Individual Health Insurance for the Young

Health Care Reform has had a chilling effect on the individual health insurance market. Anthem,

Healthnet and Aetna no longer offer individual health insurance policies for children under the age of 18 years. Individual policies for children can be purchased only when they are listed as a dependent on a policy of an individual over 19 years of age. Our agency , located on Costa Mesa, California is also concerned that all the insurance companies offering individual health plans have reduced their plans offered by 50 %. We think market based solutions, not federal mandated are the way to get affordable health insurance to consumers.

Saving on health insurance premiums

Many plans offered at significant premium savings have one thing in common. Generic prescriptions only or no drug card included on the plan. Our agency has noticed that one of the great drivers of the increasing cost of health insurance premiums is prescription drug cost. While no one can argue with the efficacy of brand drugs, most consumers have been slow to adopt more cost effective generic drug alternatives. Target pharmacy located on Harbor Blvd in Costa Mesa, CA. has a list of hundreds of generic drugs at $4.00/30 day supply. Less expensive than many co-pays on group insurance plans.

Common sense procedures

An article in Risk and Insurance Magazine, An Infectious Condition talks about Health Care organizations risk management strategies to avoid lawsuits over care. One of the areas discussed is the liability resulting from MRSA bacterial infections sustained by patients in post operative care. 85% of all MRSA infections have been attributed to invasive procedures in hospitals. Our Agency is involved in providing benefits for many businesses in Costa Mesa, CA and was surprised to learn form the article that the number one MRSA prevention instituted by hospitals was hand washing. So if you are hospitalized at Hoag Hospital, St Josephs or Fountain Valley make sure you insist that all care givers wash their hands when they enter your room.

California Insurance exchange

The legislature has approved two bills that would establish a statewide health insurance exchange to comply with the federal health care reform law. One bill would set up the state's insurance exchange to help consumers compare information about insurers before choosing a health plan. Insurance carriers are concerned that provisions may have serious impacts on consumer choice. Our agency is concerned that federal mandates will limit choice and force some insurance companies out of the health insurance marketplace in Costa Mesa, California and Newport beach, California

Tax Credit for Group Insurance premiums

Small business owners may be eligible for tax credit on group insurance premiums for their employees. According the IRS website the following eligibility rules apply:

Eligibility Rules

Provide 50% of the cost of the single rate for employees
Must have 25 or fewer employees
Average wage must be below $50,000

Amount of Credit

Up to 35% of premium cost

Orange County businesses can contact our Agency located in Costa Mesa, California for more details about this tax credit.

Anthem Blue Cross has published a free booklet with more information on managing health care costs.

COBRA subsidy lost in jobs bill

The new legislation that passed Congress extending unemployment did not extend the 65% COBRA subsidy for workers who lost their jobs after June 1st 2010. Our agency
has been kept busy trying to keep up with Federal COBRA
laws that have changed multiple times in the last 18 months.

Great Tax Break for Small Business Group Insurance

The Gelker and Rohrer Insurance Agency has learned that in 2010 small businesses can get a tax credit of up to 35% of the premium of a small group health plan. This is a tax credit, not a tax deduction and that makes this a great deal. If you have a business and do not have a group insurance plan contact our agency for a quote. With a tax credit of up to 35%, the net cost to you could be substantially less than your current coverage.The Gelker and Rohrer Insurance agency is not a tax expert and we recommend you contact your tax adviser to see if your business qualifies. See IRS eligibility rules below or follow this link to the IRS sight for more information.

http://www.irs.gov/newsroom/article/0,,id=220809,00.html

Eligibility Rules

• Providing health care coverage. A qualifying employer must cover at least 50 percent of the cost of health care coverage for some of its workers based on the single rate.
• Firm size. A qualifying employer must have less than the equivalent of 25 full-time workers (for example, an employer with fewer than 50 half-time workers may be eligible).
• Average annual wage. A qualifying employer must pay average annual wages below $50,000.
• Both taxable (for profit) and tax-exempt firms qualify.

Amount of Credit

• Maximum Amount. The credit is worth up to 35 percent of a small business' premium costs in 2010. On Jan. 1, 2014, this rate increases to 50 percent (35 percent for tax-exempt employers).
• Phase-out. The credit phases out gradually for firms with average wages between $25,000 and $50,000 and for firms with the equivalent of between 10 and 25 full-time workers.

Three Simple Steps for Employers to Qualify

To determine if your small business or tax exempt organization qualifies for the Small Business Health Care Tax Credit, follow the three simple steps on our fact sheet.

OBAMACARE - What You Can Expect For 2010

After hours of webinars with our insurance associations the Gelker and Rohrer Insurance Agency has learned what to expect in 2010 from the Obamacare health care reform legislation.
For individuals- Temporary high risk pools for persons unable to get health insurance through the normal carrier underwriting process, dependents covered up to age 26 as a dependent, coverage for pre-existing conditions for children under 19 years of age (Even if married.), coverage for specific preventive care services and in network coverage of emergency services regardless of provider.For Group Insurance- No lifetime dollar benefits limitation, coverage for dependents up to age 26 (Even if married.), No pre-existing conditions limitations on children age 19 and under, coverage for specific preventive care services and in network coverage of emergency services regardless of provider. You can contact us at our Costa Mesa, California office if you have any questions about the Obamacare health care reform legislation.

