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Informed on Reform

Posted on May 31, 2013 at 11:07 AM Comments comments (1)
Beginning in 2014, it is estimated
about 25 million people will shop
for coverage on the individual exchanges. This
group might include people who are currently in the
individual marketplace, unemployed, self-employed,
or work for businesses that don’t offer insurance
or whose plan is unaffordable.

Beginning in 2014, all individuals must maintain
“minimum essential coverage” through an employer-sponsored
plan, or individual plan such as one purchased
on an exchange. Failure to do so will result in a penalty
or tax. The penalty is on a sliding scale for three years
and is 1/12th of the greater of: for more information click here

Staying Healthy In The Face Of Norovirus

Posted on February 25, 2013 at 1:22 PM Comments comments (120)
Have you heard of a sickness called Norovirus? Chances are you have had Norovirus, also called the "stomach flu," many times in your life. Despite its nickname, Norovirus is not related to the flu.
Norovirus is highly contagious and may cause vomiting, diarrhea and stomach cramps. Symptoms usually start within 24 to 48 hours and most people begin to feel better within one or two days and have no long-term health effects.
People with the Norovirus illness are contagious from the moment they begin feeling sick until at least 3 days after they recover. There is no vaccine to prevent a Norovirus infection and no drug to treat people who get sick from the virus. Antibiotics will not help because they fight against bacteria, not viruses.
1 in every 15 Americans will get Norovirus illness each year. Norovirus is also estimated to cause over 70,000 hospitalizations and 800 deaths each year in the United States.
The Center for Disease Control offers the following tips on protecting yourself from Norovirus:
  • Practice proper hand hygiene
Wash your hands carefully with soap and water—Alcohol-based hand sanitizers can be used in addition to hand washing. They should not be used as a substitute for washing with soap and water.
  • Wash fruits & vegetables and cook seafood thoroughly
 Carefully wash fruits and vegetables before preparing and eating them. Cook oysters and other shellfish thoroughly before eating them.
Be aware that Noroviruses are relatively resistant. They can survive temperatures as high as 140°F and quick steaming processes that are often used for cooking shellfish.
  • When you are sick, do not prepare food or care for others who are sick
You should not prepare food for others or provide healthcare while you are sick and for at least 2 to 3 days after you recover.
  • Clean and disinfect contaminated surfaces
After throwing up or having diarrhea, immediately clean and disinfect contaminated surfaces. Use a chlorine bleach solution with a concentration of 5–25 tablespoons of household bleach per gallon of water or other disinfectant registered as effective against Norovirus by the Environmental Protection Agency.
  • Wash laundry thoroughly
Immediately remove and wash clothes or linens that may be contaminated with vomit or stool (feces).
You should handle soiled items carefully without agitating them, wear rubber or disposable gloves while handling soiled items and wash your hands after, and wash the items with detergent at the maximum available cycle length then machine dry them.
If you follow these tips and use caution when caring for sick loved ones, you may dramatically reduce your chances of contracting Norovirus.

Summary of Benefit and Coverage Forms

Posted on October 25, 2012 at 4:25 PM Comments comments (2)
Well we are rounding the bend regarding a very important election year and personally I will be glad when the results are in.. What ever your preference PLEASE VOTE..  Everyone wants to know what is going to happen with Health Care Reform, Medicare Benefits, Estate Taxes and more regarding insurance after the election. So far all that has been said and predicted is just that.. a prediction. So we all will have to wait and see what happens after the elections, and after the dust settles.. know I will do my very best to keep you informed on what really happens. 
Summary of Benefit and Coverage Forms  
The purpose of the Summary Benefit and Coverage (SBC) is to give policy holders information about a health insurance plan's benefits in "plain language," so they can make appropriate purchasing, enrollment and coverage decisions. Effective September 23, 2012, it is mandatory for insurance companies, agents and employers to distribute SBC Forms to policyholders in compliance with the guidelines established by the Affordable Care Act. Summary of Benefit and Coverage FormsThese SBCs are required to be distributed at certain "trigger events" including: * Before plan renewal* With enrollment materials or during the enrollment period* To newly eligible employees* After a special enrollment* Before making mid-year changes to medical plans* Upon request To learn more about this new regulation, CLICK HERE TO VIEW MORE INFORMATION FROM AETNA.
*Information from SBC Brocure by Aetna

Preventative Cancer Screening for Women and Men

Posted on September 27, 2012 at 10:28 AM Comments comments (2)
As we focus this weeks newsletter on the issue of breast cancer, we want to encourage you to be proactive in maintaining a healthy lifestyle.  Be aware of the resources that are available to you and take advantage of them.  The Affordable Healthcare Act has made it mandatory for insurance companies to pay for the following services without any cost sharing from the policy holder (YOU!):
  • Breast cancer mammography every 1 to 2 years for women over age 40
  • Breast cancer chemoprevention counseling for women at high risk for breast cancer
  • Cervical cancer pap test for women
  • Prostate cancer screenings for men
    Click here to learn about additional preventative care services that are available to women & men under the Affordable Healthcare Act.

