The 5 W’s of Marketplace Health Insurance

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Knowledge based on the 5W’s of marketplace health insurance should serve as a reliable foundation for understanding and choosing coverage which meets the qualifications of the Obama health plan. The 5W’s stand for what, why, who, when and where.

What is marketplace health insurance?

Marketplace health insurance is coverage obtained through one of the governmental health insurance exchanges which provides a minimum standard of benefits known as the essential health benefits as specified by the Patient Protection and Affordable Care Act, referred to by many as ObamaCare. The plans are sold by private insurance companies and generally are HMO and PPO plans. Each plan has a metal designation of bronze, silver, gold, or platinum, depending upon services covered and the actuarial value of the plan. Marketplace health insurance plans cannot deny coverage or charge a higher premium for pre-existing illnesses. They cover some preventive care services.

Why purchase marketplace insurance?

The answer to this question rests in Affordable-Care-Act subsidies, also known as premium tax credits, and whether or not you qualify. Eligibility for Affordable-Care-Act subsidies is based on annual household income provided that income is at least 133% but less than 400% of the federal poverty level beginning in 2014. The premium tax credit calculation is based on a provision of the Affordable Care Act that no American should spend more than 9.5% of household income on medical insurance premiums. Given that provision, Obama-health-plan insurance could be purchased outside of the marketplace from a broker or insurance company. The dollar amount of the annual premium in excess of that allowed under the Affordable Care Act for a given income level could then be claimed as an end-of-the-year deduction during income tax filing. If the coverage is obtained through a health insurance marketplace however, the credit can be applied to the monthly premium of any Obama-healthcare-plan selected, resulting in a lowering of the monthly premium of the plan.

Who is eligible to purchase marketplace insurance?

Marketplace health insurance through the federal or one of the state insurance exchanges is for individuals and families less than 65 years of age or small businesses with 50 or fewer employees. Eligibility includes United States citizenship and/or legal residence. Additionally, one must not be incarcerated.

When does having medical insurance become mandatory, when can I enroll, and when does the penalty for not having insurance take effect?

January 1, 2014 is the date that most United States citizens and legal residents must have medical insurance coverage or suffer a tax penalty of $95 per adult, $47 per child, or 1% of the annual household income (whichever is greater) if one is uninsured as of January 1, 2014 and coverage has not been obtained by February 15, 2014. Open enrollment will extend until the end of March 2014. If you have a qualifying life-changing event however, such as marriage, relocation to another state, loss of job-based insurance or expiration of COBRA coverage, marketplace insurance can be obtained as an exception at times after the closure of the open-enrollment season in March 2014 and in subsequent years.

Where can I purchase marketplace insurance?

If you reside in a state whose health exchanges operated by the federal government you will need to purchase through that exchange. Alternatively, marketplace health insurance can be purchased through a private health insurance exchange if it has contractual authority granted by the federal government to enroll Obama health plan applicants. As of December 1, 2013, residents of the District of Columbia and states with state operated insurance exchanges must obtain marketplace medical insurance through the state exchanges. Those states are Those states are California, Colorado, Connecticut, Hawaii, Idaho, Kentucky, Maryland, Massachusetts, Minnesota, Nevada, New Mexico, New York, Oregon, Rhode Island, Vermont, and Washington.

The woodlands urgent tx care gives you support throughout

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Get the best care and support in times of injury or surgery at the hospital at any time of the day. It is because the medical professionals at the center understand that medical emergencies can arise at any point of the day. So they are always ready to provide the woodlands urgent tx care to any patient. This confidence of the doctors has made the people of the area to visit this particular health center for small or big medical requirements.

Insurances accepted at the center

Many a time’s people have insurances or health cover for their medical needs. Here at the medical center you will get all of insurance claims are accepted. Plus the helpful staff of the hospital will see to it that at times of medical crisis you or your family members are not involved in the paper work of such insurances. So they will provide proper help and support to ensure your work is lessened. This way you will also save a lot on the medical bills. Same goes for regular or yearly health check – ups, as you can utilize these insurances can be claimed in such time. For which the staff at the hospital will help you know more.

24/7 emergencies handled

Since medical crisis know no time, so the cooperative staff and expert physicians are happy to help you at any time. This is the one of the main reasons as to why the people of the city are counting on them. And any time availability has helped many lives to be saved, since a delay might lead in more critical situation or the death of the patient.

Reliable tests

You can get any test done at the hospital, with the reliability that the reports would be accurate. A number of machines are present such as the X- Ray machine for complete diagnosis, a CT scan machine which is required at times. There is also a radiology department present, which has also the necessary machines present.

