Title: A Quick Introduction To California Health Insurance And Pre-existing Conditions, Waiting Periods, And Exclusions

Transcription

1 Title: A Quick Introduction To California Health Insurance And Pre-existing Conditions, Waiting Periods, And Exclusions Word Count: 872 Summary: It's important to look at a carrier's policies and restrictions regarding pre-existing conditions, waiting periods and exclusions as they can differ from company to company. This is just an overview in layman's terms. First...what is a pre-existing condition. The official definition reads as follows: Pre-existing Condition Any illness or health condition for which you have received medical advice or treatment during the six months prior to obtaining health insurance... Keywords: california,health,insurance,pre-existing,conclusions Article Body: It's important to look at a carrier's policies and restrictions regarding pre-existing conditions, waiting periods and exclusions as they can differ from company to company. This is just an overview in layman's terms. First...what is a pre-existing condition. The official definition reads as follows: Pre-existing Condition Any illness or health condition for which you have received medical advice or treatment during the six months prior to obtaining health insurance. Group healthcare policies cover pre-existing conditions after you have been insured for six months, and individual policies cover pre-existing conditions after you have been insured for one year. Reference CIC Section

2 Creditable coverage must be counted towards any pre-existing condition exclusion in either an individual or group policy. Essentially, it is a medical condition, illness, or injury for which you just had treatment, are undergoing treatment, or have had treatment in the past. The context in which an insurance company will look at pre-existing conditions strongly depends on the type of insurance. Individual and Family California health insurance. This type of coverage is medically underwritten which means that you need to qualify based on health. Pre-existing conditions have the most impact here and it affects coverage in two ways. First, you must qualify for coverage based on health so a carrier can increase your rates or decline/defer coverage altogether based on your pre-existing conditions. They typically have underwriting guidelines specifying how they may look at particular issues. Ultimately, the underwriter (person who decides to approve or decline health coverage) makes the final decision based on information found in the health application or medical records (if requested). For some issues, the health insurance carrier may want a certain amount of time away from a give situation before offering coverage. A general rule of thumb is 6 months to one year for a more simple situation (simple broken bone, infection, etc). Some issues are deemed uninsurable for which they will not offer coverage ever. If you are unable to qualify for individual - family health insurance in California, you can find options for the uninsured through the State such as MRMIP. The second way pre-existing conditions can affect coverage for Individual Family California health insurance is after approval. If approved for coverage, there can be a waiting period for treatment (payment of) pre-existing conditions of up to 6 months if you did not have prior coverage or lapsed coverage for more than 62 days. Essentially, they will take into account time on a prior qualified plan (may be individual, small group, short term) towards a six month waiting period for pre-existing conditions. Tier increase with Individual and Family coverage. If a carrier does not decline coverage based on pre-existing conditions, they can increase rates. Tier 1 is the best rate and you can find this rate when you quote individual California health insurance. Tier 2 is typically 25% higher than this standard rate. Tier 3 is typically 50% higher and Tier 4 is typically 100% higher. Some carriers apply different increases. For example, Blue Shield of California has a Tier 5 which is much higher. This tier increase is not locked in stone and you may be able to have it removed or lowered in the future once time has passed from a given situation (assuming you are in otherwise, good health). We recommend submitting the required change of coverage form every 3-4 months until this tier increase can be increased. California Small group health insurance and Pre-existing conditions. Pre-existing conditions are treated differently for Small Group in some important ways. HMO's are typically not subject to waiting periods for pre-existing conditions. Maternity in California is typically not subject to waiting periods for either HMO or PPO plans. Otherwise, the six month waiting period is the same as individual plans. Always submit all claims through the carrier regardless and let them make the decision on waiting periods.

3 Small Groups do not have tiers but by law, a carrier can go up or down 10% from the standard (Request Small Group California quote at rate based on the health of the group. This is called the RAF (Risk Adjustment Factor). A 1.0 RAF is the standard rate. 1.1 would be 10% higher and.90 would be 10% lower. The larger your group, the more likely you will have a lower RAF. Some carriers automatically give small groups the extra 10% increase as there are fewer people to spread the risk among. Exclusions of certain conditions California law prevents carriers from excluding conditions a specific applicant may have (if a covered benefit) upon approval as other states allow. This is a mixed blessing. On one hand, a new enrollee does not need to worry about a condition re-occuring and having coverage declined during a period of time. The downside is that a person might be unable to qualify for coverage altogether which defeats the purpose of banning exclusions to begin with...the law of unintended consequences. Keep in mind that this exclusion is only dealing with a specific person's pre-existing condition. Some plans will exclude certain coverages (i.e. maternity, brand name drugs) by design. A plan's summary and explanation of benefits will list their standard exclusions. It's important to look at a carrier's policies and restrictions regarding pre-existing conditions, waiting periods and exclusions as they can differ from company to company. Title: Health and Safety-It Makes Good Cents Word Count: 538 Summary: For every 1 dollar spent 3 dollars can be saved. Health and safety programs not only make the workplace safer but also save money for the business. Keywords: small business,insurance claims,insurance discounts, business insurance discounts,small business forums,safety, health and safety Article Body: Health and Safety-It Makes Good Cents Data shows that small businesses that have health and safety procedures in place reduce their injury and illness costs by 20 percent and even up to 40 percent. Nearly 95 percent of business owners report that health and safety programs have a positive impact on the company's bottom-line according to a recent survey. Of this group, 61 percent say their return-on-investment is 3 dollars for every 1 dollar they invest in improving workplace safety. In addition, companies that have working health and safety programs in place have seen

