You may be wondering about how -- and when -- healthcare reform will affect you. Love it or hate it, healthcare reform is now the law of the land. President Obama has signed the legislation passed by Congress, so the work is underway to understand how it affects us as individuals, as employers and as tax-paying citizens. At U-Haul Dealer Benefits Program, we have been closely tracking the reform legislation for over a year and we are working with our participating health insurance carriers to maintain compliance and continue to provide the most competitive and highest value plans.
We now know for certain that the private markets for group and individual health insurance are preserved. So, if you've been waiting to apply for new coverage, don't wait any longer. We can help you and your family right now and you can cancel at any time. Full details on the reforms will not be known perhaps for years, while regulations are issued by the Administration and programs are implemented by Federal and State agencies. The Department of Health & Human Services has set up health reform and healthcare websites for the public to use: http://healthreform.gov/ and http://www.healthcare.gov
How will health insurance reform affect you?
Individual & Family health insurance will not go away -- The reforms preserve the private markets for the kinds of health insurance we provide today through the Dealer Benefits program, including Individual & Family health insurance, Short-Term health insurance, and Small Business health insurance. Individuals and employer group plans that wish to keep their current health policy without changes can do so.
Insurance Reforms will Strengthen Coverage -- The reforms require that health insurance carriers improve coverage of existing and new health policies beginning with plan years starting in September 2010. These improvements include: no lifetime limits on the dollar value of benefits, removal of annual limits on all "essential" benefits, increasing the age of dependents for health plan coverage to 26, prohibiting recissions (retroactive cancelling) of health plan coverage except for fraud and intentional misrepresentation, coverage of a range of preventive care services, immunizations and screenings, and a mandatory coverage appeals process.
Personal health issues -- The reforms will prohibit insurance companies from denying coverage based on pre-existing conditions. This means everyone, regardless of health status, will eventually qualify for coverage. Beginning with plan years this September, all health plans must cover pre-existing conditions for children 19 and under. Many states (36) already operate risk pools for their residents with pre-existing conditions who have been unable to qualify for private health insurance; check with your state insurance department for details. Starting July, 2010 the Department of Health & Human Services (DHHS) is required to have a temporary Federal risk pool program up and running for adults who have not been able to obtain affordable private health insurance coverage due to pre-existing conditions. But people have to be uninsured to qualify for the new Federal pool; those who have already gotten coverage through their state's risk pool or who have qualified for private health insurance that covers their condition will not be allowed to switch to the new Federal risk pool under the rules set out by Congress. The risk pools are intended as "stop-gap" measures that will end January 1, 2014 when exclusions based on pre-existing conditions will be prohibited in all markets.
Coverage will be mandatory -- Beginning January 1, 2014, all American citizens and legal residents will be required to purchase a health insurance plan or have coverage through their employer, and if they do not, an excise tax penalty will be levied, beginning at a flat rate of $325 up to 2.5% of taxable gross income. Exceptions are provided in the reforms and include religious objectors, hardship waivers, people with incomes below 100% of poverty level and Indian tribal members. This mandate is intended to prevent people from simply waiting until they get sick before they buy health insurance. Employers will be encouraged to offer health coverage but are not required to do so; however, large employers (50+ employees) may face penalties for not offering health coverage.
Small Employer Tax Credits -- Beginning immediately for the 2010 tax year, small employers (dealers with up to 25 full-time equivalent employees) who pay for their employees' health coverage will be eligible for a maximum tax credit of 50% of premiums paid, for up to two years. Dealers who currently provide health care for their workers could receive immediate help with premium costs, and dealers who initiate small business coverage this year could receive the tax assistance. The dealer must contribute at least 50% of the total premium cost to qualify. The maximum tax credit goes to dealers having 10 or fewer employees with annual wages of less than $25,000. Employers having 25 or more employees and average annual wages of $50,000 or more are not eligible for the tax credit. Further, the tax credit cannot be used by the self-employed, 5% owners of a small business, 2% shareholders of an S Corporation, "seasonal workers," or for their dependents or other household members. The Dealer Benefits program is ready to help you with your small business health plan.