Book an appointment & the fees

The charges for different tests vary with the department and fees of the doctor, but you can be rest assured that the rates of any service will be totally in easy reach. You can book an appointment at the woodlands urgent tx care by calling on their number at time. Or you can also fill an online form available on the website of the hospital. And a representative of the company will revert back to you.

The Author is conveying information about the woodlands tx urgent care and The Woodlands Emergency Care Facilities You’re probably thinking, everyone says that, so, what’s different here. It’s the commitment of quality, genuineness, and a guarantee that values your time and interest.

Understanding Family Health Insurance

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There are different types of health insurance covering all walks of life like individual, family, employees and others.

What is a Family Health Insurance?

Families are always special and they ought to have complete protection against medical emergencies. A comprehensive Family Health Insurance helps to save medical cost and complete shield to family against emergency due to an accident or sudden illness. Family members covered under Family Health Insurance are spouse, dependent parents and children of an insured.

Benefits of Family Health Insurance

During a policy period if the sum assured has exhausted as more number of people covered, the policy can be renewed at no extra cost. Health Insurance Companies cover Health check -ups, day care treatment, pre and post hospitalisation etc. A new member to the family can be added anytime during the policy period and in case of death of family member others can avail same benefits and health cover without any hindrances.

A lump sum cash benefit is paid upon being diagnosed for a critical illness such as first heart attack, cancer kidney failure and others as well. If a family member covered under Family Health Insurance has to travel aboard for treatment, Health Insurance Companies bear all the expenses like travelling cost, cost of treatment abroad and expenses incurred by the person accompanying the insured. Cashless hospitalisation are very helpful if case of unforeseen medical uncertainties.

Common exclusions of a Family Health Insurance

Health Insurance Companies do not cover any pre-existing injuries or illness. Any diseases diagnosed within 1 month from the date of commencement of policy are not included. Only injuries due to accidents are covered within 1 month. Medical expenses due to self inflicted injury or attempt to suicide are not covered. Dental treatments, cost of contact lens are not part of Family Insurance Plan. Cost of treatment incurred due to consumption of alcohol or drugs are not born by the Health Insurance Company.

Lump sum cash benefit covering a critical illness is paid only once in life to spouse or an individual after waiting period 3 months or survival period of 1 month is met under Family Health Insurance. Children are not covered for critical illness by the Family Health Insurance.

Family member are engaged any of dangerous sporting and sustained injuries due the sporting action is not borne by the Family Health Insurance.

Sudden Illness and expensive medical expenses of a family member can cause lot of financial liability. A well planned Family Health Insurance will help in facing medical emergencies and access to best medical treatments.

For more information visit: Family Health Insurance and Health Insurance Companies.

Five Crazy But Common Car Insurance Exclusions

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Five Crazy But Common Car Insurance Exclusions

You buy your car insurance, you glance at the policy documents, and you assume you’re covered for all eventualities where your car is stolen or damaged. Think again.

Read through your policy documents in detail. Some insurers don’t cover injuries to passengers aged over 75. Others won’t pay out if your car is stolen by someone who deceives you into handing over your keys. A small number won’t cover damage to your car that’s caused in a road rage incident. It’s common industry practice not to provide gap insurance, so if your car is written off or stolen, you won’t receive the full amount you paid when you bought your car.

Every car insurance policy includes some exclusions. Many of the exclusions would be extremely frustrating if they happened to you, and you then discovered that you’re not covered by your insurance firm. Some of them are downright crazy. Five of the most crazy but common car insurance exclusions are:

1. Nuclear Fallout
If Britain was wiped out by a nuclear bomb and you managed to survive, you wouldn’t receive a pay out from your insurer for the damage caused to your car. This is not only because the insurance firm will probably have been destroyed in the blast; it’s because it’s standard practice for motor insurance policies to exclude damage caused by nuclear fallout.

The same applies if your local nuclear power plant explodes and destroys your car, or if your car is contaminated by radioactive waste: you will not be compensated for the damage caused.

Currently this exclusion applies to policies bought from almost all the major motor insurance firms, including Admiral, Direct Line, Aviva, Churchill, Saga, Prudential, Sheila’s Wheels, and Co-operative Insurance to name a few.

2. UFOs
Most car insurance firms will not pay out if your car is damaged by pressure waves from aircraft travelling at or beyond the speed of sound. This includes damage caused by sonic and supersonic UFOs from outer space.

