About 14% of health insurance plans engage in a practice of overestimating costs to reduce policyholder rebates, according to the paper “Accounting-Based Regulation: Evidence from Health Insurers and the Affordable Care Act,” published in The Accounting Review. Third party commentary in Insurancenewsnet concludes that current controls are ineffective in preventing this practice.
In October 2019 President Trump suspended the entry of immigrants who did not have health insurance. The President’s proclamation restricts entry of immigrant visa applicants who cannot demonstrate that they either will acquire qualifying healthcare coverage within 30 days of entry or have the ability to pay for reasonably foreseeable healthcare expenses. Groups sued and overturned the ruling. On December 31, 2020 an appeals court ruled in favor of the president. Opposing groups now say they are relying on President Biden to quickly overturn the rule.
Other than the immigrants affected by this rule, U.S. residents are not required to have health insurance and about 1 in 7 do not have health coverage.
Freedom Benefits has always been a leading resource in providing assistance with affordable health insurance for immigrants. Whether this is a legal requirement or not, we can help get coverage issued even before entry to the U.S.
Where does your state stand in the process of extending federal unemployment benefits? The situation changes daily but this is the status yesterday 8/20 according to Forbes. States not listed have made no announcement yet. Once approved and paid, the benefit still might not be available for long because of the federal government’s spending approval process.
|State||FEMA Approved||Enhanced Benefit Amount||Benefits Start On|
|Colorado||8/16/2020||TBD||Mid to Late Sept.|
|Indiana||8/19/2020||$300||Mid to Late Sept.|
|Louisiana||8/15/2020||$300||Week of Aug. 24th|
|Utah||8/16/2020||$300||Approx. 3 weeks|
Early this month New Jersey elected to resume the operation of its own health insurance exchange by taking back this role previously handled by the federal government. The state named contractors who will handle programming and customer service for the new state exchange.
Immediately following that announcement the legislature passed a group of related bills signed into law on January 16, 2020. The intent is to stabilize health insurance in New Jersey in the event that federal health insurance law is repealed or scaled back.This article summarizes the new laws.
No maximum benefits – prohibits insurance companies from imposing annual or lifetime spending limits on these. S562
Must include 10 essential health benefits: outpatient care (like visiting a doctor), emergency room services, hospitalization, maternity and newborn care, mental health and substance-addiction disorders, prescription drugs, rehabilitation services and devices, lab work, preventive care and chronic disease management, and pediatric services of all kinds. S562
Applicants with preexisting conditions must be offered covered at no extra charge. S626
Prohibits limited benefit or so-called mini-med insurance as “basic and essential” health benefits plans under individual health benefits plans and other statutes concerning basic health plans in all state markets.
Requires coverage for certain preventive services, like cancer screenings A5507 and expands access to birth control. A5508
The Department of Banking and Insurance may review rate increases of more than 10% for individual and small-business health-benefits plan under S3809
Requires an 85% loss-ratio requirement to large-group health insurance plans S3812 A5504
A child may remain on a parent’s health insurance until age 26. A5501
An adequate open enrollment period will be ensured under the Individual Health Coverage Program 5503
Six states now require residents to have health insurance coverage in 2020 or they may pay an increased state tax penalty. California, Massachusetts, New Jersey, Rhode Island, Vermont and Washington DC have laws similar to the Affordable Care Act health insurance requirement that expired last year. Other states are expected to follow this trend if the federal government does not set a national standard. (At Freedom Benefits we have long advocated that this should be a state-controlled and not federal legal issue).
Most types of insurance including Medicare, Medicaid and employer-sponsored coverage satisfy the coverage requirement. Many exceptions to the penalty are built into the law for people with lower income, where insurance is too expensive, or who otherwise cannot be covered by insurance.
If you live in one of these states and aren’t covered in 2020, the possible penalty is calculated when you file your 2020 tax return in 2021. The penalty is $695 for an adult and half that much for dependent children. Some people with higher incomes have to pay 2.5% of their income. Health insurance generally costs 5% to 10% of income so some people still prefer the less expensive option of paying the penalty.
Freedom Benefits works with individuals to find affordable coverage or find a way to avoid the penalty, including filing the tax return with the proper notations to avoid the extra tax.
A range of new federal regulations open the door for resurgence of small business Health Reimbursement Arrangements (HRAs) for 2020. These low cost, high efficiency health plans have been mostly dormant since the passage of the Affordable Care Act. The new plans offer the potential of lower costs, lower taxes and increased employee satisfaction. But they also bring legal risks and privacy concerns for the employees of small businesses.
HRAs vary from one employer to the next and are highly customizable. That makes it difficult to make blanket statements about their effectiveness in all small business situations. It is best to consider the options and benefits on a case by case basis. Freedom Benefits founder Tony Novak CPA explains more in this short video:
A free no-obligation consultation is available to discuss the options for your business. Please use the chat link on the bottom right corner to request follow-up or click here to schedule a call.
Three major changes in federal law are rocking the boat on small business health plans. This blog posts summarizes the three most significant changes this past year.
CHANGE #1: No more individual mandate penalty in most states.
WHAT IT MEANS: Without a steep tax penalty for not having a specific type of health insurance, some people are free to consider a wider range of options. Some of these options will save money and expand choices.
WHAT FREEDOM BENEFITS IS DOING: Our financial planning conversations with clients include a wider range of options.
CHANGE #2: Expansion of short term health insurance.
WHAT IT MEANS: This adds a simple, fast, cheap coverage option for healthy people who are in life transitions.
