The "New Normal" in Health Insurance

High prices, no providers and lousy service

I want to apologize first and foremost to all of our health insurance clients for the deterioration of the level of service which we have been providing. The implementation of Obama Care (ACA) has been a complete disaster and it has thrown all of the insurance companies into chaos. The government failed to advise the companies as to what to do because they themselves had not yet written the rules. Because of this, the companies unfortunately could not advise us as to what to tell you, our customers.

Obamacare is driving up rates for everyone unless you make less than $45,000 a year and are getting a government handout sponsored by the taxpayers or have insurance but are being surcharged for a serious pre-existing condition. We do not participate in the Covered California exchange, as that is the only way you can get the socialist taxpayer subsidy and there is already enough wealth distribution going on in California without our help. If you are willing to pay for you and your own family’s health care costs, we are ready and willing to help you navigate through the morass that is Obamacare. We have the expertise to make the process as painless as possible.

The companies are in a state of chaos. They have fired most of their intelligent, quality people to cut the costs and are then replacing them with low paid novices that can barely spell insurance. The old Palo Alto landmark “Rudy’s Pub’s” motto was, ‘Lousy service, warm beer and cheap food.’ It was a kind of a cute takeoff on English pub humor.  The “new normal” for health insurance of ‘lousy service, poor provider lists, long waits, higher premiums, fouled up billing, and no one that knows or wants to fix it’ is simply NOT CUTE.

          Now that open enrollment is almost over, the rules and rates are pretty clear, although the companies’ service is still lousy. If you attempt to call an insurance company, you will experience a hold of one to three hours followed by your call becoming disconnected, transferred, or you may even be given wrong or conflicting information. You can avoid all of this by just calling Ron at Insurance by Allied Brokers today to guide you through the chaos for no additional cost!

“Not touched by human hands” has become our new method. If we cannot do it online or via mail, then it cannot be done. We have been able to learn all the new rules and how to get things done for our clients without having to talk to the companies. Please take my advice, and do not try to do it on your own. Without us to navigate for you, it is hopeless. We will use our expertise and genuine care for your best outcome to help you through this difficult process and get the job done!

Services we provide under the “New Normal”:

• Signing Up

1. Signing up for a new or replacement policy
2. Explaining rates, coverage, and options
3. Choosing provider networks
4. Comparing companies

• Billing and Payments

1. We can check all of the companies online
2. Change of bank or payment plan

• Coverage and your share of the Bill

1. Answers to your general questions
2. Write letter to the companies contesting billing issues (Two month minimum wait)
3. The best method is to skip the insurance company and contact your doctor directly on miscoded items
4. Collection Agencies and your doctor and/or hospital are not getting paid on time so they are sending you to collections. Do not pay them; just send them your letter contesting the bill that we will have already sent to the insurance company

Let us help you get exactly what you want and need instead of headaches and wasted time that you will not get back. Insurance by Allied Brokers is the solution, YOUR solution!

What Does The Election Mean For Employers And PPACA?

Now that President Obama has been re-elected, the Patient Protection and Affordable Care Act (PPACA) will move forward largely as the law was passed in 2010.

The law left the task of working out many of the details to various regulatory agencies and with many questions remaining unanswered, employers can expect that an enormous number of regulations will be issued between now and the end of 2013.

Of great interest to employers is the employer shared-responsibility ("play or pay") requirement. As of Jan. 1, 2014, employers who have 50 or more full-time employees must offer "minimum essential" (basic) medical coverage for their employees who work more than 30 hours per week- or pay a penalty of $2,000 per full-time employee, excluding the first 30 employees.

Employers who offer coverage that is not "affordable" or fails to provide "minimum value" must pay a penalty of $3,000 for each employee who receives a premium tax credit. Coverage is not "affordable" if the employee's cost of single coverage is more than 9.5 percent of income. Coverage does not provide “minimum value” if it is expected to pay less than 60 percent of anticipated claims.

Regulations are still needed to provide details on how the penalty will be determined and collected for employers who do not provide health coverage to their full-time employees, what exactly is the "minimum value" coverage that must be provided to avoid the penalties, and when dependent coverage is "affordable."

The health insurance exchanges are also scheduled to begin operation in January 2014. While PPACA is a federal law, the health insurance exchanges were designed to be operated by the states. If a state is unable or chooses not to create an exchange, the federal government will run the exchange on the state's behalf.

