Cornerstone Benefit and Retirement Group, Inc.
163 South River Road, PO Box 10487
Bedford, NH 03110-0487
603-647-9136
Health Insurance & Employee Benefits
Health Insurance or just "healthcare", as it is now often referred to...
...is a serious issue, too important to ignore, and the full ramifications
of the recently passed health 
insurance
reform won't be known for some time. It is a time of some uncertainty.
At Cornerstone Benefit & Retirement Group, Inc. we are staying current on the issues and will inform our clients of any significant changes that will directly impact their situations.
For the time being, however, individuals and employers have the choice of a full range of carriers and benefit plans.
We can help you with:
- Individual Medical (apply on-line by following the links on the right)
- Employer/Employee Group Medical
- Short Term Medical to cover a gap
- Long Term Care Planning
- Medicare Supplement Planning
We represent all the major health Insurance providers in New Hampshire.
You can link to them below:
Health Law Implementation Begins
Over the last month, the implementation of the new health law has begun. Numerous regulations will provide guidance on how the new law will be implemented. Following is an update on the progress made by the Departments of Health and Human Services, Labor, and Treasury.
Adult Child Coverage:
On May 10, the Departments of Health and Human Services (HHS), Labor
and Treasury issued new regulations to extend coverage to young adults
by allowing them to stay on their parents' health care plan until age
26. While the new provision takes effect for policies and plan years
beginning on or after September 23, 2010, more than 65 insurance companies
have voluntarily agreed to provide coverage to young adults before
the deadline. On April 27, the Internal Revenue Service released new
guidance specifically stating that children can be covered tax-free
on their parents' health insurance policies.
Pre-existing Conditions:
Effective for policies or plan years beginning on or after September
23, the Affordable Care Act will prohibit health insurers from excluding
coverage of children because of pre-existing conditions. Regulations
expected soon.
Grandfathered Plans:
The law provides that grandfathered health plans do not have to comply
with a number of the new requirements including:
- Highly Compensated Nondiscrimination Rules - Grandfathered plans that are insured plans will not be subject to the nondiscrimination rules of Internal Revenue Code Section 105(h). The Act expands the application of these rules (effective for plan years beginning after March 23, 2010) to include all insured plans that are not grandfathered.
- Essential Benefits & Cost Sharing - Grandfathered plans do not have to provide “essential benefits” without any cost sharing for those benefits.
- Appeals & External Reviews - Grandfathered plans are exempt from the requirement that group health plans must establish and maintain a claims and appeal process that includes external review.
- Preventive Care - Grandfathered plans do not have to provide the specified preventive care that other group health plans must provide.
- Emergency Services - Group health plans must provide emergency services without prior certification and allow out-of-network expenses under the same cost structure applicable to in-network emergency services. This provision does not apply to grandfathered plans.
- Provider Choice - Grandfathered plans are not required to provide an individual with the choice of a primary care physician, do not need to permit an individual to choose a pediatrician as a primary care physician, and do not need to permit women direct access to an obstetrician or gynecologist.
- Clinical Trials - Grandfathered plans can continue to exclude coverage for a treatment solely because it is part of a clinical trial.
- Annual Reports - Grandfathered plans will not need to provide annual reports to the Secretary of Health and Human Services regarding health care quality and wellness programs.
- Cost-sharing Limits - Beginning in 2014, health plans are prohibited from imposing total cost sharing for a year that exceeds the out-of-pocket limits that are applicable to high-deductible health plans. Also in 2014, the Act will limit the maximum deductible to $2,000 for individual coverage and $4,000 for family coverage. Grandfathered plans will remain exempt from both the cost-sharing limit and the deductible requirement.
Temporary High Risk Pool:
A new transitional high-risk pool program will operate until health
insurance exchanges are implemented in 2014. States may choose whether
and how they participate in the program, which is funded by the federal
government. As of May 3, 30 states have indicated that they want
to operate their own transitional high-risk pools, while 18 have
said they would prefer a federal fallback high-risk pool for eligible
citizens in their state. The program begins on July 1, 2010.
Early Retiree Reinsurance Program:
On May 4, the Department of Health and Human Services issued a regulation
implementing the $5 billion early retiree reinsurance program, which
will be launched on June 1, 2010. Participating employment-based plans
will receive reimbursement for a portion of the costs of certain medical
claims associated with providing health benefits to early retirees
age 55 through 64, as well as for retirees' spouses and dependents.
The amount of this payment to the plan sponsor is 80 percent of the
costs attributable to that claim, provided the amount of the claim
is between $15,000 and $90,000. Both self-funded and insured plans
may apply, including plans sponsored by private entities, state and
local governments, nonprofits, religious entities, unions, and other
employers.
Small Business:
The Affordable Care Act provides tax credits to small employers who
purchase health insurance for employees. Small businesses can take
advantage of the tax credit immediately, and, last month, the Internal
Revenue Service released guidance and began delivering postcards to
the estimated four million small businesses and tax-exempt organizations
to make them aware of the tax credit.
Medical Loss Ratio:
A new policy in the Affordable Care Act—the "medical loss ratio"—requires
large-group plans to spend 85 percent of premium dollars (80 percent
in the small group market) on clinical services and activities that
improve health care quality. Insurers offering coverage in the small
group and individual markets must allocate at least 80 percent of premiums
to such services and activities while those in the large group market
must spend at least 85 percent of premiums on benefits. It also calls
for the National Association of Insurance Commissioners (NAIC) to establish
uniform definitions and methods for calculating medical loss ratios.
While the law requires NAIC to submit such definitions and methods
for the Secretary's review by December 31, 2010, at our request, NAIC
has agreed to accelerate delivery to June 1, 2010.
Medicare Part D Doughnut Hole:
As required by the new law, the U.S. Department of Health and Human
Services plans to issue $250 rebate checks to Medicare beneficiaries
who have reached the "doughnut hole" in prescription drug
coverage. The first checks are expected be mailed on June 15, and additional
checks to be mailed roughly every six weeks thereafter until the end
of the year.
Apply On-Line – Select Provider below:
|
|
|
|
|
|
|
|
Short Term Medical Policies for 30-185 days of coverage
|
Please call us at 603-647-9136 with any questions; we look forward to hearing from you!