The American Recovery and Reinvestment Tax Act of 2009 was signed into law on February 17, 2009. This law dramatically affects employers whose group health plans are subject to COBRA, which includes virtually all employers with 20 or more employees. However, the Act also impacts those plans which provide continuation coverage pursuant to Maryland state law to employers with less than 20 employees when that continuation coverage is deemed to be comparable to COBRA. Furthermore, the Act provides a 65% government subsidy to employees who are involuntarily terminated between September 1, 2008 and December 31, 2009.
Saturday, April 18, 2009
COBRA subsidy under American Recovery and Reinvestment Act of 2009
The American Recovery and Reinvestment Tax Act of 2009 was signed into law on February 17, 2009. This law dramatically affects employers whose group health plans are subject to COBRA, which includes virtually all employers with 20 or more employees. However, the Act also impacts those plans which provide continuation coverage pursuant to Maryland state law to employers with less than 20 employees when that continuation coverage is deemed to be comparable to COBRA. Furthermore, the Act provides a 65% government subsidy to employees who are involuntarily terminated between September 1, 2008 and December 31, 2009.
Friday, July 4, 2008
HSA (Health Savings Account) Basics
HSA Basics ( tri-fold brochure)for use in 2008(Can be reproduced, distributed and displayed freely)
http://www.treas.gov/offices/public-affairs/hsa/pdf/HSA-Tri-fold-english-07.pdf
http://www.treas.gov/offices/public-affairs/hsa/pdf/HSA-Tri-fold-english-07.pdf
Maryland's Health Coverage Update
WORKING FAMILIES & SMALL BUSINESS HEALTH COVERAGE ACT
http://mhcc.maryland.gov/partnership/Index.aspx
Over 100,000 Uninsured Marylanders Will Now Be Covered
SMALL BUSINESS BENEFITS
Create new small business benefit designs
*Develop “wellness benefit designs” that encourages wellness and prevention
*Available to all small businesses in the state
*Provide employees with either financial incentives or reduced cost sharing in return for active *efforts to improve their health and manage chronic disease
Assist very small low wage firms to offer insurance
To be eligible for a subsidy to purchase insurance, the employer must be:
*A very small firms (2-9 full time employees)
*Have average wages below about $50K
*Have not offered insurance to their employees in the previous 12 months
*Willing to offer health insurance benefits that include the wellness benefit design and Section 125 premium-only plan so that the employee’s contribution to premium is excluded from income and not taxed
Benefits
*Maximum premium subsidy for each low wage employee will be the lower of $2000 or 50% of the premium
*Subsidy will be divided between the employer and the employee based on the contribution each makes toward the premium
Enrollment is capped to stay within a budget of $30 million
Over 15,000 covered
WORKING FAMILIES
Expand Medicaid Coverage for very poor adults
Year 1: Expand coverage to parents with family incomes up to 116% FPL ($20K/family 3)
Year 2-3: Expand services to Primary Adult Care program – childless adults under 116% FPL ($12K for individual)
Year 4: Full Medicaid coverage for all poor adults to 116% FPL
Over 92,000 covered when fully implemented
Responsible Financing
Pay as you go: The full phase-in of the expansion is tied to the availability of funds. Medicaid enrollment of childless adults may be capped or benefits may be limited to stay within budget
More efficient financing:
*Maryland payers already finance over $800 million in hospital uncompensated care annually
*Expand insurance coverage and lower hospital uncompensated care.
*Some of these savings will be used to expand insurance coverage in future years and some will lower hospital rates
*The majority of funding for the expansion will be generated by savings in hospital uncompensated care and federal matching funds
Maximize use of existing resources: The Working Families and Small Business Coverage Act transfers $75 million from the Maryland Health Insurance Plan to fund the expansions
OTHER HEALTH CARE REFORM INITIATIVES
Improve Quality & Contain Cost
Created Maryland Health Care Quality and Cost Council chaired by Lieutenant Governor Anthony Brown to:
*Coordinate and facilitate collaboration on health care quality improvement and cost containment initiatives
*Make recommendations on health care quality and cost containment initiatives and priorities to policy makers, state and local governmental entities, professional boards, the Maryland Patient Safety Center, industry groups, consumers and other stakeholders
*Develop a chronic care management plan to improve the quality and cost effectiveness of care for individuals with, or at risk for, chronic disease.
