But is that necessarily fair to the non-athlete students who could incur large health insurance costs?

These very concerns about unfair treatment of student athletes last year caused the California Legislature to pass a bill called the Student-Athlete Bill of Rights which requires universities that generate more than $10 million in annual media revenues from athletic events to offer the same academic scholarships to varsity athletes who are injured and lose their athletic scholarships.  It’s an interesting move and time will tell if they will start giving these athletes special treatment in the way of health insurance policies.

The Centers for Medicare and Medicaid services has released a useful video to help consumers navigate through The Health Insurance Marketplace that the government is setting up in response to health care reform.  It walks you through the application process and gives a detailed example for a family of three using the online single streamlined application.

This 17 minute video was created to give the public an idea of how the dynamic tool can help individuals and families shop around for health insurance.  This will come in handy for thousands of families who may be overwhelmed by the prospect of having to find health insurance for their entire family.

The Health Insurance Marketplace will be offering user-friendly opportunities to find affordable health insurance for millions of people throughout the nation.  Check out the video to get some more detail on how this application process will work:

According to the news release on Insurance.WA.gov, individual health plan enrollment for children starts March 15th and goes through April 30th in the state of Washington.  Insurance Commissioner, Mike Kreidler, urges residents to apply early if they are looking to add their children onto their family plan.

The open enrollment periods are for all health plans in the individual market throughout the state for individuals who do not receive coverage through their employer.  Health care reform makes sure children with pre-existing conditions cannot be denied coverage but the open enrollment period allows children under the age 19 to get coverage quickly without filling out a questionnaire.  Residents can apply for a health care plan through the Washington State Health Insurance Pool.

There are some exceptions where you can apply for individual coverage for children anytime such as the birth or adoption of a child.  Some other exceptions include if your child is no longer eligible for a state plan, if you lose coverage due to divorce, if you lose employer-sponsored health insurance, including COBRA, or if you move and your plan is not available in your new area.

Beginning in the fall, Washington residents will have two options for buying a health plan for children.  From September 15th through October 31st, individuals can buy a plan that is offered outside of the new Health Benefit Exchange called the Washington HealthPlanFinder.

Written by Sam Tabes

Follow me on Twitter:  https://twitter.com/smartshopper78

One of the main aspects of the health insurance industry has been the fact that they avoid giving coverage to the riskiest applicants, typically ones with pre-existing conditions.  While this makes business sense, it’s created a nation where millions of Americans struggle to find health insurance which can prevent them from falling into financial ruin.  Health care reform will ensure that insurers will not be able deny people with pre-existing conditions health insurance, but this does not fully take effect until 2014.  Until then, many Americans are still facing the cold reality that they are unable to find health insurance coverage and this puts us all at risk of higher premiums over time.

The “Health Insurance Application Rejection Rates Rising?” report from HealthPocket states that 22% of applicants across the country are denied health insurance, typically because of a pre-existing condition.  Steve Zaleznick, HealthPocket’s executive director of consumer strategy and development, points out that health insurance carriers are taking pre-existing conditions into consideration as they review applications.  It makes sense they would only approve the lower risk applicants.  It’s concerning though that rejection rates seem to be rising and in some states, including Montana, rates are up to a staggering 45%.

The good news is that by 2014 all health insurance companies will be prohibited from denying someone coverage because of a pre-existing conditions under the Patient Protection and Affordable Care Act.  This even applies to those with major physical problems that could incur high hospital bills over time.  Until this takes effect though, it’s important consumers understand the challenges they may face as they start to shop around for health insurance coverage.

According to the article “Health Insurance Application Denied? Here are 5 Options” by Mark Chalon Smith on FoxBusiness.com, HealthPocket’s report based its data on information from the Department of Health and Human Services and looked at over 9,400 health insurance plans throughout the US.  The report shows some extremely high decline rates up to 45% with an average of 22% for the nation as a whole.  If you are rejected at this point, but are determined to find coverage, you do have options and it’s important to explore all possibilities.

Consumers who are rejected for health insurance can look into their state’s designated insurer that is required to offer coverage to everyone.  Pre-existing Condition Insurance Plans (PCIPs) offer federally administered insurance coverage to those who cannot obtain coverage elsewhere.  Another option is a high-risk pool which is available in 35 states throughout the nation.  They ensure everyone can obtain coverage regardless of their health.  And then there is always Medicaid, Medicare or the State Children’s Health Insurance Program which many lower income families are eligible for and coverage can be obtained even if their are pre-existing conditions involved.

Written by Sam Tabes

Follow me on Twitter:  https://twitter.com/smartshopper78

Health care reform is requiring that individual and small group health insurance plans sold on the state-based health insurance exchanges and on the private market offer dental coverage to children.  This is in response to the fact that tooth decay currently ranks as the number 1 chronic disease among children.  While this effort is commendable, it may not be realistic.  Many children’s health advocates are concerned there will not be enough dentists who are willing or able to treat the vast amount of children who will have coverage once health law is fully implemented.

Pediatric dental coverage is already available under Medicaid, but many children are not using these services according to Michelle Andrew’s article on NPR.org.  Families are unaware of the benefits that are available for their children through dental coverage and have not enrolled in the various plans.  Health care reform is working to make coverage more available as it expands coverage to adults with incomes up to 133% of the federal poverty level.  There is concern that as the amount of coverage rises, the availability of dentists to treat these children will decrease.

Colin Reusch, a senior policy analyst at the Children’s Dental Health Project, points out that many dentists are not particularly comfortable seeing young children since many are uncooperative in the dental chair.  Reusch co-authored a recent study on the law’s pediatric dental coverage and found that it will face many challenges.  Families of children who are using Medicaid run into language barriers and struggle to find transportation options.  A lot of times they cannot find a dentist who accepts Medicaid nearby.  All of these barriers leave experts wondering if more children will actually be treated under the health law requirement.

The Government Accountability Office completed a report in 2010 that found less than half of the dentists in 25 out of 39 states took any Medicaid patients in the previous year.  This is a shocking statistic that begs the question why?  Part of the reason is the dentists decision, but also the fact that Medicaid families may be unaware they even have dental coverage.  Health care reform could increase awareness and may encourage more dentists to see more children and accept Medicaid more often.

Shelly Gehshan, director of the Pew Children’s Dental Campaign says many rural areas simply do not have enough dentists to fulfill the needs of covered children.  Gehshan says there is a huge and well-documented access problem in the United States, with 45-50 million people living in areas where there is a shortage of dentists, especially ones that accept Medicaid and treat children.  On the other hand, President of the American Dental Association, Robert Faiella, says there isn’t really a shortage of dentist services.  He believes roughly 73% of dentists are able to accept more patients and are not completely full.

Dentists are trying to work with more community health centers and local dentists to provide to assist with distribution problems.  Dental insurance is an important part of the heath care industry and it’s good news that it’s being considered in health care reform, even if it only addresses primarily children at this point.  Children can be at high risk of serious tooth decay and early intervention is key.  If health care reform can help more children see a dentist and prevent serious dental health issues, then it’s in the best interest of all families.

Written by Sam Tabes

Follow me on Twitter:  https://twitter.com/smartshopper78