by Admin. | Nov 3, 2011 | Uncategorized
Medicare Supplement Insurance Plans (Medigap)
Medicare Supplements or Medigap are private insurance policies designed to cover the gaps in Medicare coverage. It is important to research and shop for the best rates in your area. All plans are “standardized” and must offer the same level of coverage dependi ng on which policy you choose. You may find substantial price differences between each insurance company. Our representatives will help you by providing you with a plan comparison from the various companies so that you can make an informed decision.Example: If you choose a Plan F Medicare Supplement plan you will receive the same exact benefits regardless of the company you enroll with. In this case it may be wise to choose the company that has the lowest premium.
In most states Medicare Suplement plans are seperated into 12 categories Plans A-L. As of July 2010 Plan N And M were added. Each plan has a different level of coverage and you should choose depending on your specific needs. Eligibility and enrollment periods may vary depending on the state where you live.
Medicare is a Federal program and insurance plans are regulated by individual States. You will need to find out which specific plans are available in your area. Each County has different plan offerings. If you need help or enrollment details or assistance you may call us ay 914-207-6161.
Choosing A Medigap Policy
There are several ways to save money when choosing a Medicare supplement policy. It may be best to use the assistance of a licensed broker or insurance agent to guide you through the process. The first objective will be finding the correct plan to fit your individual needs. It may be overkill to purchase a policy with more coverage than you actually need. This will result in higher premiums for benefits that you may not even use.
You can choose a policy with a higher deductible. This method is used for many who are relatively healthy and don’t visit the doctor very often. At the same time you will be covered for emergencies and protected against catastrophic costs. You will save a great deal of money on your monthly premium expenses and can use the extra cash to enjoy your retirement.
Many insurance companies will give you a discount if you pay yearly. There are also discounts available if you sign up for the electronic bank transfer payment option. There are a few companies however, that will charge you a one time application fee. You should avoid these plans since most do not charge this fee.
A few companies will offer a discount for a husband and wife combination. This can be convenient and save you money as well but make sure that the overall cost is comparative to other plans. Sometimes you will find policies with the overall lowest price even without any discounts. To compare pricing you may call our toll free number or Request A Free Plan Comparison
Medicare supplement insurance is an excellent option for those who travel frequently. Supplement plans offer the most comprehensive Nationwide coverage. There are no networks to worry about and no referrals are needed. Any provider that accepts Medicare can accept payment from a supplement policy.
Although the monthly premiums are higher, this may be a good choice for some. If you are looking for maximum freedom of choice then this would be a good type policy to choose.
by Admin. | Oct 19, 2011 | healthcare, Healthy NY, NY News, Small Business Group Health
As reported by Crains, the Healthy NY program will be undergoing significant cuts. Beginning January 1 2012, the high deductible health plans (HDHP) option will only be offered by Healthy NY.
With rates averaging 30% below market and reasonable benefits such as $20 Office Copays this was an important safety net for NYS Small Businesses. Since its inception 10 years ago the program has enrolled approx.180,000 members covering small groups, sole proprietors and working individuals. The program is not Medicaid and allows members to keep their Doctors and enroll in private insurance EPO/HMOs such as Empire Blue Cross, Oxford, Emblem GHI etc. One of the reasons the program is 30% less expensive is that the state has a pooled stop loss fund that reinsures health care companies. This fund has been underfunded with rapid growth and stagnant funding the past 3 years.
Currently, the less expensive Healthy NY HIgh Deductible Plan is $1200/single and $2400/family. Outside of preventive care, members must self insure on the entire deductible including Pharmacy. The good news is that this plan is a qualified HSA (Health Savings Account) and can be reinsured by members. For healthy members the HSA unspent money is not use it or lose and can be rolled over year to year.
Existing Healthy NY groups can still keep their plans as long as long they qualify. However, Healthy NY only allows 1st of the month effective date with only an 11.1.11 and 12.1.11 still available to prospective new groups looking to lock in the regular Healthy NY.
To view current Healthy Benefits and rates click here. For more information or to enroll Contact us today.
by Admin. | Oct 19, 2011 | Healthy NY, NY News, Small Business Group Health, Uncategorized
Healthy NY FAQ
The goal of the Healthy NY program is to promote and provide affordable insurance coverage to eligible small businesses that are not currently offering health insurance coverage to their employees. It is also available to eligible uninsured working individuals and sole proprietors. Listed below are some frequently asked questions by small employers about the Healthy NY Program.
This program does not allow employers to participate if they have “provided” group health insurance to their employees in the past year. Under what circumstances is my business considered to have “provided” group health insurance?