If you are zapped by an alien laser-beam while driving on the motorway, your insurance firm is unlikely to cover your injuries or the damage to your car. This is because such aggression would be considered an act of war. Car insurance firms usually exclude cover for damage caused by war, civil war, acts of a foreign enemy, or revolution.

Currently this exclusion applies to policies bought from almost all major car insurance firms, including Direct Line, Aviva, Admiral, Churchill, Saga, Prudential, Sheila’s Wheels, and LV=.

3. Car Stolen by Jealous Husband or Wife
Motor insurers will not provide cover if your car is taken without your permission by any member of your household or family. This includes your spouse or partner, your children, your parents or a lodger in your home. The only exception to this rule is if you report your car as stolen to the police, and prosecute the person who took your car in court.

Currently this exclusion applies to policies bought from almost all major motor insurance firms, including Direct Line, Admiral, Co-operative Insurance, Sheila’s Wheels, and LV=.

4. Earthquakes
Fortunately for us Brits, the UK is not prone to earthquakes or tremors. However, were the worst to happen and the ground opened up and swallowed your car, or even if a less violent earthquake shattered your windscreen, it’s probable that your insurer would refuse to pay out.

A small but significant number of car insurance firms do not cover for damage caused by earthquakes. Admiral is the most notable insurer with this exception. Other insurers who refuse cover for earthquakes include Saga, Prudential, and Sheila’s Wheels.

As well as looking out for earthquakes, remember to check your insurance policy documents for the phrase “acts of God”. Sheila’s Wheels breakdown service, for example, cannot be held liable if they leave you stranded by the roadside because of an “act of God”.

5. Blind Drivers
Unsurprisingly, there is not a single insurance firm who will provide cover for drivers who can’t see. This is never stated explicitly in insurance policy documents, but insurance companies cover their backs by saying they won’t pay out for claims resulting from damage caused by “unlicensed drivers”.

Being unable to get insurance or a licence wasn’t enough to stop one blind person from getting behind the steering wheel. In 2006, 31-year-old Omed Aziz was banned from driving for three years and given a suspended jail sentence after police caught him driving on the wrong side of the road.

This exclusion seems to apply to policies bought from almost all motor insurance firms.

How do you make sure you’ve got the best possible insurance cover for your car? Firstly, don’t just choose a policy based on price. Research what’s covered and what’s excluded by each company you’re considering. Secondly, if the level of cover you want isn’t available from standard car insurance firms, consider taking out extra insurance, such as gap insurance, from a specialist insurer.

Car insurance exclusions are usually not that hard to find, you just need to have a look at the rarely-read policy documents.

To be sure you’re not hit by a nasty surprise when you need to make a claim, make some time to read through policy documents when choosing your car insurance. Most insurance firms make their policy documents available online as a free download.

Impact Of Health Care Legislation Hr 3962 On The Outsourcing Industry

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President Barack Obama had a hard won victory on Saturday night (the 7-8th day of November 2009) when the landmark health care reform legislation (HR 3962) was passed with 220-215 votes. Now if everything goes the Obama way, then by the end of the year 09 Affordable Health Care for America Act would apply as a law impacting almost fifty million US lives. But what does this Act actually imply? How does it stand to impact an average US life? How does the Act affect the outsourcing industry at large? Through my article below I endeavor to answer these and many more questions.
Ab-initio we will refresh the fundamentals of federalism, stating the Roles, Duties, Nature, Scope and Restrictions on the government in a written federal constitution. Next we proceed to see whether the above attempt by the federal government to accede healthcare legislation is ultra-vires the powers granted by the US Constitution.

What is Federalism?

According to the traditional classification followed by the political scientists, constitutions are either unitary or federal. In a unitary constitution, the powers of the government are centralized in one government viz., the Central Government. In the federal constitution, on the contrary, there is a division of power between the federal and the state governments in a way that they are both inter-dependent and independent at the same time.
As we all know that Constitutions are organic documents which operate as fundamental law. The governments and their organs owe their origin to the constitution, derive their authority from the constitution and discharge their responsibilities within the framework of the constitution. The judiciary has the power to declare a law unconstitutional if the law is found to have contravened any provision of the constitution. The American Constitution is the oldest and a well praised example of federalism.

What are the powers granted by the US Constitution to the State Government?

Powers reserved for State Governments are:
Establishing local governments
Issuing licenses (driver, hunting, marriage, etc.)
Regulating intrastate commerce
Conducting elections
Ratifying amendments to the U.S. Constitution
Providing for public health and safety
Exercising powers which are neither delegated to the Federal Government nor were prohibited from the States by the Federal Constitution (residuary powers)
Framing other domestic law (for example, setting legal drinking and smoking ages etc.)

