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California Health Insurance

That time of the year is coming up again! The Medicare Annual Enrollment Period is just around the corner. Each year from October 15 to December 7th you have the ability to enroll for Medicare. But as you prepare to enroll, now is an excellent time to go over what plans there are and more importantly than that, to look over what is important to you so that as you look through plans you can find the one that will meet your needs. You won’t want a plan that will keep you in a compromising position all year long. Make sure that you are well informed and take the time to know what you really want. For example, If you know that you are going to be on a fixed income you will want to make sure that you are looking at plans that will have low out of pocket costs. Or if you want to ensure that you are maintaining the best health possible then you may want a plan that is very proactive in prevention care.

When you are looking at you coverage make sure that you read the fine print to see what is covered in your care. You may be surprised at what you find there. Many health plans offer extras that are included in their plans such as wellness check ups, 24 hour hotlines to speak to nurses and discounts on fitness and nutrition plans. There is also often preventative care available to you. And the easiest way to prevent expensive out of pocket costs is to make sure that you are catching things before they really blow out of control. In fact, the Center for Disease Control has made an estimation of about 100,000 lives could be saved each year if they received the recommended preventative care. You will also want to know not only what doctors and hospitals are covered but what specialists and specialized medical facilities will be available to you.

We hope that these tips will help you prepare for open enrollment, but if you have any questions about Medicare, please let us at Bernardini & Donovan help you.

There are some people in the world that just know things. They are the mavens that can rattle off facts, dates and details that the rest of the population just never grasped. This blog post is not for them. This post is for those of us who don’t know the first thing about Medicare and the deadlines needed to sign up.

So first things first. You become eligible for Medicare when you turn 65. But the deadlines for signing up extend to the months that surround you birthday. However, there is an exception if you already are receiving Social Security benefits you are automatically enrolled in Medicare A and B. But if that is not the case then you need to sign up yourself. You have a window of enrollment that last seven months. The seven month window begins three months before your birthday month, goes through your birthday month and continues on for the next three months after your birthday. So if your birthday was in June you could sign up for Medicare starting March 1st and it would end September 30th. If you miss this deadline you can join during open enrollment from January 1 to March 31 each year.

The reason that you will want to make sure that you sign up during these seven months is so you will avoid any fees that come with signing up late. The monthly Part B premiums will be raised by 10% for each 12 month period you wait to sign up for Medicare. “The idea behind the penalty is to give people a financial incentive to enroll in insurance from the get-go as opposed to waiting until they have some kind of negative health event,” says Mark Duggan, an economics professor at Stanford University.

It is important to note that if you or your spouse are still working for an insurance providing company when you or your spouse turn 65 it is not mandatory to enroll at that time, you can stay with your current provider. However, once the household member that they insurance is provided through retires then you will need to enroll. You will have an 8 month period enrollment time. The 8 month time period starts the month after the employment ends or when your insurance coverage from that job ends.

We hope this information helps, but if you have more questions please feel free to contact us at Bernardini & Donovan

Change is inevitable. Each day when you wake you just can’t be sure what that day will bring. Granted, sometimes you get a heads up. Like when you see the storm clouds brewing off in the distance, it’s a good idea to bring your umbrella. Or when you hear of a huge traffic hold up on your normal commute, you avoid that route and take the side roads. So here is your heads up when it comes to Covered California rates. They are going up to the tune of 13.2%

For the past two years California has been able to negotiate to keep the rates in an affordable increase averaging around a 4% increase. However, the legislation that allowed for them to do that is now is now expiring. With these rate increases we will see California’s rates being more comparable to the rest of the nation whose rates have been rising steadily over the past few years.

Also, if you are small business owner with 50-100 employees, the laws are changing for your health coverage. If you have 50 and up to 100 full time eligible employees then it is required that you provide health insurance for your employees.

So why are these changes happening? Peter Lee, the executive director of Covered California says that “Under the new rules of the Affordable Care Act, insurers face strict limits on the amount of profit they can make selling health insurance… We can be confident their rate increases are directly linked to health care costs, not administration or profit, which averaged 1.5 percent across our contracted plans.”
Of course as our country continues in our heated political race this discussion will continue to play a part as the presidential candidates weigh in on the effectiveness of the Affordable Care Act. With this change coming it will be interesting to see the full effects of these coming changes.

Looking into insurance for your employees at your small business? What does Covered California have to offer you as a small business employer? Well, we are glad you asked. Here is some basic information about what you could expect:

First, let’s define a small business. Covered California defines a small business as any business with under 100 full time equivalent employees which is a W-2 employee working 30 hours a week measured on a monthly basis. Covered California offers a variety of health insurance plans to puts you in charge of your health insurance budget while letting your employees get to choose from affordable, quality, and popular health insurance plans from private health insurance companies. The plans have levels of Bronze, Silver, Gold or Platinum. As an employer you can chose one or two plan levels of coverage to offer employees and define the amount they will contribute towards their employee premium. At that point the employee has the choice of which plan will meet their families needs. But regardless of the plan that they choose, all the plans offer these 10 basic benefits:

1. Doctor Visits
2. Prescription Drugs
3. Emergency Services
4. Pediatric Care with Dental and Vision
5. Lab Services
6. Maternity and Newborn Care
7. Hospitalization
8. Preventive and wellness care
9. Rehabilitation
10. Mental health and substance abuse services

You can enroll in Covered California at any time and the coverage will last for the 12 months following when you signed up. You can also add new employees to the program throughout the year as they get hired. You may even be eligible small business tax credit to offset the cost of providing insurance. To find out more about Covered California, more of what is offered, if this could be a good fit for your business and what is needed to qualify for the small business tax credit contact us at Bernardini & Donovan. We are experts in all the ins and outs Covered California and can help you make the best choice that fits your unique situation.

Most people assume that our healthcare systems are paid for through private funds. Those private funds coming from health insurance premiums or from employer based coverage. However, a recent study shows that in California, that is just not the case. In fact about 71% of all funds paying for California’s healthcare comes from public funds, meaning California’s taxpayers are paying for a majority of the state’s health coverage. In 2016 it is estimated that $367 billion will be spent on health care. With these numbers that means that roughly around $260 billion will come from taxpayer money.

But California seems to be a unique case. When looking at the country as a whole, it was estimated that only 45% of the $3 trillion spent on health care comes from public funds. So what has made California stand out so much from the national average? Well there are a few factors to look at. One is that the national average is estimated to be much lower than what is actually being used. The American Journal of Public Health estimates that a more accurate picture of national spending is around 65% of public funds are put towards health care. The second aspect is that California does have some unique cases. UCLA’s study on California’s expenditures states that “health spending through county public health expenditures, new Affordable Care Act subsidies and tax subsidies for employer-based health insurance drives the proportion of care paid for by the public well beyond the CMS estimate” California also has had a larger expansion of Medi-Cal coverage showing around ⅓ of the state’s population is covered through this low income program.

What does this mean for you? Researchers are now beginning to question what it would look like to have a single payer health care system because we are already leaning towards that end of the spectrum as it stands. But we will have to wait and see how things continue to change with our aging generations and shifting political systems.