Category Archives: Uncategorized

If your state high risk pool cancelled your policy you do have options.

If you have a preexisting condition such as Cancer, Heart Disease or Diabetes or your build falls outside what is considered acceptable underwriting guidelines and you have received a policy termination letter from your state High Risk Health Insurance Pool like this one from the Illinois ICHIP – Illinois Comprehensive Health Insurance Plan. Know that you should apply now for a guaranteed issue (you can not be denied coverage) replacement plan with an effective date of 1/1/2014.

Since State High Risk Health Insurance Pools are already ‘maximum rated’ due to the fact that our state risk pools cover those with severe preexisting conditions, your premium should be less than what you are paying now most especially if your household MAGI – Modified Adjusted Gross Income – (income after taxes and after retirement contributions) is less than:

$46,960 for an individual
$62,040 for a couple
$78,120 for a family of three
$94,200 for a family of four
$110,280 for a family of five
$126,360 for a family of six

Since Blue Cross Blue Shield of Illinois is the administrator for our ICHIP program you have been using Blue Cross Blue Shield of Illinois providers whilst insured with ICHIP. If you wish to stay with BCBSIL providers click the logo below and apply for coverage with Blue Cross Blue Shield of Illinois, a Division of Health Care Services Corporation. Find the right health insurance plan for you by exploring all of the options, save the plans that fit your needs in your Shopping Cart and return to apply for coverage when you are ready. Don’t forget, the last day for the Patient Protection and Affordable Care Act (PPACA) “Open Enrollment” is February 15, 2014.

 

If you have received a policy termination letter from another State High Risk Health Insurance Pool. Yes, that’s right we had state based High Risk Health Insurance Pools which provided guaranteed issue coverage to individuals with preexisting conditions in 34 other states long before Obamacare. You can shop for all plans on (subsidized) and off (unsubsidized) the “Health Insurance Exchange Marketplace” in all 50 states by clicking the banner below. Remember that all Qualified Health Plans (excluding Temporary plans) sold on and off  the exchange will be guaranteed issue between the two national “Open Enrollment” periods beginning 1/1/14 – 3/31/14 and again during the recently delayed new second “Open Enrollment” period of  11/15/14 – 01/15/15.

http://www.smedleyinsurancegroup.com/images/health-care-reform-quick-quotes.jpg

Please note: Outside of these two national “Open Enrollment” periods you will not be able to obtain guaranteed issue coverage for a preexisting condition as an individual or family applicant and you will be denied coverage unless your situation is deemed a “Special Enrollment”.

In addition to increasing your lifetime coverage to an unlimited coverage amount for each insured member and the addition of four more of these ten “Essential Health Benefits“. You already have 6 of them on your policy. However, now you get to pay for Maternity coverage, “Substance Abuse Disorder Services” and Pediatric Dental, whether you want that or not.

You will also have ‘first dollar’ coverage (no deductible or co pay required) for the following Preventative Care services and exams on all policies sold after 1/1/2014. You do not have any these benefits currently provided on your existing High Risk Health Insurance Pool coverage:

15 Covered Preventive Services for Adults:
  1. Abdominal Aortic Aneurysm one-time screening for men of specified ages who have ever smoked
  2. Alcohol Misuse screening and counseling
  3. Aspirin use for men and women of certain ages
  4. Blood Pressure screening for all adults
  5. Cholesterol screening for adults of certain ages or at higher risk
  6. Colorectal Cancer screening for adults over 50
  7. Depression screening for adults
  8. Type 2 Diabetes screening for adults with high blood pressure
  9. Diet counseling for adults at higher risk for chronic disease
  10. HIV screening for all adults at higher risk
  11. Immunization vaccines for adults–doses, recommended ages, and recommended populations vary:
  12. Obesity screening and counseling for all adults
  13. Sexually Transmitted Infection (STI) prevention counseling for adults at higher risk
  14. Tobacco Use screening for all adults and cessation interventions for tobacco users
  15. Syphilis screening for all adults at higher risk

