By Dennis Jarvis

What a difference a decade can make. We remember getting the phone calls and going through various California health plans with people. We would eventually get to the question of HMO or PPO. We might be discussing a PPO plan when the person on the phone would ask, “But aren’t PPO plans more expensive?”. They use to be but not anymore. Let’s go into the slow but steady disappearance of HMO plan on the California individual health insurance market.

So what happen? Where did all the HMO plan go? The short answer is that they went real expensive and any plan that goes real expensive in today’s California health market quickly fades into oblivion. Let’s take a quick look at the history of HMO’s, their progression, and most importantly…how they stack up today as an option for health coverage on the individual market. Keep in mind that group health insurance in California is quite different which we’ll get into later. First, how did the HMO’s come about.

We’ve had a series of inflation periods in California health coverage. HMO’s and PPO’s were developed to try and counter one of these spells of inflation and they worked…for a while any way. This was the era of “managed care” which although the source of some derision, did what it was supposed to do and curtailed the onslaught of rapidly increasing health insurance rates. This period occurred from 80’s on and kept rates down until around the early 2000’s. HMO’s were a key part of this managed care initiative which flipped the responsibility of health care cost management on it’s head so that doctors were now given a capitated amount per person per month to treat patients. This was quite different from the indemnity style plans which basically payed as you used the coverage regardless with very little management from the California health insurance carrier. As a result of this management (through financial incentive to the doctor), HMO’s became attractive cost options especially to the group health market. Like we said, what a difference a decade makes.

Various changes occurred that impacted HMO’s ability to keep cost down. By definition, HMO’s are more managed in terms of the care. This is great for keeping costs down but doesn’t generate great PR and there was push back from the insured and eventually, the State government. Restrictions increased and HMO’s became more flexible as a result. Unfortunately, more flexible in a manage care means higher costs. The other issue is that HMO’s generally had richer benefits and in a world of ever increasing health care cost, absorbing more cost even under greater management doesn’t bode well. You can manage medication costs (say mandate a generic over a brand) but you can’t really manage an open heart bypass. With obesity skyrocketing, there are going to some real-world health care costs that can’t really be “managed” away. So where are we now?

For every 100 policies we issue, maybe…MAYBE 1 is an HMO and that’s probably an outlier. This is the individual market. The reason is simple. First, many of the HMO’s have deductibles built in now (not as rich) and they can be double to triple what PPO plans are. When you look at the annual premium difference, it’s hard to justify getting an HMO plan. It’s almost impossible. Okay, it’s impossible. We can’t think of a situation where a California individual HMO plan makes sense. Group insurance is difference where the cost comparison is still more favorable towards HMO’s but with the underlying trends in the market, it’s probably only a matter of time before they follow suit. Unfortunately, there are two ways to reduce health care cost. One is to restrict benefits or manage care the way HMO’s attempted or the other is to offer incentives (financial) for people to take better care of themselves. Eventually, we’ll get to the latter once we realize that we have no stomach for the former. You can quote PPO and HMO health plans side by side at our site www.calhealth.net

About the Author: Dennis Jarvis is a licensed California health insurance broker with extensive knowledge of the Individual and Small Group health market in California. Individual California health insurance

Source: isnare.com

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By Anita Fowler

Our meals should consist of certain amounts of proteins, carbohydrates, and fats. It is best to limit the amount of sugar and fat that we intake daily. In this article, I will share with you different foods that, when incorporated into your daily diet, will bring instant satisfaction to the way you look and feel.

Our meals should consist of certain amounts of proteins, carbohydrates, and fats. It is best to limit the amount of sugar and fat that we intake daily. In this article, I will share with you different foods that, when incorporated into your daily diet, will bring instant satisfaction to the way you look and feel.

First, we do not want to mix the good with the bad. If you want to see the benefit of nourishing foods, take a look at what is currently in your refrigerator, freezer and kitchen cabinets.

In order to make room for the yummy stuff, clean out old foods and junk from your kitchen. If you have any of this stuff on this list, toss it!

Bad Food Checklist:

1. Frozen Dinners – Watch out for the sodium and fat content. You will save a lot of calories, by making your own dinners. In place of baking the frozen dinner, bake some chicken or fresh fish.

2. Potato Chips – Are just too high in sodium and fat. Potato chips are empty calories. No real nutrition value.

3. Margarine – Next time you pick up margarine in a tub, read the label. Check for amounts of Trans fat.

4. Candy – Most candy contain highly saturated palm and coconut oils, and a lot of sugar.

5. Donuts – Before you buy those donuts, keep in mind, an average size donut is about 300 calories, will contain around 10-15 grams of fat, and mainly made up of Trans fat, enriched flour, and sugar.

6. Soda – These drinks are nothing but carbonated water, and sugar.

Now, for the good stuff. You may not like some these items. Buy the ones you do like. For every bad food item you eliminate, replace it with one of the Super Foods.

Super Food Checklist:

I have an extensive list of wonderful super foods. Today I will share just a few to get you started.