Facilitate the integration of health information technology in health care systems
*Examine and make recommendations regarding other issues relating generally to the Council’s mission to improve health care quality and reduce costs
Accelerate adoption of Health Information Technology by:
*MHCC Request for Applications on Citizen-Centric Health Information Exchange for Maryland to provide funding for planning projects related to a statewide health information exchange
*Funding to build best design for health information exchange with $10 million in funds through Maryland’s All-Payer System
*Charge Access and Reimbursement Task Force to examine payment incentives for provider adoption of information technology
Wednesday, March 7, 2007
Health Insurance History Tidbits
● The concept of Health Insurance was proposed in 1694 by Hugh the Elder Chamberlen from the Peter Chamberlen family (famous as they discovered the modern use of obstetrical forceps. It remained a family secret for over a century)
Hugh the Elder published he advocated the introduction of a health insurance scheme for the rich as well as the poor. For a small yearly sum the insured would be attended by approved skillful physicians and surgeons, furnished with the necessary medicines for all diseases, except the pox, midwifery, and the stone, for which a supplementary charge would be made. Another 254 years were to pass before the National Health Service was introduced in the UK in 1948.
(National Insurance Act in 1911, a small amount was deducted from weekly wages, to which was added contributions from the employer and the government. In return for the record of contributions, the workman was entitled to medical care, though not necessarily to the drugs prescribed. To obtain medical care, he registered with a doctor. Each doctor who participated in the scheme thus had a 'panel' of those insured under the system, and was paid a capitation grant out of the fund calculated upon the number.) This is much like the HMO system we know today!
Before 1948 patients were generally required to pay for their health care. Free treatment was sometimes available from teaching hospitals and charities hospitals, such as the Royal Free Hospital. Some local authorities operated local hospitals for local ratepayers, (under a system originating with the Poor Law), but provision was patchy and quality of care varied greatly..
(In the late 19th century, early health insurance was actually disability insurance, in the sense that it covered only the cost of emergency care for injuries that could lead to a disability)
● Modern Health Insurance really began with Germany, under Chancellor Bismarck, with 2 insurance laws put into effect in 1883. He enacted a variety of paternalistic social reforms, which can be considered the first European labor laws. The Health Insurance Act of 1883 entitled workers to health insurance; the worker paid two-thirds, and the employer one-third, of the premiums. Accident insurance was provided in 1884, whilst old age pensions and disability insurance in 1889.
●In America Prior to the 20th century there had been little consideration given to the health insurance issue, as medical care was a relatively unimportant economic activity. Health care was not perceived as a major industry, and most of the care of the sick was not part of the market economy, but, rather, was taken care of at home or through charity services at almshouses. Throughout most of the 19th century, the lack of transportation and communication capabilities made health care a household.
There eventually was a shift from the home to the doctors’ office and by the turn of the 20th century to the hospital setting. With each shift in location the cost of health care increased for the individual.
The typical physician in 1913 averaged only $500 to $700/year, which little more than the income was made by members of the American manual laboring classes.
● The Gilded Age, 1875-95, it was widely believed that the federal government had no direct responsibility for the welfare of the individual in society.
● The Progressive Movement, 1895‑1920, was a multi-faceted attempt to have private charity and the federal government cooperate in reforming American society and promoting the individuals betterment. The push for this mandatory health insurance came from the American Association of Labor Legislation, a private organization. However, this attempt at social reform was hampered by WWI as well as the growing economic success of physicians, who no longer needed to look to health insurance as their major source of income. Then came the Great Depression.
● The Blue Cross concept was created in 1929 by a pioneering businessman, Justin Ford Kimball. He offered a way for 1,300 school teachers in Dallas to finance 21 days of hospital care by making small monthly payments to the Baylor University Hospital.
● The Blue Shield concept around the same time was growing out of the lumber and mining camps of the Pacific Northwest. Serious injuries and chronic illness were common among workers in these hazardous jobs. Employers who wanted to provide medical care for their workers made arrangements with physicians who were paid a monthly fee for their services.
Enrollment in Blue companies grew from more than 1,000 in 1929 to 3 million in 1939. By 2006, Blue companies covered more than 94 million Americans. Through the years, the Plans have developed private and public partnerships.
The Blue Cross and Blue Shield Association is the trade association for the independent, locally operated Blue Cross and Blue Shield companies.