22 Covered Preventive Services for Women, Including Pregnant Women

  1. Anemia screening on a routine basis for pregnant women
  2. Bacteriuria urinary tract or other infection screening for pregnant women
  3. BRCA counseling about genetic testing for women at higher risk
  4. Breast Cancer Mammography screenings every 1 to 2 years for women over 40
  5. Breast Cancer Chemoprevention counseling for women at higher risk
  6. Breastfeeding comprehensive support and counseling from trained providers, as well as access to breastfeeding supplies, for pregnant and nursing women*
  7. Cervical Cancer screening for sexually active women
  8. Chlamydia Infection screening for younger women and other women at higher risk
  9. Contraception: Food and Drug Administration-approved contraceptive methods, sterilization procedures, and patient education and counseling, including abortifacient drugs – some religious organizations are now exempt from this mandate
  10. Domestic and interpersonal violence screening and counseling for all women*
  11. Folic Acid supplements for women who may become pregnant
  12. Gestational diabetes screening for women 24 to 28 weeks pregnant and those at high risk of developing gestational diabetes
  13. Gonorrhea screening for all women at higher risk
  14. Hepatitis B screening for pregnant women at their first prenatal visit
  15. Human Immunodeficiency Virus (HIV) screening and counseling for sexually active women*
  16. Human Papillomavirus (HPV) DNA Test: high risk HPV DNA testing every three years for women with normal cytology results who are 30 or older
  17. Osteoporosis screening for women over age 60 depending on risk factors
  18. Rh Incompatibility screening for all pregnant women and follow-up testing for women at higher risk
  19. Tobacco Use screening and interventions for all women, and expanded counseling for pregnant tobacco users
  20. Sexually Transmitted Infections (STI) counseling for sexually active women
  21. Syphilis screening for all pregnant women or other women at increased risk
  22. Well-woman visits to obtain recommended preventive services

26 Covered Preventive Services for Children

  1. Alcohol and Drug Use assessments for adolescents
  2. Autism screening for children at 18 and 24 months
  3. Behavioral assessments for children of all ages
    Ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years.
  4. Blood Pressure screening for children
    Ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years.
  5. Cervical Dysplasia screening for sexually active females
  6. Congenital Hypothyroidism screening for newborns
  7. Depression screening for adolescents
  8. Developmental screening for children under age 3, and surveillance throughout childhood
  9. Dyslipidemia screening for children at higher risk of lipid disorders
    Ages: 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years.
  10. Fluoride Chemoprevention supplements for children without fluoride in their water source
  11. Gonorrhea preventive medication for the eyes of all newborns
  12. Hearing screening for all newborns
  13. Height, Weight and Body Mass Index measurements for children
    Ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years.
  14. Hematocrit or Hemoglobin screening for children
  15. Hemoglobinopathies or sickle cell screening for newborns
  16. HIV screening for adolescents at higher risk
  17. Immunization vaccines for children from birth to age 18 —doses, recommended ages, and recommended populations vary:
  18. Iron supplements for children ages 6 to 12 months at risk for anemia
  19. Lead screening for children at risk of exposure
  20. Medical History for all children throughout development
    Ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years.
  21. Obesity screening and counseling
  22. Oral Health risk assessment for young children
    Ages: 0 to 11 months, 1 to 4 years, 5 to 10 years.
  23. Phenylketonuria (PKU) screening for this genetic disorder in newborns
  24. Sexually Transmitted Infection (STI) prevention counseling and screening for adolescents at higher risk
  25. Tuberculin testing for children at higher risk of tuberculosis
    Ages: 0 to 11 months, 1 to 4 years, 5 to 10 years, 11 to 14 years, 15 to 17 years.
  26. Vision screening for all children
    Source:
    https://www.healthcare.gov/what-are-my-preventive-care-benefits

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Health insurance advice for all those trying to “navigate” Obamacare

For all who are trying to deal with the health insurance side of Obamacare, most especially the millions who have lost their plans because of this law. I will be including in this post a 50 state private health insurance quote engine which will allow you to receive real time quotes from all carriers without entering all of your personal information and without linking to the IRS, unless and until you qualify for a subsidy and wish to actually purchase a plan.

