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Healthcare Coverage For Ohio Children And Infants – Best Plans

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Ohio child-only health insurance plans are now easy to find. Most companies offer this type of coverage due to some of the changes implemented with Obamacare. Previously, most carriers required an adult to be the primary applicant before any dependents could be added. This created many scenarios that forced babies and young adults to be uncovered or accept inferior benefits until group coverage could be obtained.

Prior to the Affordable Care Act legislation, Assurant offered these types of plans A full description of the policy with details is shown below. But times have indeed changed, since Assurant no longer offers child-only health insurance policies in Ohio (or any other state!), and many low-cost options are now available through Anthem, Medical Mutual, Aetna, Premier, SummaCare, and many other companies.

It is also important to understand that placing your dependent on a parent’s policy may actually result in a lower premium. For example, if a household’s family income qualifies for a federal subsidy, when compared to a single policy, rates could be lower, and deductibles and maximum out-of-pocket expenses may also reduce.

Assurant Plan Details (No Longer Available)

The Assurant “Short-Term” policy will approve a “child-only” policy (assuming the application is accepted and underwriting guidelines are met). Since it is a temporary policy, typically you can keep coverage for up to a year. However, during that time, we will help you find other affordable options that may offer the long-term protection you may need. Periodically, another carrier may offer a more comprehensive option.

Several Deductible Options

Deductible options range from $250 to $5,000. Subsequent coinsurance options are also offered at either 0%, 20% or 50%. Generally, we recommend the 0% or 20% options. A generous lifetime maximum benefit of $2 million ensures that major illness and disease will be adequately covered. The unlimited lifetime benefit mandated by national  healthcare reform, does not apply to temporary plans. Also, many other similar plans only include a $250,000 limit, which we feel is not a high enough cap.

Office visits, prescriptions, emergency room charges, X-rays, lab tests and hospital expenses are all covered but subject to a deductible of your choice. Although the policy allows you to utilize your own doctors and facilities, we highly recommend you use providers in the Assurant network. Your out of pocket costs will substantially reduce and there are thousands of providers throughout the Buckeye State. Since the carrier is countrywide, you can also utilize many out of state facilities, although verifying the network provider in advance is recommended.

There are exclusions to the policy including pre-existing conditions, self-inflicted injuries, dental and vision expenses, mental illness. A complete list of exclusions can be found in the brochure.

Celtic Plan Also No Longer Available

Certainly, we realize that if you need coverage on your child (without insuring an adult), the Assurant short-term plan is not the ideal policy. However, it will provide a temporary solution and most importantly, provide much-needed major medical benefits in the event of a hospital claim. And, as previously mentioned, even office visit and RX coverage is provided once the deductible has been met.

Another low-cost option (actually, lower cost than Assurant) is Celtic Insurance Company, based in Chicago. They offer many deductible options ($500 to $5,000) and when you view your quotes, please take note of Celtic’s rates. Unfortunately, within the next 30 days, they will not be offering their short-term plans here in Ohio, so it may be too late to use them as an option.

If  a child (or adult) has existing health problems that would typically cause an application for coverage to be denied, then perhaps the “Open Enrollment” program may be the solution. There is both a federal and non-federal program and child rates are not terribly high. Additional information can be found on the United States Department of Labor page that offers “young adults” free guidance. The link  can be found here.

Please feel free to call (888) 513 6446) or contact us (contact form at top of page) if you would like to review your options. You can also view rates right now by clicking on the “Get Instant Quote” button at the top of the page. For “children only” policies, the Assurant short-term policy will be the only plan that is shown.

UPDATES

May 2016 – Since the original publish-date of this article, children-only health insurance plans have become more widely available. Although inexpensive temporary policies continue to be offered, they still do not cover pre-existing conditions or satisfy the federal mandate for having qualified individual or small group healthcare benefits.

Exchange (Marketplace) plans are offered to both adults and children on single policies. However, since dependents can remain on their parent’s coverage until age 26, retaining all household members on a single family policy is very popular.