Health Care Reform- Real Health Care Savngs

Great Article that the Gelker and Rohrer Insurance Agency agrees with.

• By Marty Trussell

While the folks in Washington talk about how to reform the health care system, many of the nation’s employers and state governments are actually making it happen. They are finding ways not only to control costs, but also to provide better care.

The latest example comes from America’s heartland – Indiana – where five years ago, newly elected Governor Mitch Daniels asked that a consumer-directed health insurance option, or Health Savings Account (HSA), be added to the conventional plans then available to state employees. He thought that the plan may interest a few of the state’s 30,000 employees.

Today the HSA option has proven to be popular with more than just a few. This year, over 70 percent of the state’s workers chose it and with good reason. The employees enrolled in the consumer-driven plan will save more than $8 million in 2010 compared to their co-workers in the old-fashioned preferred provider organization (PPO) alternative. That’s a pretty nice pay increase for workers who have seen their salaries frozen for the last two years.

In addition to saving money on premiums in tough economic times, these Hoosiers are putting lots of cash away in their HSAs – some $30 million or about $2,000 per employee and growing fast.

Most importantly, the state says it is seeing significant changes in behavior, and consequently lower total costs. For example, employees who opted for the HSA are less likely to go to the emergency room, the doctor or be admitted to the hospital, and they are more likely to take generic drugs. Skimping on care, are they? The state says there is no evidence HSA members are more likely to defer needed care or common-sense preventive measures such as routine physicals or mammograms.

Yes, health care reform has already come to Indiana in the form a consumer-directed health plan. It turns out that, when someone is spending their own money, they are indeed far more likely to ask the questions and make rational choices.

Washington might want think about that before it enacts more top-down balloon squeezing.

Source: Mitch Daniels, “Hoosiers and Health Savings Accounts; An Indiana experiment that is reducing costs for the state and its employees,” Wall Street Journal, March 1, 2010.

While the folks in Washington talk about how to reform the health care system, many of the nation’s employers and state governments are actually making it happen. They are finding ways not only to control costs, but also to provide better care.

The latest example comes from America’s heartland – Indiana – where five years ago, newly elected Governor Mitch Daniels asked that a consumer-directed health insurance option, or Health Savings Account (HSA), be added to the conventional plans then available to state employees. He thought that the plan may interest a few of the state’s 30,000 employees.

Today the HSA option has proven to be popular with more than just a few. This year, over 70 percent of the state’s workers chose it and with good reason. The employees enrolled in the consumer-driven plan will save more than $8 million in 2010 compared to their co-workers in the old-fashioned preferred provider organization (PPO) alternative. That’s a pretty nice pay increase for workers who have seen their salaries frozen for the last two years.

In addition to saving money on premiums in tough economic times, these Hoosiers are putting lots of cash away in their HSAs – some $30 million or about $2,000 per employee and growing fast.

Most importantly, the state says it is seeing significant changes in behavior, and consequently lower total costs. For example, employees who opted for the HSA are less likely to go to the emergency room, the doctor or be admitted to the hospital, and they are more likely to take generic drugs. Skimping on care, are they? The state says there is no evidence HSA members are more likely to defer needed care or common-sense preventive measures such as routine physicals or mammograms.

Yes, health care reform has already come to Indiana in the form a consumer-directed health plan. It turns out that, when someone is spending their own money, they are indeed far more likely to ask the questions and make rational choices.

Washington might want think about that before it enacts more top-down balloon squeezing.

Source: Mitch Daniels, “Hoosiers and Health Savings Accounts; An Indiana experiment that is reducing costs for the state and its employees,” Wall Street Journal, March 1, 2010.

First Look at OBAMACARE Reform - OUCH!

After spending on hour on a conference call with hundreds of insurance advisers across the U.S. I was very disappointed with the first look at the opening stages of the OBAMACARE Health Reform legislation enacted last month. The Senate bill does nothing to control the cost of treatment, doctor care or hospitalization, the true drivers of rising health insurance premium. What it will do is mandate certain benefits, raise taxes on small business, increase premiums on the young and create a federal bureaucracy that controls what was once a States area of expertise. The Gelker and Rohrer Insurance Agency will help educate our clients on the best way to navigate this new federal government program and influence the decision making process of the federal government as they try to implement the new legislation.

Cut the Cost Of Health care

While the battle rages in our capitol over Health Care Reform, the Gelker and Rohrer Insurance Agency is helping our clients and employees access good information and quality care options with online tools. An informed consumer can help limit cost and get great care from their providers if they take the time to understand the process and procedures. Generic drugs, preferred providers, common sense, and alternative therapies are just a few of the ideas discussed that can save you a lot of money when accessing health care. At employee meetings our agency takes the time to make everyone aware of simple strategies to help them save money. In health care, knowledge is power.