An employer is considered to have “provided” health insurance if the employer arranges for group health insurance and contributes more than $50 (or $75 if the business is located in the Bronx, Kings, Nassau, New York, Orange, Putnam, Queens, Richmond, Rockland, Suffolk, and Westchester counties) per month per employee towards the premiums for coverage. If an employer has merely arranged for health insurance coverage for employees but has not contributed more than the previously noted amounts, then the business may still be eligible for Healthy NY.
What if my business has provided other health insurance during the past twelve months, but the insurance had limited benefits?
If your business has provided other insurance during the past twelve months, but the coverage included only limited benefits (for example – only medical benefits or only hospital benefits, but not both) then your business may still be eligible for HNY.
What if my business has not provided group health insurance coverage in the past twelve months, but some of the employees have been covered through other sources, like their spouse’s employer plan?
The coverage of individual employees through other sources does not affect a small employer’s eligibility to participate in the HNY program.
I have 5 employees. One is enrolled in Medicare and two others receive health insurance through a spouse. The remaining two employees wish to enroll in Healthy New York. Is my business eligible?
Your business would be eligible because the three employees who have other coverage count towards satisfying the minimum 50% participation requirement.
Why is this program available only to small employers who did not provide insurance during the twelve months preceding application? Doesn’t this penalize the “good guys” who struggled to maintain coverage for their employees over the past few years?
HNY was designed to target those individuals who were completely uninsured. These so called “crowd out” provisions of the legislation are also designed to ensure that employers and individuals do not drop existing coverage in favor of this new product.
If my business offers family coverage through Healthy NY, does my business have to contribute towards the cost of the premiums for my employees’ dependents?
No. Employers are encouraged to share in the cost of the Healthy NY premium for their employees. However, there is no requirement that the employer contribute towards the cost of dependent coverage.
Can my business offer Healthy NY coverage to my employees’ families?
Yes, the employer may choose to offer coverage for dependents through the HNY program. Qualifying dependents include dependent children up to age 19 and full time students up to age 26. However, it may be financially beneficial to employees to obtain health insurance coverage for their children through New York’s Child Health Plus program, rather than Healthcore. For more information about Child Health Plus, contact New York’s toll free hotline at 1-800-698-4543.
Is there a re-certification process?
Yes. On an annual basis, employers participating in the HNY program are required to submit a re-certification that attests to their continued eligibility for the Healthcore program. The employer’s health plan will notify participating employers of when this re-certification is due and will provide them with the necessary forms.
What if my business qualifies for HNY and things change? What if I hire more employees and it brings my workforce total over 50? What if some of my employees drop coverage and my business no longer satisfies the 50% employee participation requirement? Would the coverage then be terminated?
Mid-year fluctuations in group size, wage levels and employee participation will not result in immediate termination of HNY coverage. However, HNY requires an annual re-certification process at which time your business’ eligibility would be reevaluated. If your business does not meet the eligibility criteria at the time of re-certification, you will be unable to continue to participate in the program. Please note that the wage levels set forth in the eligibility criteria for the HNY program are increased annually to account for inflation.
Can my business offer coverage to part-time and seasonal workers?
Yes, employers may offer coverage to part-time and seasonal workers who work less than 20 hours weekly, but they are not required to do so. If they choose to offer coverage to these employees, the employer may choose to contribute toward the cost of their premium but is not required to do so.
Can I count the wages of part-time and seasonal workers in determining if my business is eligible for participation in the Healthy NY program?
Yes, the annual wages of part-time and seasonal workers may be included for the purpose of determining an employer’s eligibility if the employer also extends coverage to part-time workers.
Which employees must be offered Healthy NY coverage?
Small businesses must offer HNY to all employees working more than 20 hours weekly and earning $40,000 or less annually.
My child just graduated from college and will no longer be eligible to remain on my policy. Would my child be eligible for Healthy NY?
Students who are graduating from high school or college who are aging off a parent’s policy may be eligible for HNY if they meet the other eligibility guidelines of the program.
If I do not qualify for Healthy NY, are there other affordable health insurance products available?
Yes, there are several other affordable options available to individuals, sole proprietors and small businesses. For a list of other programs, contact information and general eligibility requirements, please visit Millennium Medical Solutions Corp.
by Admin. | Oct 19, 2011 | Uncategorized
HEALTHY NY SLASHED!
As reported by Crains, the Healthy NY program will be undergoing significant cuts. Beginning January 1 2012, the high deductible health plans (HDHP) option will only be offered by Healthy NY.
With rates averaging 30% below market and reasonable benefits such as $20 Office Copays this was an important safety net for NYS Small Businesses. Since its inception 10 years ago the program has enrolled approx.180,000 members covering small groups, sole proprietors and working individuals. The program is not Medicaid and allows members to keep their Doctors and enroll in private insurance EPO/HMOs such as Empire Blue Cross, Oxford, Emblem GHI etc. One of the reasons the program is 30% less expensive is that the state has a pooled stop loss fund that reinsures health care companies. This fund has been underfunded with rapid growth and stagnant funding the past 3 years.