Buy Ohio Catastrophic Or Comprehensive Health Insurance?

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What type of Ohio health insurance should you buy? Catastrophic or comprehensive coverage?  Catastrophic plans  cost substantially less, but typically place a deductible on most benefits, often have higher out-of-pocket expenses, and limit the number of times times you can visit a physician with just a copay.

Comprehensive plans are less expensive, and feature low copays on primary-care physician  and specialist office visits, Urgent-Care,  and prescriptions. Also, federal subsidies (if you qualify) can drastically reduce the rate for comprehensive plans. Catastrophic-tier options are not eligible for the instant tax-credit.

So…What’s the answer? Based upon my 35 years of experience in the healthcare business, you would expect an easy explanation. It actually is not so simple. To accurately answer that question, we need to somehow accurately predict your medical expenses for each calendar year. Since there is no psychic in the house, perhaps utilizing actual rates and family scenarios will help determine the most cost-effective choice.

Cheapest Columbus Ohio Medical Plans

All Roads Lead To Lower Columbus Health Insurance Rates

Case Study Comparison

Perhaps comparing specific rates and coverage would help. So we created a hypothetical family to use in our calculations. Both husband and wife are 40 years old and they have two children (ages 10 and 12). There are no pre-existing conditions and they live in the Columbus area (Franklin County).  The total household income is $55,000 which provides a federal subsidy of approximately $480 per month. This amount has automatically been deducted from the premium.

Typically, they use their 100% covered preventive benefits, including routine annual physicals and OBGYN visits. But they rarely utilize their policy for other expenses. Although an occasional flu or allergy expense occurs, this family is quite healthy.

Let’s Compare Monthly Rates!

 

Bronze Plans With Higher Deductibles And/Or Out-Of-Pocket-Expenses

$257 – Aetna Bronze Deductible Only HSA

$309 – UnitedHealthcare Bronze Compass HSA 5500

$313 – Anthem Bronze Pathway X HMO 5000-40

$325 – Aetna Bronze $15 Copay

 

Gold Plans With Lower Deductibles And/Or Out-Of-Pocket Expenses

$556 – Molina Marketplace Gold Plan

$594 – UnitedHealthcare Gold Compass 0

$703 – Anthem Gold Pathway X HMO 1450 20

$744 – Aetna Gold $10 Copay

Interpreting  these premiums shows that savings of approximately $2,500-$6,000 are possible when choosing plans with higher deductibles and/or higher maximum out-of-pocket expenses. Therefore, when enrolling for new coverage, or renewing an existing plan, strongly consider less-expensive options if no significant medical conditions are present. NOTE: If you missed Open Enrollment in Ohio, an alternative plan may have to be selected, or you can retain your current qualified coverage.

Every Household Situation Is Different

Each individual and family is different and that’s why we take the time to review your specific details and make recommendations based on what’s best for you. Please feel free to call us anytime at (888) 513 6446 or contact us by clicking on the “Contact Us” tab at the top of the page.

Buy Ohio catastrophic health Insurance or  comprehensive coverage easily through our website.  View personal and family quotes from the top companies and enroll online in minutes.

You Just Lost Your Ohio Group Health Insurance At Work. Now What?

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You just lost your group health insurance at work. Now what? Well…Don’t panic because help is on the way. There are many Ohio private medical coverage options to consider, and most of these plans offer office visit, prescription and preventive benefits. If you recently lost healthcare benefits, individual and family policies are very affordable in most areas of the state.

We are located here in Ohio, so we completely understand the situation you are facing. We have designed this website to specifically help persons that may be losing coverage or have just had a policy terminated. Most of the plans can be paid month-to-month so your immediate out-of-pocket expenses are reduced. You may not be able to duplicate the exact coverage your employer provided, although in some situations, you can obtain more comprehensive coverage at a reduced rate (assuming you qualify for a federal subsidy).