4 抯 employee absenteeism drop in half. A well planned health and safety program is obtainable even for small businesses. For example in this worst to first situation, a small manufacturing company was forced into putting a health and safety program in place or be shut down. They started by doing an audit, identified and controlled hazards, showed working procedures, and had to keep their injury rates below the national average for their sector. After they had implemented their health and safety program, they had many years with not one injury and saved more than $45,000 on insurance premiums. The company was even recognized with an award for their safety record. The owner, Rick, said "Our health and safety program has helped us protect our employees, maintain compliance, keep our vital employees working for us, and has saved us real money to put back into our company." Health and safety is no longer just viewed as a good idea, but a crucial investment in the business' long term success. Mounting costs of unhealthy employees and the expense and disruption of staff turnover is turning many small business owners to health and safety. The payback in health and safety programs comes in the form of: improved productivity, fewer insurance and worker comp claims, less absenteeism, decrease in accidents, reduced staff turnover, higher employee morale, and leads to a better business reputation and customer loyalty. Unhealthy and absent employees are costly. Businesses incur direct costs such as worker's comp payments, disability costs, replacement employees, equipment damage, and even lost productivity. By having a health and safety program in place, employers also protect themselves from liability in employee's injury in being exposed to unidentified hazards in the workplace. Employers can be charged in injuries caused to untrained employees. An unhealthy may also threaten the safety of others such as fellow employees, the business owner, and even the customer of the business. In starting a program, there needs to be commitment. Employers must get a feeling of the seriousness of this new procedure. The planning should be a partnership between the business owner and employees. To be able to actively engage all aspects of the on-going process in the business, the program should consider all of the major health risks in all of the areas of the workplace to meet the needs of all employees. Deciding on whether to have a health and safety program should be clear. Health and safety issues in the workplace cost the business owner directly and even in lost opportunity. A change to making the business safer will lead to a more positive bottom-line. For any questions or even help in getting started, drop us an at abbsafetynet@gmail.com. Title: Relationship Help: Solution For A Healthier And Rewarding Relationship Word Count:

5 573 Summary: There is no such thing as a perfect relationship. All couples go through rough times and experience difficulties in maintaining a healthy relationship. However, there are some who do not take these as a challenge and so they easily let go and end the relationship for good. Ending the relationship is not always a best solution when conflicts arise. Conflicts are normal part of the relationship and these even make the relationship stronger and test your love for each other... Keywords: relationship, love, lost love Article Body: There is no such thing as a perfect relationship. All couples go through rough times and experience difficulties in maintaining a healthy relationship. However, there are some who do not take these as a challenge and so they easily let go and end the relationship for good. Ending the relationship is not always a best solution when conflicts arise. Conflicts are normal part of the relationship and these even make the relationship stronger and test your love for each other. If you end the relationship sooner, it only goes to show that you have a weak foundation and your feelings for each other are not that intense. So, when you encounter problems in the relationship, the best thing that you can do is to seek relationship help. Relationship help is very much available on the Internet nowadays. More and more relationship counselors have taken advantage of the power of the Internet to reach a wider market that is in need for relationship help. But since there are lots of options available, you have to make sure that you choose a reliable adviser for you, one who really has the experience and the commitment to serve other people who long for a rewarding love life and great relationship. There are several ways where relationship help can be provided. These can be through significant tools for positive change, personal coaching, and retreat for couples. Because of the Internet, these are very much available for easier access and more convenience. You need not to leave the comfort of your home or office just to inquire and avail of all these. By simply browsing through sites, you can now seek relationship help in minutes. Nowadays, there are lots of books about relationships that can be purchased in local stores and online. These books include articles about improving relationships, different advice from marriage and relationship counselors, and success stories of couples who overcome very difficult times in their relationship. These books can help you a lot in assessing your relationship problems as well as yourself in order to figure out the best solution to undertake. Aside from that, these books can also help you stay on a positive track and are essential if you want a truly rewarding partnership. Personal coaching can also play a significant role in providing relationship help. You can check online for a site that offers a coaching session for couples. This session can help you have a healthy, joyful, and rewarding relationship. After the session, you will sure gain clear insights about resolving relationship issues and you will learn new strategies to make positive changes

6 even if you are in very rough times. If a personal coaching session is not the thing for you, then you can always opt for a retreat. By spending a week with your chosen relationship counselors, you can really seek relationship help. A retreat for couples is often held in an intensive and supportive place to achieve profound results. A concentrated weekend program is included to really transform your relationship. When you get home, you will really feel that your relationship is renewed and the romance is rekindled. All these ways can really provide you with effective relationship help that gives positive results. You should keep in mind to seek relationship help as soon as you see a first sign of trouble. This will help you resolve the problem sooner and avoid much bigger conflicts in the future.