    October is Breast Cancer Awareness Month

    Posted on September 27, 2012 at 10:24 AM Comments comments (185)
    Most of us know someone who has been affected by breast cancer in one way or another.  Since October is Breast Cancer Awareness Month we want to help you be aware of the risks and learn about some of the preventative resources that are available to you. 
    Consider the Facts:
    In 2012, it is estimated that among US women there will be:
    - 226,870 new cases of invasive breast cancer 
    - 63,300 new cases of "in situ" breast cancer
    - 39,510 breast cancer deaths.
    A Few of the Known Risk Factors*:
    - Being a Woman
    - Getting Older
    - Starting menopause after age 55
    - Never having children
    - Having your first child after age 35
    Being overweight or gaining weight as an adult
    - Family history of breast, ovarian or prostate cancer  
    Mammography and rates of early detection over time  
    As mammography screening rates have increased, more cases of breast cancer have been found at earlier stages, when they are most easily and successfully treated. During the 1980s and 1990s, diagnoses of early-stage breast cancer increased greatly. Since the late 1990s, these rates have remained steady. At the same time, diagnoses of advanced stage (metastatic) breast cancer have remained stable or dropped slightly. 
    Prevention is key, and as a result of the Affordable Healthcare Act many of these preventative services are available to you with no out of pocket costs through your health insurance carrier. Check our other blog articles to learn more about Healthcare Reform.
    *This is not a complete list of risk factors. Consult a medical professional to learn about all of the risk factors of breast cancer.

    Healthcare Reform: New Dependent Coverage Guidelines

    Posted on September 10, 2012 at 12:41 PM Comments comments (0)
    Did you know that the law calls for dependents to be permitted to be covered under their parent's health insurance until the age of 26?  It does not matter if they are single or married, where they live or what their student status is, they can remain as a dependent on their parent's policy until the age of 26. Interested in learning more?  Click Here

    New Preventive Care Gudelines

    Posted on August 15, 2012 at 1:41 PM Comments comments (0)
    Did you know that many preventive care services are now required to be provided to you without cost-sharing?  Check out the list below from for a general list of services to be offered without copay, coinsurance, or deductible.
    Evidence-based preventive services:
    This list of items is from the current recommendations of the United States Preventive Services Task Force. This broad list generally includes:
    • Breast cancer and cervical cancer screenings
    • Colon cancer screenings
    • Screening for iron deficiency anemia in pregnancy
    • Screenings for diabetes, high cholesterol and high blood pressure
    Routine vaccinations:
    A list of immunizations recommended by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention are included in the rule. They are considered routine for use with children, adolescents, and adults and range from childhood immunizations to periodic tetanus shots for adults.
    Prevention for children:
    The rule includes preventive care guidelines for children from birth to age 21 developed by the Health Resources and Services Administration with the American Academy of Pediatrics. Services include regular pediatrician visits, vision and hearing screening, developmental assessments, immunizations, and screening and counseling to address obesity.
    Prevention for women:
    The regulation mandates certain preventive care measures for women. These recommendations will be in place until new requirements for prevention for women are issued by the United States Preventive Services Task Force or appear in comprehensive guidelines supported by the Health Resources and Services Administration. The new requirements are expected to be released by August 1, 2011.
    Breast cancer screening:
    All women age 40 and over should have an annual mammogram.
    To see a more extensive list of services offered Click Here.

    Healthcare Reform Update - Will You be Receiving a Rebate?

    Posted on July 30, 2012 at 1:56 PM Comments comments (1)
    The new Affordable Healthcare Act has set regulations for insurance companies when it comes to how they spend your money.  Insurers are held accountable by the Medical Loss Ratio which outlines the percentage of your premiums insurers must use on medical care costs and how much they can use towards administrative expenses. If the insurance company spends more than 20% of premiums on administrative expenses (15% for large groups) they must provide rebates to policyholders.
    Will I be receiving a rebate?
    It depends on your policy’s “block”.  The “block” is determined by: the type of policy you have, which insurance company it is, and in which state you are located.  You may contact your insurance company directly to find out if you will be receiving a rebate.
    If my policy qualifies for a rebate, when will I be receiving it?
    All rebates are due by August 1, 2012.
    What if I am on a group policy?
    If your policy qualifies for a rebate, your employer will receive the rebate and distribute it in proportion to your employee contribution.  This can be done by either reducing your premium for the following year or by providing you with a cash rebate.  Your employer has the right to decide how these funds will be distributed.
    Will I pay taxes on my rebate?
    In accordance with the revised regulations that were issued on December 2, 2011, consumers will not pay taxes on any rebates they receive.
    If I don’t receive a rebate, do I still have access to the insurance companies MLR information?
    Insurers are required to provide individual policyholders and subscribers under group plans information about their MLR regardless of whether there is a rebate.
    For further questions, you may contact our office at 239-275-5834 or email us at [email protected]
    References Used:
    Cigna Informed on Reform, HHS/CMS News Release & HHS/CMS Fact Sheet