Most likely, your group health care benefits were very rich in benefits, with low deductibles on hospital visits and low copays on covered office visits and prescriptions. Also, any emergency room visit probably featured low copay. Although you can duplicate your benefits with an individual policy, the cost would be very high with most carriers. For that reason, other alternatives should be considered.

Short-Term Options

If you’re concerned with only securing coverage for a few months (perhaps six months or less), a “temporary” (short-term) policy might be a wise choice. Although this type of plan places a deductible on the vast majority of benefits, premiums are extremely low and policies are often approved within 24 hours. Many persons that have lost group benefits will select this type of coverage until they have a clearer picture of how long they will be without health insurance.

However, you may not be able to renew a temporary plan if you develop a serious medical condition such as cancer, diabetes or heart disease. Also, pre-existing conditions are not covered which should be strongly considered when selecting the type of coverage you apply for. We’re always happy to discuss the advantages and disadvantages of plans like this.

Ohio major medical policies for individuals and families that have lost their group health care benefits through their employer are also an option to consider. Costs for major medical coverage have remained low and plans can be paid on a monthly as-needed basis. Large expenses such as hospital and emergency-room charges are one of the benefits of this type of policy. And although most office visits and prescriptions are not covered, catastrophic plans are often used to bridge the gap between one group plan and another. If you are self-employed, an HSA is a plan that may help.

Low-Deductible Plans – Great Coverage But Expensive

Low-deductible medical plans that feature low copays are the most expensive type of coverage. And while they closely resemble company group plans, they may not be the most appropriate choice, considering the premium and the length of time the policy is kept.

We realize that many Ohioans are losing their group health insurance at work. We’re here to help. Please call us any time at (888) 513 6446. And of course, you can view rates by clicking on the “Get Instant Quote” button at the top of this page.

What About Ohio After Federal Judge Declares National Health Care Law Unconstitutional

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The national health care law, that affects all Ohio citizens, (Obamacare) is unconstitutional, according to a ruling this week by Federal District Court Judge Roger Vinson in Florida. So far, four federal judges have ruled on the constitutionality of forcing citizens to purchase health insurance. Two have upheld the law and two have ruled against it.

Here in Ohio, individual and family  coverage remains unaffected (for now). The recent required preventive benefits mandate will remain in place along with a few other changes that had been made, such as the elimination of lifetime maximum limits. Rates continue to be a “good buy” compared to almost every other state. Of course, if the bill is allowed to pass, most experts agree that rates will increase (perhaps substantially) in 2014.

Currently, e(5-23-2012), we are still waiting to hear the Supreme Court’s ruling on the mandate forcing consumers to buy health insurance. Of course, this will have a big impact on the entire “Affordable Care Act.” If approved, the “Affordable Care Act” will continue. If the mandate is deemed to be unconstitutional, it is expected that all carriers will face major profitability challenges, and would exit the Marketplace.

My Opinion

Based on my 30 years in the health care business, I expect (and any others agree), that we will see a Supreme Court decision in 2012 to determine the fate of the bill. The majority of Americans are not particularly happy with the legislation, and I have a feeling the court will rule 5-4 in favor of the repeal.

What bothers many Ohioans are the “backroom deals” that were used to sway votes in Congress along with the fact that most members of Congress never bothered to read the bill. Also, shortly after it was passed, it became very obvious that  individuals and families would NOT be able to keep their present healthcare coverage exactly as it was. This, despite President Obama’s guarantee, that policyholders would be able to maintain their existing coverage.

A Better Health Care Reform Idea

While some type of reform of the current system is needed, we don’t want Ohio health insurance rates to surge. Perhaps a better idea last year would have been the increased utilization of Health Savings Accounts, added financial incentives to those that pay for their own coverage and increased funding for the high risk pools for those with major health issues. Oh…and reading the legislation you’re voting on always helps!

You can keep up to date on Ohio health insurance reform information by clicking here. And of course, to view, compare or apply for quality health care at the lowest available rates, please click on the “Get Instant Quote” button at the top of the page. You can also call us at (888) 513 6446 any time.