Below are instructions to find an alternative plan for those who do and do not qualify for an APTX – “Advance Premium Tax Credit” – a.k.a. taxpayer provided subsidy to lower premiums inside the new HIX – ‘Health Insurance Exchange Marketplace” under the PPACA – “Patient Protection and Affordable Care Act” a.k.a. “Obamacare”.

Please note: The only reason to purchase health insurance inside the HIX is if you qualify for an APTX . If you do not, you should purchase health insurance outside of the HIX. The application process will be much faster and secure for those who purchase health insurance outside of the HIX. All major medical health insurance products purchased inside and outside the HIX will be guarantee issue (no preexisting conditions) during the two national “Open Enrollment” periods in 2014. Those time periods are:

Open Enrollment Period One: 1/1/14 – 3/31/14 -

Open Enrollment Period Two: 11/15/14 – 2/15/15

Open Enrollment Application Timeline: December 23, 2013 was the last day to purchase health insurance inside the HIX and receive a 1/1/14 effective date. During the rest of open enrollment, if you enroll between the 1st and 15th day of the month and pay your premium, your coverage begins the first day of the next month. So if you enroll on February 10, 2014, your coverage begins March 1, 2014.

If you enroll between the 16th and the last day of the month and pay your premium, your effective date of coverage will be the first day of the second following month. So if you enroll on March 16, 2014, your coverage starts on May 1, 2014. At that point you will be assessed an IRS ‘fine’ (TAX) for not having ‘qualified’ health insurance in place for at least 90 days in the year 2014.

Guidance pertaining to the second national “Open Enrollment” period which is currently 11/15/14 to 2/15/15 is forthcoming.

For those who do qualify for an APTX:

If your 2014 total household MAGI – Modified Adjust Gross Income (after taxes and retirement contributions) will be lower than:

$46,960 for an individual
$62,040 for a couple
$78,120 for a family of three
$94,200 for a family of four
$110,280 for a family of five
$126,360 for a family of six

you will be better off financially buying a new health insurance plan inside the HIX. By doing so, you will qualify for an APTX to reduce the cost of the Bronze, Silver, Gold or Platinum health insurance plans.

PLEASE NOTE: The cheapest plan inside the HIX – the “Bronze” plan equivalent – will expose a couple or a family to $12,700 in out of pocket risk each year. For single applicants, that risk will be $6,350. So you are better of purchasing the Silver, Gold or Platinum plans if they are within your affordable range after your APTX is granted to artificially lower the actual premium.

To shop for all plans on and off the “Health Insurance Exchange Marketplace” in all 50 states click the banner below:

http://www.smedleyinsurancegroup.com/images/health-care-reform-quick-quotes.jpg

For those who do not qualify for an APTX:

If your 2014 total household MAGI will be higher than:

$46,960 for an individual
$62,040 for a couple
$78,120 for a family of three
$94,200 for a family of four
$110,280 for a family of five
$126,360 for a family of six

you will be much better off buying a new plan from a carrier that is staying out of the new PPACA “Health Insurance Exchange Marketplace”. The two carriers with the best priced and best designed plans that are offering plans outside of the new “Health Insurance Exchange Marketplace” in most states are two of the largest health insurers in the nation. Namely, United HealthOne (Golden Rule), Assurant Health (Time Insurance company) and Aetna (in most states). By doing so you will receive fast, efficient service without dealing with Healthcare.gov or any branch of the federal government and your privacy will be protected.

