By Rene Girard – Hesed Insurance Solutions
Q: I need health insurance for myself/my family. I know a lot of changes have taken place so I’m wondering if you can help me?
A: I’m here to help. Let’s get up to date then explore a few options.
The Patient Protection and Affordable Care Act (PPACA), sometimes called the Affordable Care Act (ACA) or Obamacare, was signed into law in 2010 and was mostly upheld by the Supreme Court in 2012. Now every long term health insurance plan sold in the USA must be PPACA compliant by providing Minimum Essential Coverage – a host of health benefits including maternity and prescription coverage. So what does that mean for you? It depends on your particular circumstances.
Changes to non-employer based plans for individuals and families only:
- UNDERWRITING: You can no longer be denied coverage for preexisting conditions. Because health issues are a non-factor, this means applications are approved for just about everyone. Tobacco users will still pay more.
- COST: Healthier people now pay more for coverage in order to offset the medical costs of those who are less healthy. Men no longer pay less than women. Rates vary by age, zip code, tobacco usage, and plan coverage.
- PLANS: All new long term major medical plans are “Metallic”: Platinum, Gold, Silver and Bronze. Many PPO plans are being replaced by EPO or HMO plans in 2016. People under 30 or with hardship exemptions may purchase Catastrophic Plans which have the lowest monthly premiums with the highest annual deductibles.
- AGE RANGE: Plans are available for ages 0-64. Dependent children can remain on their parent’s plan until their 26th birthday. From age 65 onward the Government offers Medicare insurance.
- MEDICARE: The rules for Medicare recipients are not the same as those for the PPACA. Medicare makes its own changes each year. For 2016, Medicare Part B premiums and the annual Part B deductible are expected to increase up to 52%. Please see my Ask an Expert article from September/ October 2014 entitled “Understanding the Various Types of Medicare Insurance” on the CAP website (http://www.bit.ly/CAP-MedicareInfo).
- MEDICAID: Medicaid is directly affected by the PPACA. Medicaid expansion for low income individuals was encouraged and expected by the federal government. Many states voluntarily expanded; however, as of this writing, the following states have not: AL, FL, GA, ID, KS, LA, ME, MS, MO, NE, NC, OK, SC, SD, TN, TX, UT, VA, WI, WY. The federal government encourages states to seek reimbursement – this could be from your estate after death, or a lien on your home while you’re alive. Be sure to consult with an experienced attorney before applying for Medicaid.
- SUBSIDIES: Some health plans are subsidized by the Government and others are not. These subsidies for financial assistance are based upon total household income and number of household residents.Subsidized plans are “On” the Public Exchange. Think of an “exchange” as an online marketplace. Premiums/Prices are based upon projected income. If your income increases, you may be required to reimburse the government for subsidies received. Non-subsidized plans are “Off” the Public Exchange as part of the Private Exchange. Premiums are the full responsibility of the insured – just like it has been for decades. There are no IRS forms or income qualifications.
Note: Hesed Insurance Solutions offers only off-exchange, non-subsidized plans.
- ENROLLMENT: Healthcare.gov is the now infamous Government website where individuals are encouraged to enroll online. The website helps to determine if you may or may not qualify for Government subsidies to reduce your monthly premiums. Enrollment is possible over the phone, on other insurance websites, or with a paper application.
- OPEN ENROLLMENT PERIOD: Individuals and families can no longer enroll anytime of the year because now there is an official Open Enrollment Period (OEP). The next OEP is from Nov. 1st 2015 to Jan 31st 2016. If you need coverage and miss this OEP, then you may be penalized.
- PENALTIES: If a person does not have “minimum essential coverage” then there is an IRS penalty. For 2015: $325 per adult + $162.50 per child not to exceed $975 total, or the greater of 2% of annual household income. For 2016 $695 per adult + $347.50 per child not to exceed $2085 total, or the greater of 2.5% of annual household income. (The maximum penalty is the national average premium for a Bronze plan. If you’re uninsured for just part of the year, 1/12 of the yearly penalty applies to each month you’re uninsured. If you lacked coverage for no more than two continuous months of the year, there is no penalty.)
- SPECIAL ENROLLMENT PERIODS: If you lose health coverage from an employer, you may qualify for a 60-day Special Enrollment Period (SEP). An SEP allows you to apply for new health insurance coverage if you missed the OEP. Other factors that may trigger an SEP include: marriage or divorce, gain or loss of a dependent, change of residence, change in disability status, loss of Medicaid eligibility, loss of COBRA, and more.