Will Obamacare Raise Your Taxes? Fact Check Says Yes

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As the US House of Representatives prepares to vote on the repeal of Obamacare, I thought it may be important to review the many tax increases Americans will face, unless Obamacare is changed or repealed. The good folks at atr.org have put together a comprehensive list (see below) that is worth reading.

We need healthcare reform, and many of the recent changes, such as mandatory 100% preventive benefits, are quite beneficial. But at the same time, the country can’t afford all of the proposed mandates, and unless changes are made, we may face a very gloomy scenario. Perhaps increased utilization of Health Savings Accounts (HSAs) may be where we should be focusing most of our attention.

Another concept to consider is adding additional funding to State Risk Pools that help persons that can not qualify for a policy. Along with Open Enrollment, the Risk Pools are sometimes the lifeline for folks with serious health conditions. And in many states, they have provided guaranteed medical coverage to persons that could not qualify for an underwritten policy.

Here Are Affordable Care Act Legislation Taxes!

 

Individual Mandate Excise Tax (Jan 2014): Starting in 2014, anyone not buying “qualifying” health insurance must pay an income surtax according to the higher of the following

1 Adult2 Adults3+ Adults
20141% AGI/$951% AGI/$1901% AGI/$285
20152% AGI/$3252% AGI/$6502% AGI/$975
2016 +2.5% AGI/$6952.5% AGI/$13902.5% AGI/$2085

Exemptions will be given for religious objectors, undocumented immigrants, prisoners, those earning less than the poverty line, members of Indian tribes, and hardship cases (determined by HHS). Of course, enforcing this new penalty may be difficult since many persons are not aware of it and the IRS has never had to impose the tax.

Employer Mandate Tax (Jan 2014):  If an employer does not offer health coverage, and at least one employee qualifies for a health tax credit, the employer must pay an additional non-deductible tax of $2000 for all full-time employees.  This provision applies to all employers with 50 or more employees. If any employee actually receives coverage through the exchange, the penalty on the employer for that employee rises to $3000. If the employer requires a waiting period to enroll in coverage of 30-60 days, there is a $400 tax per employee ($600 if the period is 60 days or longer). Yes, that is confusing.

Combined score of individual and employer mandate tax penalty: $65 billion/10 years

Surtax on Investment Income ($123 billion/Jan. 2013):  This increase involves the creation of a new, 3.8 percent surtax on investment income earned in households making at least $250,000 ($200,000 single).  This would result in the following top tax rates on investment income. NOTE: Do you think this will encourage high-income earners to invest more? Of course not.

Capital GainsDividendsOther*
2010-201215%15%35%
2013+ (current law)23.8%43.4%43.4%
2013+ (Obama budget)23.8%23.8%43.4%

*Other unearned income includes (for surtax purposes) gross income from interest, annuities, royalties, net rents, and passive income in partnerships and Subchapter-S corporations.  It does not include municipal bond interest or life insurance proceeds, since those do not add to gross income.  It does not include active trade or business income, fair market value sales of ownership in pass-through entities, or distributions from retirement plans.  The 3.8% surtax does not apply to non-resident aliens.

Excise Tax on Comprehensive Health Insurance Plans($32 bil/Jan 2018): Starting in 2018, new 40 percent excise tax on “Cadillac” health insurance plans ($10,200 single/$27,500 family). For early retirees and high-risk professions exists a higher threshold ($11,500 single/$29,450 family).  CPI +1 percentage point indexed. If you have one of these plans, you won’t be happy. We expect this piece of the legislation to be altered before it is implemented.

Hike in Medicare Payroll Tax($86.8 bil/Jan 2013): Current law and changes:

First $200,000
($250,000 Married)
Employer/Employee
All Remaining Wages
Employer/Employee
Current Law1.45%/1.45%
2.9% self-employed
1.45%/1.45%
2.9% self-employed
Obamacare Tax Hike1.45%/1.45%
2.9% self-employed
1.45%/2.35%
3.8% self-employed

Medicine Cabinet Tax($5 bil/Jan 2011): Americans no longer able to use health savings account (HSA), flexible spending account (FSA), or health reimbursement (HRA) pre-tax dollars to purchase non-prescription, over-the-counter medicines (except insulin). This will negatively impact about 40%-60% of all households that utilize HSAs.