The BlueCard Program
Enables members to obtain healthcare services while traveling or living in another Plan's service area, receiving the same benefits provided by their home Plan. The program provides a single electronic network for claims processing and reimbursement among Plans.
resources:
HISTORY OF AMERICAN HEALTH INSURANCE by Jonathon Erlen
Wikipedia, the free encyclopedia
Blue Cross Blue Shield Association http://bcbs.com/about/search.jsp?query=history
Hugh the Elder published he advocated the introduction of a health insurance scheme for the rich as well as the poor. For a small yearly sum the insured would be attended by approved skillful physicians and surgeons, furnished with the necessary medicines for all diseases, except the pox, midwifery, and the stone, for which a supplementary charge would be made. Another 254 years were to pass before the National Health Service was introduced in the UK in 1948.
(National Insurance Act in 1911, a small amount was deducted from weekly wages, to which was added contributions from the employer and the government. In return for the record of contributions, the workman was entitled to medical care, though not necessarily to the drugs prescribed. To obtain medical care, he registered with a doctor. Each doctor who participated in the scheme thus had a 'panel' of those insured under the system, and was paid a capitation grant out of the fund calculated upon the number.) This is much like the HMO system we know today!
Before 1948 patients were generally required to pay for their health care. Free treatment was sometimes available from teaching hospitals and charities hospitals, such as the Royal Free Hospital. Some local authorities operated local hospitals for local ratepayers, (under a system originating with the Poor Law), but provision was patchy and quality of care varied greatly..
(In the late 19th century, early health insurance was actually disability insurance, in the sense that it covered only the cost of emergency care for injuries that could lead to a disability)
● Modern Health Insurance really began with Germany, under Chancellor Bismarck, with 2 insurance laws put into effect in 1883. He enacted a variety of paternalistic social reforms, which can be considered the first European labor laws. The Health Insurance Act of 1883 entitled workers to health insurance; the worker paid two-thirds, and the employer one-third, of the premiums. Accident insurance was provided in 1884, whilst old age pensions and disability insurance in 1889.
●In America Prior to the 20th century there had been little consideration given to the health insurance issue, as medical care was a relatively unimportant economic activity. Health care was not perceived as a major industry, and most of the care of the sick was not part of the market economy, but, rather, was taken care of at home or through charity services at almshouses. Throughout most of the 19th century, the lack of transportation and communication capabilities made health care a household.
There eventually was a shift from the home to the doctors’ office and by the turn of the 20th century to the hospital setting. With each shift in location the cost of health care increased for the individual.
The typical physician in 1913 averaged only $500 to $700/year, which little more than the income was made by members of the American manual laboring classes.
● The Gilded Age, 1875-95, it was widely believed that the federal government had no direct responsibility for the welfare of the individual in society.
● The Progressive Movement, 1895‑1920, was a multi-faceted attempt to have private charity and the federal government cooperate in reforming American society and promoting the individuals betterment. The push for this mandatory health insurance came from the American Association of Labor Legislation, a private organization. However, this attempt at social reform was hampered by WWI as well as the growing economic success of physicians, who no longer needed to look to health insurance as their major source of income. Then came the Great Depression.
● The Blue Cross concept was created in 1929 by a pioneering businessman, Justin Ford Kimball. He offered a way for 1,300 school teachers in Dallas to finance 21 days of hospital care by making small monthly payments to the Baylor University Hospital.
● The Blue Shield concept around the same time was growing out of the lumber and mining camps of the Pacific Northwest. Serious injuries and chronic illness were common among workers in these hazardous jobs. Employers who wanted to provide medical care for their workers made arrangements with physicians who were paid a monthly fee for their services.
Enrollment in Blue companies grew from more than 1,000 in 1929 to 3 million in 1939. By 2006, Blue companies covered more than 94 million Americans. Through the years, the Plans have developed private and public partnerships.
The Blue Cross and Blue Shield Association is the trade association for the independent, locally operated Blue Cross and Blue Shield companies.
The BlueCard Program
Enables members to obtain healthcare services while traveling or living in another Plan's service area, receiving the same benefits provided by their home Plan. The program provides a single electronic network for claims processing and reimbursement among Plans.
resources:
HISTORY OF AMERICAN HEALTH INSURANCE by Jonathon Erlen
Wikipedia, the free encyclopedia
Blue Cross Blue Shield Association http://bcbs.com/about/search.jsp?query=history
Monday, January 22, 2007
Self Employed or Business Owner?
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