WHAT FREEDOM BENEFITS IS DOING: Building relationships with insurance companies that offer these short term medical insurance products, reviewing specific products, expanding online enrollment
CHANGE #3: Health Reimbursement Arrangements may pay for individual insurance.
WHAT IT MEANS: Small employers are no longer persuaded to offer a group health plan. The same advantages or more
WHAT FREEDOM BENEFITS IS DOING: Emphasizing the HRA’s ability to control health costs for the employer, the ability to increase choice and value to the employee and a new tax advantage. For 2020 employee benefit plans, we include an HRA option at no additional cost in all small business benefit plans and all small business clients where we handle payroll processing.
New cost saving options for some small business health plans.
Freedom Benefits completes its state-by-state analysis of non-ACA low cost health plan options. Summary results are now online.
Beginning with the executive order he signed on the first day he took office, president Trump and his administration have taken many actions to dramatically affected the health insurance and care options available to individual consumers. The White House web site recently removed some of the press releases and links to many of the politically sensitive actions but nevertheless they remain a part of the legal and market structure. Endorsements of inexpensive alternative health plans rated by health and age of the applicant and short term health insurance remain promoted on Whitehouse.gov web site. Behind the scenes, health insurance companies rushed to create a wide range of new product offerings and get them approved for sale to the public. These plans offer choice but do not include the protections intended by the 2010 Affordable Care Act. That means that consumers may need more information and education about the range of new health plans on the market today. But that’s not the whole story.
Regulation of health plans rests primarily with state government, not federal government. Every state reacted differently to the federal government’s changes intended to loosen legal requirements and make health insurance options available to consumers. This means that it was important for firms like Freedom Benefits, that follows these legal changes for their impact on consumers, to expand our coverage on current legal events in each state.
Each state has the ability to regulate or restrict health insurance plans issued within its boundaries. States do not have the authority to regulate or restrict health insurance issued in another state or nation that cover individuals who live in or visit their state. As a result, the medical insurance travel industry was born. People who do not qualify for coverage where the live can visit another state and purchase a short term medical insurance policy, for example, that covers them everywhere within the U.S., including their home state where the coverage cannot be purchased. It’s created an odd market scenario!
Freedom Benefits investigated the status of health insurance laws of each of the 50 states and the District of Columbia. The summarized results are included as a news item on “Status of alternative non-ACA health plans” available by clicking on the state page icons on the right sidebar of this page. We do not endorse any product or strategy but support every individual’s right to have access to information and the widest possible range of health insurance and treatment options.
National Health Interview Survey data published last week showed that 16.4 percent of adults living in the South region of the U.S. (defined in this survey as Alabama, Arkansas, Delaware, the District of Columbia, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia and West Virginia) said “there is no place” where they typically received healthcare. In this survey result the people who said they got care at more than one place were counted as having a regular provider.
In contrast, adults in the northeast region (Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island and Vermont) were most likely to say they have a regular primary healthcare provider.
The past week was a crazy period for U.S. health insurance. Consumers are understandably confused. The turmoil resulted in a higher level of user activity for Freedom Benefits, a web-based service that directs online consumers to various health insurance exchanges.
Within a period of just one week – Monday April 25 to Monday April 1 – we saw the executive branch of the federal government make a surprise announcement that it will not support the popular features of the Affordable Care Act in federal court, then the Trump administration’s new alternate small business health plan was defeated in federal court, then the President denounced Obamacare and promoted his party’s health plan that does not exist, then the White House announced that it will not make any more health care push until after the 2020 election. Whew!
The commotion triggered a higher than usual amount of consumer web traffic, calls and emails to the OnlineNavigator service supported by Freedom Benefits. Our focus is to direct consumers and small businesses on the options as they exist under the law now, and deliberately staying away from the confusing news headlines that cause speculation about what options may or may not exist in the future.
Freedom Benefits’ simple strategy of focusing on facts, not opinion, is apparently paying off in this tumultuous and otherwise divisive environment. The number of enrollments in currently available health plan options effective April 1 appears to be at the highest level since the implementation of the Affordable Care Act that began in 2010.
Freedom Benefits was founded by Philadelphia accountant Tony Novak to provide health insurance support to regional construction workers. It grew to a national service by 1999 when Novak joined the Board of the National Association of the Remodeling Industry. Novak believed that by being insurance-licensed and up-to-date on health insurance legal and market issues in all 50 states and DC, consumers would use an online adviser that eventually became the trademarked OnlineNavigator service. Novak was then asked to testify before Congress on Republican Party ideas to modernize healthcare for small businesses under the Bush administration. Most of Freedom Benefits’ business assets were sold to a public company prior to passage of the Affordable Care Act (ACA). After enactment of the ACA, Yahoo Finance and the Better Business Bureau were critical of our fee-based business model and so Freedom Benefits has been mostly dormant since then. Freedom Benefits is not an insurance company, producer, exchange or agency. It has no direct revenue and web site operating expenses are paid by another related business. It is still not clear that a business model that does not collect leads or make sales can be successful. Freedom Benefits’ sole function has been to make referrals – both paid and unpaid – based on specific consumer circumstances. Occasionally that advice is combined with basic related personal or business financial planning.
The recent surge in consumer activity triggered discussions about reviving the Freedom Benefits brand and updating the services offered. Last week a Philadelphia area employee benefits and health insurance business wrote that they now perceive Freedom Benefits as a competitor. That strategic business planning is ongoing and no decisions are finalized.