In addition to deciding whether to "play" (provide health coverage) or "pay" (the penalties), employers (including those with fewer than 50 employees) have a number of compliance obligations between now and 2014, including:

• Distributing medical loss ratio rebates if any were received from the insurer
• Expanding preventive care to include a number of women’s services
• Issuance of summaries of benefits and coverage to all enrollees
• Reducing the maximum employee contribution to $2,500, if the employer sponsors a health flexible spending account (FSA), beginning with the 2013 plan year
• Withholding an extra 0.9 percent FICA on those earning more than $200,000 beginning in 2013
• Providing information on the cost of coverage on each employee's 2012 W-2 if the employer issued 250 or more W-2s in 2011
• Providing a notice about the upcoming exchanges to all eligible employees in March 2013
• Calculating and paying the Patient Centered Outcomes Fee in July 2013 if the plan is self-funded
• Working with the exchanges to identify those employees eligible for premium tax credits
• Reporting to the IRS on coverage offered and available- first reports due in 2015 based on 2014 benefits
• Limiting eligibility waiting periods to 90 days, beginning with the 2014 plan year
• Removing annual limits on essential health benefits and pre-existing condition limitations for all individuals, beginning with the 2014 plan year

If you have questions about how these new regulations will affect your business, call Allied Brokers today. Visit our website at www.alliedbrokers.com for information about all the types of insurance we offer. Or call 1-888-505-7988 for a free rate quote.

Information provided courtesy of AEIS 306 6th Ave. Ste. B, San Mateo, CA 94401

Buy Local, Hire Local, Support Local: Say NO to Call Centers and Outsourcing

Time Magazine recently reported that Aetna, the US’s third largest health insurer, has partnered with Costco to offer individual health care policies to its customers in nine states- Connecticut, Illinois, Texas, Michigan, Virginia, Georgia, Arizona, Pennsylvania and Nevada- as well as lower co-pays for customers who use Costco pharmacies. Aetna says its Costco plans are about 5% cheaper than the individual policies it normally offers and intends to add more states later this year.

Insurers, financial firms and retailers are anticipating that millions of uninsured people will have to buy health care by 2014 under the new Affordable Care Act and have been experimenting with ways to attract new customers. Humana now offers prescription drug plans through Wal-Mart and Aetna has also teamed up with Best Buy to sell supplemental wellness plans. Health insurance has become the Wild West and major carriers will continue making land grabs at big-box stores.

Unfortunately, Progressive and Hartford AARP have also joined in on the commoditization of what remains a complicated and personal product. Service and expertise will soon be a thing of the past. Buyers beware- anyone who chooses a carrier based on price alone deserves what they get when they submit a claim that is not covered.

Allied Brokers hires and trains the best local professionals so we can provide top-notch service and expert advice for our clients. Call us if you want a dedicated agent who knows you and can educate you on the  best choices for your unique insurance needs. You will get a real person who remembers your name and your previous conversation. We have an office on Cowper St. you can visit- and if you want to talk to the owner, he is there every day. Availability and accountability are among our core values.

By working with us, you are also supporting a local merchant that pays local taxes and rents, supports local charities and patronizes local businesses. Allied Brokers has been part of the Palo Alto community for over 50 years and although we won’t stuff you with mini quiche samples like at Costco, your agent will always be available when you need help.

Visit our website at http://www.alliedbrokers.com/ for information about all the types of insurance we offer. Or call 1-888-505-7988 for a free rate quote.

Blue Shield Accused of Culling the Herd

Last week in San Francisco a consumer advocacy group called Consumer Watchdog filed a lawsuit against Blue Shield of California. They accuse Blue Shield of a pattern in which it stops selling a policy and then raises rates for those who are left in the plan. Those who stay tend to have more health problems because they don't have many other options for coverage.

The lawsuit argues Blue Shield is violating a 1993 state law that requires health insurers that intend to stop selling a type of policy to "pool" the health history of the members in the closed block of business with other enrollees to minimize rate increases for those left in the old policy.

The 1993 law also requires insurers to offer members the option to switch to a comparable policy that is accepting new members. But the consumer group's attorney, Jerry Flanagan, said offering members another policy with a deductible more than twice as high as the old policy and fewer benefits isn't "comparable."