What are the powers granted by the US Constitution to the Federal Government?

Under the Constitution, powers reserved for the Federal Government are:
Printing of money
Declaration of war
Establishing the armed forces
Entering into treaties with foreign governments
Regulating commerce domestically and internationally
Establishing post offices and issuing postage
Making laws necessary to enforce the Constitution

What are the powers shared by Federal and State Government?

Under the Constitution, the shared, or “concurrent” powers are:
Setting up courts
Creating and collecting taxes
Building highways
Borrowing money
Making and enforcing laws
Chartering banks and corporations
Spending money for the betterment of the general welfare
Acquiring private property with appropriate compensation

What is the HR 3962 Act ?

The HR 3962 Act conceptualizes a new, voluntary, public, long-term care insurance program to help purchase services and support for people who have functional limitations. The Act endeavors to form a new national program to provide affordable coverage for those who cant get health insurance today because of pre-existing conditions. Under this, the insurance companies must spend 85 cents out of every premium dollar on medical services, thereby fostering the expansion of Medicaid and improving the Medicare. Under this, the young adults, till the age 26, are covered within their parents policies.

The Obama administration intends to attain this by creating mandates. As a self-sustaining public insurance option (that is financed not by tax dollars but by insurance premiums), this provides an alternative to and competes with private health insurance companies, on a level playing field. Additionally, the Act intends to eliminate the antitrust exemption for health insurers and medical malpractice insurers thereby fostering competition thus targeting the existing monopolies in the health insurance market. It aims to establish a new mandatory essential benefits package that shall become the minimum quality standard for employer plans, with the passage of time. The package places a cap for annual out-of-pocket spending, at a maximum of $5,000 per individual and $10,000 per family to prevent bankruptcies from medical expenses.

This Act requires the employers to either provide insurance to their employees or contribute to the cost of their coverage through the public plan/exchange, though the small businesses are exempted from this requirement.

Arguments regarding Constitutionality of HR 3962

The legal fraternity is divided between two schools of thought about the constitutionality of the Act. First school believes that the Act is unconstitutional and places reliance on Articles I 8 and V of the US constitution and on Tenth Amendment. They claim that their argument is supported by the celebrated case of MARBURY v. MADISON, 5 U.S. 137 (1803) and some federalist opinions. The second school of thought places reliance on Article I 8 and the celebrated case of McCulloh v. Maryland, 4 Wheaton 316 (1819); Steward Machine Co. v. Davis, 301 U.S. 548 (1937); United States v. Butler, 297 U.S. 1 (1936) and some federalist opinions. An in-toto analysis of these school of thoughts would conclude that the true interpretation of the word general welfare in Article I 8 of the U.S. Constitution can only determine the constitutionality of an Act like HR 3962. Till date the court opinions have been more inclined towards Hamilton (Federalist 33, 83 etc.) and Story rather than Madison (Federalist 41, 45 etc.).
Simply put, when the government mandates welfare as a quid-pro-quo for premiums collected, such welfare translates to nothing but a tax liability for the country men. Such an attempt by the government to regulate insurance sector by masquerading as an industry player is inspired from socialism. I personally feel that socialism is a Marxian concept and may not go well in an economy with capitalist foundations. The good thing is that people all over the world should buy insurance; this however turns bad when the government forces people to do so.

What are the implications of HR 3962 on the Outsourcing industry?

The object clause to the Act states that it is meant to provide affordable, quality health care for all Americans and reduce the growth in health care spending.

In reality, the act is a victim of haste. Ideally if the intention of the Obama administration and the object clause of the Act were actually in-sync then the administration should have awaited a confirmed indication of the end-of-recession. The administration should have first looked at strengthening the fundamentals of the economy, by:
better regulating the existing insurance sector,
improving the US agrarian culture and making the country self sufficient regards its food requirements,
checking the cost-of-living index and
creating more jobs in the private sector.
But if the intention is to make more and more Americans dependant on Federal Government for basic requirements, then the attempt is bang on.

Impact on the outsourcing industry:

Prima-facie it may seem complex but there are clear indications for the outsourcing industry to benefit once the HR 3962 is implemented. The benefit roots from the fact that the employees will become expensive for the employers post this Acts applicability. Now given the very competitive market scenarios, thin profit margin and the inability of the employer to transfer this increased cost to the end consumer, the employer is forced to search for the less costly alternatives. It is needless to say here that the Act magnifies the already existing labor arbitrage opportunities internationally. To appreciate the existing labor arbitrage opportunities you can refer to my older blog post.