Posts Tagged ‘ Insurance

Health Insurance in CA For The Self-employed

Is health insurance a boon or a bane? It is a question on which people can argue till the cows come home and still not be any wiser.

At one end of the spectrum are the people, whose lives have been saved by different types of medical insurances, including California Individual Health Insurance, which made personally unaffordable medical treatment available to them. At the other end of the spectrum are people who have paid through their nose for medical coverage but were refused it because the insurance company decreed it that their condition was a ‘pre-existing’ one. Hanging in the middle are the myriad uninsured people who have no health insurance in CA or anywhere else.

The uninsured people, from the state of California, are likely to be in need of California Individual Health Insurance. Those who need individual health insurance in CA are mainly those who are not covered under any group insurance because they are either not working, or are self-employed. Insurance providers are often apprehensive of providing California Individual Health Insurance to self-employed people, as the companies are doubtful about their credit worthiness and ability to pay the premium on time.

Health insurance in CA may become available to a self-employed if his or her spouse is covered under a group health insurance plan provided by the spouse’s employer. Many group health insurance in CA automatically cover the spouse also. Sometimes an individual may leave an employer and start self-employment on his own. In that case he has the right to extend up to 18 months, the employer-sponsored group health insurance in CA under which he was covered. This will give him time to make alternate arrangement for his California Individual Health Insurance. However, during this time he has to pay the premium of the insurance himself.

After the 18-month period when he will lose the benefit of keeping the group health insurance in CA, he can buy a California Individual Health Insurance from any one of the myriad insurance companies that offer California Individual Health Insurance. A little searching around and comparing quotes will be necessary to select the right one, but it should not be difficult considering the number of sites that offer a whole range of covers available for the area where you are stationed. The snag in shifting out of the employer-sponsored health insurance in CA to a private California Individual Health Insurance is that the latter is unlikely to cover any pre-existing condition. As long as the person is within the protective arms of the former, he gets coverage for his pre-existing medical problems also.

Besides the self-employed, those who seek California Individual Health Insurance are those who find their employer-sponsored group coverage insufficient, or those who need additional health insurance in CA for their family members.

Hefty Health Insurance Request Shocks Hernando County School Officials

As President Barack Obama prepared to take to the airwaves to defend his health care overhaul last week, Hernando school officials got a little insurance sticker shock of their own.

The district’s insurance carrier, Blue Cross Blue Shield of Florida, is seeking a 21.5 percent rate increase.

“We expected increases in health insurance, but you don’t really expect 21 percent increases,” said Heather Martin, the district’s executive director of business services. “It’s very disappointing in these economic times.”

The actual increase will likely come in at least a few percentage points below that, Martin said. Last year, for example, Blue Cross started with an 18 percent increase. By tweaking plans and raising deductibles and co-pays, the two sides brought that down to 12 percent.

Martin said she’s hopeful this year’s increase will be closer to 15 percent and that the district’s insurance committee — composed of staffers and members of both unions — had made progress toward that number during talks with Blue Cross on Wednesday.

Blue Cross declined to comment beyond a written statement issued through spokesman Mark Wright.
“The specifics of our negotiations with any client are confidential. However, I can say that for groups such as this, projected claims experience for the upcoming plan year is the determining factor for premium rate calculations.”

In other words, the company uses the district’s claims history and estimates for what next year’s claims will be to justify the rate increase.

The district’s history isn’t exactly pretty, Martin acknowledged.

Claims have been “relatively high” in recent years, she said. Last year, Blue Cross paid more than $14 million in claims.

“We are not an extremely healthy district,” Martin said. “We have not improved it.”
Martin noted, though, that the district is “punished” for the lack of urgent care facilities in the county. That forces employees to go to hospital emergency rooms, an expensive way to get urgent care that drives up the district’s clams, she said.

The School Board has agreed in past years to have the district absorb most or all of insurance premium increases and should try to do the same again this year, said board member Sandra Nicholson.

“If there’s any possibility of us being able to eat the increase, I think we probably will,” Nicholson said.

That could be a tall order, considering this year’s proposed budget has only $1 million in reserves that aren’t set aside for some purpose.

But it would help employees who have seen out-of-pocket costs rise, said Colin Davies, president of the Hernando United School Workers.

Davies said some employees have decided to go without insurance because they can no longer afford it, and he predicted that number could rise.

“You choose whether to eat or have insurance,” Davies said.

The unions accepted smaller pay raises last year in exchange for the district covering more insurance premium costs. Insurance will likely dominate negotiations again this year, said Joe Vitalo, president of the Hernando Classroom Teachers Association.

Vitalo expressed the kind of sentiment voiced by many Americans and that Obama says is motivating him to get health care reform done sooner rather than later.

“It’s probably the most legalized form of extortion there is,” Vitalo said.

Saving Money With Health Insurance

Everyone likes to save money and your health insurance is a place where you can find savings. The easiest way to save money with health insurance is to only insure yourself for large, catastrophic medical problems or to increase your deductible in order to decrease your monthly premium. Both of these choices might not be the best health insurance option for everyone because each will increase your out-of-pocket medical expenses for everyday medical care and preventative examinations.

There are a number of tips to keep in mind beyond increasing your out-of-pocket expenses to minimize your health insurance costs while receiving the health insurance coverage you and your family needs.

Here are six things to consider for saving money through your health insurance:

1) If you are part of a health insurance plan such as a POS (point-of-service) or PPO (preferred provider organization), make sure you only use doctors and medical services that are in-network for your plan.

2) Take every tax deduction offered on health insurance. For the self-employed this means deducting all your health insurance premiums, and for participants in employer-based plans deducting the portion you pay of your health insurance premiums. And medical and dental expenses you incur that your insurance doesn’t cover that exceed 7.5 percent of your adjusted gross income (AGI) can be deducted as well.

3) When you are comparing health insurance quotes take a look at the long-term implications of your plan. Lower health insurance premiums and up-front costs will mean more out-of-pocket expenses and possibly much higher medical costs over the long run. Consider how you expect to use your health insurance and factor all the costs when comparing health insurance quotes.

4) Don’t make visits to the emergency room unless you are experiencing an actual medical emergency. The co-pay will likely be very much higher than for a regular office visit.

5) If possible participate in employer- or other organization-based group health insurance. The rates and qualification requirements are typically lower. If you are part of a employer-based group health insurance plan have your employer pay the premium on a pre-tax basis to lower your overall taxable gross pay. Another way to reduce your taxable income is to participate in your employer’s flexible spending plan to save money for out-of-pocket health insurance expenses such as co-pays, some medications and certain medical devices.

6) Save money on health insurance prescription medication by using online pharmacies. Traditional pharmacies will typically dispense only a 30-day supply of medicine while online pharmacies will allow for 90-day supplies for the same co-pay.