HSA Withdrawal Tax Hike($1.4 bil/Jan 2011): Increases additional tax on non-medical early withdrawals from an HSA from 10 to 20 percent, disadvantaging them relative to IRAs and other tax-advantaged accounts, which remain at 10 percent. This hurts anyone with an HSA and is unnecessary.

Flexible Spending Account Cap – aka“Special Needs Kids Tax”($13 bil/Jan 2013): Imposes cap of $2500 (Indexed to inflation after 2013) on FSAs (now unlimited). . There is one group of FSA owners for whom this new cap will be particularly cruel and onerous: parents of special needs children.  There are thousands of families with special needs children in the United States, and many of them use FSAs to pay for special needs education.

Tuition rates at one leading school that teaches special needs children in Washington, D.C. (National Child Research Center) can easily exceed $14,000 per year. Under tax rules, FSA dollars can be used to pay for this type of special needs education. But the proposed cap should be drastically increased.

Tax on Medical Device Manufacturers($20 bil/Jan 2013): Medical device manufacturers employ 360,000 people in 6000 plants across the country. This law imposes a new 2.3% excise tax.  Exemptions include items retailing for less than $100. We also feel this tax is unjustified and simply an additional option to pass the cost of the legislation onto consumers.

Raise “Haircut” for Medical Itemized Deduction from 7.5% to 10% of AGI($15.2 bil/Jan 2013): Currently, those facing high medical expenses are allowed a deduction for medical expenses to the extent that those expenses exceed 7.5 percent of adjusted gross income (AGI).  The new provision imposes a threshold of 10 percent of AGI; it is waived for 65+ taxpayers in 2013-2016 only. Thus, high-income earners with significant medical expenses get penalized.

Tax on Indoor Tanning Services($2.7 billion/July 1, 2010): New 10 percent excise tax on Americans using indoor tanning salons. Obviously, bad news if you own a tanning salon.

Elimination of tax deduction for employer-provided retirement Rx drug coverage in coordination with Medicare Part D($4.5 bil/Jan 2013)

Blue Cross/Blue Shield Tax Hike($0.4 bil/Jan 2010): The special tax deduction in current law for Blue Cross/Blue Shield companies would only be allowed if 85 percent or more of premium revenues are spent on clinical services

Excise Tax on Charitable Hospitals(Min$/immediate): $50,000 per hospital if they fail to meet new “community health assessment needs,” “financial assistance,” and “billing and collection” rules set by HHS.

Tax on Innovator Drug Companies($22.2 bil/Jan 2010): $2.3 billion annual tax on the industry imposed relative to share of sales made that year.

Tax on Health Insurers($60.1 bil/Jan 2014): Annual tax on the industry imposed relative to health insurance premiums collected that year. The stipulation phases in gradually until 2018, and is fully-imposed on firms with $50 million in profits.

$500,000 Annual Executive Compensation Limit for Health Insurance Executives($0.6 bil/Jan 2013)

Employer Reporting of Insurance on W-2(Min$/Jan 2011): Preamble to taxing health benefits on individual tax returns.

Corporate 1099-MISC Information Reporting($17.1 bil/Jan 2012): Requires businesses to send 1099-MISC information tax forms to corporations (currently limited to individuals), a huge compliance burden for small employers.

“Black liquor” tax hike(Tax hike of $23.6 billion).  This is a tax increase on a type of bio-fuel.

Codification of the “economic substance doctrine”(Tax hike of $4.5 billion).  This provision allows the IRS to disallow completely-legal tax deductions and other legal tax-minimizing plans just because the IRS deems that the action lacks “substance” and is merely intended to reduce taxes owed.