Currently, the less expensive Healthy NY HIgh Deductible Plan is $1200/single and $2400/family. Outside of preventive care, members must self insure on the entire deductible including Pharmacy. The good news is that this plan is a qualified HSA (Health Savings Account) and can be reinsured by members. For healthy members the HSA unspent money is not use it or lose and can be rolled over year to year.
Existing Healthy NY groups can still keep their plans as long as long they qualify. However, Healthy NY only allows 1st of the month effective date with only an 11.1.11 and 12.1.11 still available to prospective new groups looking to lock in the regular Healthy NY.
To view current Healthy Benefits and rates click here. For more information or to enroll Contact us today.
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by Admin. | Oct 6, 2011 | healthcare
“Almost everything–all external expectations, all pride, all fear of embarrassment or failure–these things just fall away in the face of death, leaving only what is truly important. Remembering that you are going to die is the best way I know to avoid the trap of thinking you have something to lose. You are already naked. There is no reason not to follow your heart.”
Steve Jobs
US computer engineer & industrialist (1955 -2011 )
I started on the Mac in HS and College and was forced to wander the corporate dull Microsoft PC Valley until Vista. The Vista operating system broke our back as a Small Business with endless malfunctions and slowdowns. That monstrosity led me to MAC out our office completely 4 years ago never to look back again.
His genius is humbling and inspiring. In a small way we have try to live to our lives by taking chances with love and passion in everything we do.
He was our modern day DeVinci.
2005 Steve Jobs Stanford Commencement Speech
Twitter- Thank You Steve
Steve Jobs Bio
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by Admin. | Sep 23, 2011 | PPACA
In another downsizing move of the Health Care Reform ACT – Patient Protection and Affordable Care Act (PPACA) the office responsible for the new Long Term Care Act claus have been reassigned. This portion of the law is known as CLASS (Community Living Assistance Services and Supports) that was intended to make private Long Term Care Ins more affordable and available through the work site.
There are Long Term Care concerns as less than 10% of the US Consumers carry a LTC policy. Part of the disparity is obvious costs and part is the feeling that Public Gov will take care of this. In order for Medicaid to pay for Nursing Homes though ones assets with some exceptions are liquidated. The other is not realizing that LTC does cover Home Health Care.
Under the CLASS provision “the Secretary shall designate a benefit plan no later than October 1, 2012.” However, with this week’s action of “reassigning” 8 members of the CLASS unit go is another step in diminishing the act. Also, politically before an election year it would of given too much fodder for the Republican Party. To have CLASS succeed, HHS would have to make it affordable, but, because the CLASS Act plan would be a voluntary plan, the plan would could face enormous risk of adverse selection, with only unhealthy workers signing up. Critics contend that the program managers would have to raise premiums substantially over time to keep the program solvent, and that, over time, the program would fall into a costly deathly spiral. The program has become a favorite target for Republicans.
There may be political winners and losers but sadly who can calculate the amount of time + resources wasted to land back to square 1?
Resources:
http://www.washingtontimes.com/news/2011/sep/22/obama-pulls-back-part-affordable-care-act/
http://blogs.wsj.com/washwire/2011/09/22/long-term-care-program-in-jeopardy/?mod=WSJBlog
by Admin. | Sep 1, 2011 | group health insurance, Health Care Reform, healthcare, PPACA, Small Business Group Health
UnitedHealthcare Buying Medical Groups?
Optum Health owned by UnitedHealth Group
Today’s WSJ reports UnitedHealth Buys California Group of 2,300 Doctors may be a signal of future trends in healthcare where there is blurring of the lines between insurers and providers. The article goes on to to mention that United Healthcare has stated that providers acquired by Optum will not work exclusively with United’s health plan, and will continue to contract with an array of insurers.
The article goes on to state that “the potential complications that might ensue, Monarch is currently in an arrangement with United competitor WellPoint Inc. to create a cooperative “accountable-care organization” aimed at bringing down health-care costs and improving quality.”
In the aftermath of Health Care Reform, insurers profits will be curtailed. New price limitations imposed by MLR (Maximum Loss ratios) where 85% of large group premiums collected must be spent on healthcare services(claims) and health quality improvement . New state tax surcharges such as New York’s 82% of above MLR applies to small groups. In fact in NY the cost of doing business is a staggering 16%+ added to the usual corporate tax. See The NYS Surcharge.
Additionally, the industry as a whole will be paying an annual tax to help pay for PPACA(Patient Protection Affordability Care Act). This tax rises from $8 billion in 2014 to $14.3 billion in 2018 and in later years, even higher according to a complex index. See Kaiser Bill Summary .