- EXEMPTIONS: It is possible to be exempt from Obamacare for a number of reasons including: the minimum amount you must pay for health insurance is greater than 8% of your household income; your annual income is below the income tax return filing requirement; financial or domestic hardship; incarceration; not lawfully present in the U.S.; you are a member of an Indian tribe or a religious sect that opposes insurance benefits, or you are enrolled in a health care sharing ministry.
OTHER COVERAGE OPTIONS:
OPTION #1: HEALTH CARE SHARING MINISTRIES
Christians can be exempt from Obamacare if they maintain health coverage through a health care sharing ministry such as Medi-Share or Samaritan Ministries. This is not insurance! This is a way for devout non-tobacco using Christians to share each other’s financial burdens. Monthly dues are used to pay immediate needs. Medi-Share administration receives monies and sends checks to qualifying members. Samaritan Ministries members send checks directly to other members. Both encourage writing notes and praying for other members. Significant qualifying needs are publicized in newsletters. Medi-Share negotiates on your behalf to lower the amount you owe. Samaritan Ministries makes participation easier and more affordable. There are quite a few similarities and differences between these two organizations that serve individuals, families, and groups. Unlike insurance, there are no guarantees that the amount of money you need to pay your bills will be there when you need it; however, with tens of thousands of committed believers as members, it is possible to receive all that you need and more.
OPTION #2: SHORT TERM HEALTH INSURANCE
Some companies offer short term health insurance plans that last from 1 to 12 months. Rates may be more affordable than regular long term health insurance, but the plans do not necessarily cover any preexisting conditions and do not count as creditable coverage to avoid the IRS penalties of Obamacare. Electronic enrollment is quick and easy any time of the year and coverage can sometimes start the next day.
OPTION #3: EMPLOYER INSURANCE
We direct employers to a Christian agency partner. Employees need to revisit all options available through their employer before searching elsewhere. A change of employment in order to attain a more desirable income or improved healthcare benefits may also be worth serious consideration.
The preceding information is neither comprehensive nor complete. If you would like more information on any of these topics, please visit my website: InsureMyParts.com, where you can also compare non-subsidized health insurance plans and prices from some of the largest insurance companies in the nation (varies by state). This Self-Serve Insurance® website is safe and secure, allowing you to enroll online 24/7 from the comfort and convenience of home. There are also special links for the Health Care Sharing Ministries mentioned above. Both Hesed Insurance Solutions and CAP will benefit should you decide to enroll in any of the available plans at the same low prices as going direct.
No access to the internet? Call my office: 1 (619) 730-HELP. No nationwide calling? My call center’s phone number: 1-800-9-800-342.
Whether you have regular insurance or decide to try a Health Care Sharing Ministry, make sure those you care about have coverage “just in case.”
Mr. R. Girard has been selling insurance since 2004 and is now doing business as Hesed Insurance Solutions. By offering a wide variety of insurance and financial products to residents of all 50 states, Mr. Girard and his team are here to meet your needs with free consultations courtesy of CAP member benefits.
ENROLLMENT PERIODS AT A GLANCE
Annual Open Enrollment Period SEP
Under 65 Health Nov 1/2015 – Jan 31/2016 Yes
Medicare Part C Advantage Oct 15 – Dec 7 Yes
Medicare Part D Oct 15 – Dec 7 Yes
Medicare Supplement None (Enroll/Switch when able) No
Senior’s Choice None (Enroll anytime) No
It was the early 1980s when John Bell looked back at his personal family history, realizing he had lost his father and several other relatives before they reached their 50th birthday. Inspired and motivated by the loss of loved ones, John began studying the causes of heart attacks and learned of the correlation between elevated cholesterol and heart disease. Suddenly, wellness and early detection became a personal crusade. As a vigorous member of the rapidly growing healthcare industry, John founded his first wellness company in 1983. Heart Chek offered onsite screening programs performed nationwide by more than 50 phlebotomy teams. Collectively, the franchises were running more than 150,000 tests a month.
The Birth of Direct Access Testing
Expanding from cholesterol and cardiovascular screening into additional areas of wellness, John founded Direct Laboratory Services, Inc. (DLS) in 1993. As the early 1990s saw the opening of Patient Service Centers by the nation’s major laboratories, DLS was able to establish the Direct Access Testing (DAT) concept, primarily through Internet marketing. And as the industry pioneer and leader, he formed a DAT trade association to establish and maintain standards of excellence as competitors with a common mission entered the field.