Save Money on Group Health Insurance - Defined Contribution

Orange County, California employers wanting to budget rising health insurance costs need to look no further than defined contribution. At our annual meetings with business owners the Gelker and Rohrer Insurance Agency provides quotes for multiple plans and carriers. The management decides how much each employee will be provided to purchase benefits. A business in Costa Mesa, CA recently decided that they would give each employee $250.00 a month to pay for health and dental coverage. Our agency provided each employee rates and benefits for five health plans and three dental plans. The employee could decide to buy an inexpensive dental plan and a rich benefit health plan, or no dental plan and the lowest co-pay PPO plan. The employer pays a fixed cost and the employee decides what benefits will fit their needs. This is the beauty of the defined contribution approach to employee benefits.

Cheaper Health Insurance -Tracking claims payments

After paying the appointment co-pay and leaving the doctors office, most consumers forget about the visit and assume all is finished with the claim. At the gelker and Rohrer Insurance Agency we advise our small group insureds located in Orange County, California that registering at the carrier website they are covered by allows them to check the status of all claims they or their family members have incurred. Getting a notice of collections is not the way to learn about a problem with a claim. Our experience has taught us the most of the problems start with poor billing practices at their doctor's office. A good portion of out time at GandR Insurance is spent assisting clients with improperly billed claims. Please call us at our Costa Mesa, California office if we can be of assistance with a claim problem.

Health Insurance reform- Price-Access- quality

At the Gelker and Rohrer Insurance Agency we hold group insurance enrollment meetings for our Orange County small business owners. At the enrollment meetings employees make plan choices, complete enrollment forms and ask questions about the benefits. Every employee wants three things from their health plan: 1. Choice- Doctors and hospitals 2. Quality- Newest treatments-Best Drugs 3. Best (Cheapest) price. Our Agency informs employees that you can get two out of the three things they want, but not all. Quality and choice come at a premium. Less expensive plans reduce benefits and limit choice.

Smart Health Insurance Plans for Younger Consumers

For the 30 year olds, it might be a good time to adjust their thinking when buying health insurance. The conventional wisdom is to purchase the least expensive plan with the richest benefits. At the Gelker and Rohrer Insurance Agency
we advise our young clients to get quotes for High Deductible Health Savings Account (HSA) health plans. The premium savings from a HSA plan over the cost of a typical HMO plan can be put into a special tax- sheltered to pay for expenses below the high deductible. If you're like most of our younger clients, your medical bills are low and a HSA plan can be much more cost effective over a three to five year period when compared to conventional HMO plans. Please contact us for a health plan review to see how an HSA can benefit you.

Exercise and what happened to our beaches

As the principal of the Gelker and Rohrer Insurance Agency my job can get a little stressful and hectic. One of the tried and true recipes for stress relief is regular exercise. A little running, some light weight lifting and core strengthening has helped keep stress at a manageable level for three decades. One of the most enjoyable modes of exercising is a walk at one of my spouse and I's favorite beach, Crystal Cove State Beach. Located in the southern most part of Newport beach, CA it is an unspoiled treasure of the California coast.
Last Sunday we arrived to find the last storm that nearly drown Costa Mesa, California had move most of the sand at Crystal Cove off the beach. Where we walked briskly on packed sand bear the shore break was covered with large rocks or exposed slabs of ancient stone. What happened to the beach?

Picking the right health plan

When choosing a health plan do not overlook the network of doctors and hospitals that is associated with the plan you choose. Some lower cost plans have limited networks that may not allow you to see your current doctor or get treatment at the hospital of your choice. All health insurance carriers in Orange county, California have dedicated websites that you can find out if your doctor or favorite hospital is on their PPO or HMO provider list. In Newport Beach, CA Hoag Memorial Hospital is a provider for
Anthem Blue Cross
Healthnet
United Health Care
and Aetna.
At each carriers website you can research networks by a doctors name or office location. At the Gelker and Rohrer Insurance Agency
we help business owners and their employees search networks for primary and specialty doctors prior to changing health plans to make sure a trusted doctor relationship remains intact.

How to Control Small Business Healthcare Cost

The Gelker and Rohrer Insurance Agency recommends a simple strategy for controlling the rising cost of employee health insurance, Defined Contribution. A small business defines the amount it will pay for employees health benefits in one of two ways ; Paying for the cost of a designated plan or a giving employees a fixed dollar amount to pay for health benefits. Employees know the cost of health care is going up and if given multiple plan choices they are empowered to choose benefits that work for them, and are willing to pay for richer benefits. With proper planning a business can budget health care cost and provide employees with great benefits. A simple benefits review
by the Gelker and Rohrer Insurance Agency will show you how to control health benefits expenses.