"You can't close out older policies for the purposes of kicking out sick people," Flanagan said. "You buy insurance when you're healthy, you pay into it, and eventually people are going to get sick and are going to use their health insurance. That's how it works." He claims Blue Shield is trying to force policyholders out of older, more comprehensive individual plans into newer options that offer less coverage with higher out-of-pocket costs.

Blue Shield officials denied wrongdoing.

When this happens to your pool, call Allied Brokers. There are things you can do to avoid paying the increased rates. Blue Shield establishes lower rates within the same pool for those who are in better health. This is called “tier rating” and it is normally in five different levels.

If you are in good health, you can apply for one of the new plans that have lower rates. Or you can apply for a change to a lower tier premium rate for your present plan.

Another option is to change your deductible and/or drop some of the coverage. One Allied Brokers client saved $4,800 per year by dropping some coverage and raising his deductible from $750 to $2,000.

If you are in poor health, you can apply for a change to a lower tier rate level premium as your health improves. If you do not re-apply to prove you are healthy enough to change tiers, you are stuck. Most people do not know they can transfer to get a better deal. Call us- this service is free.

Visit our website at http://www.alliedbrokers.com/ for information about all the types of insurance we offer. Or call 1-888-505-7988 for a free rate quote.

The original article, by Victoria Colliver, can be found on SFGate.com

Year End Tax Saving Tips

The end of the year is the time when most of us think about taxes and ways to save on them. Two common and effective ways are:

By deferring income. If you are planning to sell off investments on which you have made a profit, consider the potential tax savings if the sale is deferred till next year. Similarly, if you expect a year-end bonus, you could defer the receipt for a month and take the money in January, thus deferring the tax liability till 2012. The same applies to any stock options you may be entitled to. While exercising the option may not be taxable, selling the stock is. For the self-employed, examine which invoices and bills can be deferred (thus deferring the
income) till January 2012.

You can also accelerate deductions. Make a reasonable estimate of your state tax and pay the installment in December rather than the January due date. You can also pay your complete property tax bill for 2012 in December 2011. Please note that this is not applicable to mortgage escrow accounts. Medical and other “threshold” expenses are deductible only to the extent they exceed a defined percentage of the Adjusted Gross Income. If you can group all these expenses into one year, the chance of exceeding the threshold increases; as does the amount of deduction.

At Allied Brokers we do not just sell insurance policies. We work with our clients to provide them the optimum insurance coverage at the right cost. Whether it is life insurance, health insurance, home insurance, various types of business insurance, auto insurance or any other kind of insurance, we customize solutions that are right for our clients. We have been in business over 50 years and are proud of the reputation we
have built. Visit our website at http://www.alliedbrokers.com/ to learn more about Allied Brokers and the insurance services and products we offer. Or call 1-888-505-7988 (toll free) for a free quote.

Information courtesy Orlando, Mitts, Moore & Company, San Jose, CA. Phone: 408 278-0300.

Blue Shield and Lucile Packard Work It Out- Finally

Two of the region’s leading pediatric care providers were locked in protracted negotiations with Blue Shield of California which caused them to remain outside the Blue Shield network from August 31st to October 19th of this year. With the signing of a new two year contract, both Lucile Packard Children’s Medical group and Lucile Salter Packard Children’s Hospital are once again part of Blue Shield of California and Blue Shield of California Life & Health Insurance Company Networks.

It must be noted, however, that since the new contracts are not retroactive, any services provided by the Medical Group and Hospital during the out-of-contract period will be treated as out-of-network or as being non-participating and will be paid at out-of- network rates. However, if the member was approved for Continuity of Care (COC) during that period, services that are covered under the COC will be paid at the old contract rates. These agreements will once again allow Bay Area residents to have a wider choice of pediatric care providers.

Such contract negotiations with health care providers are Blue Shield’s attempt to contain the ever rising costs of medical care. As a result, Blue Shield customers enjoy lower co-payments, deductibles and premiums.

Health insurance is a complex and often confusing subject where potential health risks and care costs have to be balanced against the cost of the policy. Working out the best balance is something that requires both experience and an expert knowledge of health care costs and options. Allied Brokers has over 50 years of insurance experience and expertise which is always at the disposal of our clients. Contact us for all your health and other insurance needs. Call 1-888-505-7988 (toll free). Visit our website at http://www.alliedbrokers.com/ to find out more about us and the insurance products and services we offer. You can also ask for a free rate quote.