In recent years, DLS’ volume of fast, affordable, convenient and confidential online lab tests to individual consumers has significantly increased each year. Today, millions of Americans have no health insurance or have high-deductible health plans, so in addition to providing consumers with the ability to take charge of their own health at affordable prices, DLS offers a much-needed healthcare provider affiliation, giving physicians a safe, confidential, cost-effective resource for their uninsured patients. In 2003, Lab Services Benefits for groups, wellness companies and associations began as a component of mini-med plans. This benefit fills the gap created by expansion in the High Deductible Health Plan/Health Savings Account area. This segment of the company currently covers over 500,000 members.
Direct Lab’s Stellar Reputation
DLS’ reputation consistently earns recognition for organizing and administering health screenings for some of the country’s largest retailers, as well as state and local health departments. Periodic reviews of DLS’ operations by state health departments and medical regulatory boards consistently result in enthusiastic approval. For almost 20 years, DLS has provided wellness screening to employees of the State of Louisiana insured by the State Employees Group Benefits Program. And the City of New Orleans awarded DLS a certificate of appreciation for administering their Metro Area Health Awareness Program, which tested 20,000 people over nine days. Consumer testimonials from new and established consumers are a daily tribute to DLS’ success.
Sadly, John lost his battle with pancreatic cancer in December 2011. However, his vision and legacy live on in the company that he so dearly loved and built from the ground up.
Nearly every state in America requires vehicle owners to establish financial responsibility for their vehicles, and for good reason: Establishing financial responsibility for your vehicle means you’re able to cover the cost of damages sustained in an accident. To meet these financial responsibility requirements, many drivers choose to purchase auto coverage from an insurance company, and for those drivers it might seem sensible to also purchase roadside assistance from their insurance companies.
However, before you automatically tack roadside assistance coverage onto your auto insurance plan, you need to determine whether purchasing roadside assistance coverage from your auto insurer would be more beneficial than purchasing it from a third-party automobile club. In some situations, doing business with an automobile club makes more sense.
Roadside Assistance Through an Auto Insurer Might Not Be Worth the Cost
Your insurance company looks at several factors when determining your auto insurance premium. Such factors might include those you can control (such as your driving record), those you might or might not have immediate control over (such as the type of vehicle you drive), and those you have no control over (such as your gender and age).
Unfortunately, these factors sometimes work together to make your insurance premiums pricey. If you’re already paying high dollar for your insurance coverage, does it really make sense to tack on extra costs for roadside assistance?
The good news is that many automobile clubs offer roadside assistance services at a fraction of what you’d pay if you purchased the services through your insurance company. Ask your insurance company how much roadside assistance will cost, compare that cost to the prices of automobile clubs, and determine which company will best suit your budget and needs.
Using Your Insurer’s Roadside Assistance Could Affect Your Premiums
Having roadside assistance coverage is a good thing. It gives you peace of mind while you’re traveling and can be quite budget friendly when emergencies like flat tires and dead batteries surprise you.
However, if using these services means your auto insurance premiums could increase, it might make more sense for you to purchase a roadside assistance plan from an automobile club. With an automobile club, you’ll get the services you need at one flat rate.
Roadside Assistance Calls Could Haunt You Down the Road
Some insurance companies take your calls for roadside assistance into consideration when determining your insurability, so whether your insurance company is reevaluating your premiums or you’re purchasing auto insurance from another carrier, you might find the agent is looking at your roadside assistance calls as he or she determines your coverage eligibility and premiums.
If you purchase roadside assistance through an automobile club, chances are you won’t have to worry about how your calls might affect your insurance coverage and premiums because you’re doing business with a third-party company.
Before making a decision, talk with your insurance agent about the cost of your company’s roadside assistance coverage, how using the coverage might affect your premiums, and whether the company takes your roadside assistance calls into consideration when determining your insurability. In the end, choosing to purchase roadside assistance from an automobile club rather than from your insurance company might better suit both your budget and service needs.
Article courtesy of Best Roadside Service.
Purpose Driven Tours — founded by Wayne and Corrine Barber in 2006 — is a one-of-a-kind tour ministry that reveals God at work through biblical creation and our Christian heritage. These tours aren’t just for adults; they’re for everyone: singles, married couples, and families who want to enjoy touring America while growing and strengthening their faith.
Our exceptional Christian guides present fascinating, in-depth information that’s been missing from textbooks and public markers for more than 50 years. In fact, we call these lost pieces of history “Stolen Treasures.” We visit places like the Grand Canyon, Yosemite, Mt. St. Helens, Washington D.C., Plymouth, Gettysburg, Boston, and Philadelphia to discover truths about creation science, the faith of our founding fathers, and the stories behind our national landmarks. Purpose Driven Tours has also visited Moody Bible Church, Brooklyn Tabernacle, Shadow Mountain Church, Coral Ridge Presbyterian Church, Parkside Church in Cleveland, and other churches impacting our world for Christ.
