How Health Insurance Has Changed Throughout the Years
Over the past few years, health insurance has changed a great deal. Due to health care reform, there are new rules and regulations in place now that could affect the way that you obtain your coverage. Because of so many new changes, it can help to have a professional on your side who is knowledgeable about which way you should turn – and what your best options are for obtaining insurance coverage going forward.
Finding You the Best Health Insurance Coverage for Your Needs
After the Affordable Care Act was voted into law the options for individual health plans have declined. This year in Texas and New Mexico there are only three options available for people looking for an individual Health Plan.
- The most comprehensive option would be a Major Medical plan through Blue Cross, these plans are guaranteed issue which means there is full coverage day 1 of coverage without any exclusions or look back waiver periods.
- The second option, Medical sharing programs are becoming more and more popular due to the lower premium costs.
- The last option are short term health plans that can now be written for as long as three years. However, the short term plans were designed to cover gaps in your health coverage for a period of a few months up to a year.
Major Medical Plans
The Affordable Care Act (ACA) plans use date of birth and home zip code to calculate the base premium rates. The plans are guaranteed issue which means there is full coverage day 1 of coverage without any exclusions or look back waiver periods.
Major Medical plans are purchased through the marketplace through which you can apply for subsidy based on income which may lower the base premium. It is a sliding scale, the further you are from the top income limit of income the more assistance you receive. If you do not qualify for a premium subsidy you can still enroll in a health plan through the Marketplace, Below we have added a quick and easy link to our enrollment system for you to get quotes and enroll online.
Blue Cross Blue Shield with their HMO network is the only major carrier offering plans in 100% of counties in Texas and New Mexico.
For additional information on choosing the right health insurance, Texas, Washington, and New Mexico residents should call or visit the nearest Insurance Connection USA location today.
Medical Sharing Plans
Medi-Share is one of the largest of these programs. Healthcare sharing is when a group of people unite to help pay each other’s medical bills. Medi-Share is based on the biblical principles of sharing others’ burdens. Members contribute monthly “shares” to assist other Christians who agree to live similar lifestyles. Medi-Share began in In 1993 Medi-Share was organized, offering a formalized approach to healthcare sharing. Medi-Share households have saved and shared more than $2.6 billion in medical expenses since then. Medi-Share is administered by Christian Care Ministry, a 501(c)(3) organization. To find out if Medi-Share is right for you visit Medi-Share
Medi-Share is not insurance, does not guaranty payment of any member’s medical bills, and is not subject to insurance regulation in any state.
Short Term Health Plans
What Is Cobra Continuation Coverage?
Congress passed the landmark Consolidated Omnibus Budget Reconciliation Act (COBRA)1 health benefit provisions in 1986. The law amended the Employee Retirement Income Security Act (ERISA), the Internal Revenue Code and the Public Health Service Act to require most group health plans to provide a temporary continuation of group health coverage that otherwise might be terminated.
Group Health Plans Subject to COBRA
COBRA generally applies to all private-sector group health plans maintained by employers that have at least 20 employees on more than 50 percent of its typical business days in the previous calendar year. Both full- and part-time employees are counted to determine whether a plan is subject to COBRA. Each part-time employee counts as a fraction of a full-time employee, with the fraction equal to the number of hours that the part-time employee worked divided by the hours an employee must work to be considered full time.
Texas State Continuation
Companies in Texas with less than 20 full time employees are subject to the State Continuation rules. Most of the insurance companies manage the state continuation process for employers. The support staff of Insurance Connection USA will also assist employers make sure they are in compliance.
A Health Savings Account is an interest-bearing bank account you may set up with a financial institution. Participation in a Health Savings Account (HSA) is limited to those enrolled in a HDHP qualified health plan.
Companies can partner with a bank to allow employees to make pre-tax payroll contributions into their HSA account. The money that is deposited into an HSA account is the employees money to use for any qualified medical expense. Contributions to an HSA account cannot exceed the IRS contribution limits. You do not have to use any of the money deposited into the HSA on an annual basis. Your account balance will roll over each year without a penalty on a tax-deferred basis.
Health Savings Account (HSA) Facts
CONTRIBUTIONS How much can I contribute to my HSA? The maximum annual contribution that an individual, with individual coverage, can make to an HSA is $3,250 for 2013. In the case of a family, with family coverage, the maximum annual contribution is $6,450 for 2013. The deductible contribution is not limited to the annual deductible under the high deductible health plan.
How much may I contribute to the account if I establish my HDHP after January 1, 2013? An individual or family, who are covered under an HDHP in a month other than January, may make a full HSA contribution for the year as long as certain conditions are met. However, if you cease to remain an eligible individual throughout 2013, the extra amount contributed is included in income and subject to an additional 10 percent tax; the 12 month rule.
An individual enrolls in an HDHP in December of 2012 and is otherwise an eligible individual in that month.The individual is not an eligible individual in any other month in 2012. The individual can make an HSA contribution for 2012 as if he or she had been enrolled in the HDHP for all of 2012. If the individual ceases to be an eligible individual (e.g., if he or she ceases to be covered under an HDHP) in June 2012, an amount equal to the HSA deduction attributable to treating the individual as an eligible individual for January through November 2012 is included in the individual’s income in 2012.
How do I make withdrawals (or take distributions) from my HSA? You can make tax-free withdrawals (also known as distributions) from your HSA to pay for qualified medical expenses at any time during the year. When your account is opened, you receive a debit card and checks for easy access to your funds. However, you do not have to make withdrawals from your HSA each year. Your contributions remain in your HSA from year-to-year until you use them. If you make withdrawals for non-qualified medical expenses or for other reasons, the amount withdrawn will be subject to income tax and may be subject to an excise tax as well. Please keep in mind you should track all of your withdrawals from your HSA so you can supply documentation on your expenditures if needed.