Health insurance will not be "free" but premium subsidies will be available -- The reforms seek ways to lower the cost of health care and health insurance, but there are no guarantees. Increases in health insurance premiums reflect numerous factors, including increases in the price per medical service charged by care providers, greater utilization of services, introduction of new medical technology and pharmaceuticals, cost shifting to insurance plans by providers needing to cover their charity care, state insurance taxes and fees, statutory reserves required to back up claims, costs of regulatory compliance, the aging of the population, and unhealthy lifestyles. As an industry, health insurers have profit margins on average of 3.2%, compared with 25% for drug makers and 11% for medical device companies, according to testimony in April 2010 at Senate health, education, labor and pensions committee hearings. January 1, 2014 a sliding-scale Federal tax credit will go into effect for low income individuals (including self-employed) that will provide limited premium assistance. Individual's income must be below 400% of the Federal "poverty level" (below $43,320 individual, $88,200 family of four) and must not be on Medicaid. States may offer premium assistance to Medicaid beneficiaries. Each State is required to establish one or more exchanges by January 1, 2014 to facilitate the sale of health plans, including individual and group. The exchanges may include information on private plans, non-profit plans, co-op plans and federally administered multi-state plans as well as the new tax penalties and credits. If more affordable options become available as a result of reforms, you may cancel any plan purchased through the Dealer Benefits program and buy a lower cost option in the future. Of course, under the Dealer Benefits program, we continually strive to bring you a choice of health insurance options that represent the best cost and benefit value currently approved by the insurance authorities in each State.
Why should I have health insurance? -- There are sound financial reasons to encourage all consumers to have some level of health insurance coverage, if possible. The most important reasons to obtain health insurance coverage include:
Care is generally more expensive for the uninsured. Insurers provide access to lower fees through their negotiated provider discounts. These discounts may be 50% to 80% less than what the provider would bill a cash paying patient, however lower prices are not guaranteed by insurers.
Not all situations afford the patient time to shop. In some instances patients experience emergency care needs that do not allow time to shop for care. Unfortunately, this type of care can result in extremely high medical bills that are often two, three or four times what an insurer would have paid for the same care. An insurance policy can help protect consumers in these rare, but financially risky situations. When there is time to shop around for price on a needed treatment, whether you are an uninsured patient or already have coverage, try using The Healthcare Blue Book. The Blue Book is a free consumer guide to help you determine
fair prices in your area for healthcare services. For people who pay for their own healthcare,
have a high deductible or need a service their insurance plan does not fully cover, the Healthcare
Blue Book will help find fair prices for surgery, hospital stays, doctor
visits, medical tests and more.
Catastrophic or complex events can be extremely expensive. Unfortunately, people do sometimes develop serious conditions, such as cancer or chronic disease, which can be very expensive to treat. Aside from the benefit of offering the patient access to treatment options, an insurance policy provides financial protection.
Obtaining coverage when you really need it may be more difficult. You may be healthy now, but if you are uninsured and diagnosed with a serious medical condition, until 2014 you could find that you do not qualify for commercial health insurance coverage when you need it. It is advisable to purchase an insurance policy from a reputable company when you are healthy. This will let you have the best insurance options, the best pricing and the safety of having coverage when you need it.
Reforms will take time -- Reforms will not be implemented overnight. Reforms are scheduled to take effect all the way through 2018. So, don't wait any longer to protect your health and financial security. You can find and easily apply for affordable coverage right now through the Dealer Benefits program.
Use our convenient online Comparison Shopping Tool to view and compare health insurance plans in your area, or call the Benefit Center for assistance at 888-551-9801. We do not provide legal or tax advice. Please contact your legal or tax advisor for advice on how the Health Reforms will impact you.