While its unglamorous to defend insurers they are clearly paying their share and like it or not they are good at health care management. Unlike foreign HQ tax loop holes taken advantage by companies such as G.E. , an insurer cannot place patent rights in Zug, Switzerland and take advantage. Each of these taxes is increased regularly by the State and contributes significantly to annual increases in rates. The competition in the health insurance industry is already at a dangerous low levels. Negotiating with insurers has become an overwhelming challenge in the large group market. Hospital groups have merged to mirror this Oligopoly trend and contractual issues are the new normal. See Empire & Stelllaris Reach pact.
So what to do other than to find profits elsewhere? Many issues and questions will abound as to the antitrust nature of this action. A similar issue appeared in the 90s Merck-Medco merger between a pharmaceutical and mail order PBM. The conflict of interest claims will abound, how do you negotiate one provider group owned by United-Healthcare as opposed to one owned by HealthNet? Will insurer share competitive insights with other practices? Are small independent Dr. Groups completely left out of the loop and feel pressured to be bought out? Will the insurers medical group have unfair advantage in buying out the smaller physician practice? Perhaps in the same vein of the Merck-Medco analogy the health insurer shareholders will do well for a decade and then simply split up?
Its all too early to tell but this much is clear, there aint no money in running a health insurance management company today.
by Admin. | Sep 1, 2011 | Health Care Reform, Health Care Refrom, healthcare, Hospitals, NY News, Tax
Ever Wonder why in a Metropolis of 25 Million there are maybe 5 insurers left?
New York Taxes – As published with the NYS Insurance Dept.
New York adds more insurance taxes than any other state in the country. These consist of both direct taxes and a number of “hidden” taxes amounting to a total of over $4.1 billion in taxes passed on to our customers in the form of higher premiums. These taxes include:
• NYS Premium Tax- this 1.75% tax is on all HMO and insurance contracts and is projected to raise $353 million for the State in 2010. Empire alone pays $103.9 million to the State in premium taxes (this amount includes a special surcharge for customers in the MTA service area).
• Covered Lives Assessment- this “hidden tax” is a charge on all fully and self insured “covered lives” and raises, statewide, projected to raise $1.16 billion for the State in 2010. Empire alone will pay about $296.2 million in covered lives assessments in 2010. The purpose of the Covered Lives Assessment is raise funds for a variety of state programs and for the state Budget. The Assessment is included in claims costs for purposes of calculating the MLR.
• HCRA Surcharge- this is a 9.63% surcharge on all hospital discharges projected to raise $2.33 billion in 2010. Empire alone will pay approximately $379.4 million to the State in HCRA surcharges in 2010. The purpose of the HCRA Surcharge is to raise funds for a variety of state programs and for the state Budget. The Assessment is included in claims costs for purposes of calculating the MLR. NYS Insurance Department “332” Assessment- while this assessment is legitimately intended to fund the cost of the Insurance Department’s regulatory activities there is a “hidden tax” whereby a large portion of the revenue generated by the assessment is used to fund other programs funded not directly related to insurance regulation and is projected to raise $270 million from New York’s health insurers and HMO’s in 2010. Empire will pay the state $57.9 million in 332 assessments for 2010.
Each of these taxes is increased regularly by the State and contributes significantly to annual increases in rates. The competition in the health insurance industry is already at a dangerous low level. Negotiating with insurers has become an overwhelming challenge in the large group market.
by Admin. | Aug 18, 2011 | group health insurance, healthcare, Hospitals
After balancing the budget and announcing $2.4 trillion in government spending cuts over ten years, politicians and media pundit are insisting that it is only the beginning of the attack on health care, pensions and other social programs.
So why is balancing the budget and cutting medicare so bad for the Privately Insured? After all, the Democrats have made sure the automatic cuts leave Medicare benefits untouched, and the Republicans have blocked any new taxes.
Everyone is content right? Or so it seems. But the truth is that cutting payments to Medicare providers will mean some Americans are going to pay more. It may not be called a tax, but if you’re covered by private health insurance, money will be coming out of your pocket nonetheless.
Here’s how cuts in Medicare affects the rest: If a hospital provides a service that costs $1,000,000, and the government elects to pay just $980,000, the $20,000 gap doesn’t disappear. The hospital has to cover it somehow. It will likely do so by shifting the costs to commercial insurers, which eventually means higher premiums. This cost shifting is nothing new-it’s been happening for years-but more cuts will just make it worse.
NY Hospitals in particular have felt Federal Funding cuts for teaching hospitals over the last decade. This has been a contributing factor to St. Vincents declaring bankruptcy last January. Many surviving hospitals however have the size to negotiate effectively with private insurers to make up that funding short fall.
So guess who makes up that difference? The fact remains, if you don’t deal with underlying costs, you’re not fixing the problem, you’re just covering it up.
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by Admin. | Aug 3, 2011 | Health Care Reform, PPACA, State Exchanges
