Federal Ruling on Health Insurance

A federal appeals court recently ruled that Congress does not have the authority to require individuals to purchase health insurance, which essentially throws out a key provision of the health care reform law.

The three-judge panel of the 11th Circuit Court of Appeals in Atlanta ruled 2-1 that the individual mandate is unconstitutional.

“The individual mandate exceeds Congress’ enumerated commerce power and is unconstitutional,” wrote Judge Joel Dubina. “This economic mandate represents a wholly novel and potentially unbounded assertion of congressional authority: the ability to compel Americans to purchase an expensive health insurance product they have elected not to buy, and to make them re-purchase that insurance product every month for their entire lives.”

Judge Frank Hull, an appointee of former Democratic President Bill Clinton, backed Judge Dubina, an appointee of former Republican President George W.H. Bush. Judge Stanley Marcus, also a Clinton appointee, said Congress does have the authority to require individuals to obtain insurance.

“Congress rationally found that the individual mandate would address the powerful economic problems associated with cost shifting from the uninsured to the insured and to health care providers, and with the inability of millions of uninsured individuals to obtain health insurance,” Judge Marcus wrote. “Thus, to the extent the plaintiffs’ individual liberty concerns are rooted in the Fifth Amendment’s Due Process Clause, they must fail.”

The lawsuit was originally filed in Florida by 26 states, where a federal judge ruled against the individual mandate and struck down the law in its entirety.

The 11th Circuit ruling conflicts with a Cincinnati appeals court ruling that found the coverage requirement to be within the authority of Congress. An additional federal appeals court in Richmond is also deciding on the same issue.

Posted in Health Care Reform, Health Insurance |

The Financial Benefits of Life Insurance

If someone in your family will suffer financially when you die, you more than likely need life insurance. Life insurance provides money to your family after your death. This money — known as the death benefit — replaces your income and can help your loved ones meet many important financial needs, such as funeral costs, daily living expenses, paying off loans and other debts, and college tuition. More importantly, there is no federal income tax charged on life insurance benefits.

To determine if you need life insurance, think through this worst-case scenario: If you died tomorrow, how would your spouse and children fare financially? Would they have the money to pay for your final expenses, including funeral costs, medical bills, taxes, credit-card debts, and attorney fees? Would they be able to meet ongoing living expenses, such as the monthly home mortgage or rent, food, clothing, transportation costs, and healthcare? What about long-range financial goals?

Without your contribution to the household, would your surviving spouse be able to save enough money to put the kids through college or retire comfortably? It’s always a struggle when you lose someone you love, but your emotional ordeal does not need to be compounded by financial difficulties.

Life insurance helps make sure that the people you care about will be provided for financially, even if you’re not there to care for them anymore. To help you understand how life insurance might apply to your particular situation, contact a local professional who can sit down and explain the various options. Whether you’re young or old, married or single, with or without children, you need to make the time to consider how life insurance might fit into your financial plans.

Posted in Life Insurance |

Medicare Advantage and Medigap – What’s the Difference?

Medigap is just a nickname for private insurance that supplements existing Toledo, Ohio Medicare users. Medigap’s formal name is Medicare Supplemental Insurance. While Medicare Advantage plans and Medigap plans are both commonly referred to as supplemental insurance plans, Medigap is the only true Ohio supplemental health insurance.

Medigap (Medicare Supplemental Insurance)

Medigap is NOT run by the government. It is sold by private insurance companies to those enrolled in Toledo, Ohio Medicare to help take care of any costs left over by your Medicare health coverage. Continue reading

Posted in Health Insurance, Medicare |

How to Choose a Toledo Health Insurance Provider

Choosing a Health Care ProviderHave you chosen Toledo health insurance coverage before? No? Then this article is for you.

Choosing a Toledo health insurance plan can be confusing and frustrating for the uninitiated. No cookie-cutter plan exists that will be perfect for everyone. There are lots of different options and each insurance plan has its own pro’s and con’s. Decisions must be made based on income, convenience, location (Toledo, Sylvania, Maumee, Perrysburg, etc.) preference, and other things. Let’s take a look at the different insurance plans available.

Traditional Health Insurance

In the beginning, the dominating health insurance plan was traditional, or indemnity, insurance. In this type of insurance you may choose any doctor, health provider, or hospital for the care you need and your insurance company will foot the bill. Once you have paid the plan’s yearly deductible, the insurance company will begin to cover your expenses.

In the Toledo area and abroad, health insurance costs are climbing rapidly. Managed Toledo Health Insurance Plans have been created to provide health care for less cost to the patient.

Managed Toledo Health Insurance Plans

Health Maintenance Organization (HMO)

HMO’s are very controlled. This means, while you can choose your doctor, hospital, etc., you must choose one endorsed by the HMO. If you choose a physician working outside the HMO, your expenses will not be covered by your health insurance company. Continue reading

Posted in Health Insurance |

Health Care Reform Timeline

National Association of Health Underwriters

Timeline of Health Insurance Reforms that Will Impact Private Health Insurance Coverage under H.R. 3590, the Patient Protection and Affordable Care Act and the Health Care and Education Affordability Reconciliation Act of 2010

January 13, 2011

Grandfathered Health Plans

Individuals and employer group plans that wish to keep their current policy on a grandfathered basis would only be able to do so if the only plan changes made were to add   or delete new employees and any new dependents. In addition, an exception is made for employers that have scheduled plan changes as a result of a collective bargaining agreement. Even if a plan is grandfathered, some of the new market reform provisions will still be applicable including many that take effect within six months. These are noted by provision elsewhere in this summary.

Effective Date: Immediately. Grandfathered status is available for plans in effect on date of enactment.

Small Employer Tax Credits

Makes available tax credits for qualified small employer contributions to purchase coverage for employees. In order to qualify, the business must have no more than 25 full-time equivalent employees, pay average annual wages of less than $50,000 and provide qualifying coverage. The full amount of the credit will be available to employers with 10 or fewer employees and average annual wages of less than $25,000, and will phase out when those thresholds are exceeded. The average wage threshold for determining the phase-out of credits will be adjusted for inflation after 2013. Small employers will receive a maximum credit of up to 50% of premiums for up to 2 years if the employer contributes at least 50% of the total premium cost. The credit would phase out entirely for employers of more than 25 employees whose average annual salaries exceeded $50,000. Continue reading

Posted in Health Care Reform |