Traveling on a luxury coach with wireless sound, passengers can choose from a variety of Christian teaching, music, movies, and comedies. Tours are all inclusive, so all meals, hotels, admissions, tips, and travel insurance are covered. Guests stay in top-rated hotels and eat hearty meals in excellent restaurants, earning Purpose Driven Tours outstanding reviews from travelers such as Dr. Bernard Taylor, who said, “Every aspect of our New England Tour from the wonderful food, outstanding lodging, comfortable bus, and much appreciated Christian atmosphere was a royal experience. We highly recommend Purpose Driven Tours and give the company a five-star rating.”
Best Roadside Service is an American owned and operated company that began with the vision of providing customers with the best emergency roadside assistance plans available at competitive prices. Our core values have always focused on offering the best customer service standards in the industry.
Our service administrator* has been in business for over 50 years, since 1962, servicing the needs of over 15 million customers, so you can count on our stability, professionalism, and reliability 24 hours a day, 365 days a year. They handle over 70,000 calls a month and help over 1 million members each and every month!
Our model has been to keep things simple by offering comprehensive roadside service plans for consumers with our vehicle and individual plans, and for businesses with our commercial and fleet packages. What you won’t find are distracting services that don’t provide any value to our members.
Simply put, Best Roadside Service’s mission statement is to serve our members by providing the peace of mind and security that comes from having the best emergency roadside assistance policy, administered and provided by an American owned and operated company with conservative values and beliefs.
We cover individuals, a variety of vehicles including motorcycles and scooters, and commercial/fleet vehicles. Our services cover any passenger vehicle with the exception of class 5-8 vehicles and large buses.
Our Service Works Everywhere!
Our service works in any location throughout the United States and Canada. If you live in any of the 50 states or 10 Canadian provinces, you can take advantage of our membership programs and benefits. We have one of the largest databases of qualified service providers – 45,000 and growing – who have been pre-screened in all areas of the U.S. and Canada. With Best Roadside Service, help is always nearby and just a phone call away.
Fast Response Time
Our nationwide average response time is 34 minutes. This is made possible by the technology of our dispatch systems and by our well-trained service representatives. This is an average nationwide response time for our services. Actual response time can fluctuate based on weather, time of day, and year, as well as by proximity to highly populated areas.
Your satisfaction is important to us, so we focus on providing you with the best service possible.
• All customer service professionals have a minimum of three years of experience.
• We support English, Spanish, and French speaking members.
• Our services are available 24 hours a day, 365 days a year.
Included Services and Benefits
We offer some of the best services in the roadside assistance industry including:
• Towing – up to 75 miles per service call
• Lockout and lost key services
• Flat tire services
• Fuel delivery
• Dead battery services
• Trip and routing services
• Personal assistance
• Travel arrangement services
• Full VIP concierge services
• and more…
Why Choose Us?
Flexible Plans – Our emergency roadside assistance plans are flexible to meet your needs! Plans may cover either an individual and follow them regardless of the vehicle they are in, even if they are not the driver, or they can cover a specific vehicle or vehicles no matter who is driving. Our goal is to help make sure you and your loved ones are covered in the event of a roadside breakdown or emergency.
Affordable Coverage – Our plans are also affordable, while still providing you with the premium service you normally find on the most expensive roadside assistance plans. In addition, you’ll get the $5 a month discount just for being a
CAP member. All of our plans at Best Roadside Service include access to our VIP member benefits, including travel and cruise discounts, automotive discounts and trip planning services.
Fast Response Time – The technology of our dispatch system and our well-trained service representatives mean we’re able to get help routed to you quickly and consistently. With our nationwide average response time of 34 minutes, you can rest easy knowing in the event of a vehicle disablement, our goal is to get you back on the road as quickly as possible.
*All 24-Hour Roadside Assistance Services and Benefits are administered through Nation Motor Club, Inc.
Administrative offices at 800 Yamato Road, Suite 100, Boca Raton, FL 33431. For Arizona, Arkansas, Hawaii, Louisiana, Massachusetts, Nevada, Tennessee, Texas and Washington members, services are provided by Nation Motor Club, Inc. dba Nation Safe Drivers. For California members, services are provided by Nation Motor Club, Inc. | California Motor Club Permit Number 5157-3