1. Nuts – Nuts are my favorite Super Food. I always make them number one, because of the variety and the simplicity of nuts. Nuts are so easy to add to your grocery list. Choose any nut like, almonds, Brazil nuts, cashews, pecans, or walnuts. Nuts drastically reduce the risk of cancer, heart disease and diabetes. They also can reduce visible signs of aging and wrinkles.

2. Yogurt – If you are wanting to lose weight, add yogurt into your daily food intake. Naturally rich in calcium. Studies have shown that yogurt, helps to reduce belly fat, while maintaining muscle.

3. Onions and Garlic – Both in the same vegetable family. They contain flavonoids that stimulate the production of glutathione. Glutathione enhances the elimination of toxins. This aids in reducing risk of stomach cancer.

4. Beans and Lentils – Beans are high in protein, carbs and dietary fiber. Pick the ones you like best, pinto, navy, black or kidney). Beans are low in fat, and release very slowly into the bloodstream to provide long lasting sustained energy.

5. Acai Berry – I saved this one to highlight last on my list. This little berry has gained a lot of attention lately in the health world, and with good reason. Harvested in the Rain Forest of Brazil, acai taste like berries and chocolate. Recent studies say that Acai is one of the most nutritious and most powerful foods in the world! Packed with anti-oxidants, amino acids, and essential fatty acids. It has 10 times more anti-0xidents than red grapes.

This is not a diet, it is not a weight loss program, it is a process. It takes time to get rid of old habits. You can take baby steps. Remember, just do a little bit at a time. By implementing some of the suggestions, you can begin to reap the benefits of our food supply, hopefully begin to look and feel better.

About the Author: Anita is a Ace Certified Fitness trainer, and a Former National Bodybuilding Champion. She has worked over 20 years in the Fitness Industry. For more info visit afitgirl.info. Or contact Anita at afitu@yahoo.com

Source: isnare.com

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Submitted by: Dennis Jarvis

The whole health subsidy change is new to American and most people. There are many questions on how it works and whether a person is eligible. Your answers are below! Keep in mind that the health reform bill which created the health subsidies is 1000’s of pages….none of them easy or fun to read. Our goal at

HealthSubsidy.net

is to take all that information and simplify it so that real people can understand their options. A quick lay of the land. On this page, we’ll hit the big ticket items that touch on the health subsidy universe with links to additional detail on each topic. Let’s get into it!

Eligibility

In general, the subsidy will be available for individuals and families (not through group health insurance) who are citizens of the United States. There are three important considerations to look at in terms of eligibility. There other constraints and rules (it was a product of Congress after all) but these are the big three.

Up to 400% of the Federal Poverty Level

The subsidies are designed to help people afford health insurance for those that make up to 400% of the Federal Poverty Level. You can access those numbers here and the qualification will have a look back period. For example, 2013 income will drive 2014 eligibility. Below between 133% and 150% of the FPL, you may qualify for no cost Medicaid depending on your State. From that baseline up to 400% of the FPL, you will likely be eligible for a health subsidy. Above 400% of poverty, there will be NO subsidy. More detail on the 400% Rule

How much Health Subsidy can you Expect

9.5% of your income becomes a factor

So let’s say you qualify based on the 400% Rule of the FPL? How much will you receive. There’s two considerations here. First, how much is the underlying health insurance plan premium itself. This is driven by your age, area, and family make up. The second factor is the 9.5% Rule. Basically, the law states that you shouldn’t have to pay more than 9.5% of your MAGI (Marginal Adjusted Gross Income) towards health insurance. For example, if you make $1000 monthly in MAGI, your health insurance shouldn’t be more than $95/monthly. If your health insurance is $400/monthly, your expected subsidy would be $305/monthly or more than $3600 annually. We recommend using our Health Subsidy Calculator (props out to Kaiser Foundation) for an estimate and the Health Subsidy Quoting page will show actual numbers starting Oct 1st 2013.

How will the health subsidy actually work

Keep in mind that there may be differences by State but the health subsidy is expected to process this way. You will run your quote through our Partner (eff Oct 1st 2013). Part of this process will ask for income information. The system will automatically determine whether you qualify for a health subsidy and show the net premium by plan. You can then apply for coverage right through our Quoting partner and you will only pay the net difference. The health subsidy is all handled automatically starting the first month that you actually have the coverage. There may be some tax time considerations if your income increased or dropped significantly (the 400% and 9.5% rule above) but the process is fairly automated. That’s great news!

Which plans can you enroll in with the Subsidy

The health subsidy will be based on the Silver Metallic plan (see Health Exchange plans and Metallic plans). Each State will have different options to qualify with the subsidy which you can find in our Health Subsidy Quote page when the Exchange is live (Oct 1st 2013). If you qualify for a subsidy, there will be very little reason not to get a qualified Exchange plan. If you do not qualify for a subsidy, you’re best options will likely be off the Exchange or to keep your Grandfathered plan (a plan unchanged with effective date prior to 10/23/2010). More detail on Exchange Plans and Grandfathered Plans.

About the Author: Dennis Jarvis is a licensed health insurance agent who focuses on helping people understand the new

health subsidy

available through Reform for healthcare. More info on

Understanding health subsidy

Source:

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