To shop for and purchase an unsubsidized plan from United Health One or Assurant Health, Aetna (in some states) and all carriers off the “Health Insurance Exchange Marketplace” in all 50 states click the banner below:

http://www.smedleyinsurancegroup.com/images/health-care-reform-quick-quotes.jpg

3.) If you do not have any serious preexisting conditions, you can save a lot of money if you purchase a Temporary health insurance policy for a period of one year. These health insurance policies do not cover preexisting conditions nor do they include all of the federally mandated “Essential Health Benefits” such as Maternity, Drug Rehab coverage and Pediatric Dental. This also means that they are not considered ‘Qualified Health Plans’ meaning that you will be subject to the 1% of your MAGI penalty in 2014 if you purchase one of these plans. That stated the premium difference between these plans and ‘Qualified Health Plans’ is significant. Far outweighing the additional fine you would pay to the IRS in most cases.

To run quotes for a Temporary health insurance plan off the exchange click the banner below:

http://www.smedleyinsurancegroup.com/images/health-care-reform-quick-quotes.jpg

Very Important Note: Since the PPACA mandates that all health insurance policies cover preexisting conditions during the first national “Open Enrollment” period from 1/1/14 – 3/31/14 and the second national “Open Enrollment” period from 11/15/14 – 02/15/15. You can now safely purchase Temporary health insurance knowing that when your one year Temporary policy ends you will qualify by Federal law for any ‘Qualified Health Plan’ regardless of preexisting conditions during the second annual “Open Enrollment” period in 2014. Outside of those two aforementioned “Open Enrollment” periods you will not be able to obtain coverage for a preexisting condition. For this reason you must not purchase the 6 month Temporary health insurance option.

Only the 12 month Temporary insurance option is acceptable at this juncture. If you purchase a 6 month Temporary policy your coverage will end in between the two aforementioned “Open Enrollment” periods and you will not be able to obtain another policy that will cover a preexisting condition that you may develop during the first 6 months of Temporary policy ownership. HHS may yet provide us with further guidance as to whether or not the loss of a Temporary health plan outside of “Open Enrollment” periods will qualify as a “Special Enrollment” period in 2014 so that one could obtain a “Qualified Health Plan” on a guaranteed issue basis outside of “Open Enrollment” periods. As of the date of this writing no such guidance has been received.

Lastly, if you have lost your health insurance policy because of Obamacare you can fight back and win. Find out how at www.TruthAboutPreexistingConditions.com

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The TRUTH About Preexisting Conditions.

On Thursday November 7, 2013 my new friend Bill Elliot appeared on “The Kelly File” with Megyn Kelly on the Fox News channel. I say “new friend” because immediately after I watched his heart breaking interview I ‘friended’ Bill on Facebook. I wanted him to know that even though his insurer was being forced to terminate his health insurance policy due to regulations posted by HHS and referred to in the Federal Register in June 2010 - three months after the PPACA – Patient Protection & Affordable Care Act (Obamacare) was signed into law – such a posting in the Federal Register that has not been passed by Congress does not trump an existing Federal law. I will explain what law I am referring to in a moment but first please watch Bill’s testimony:

The following day Bill was interviewed by radio host Rocky D on AM1340 WQSC in South Carolina. In that interview Bill goes into detail about the type of illness he suffers from and how hopeless he felt after the president’s Obamacare took away his health insurance policy in the middle of ongoing treatment for Stage 4 Cancer. Click the MP3 logo below to hear the replay:

This is the worst time to cancel someone’s coverage. And, that is precisely why Public Law 104-191 was written and passed by Congress in 1997. It was written to protect Americans from such a situation. I am writing this article not just to help Bill but to help all Americans who are suffering from an ongoing preexisting condition. If you are one of the 5 million Americans who have already received a policy termination letter or one of the 14 million Americans who will soon receive a letter, you need to print out Public Law 104-191 and highlight section 2742 and then contact an attorney. Or, if you have access to your governor – as Bill does – (his governor is the awesome Nikki Haley) contact your governor or state Attorney General’s office because your health insurer is violating a Federal law based on a posting in the Federal register that was not passed by Congress and as such does not trump an existing Federal law.

Since Bill did nothing wrong, no fraud was committed, his health insurer is not leaving the state and they charged him more based on a preexisting condition, they are in violation of Public Law 104-191 section 2742. As such, they have no legal right to terminate his coverage, regardless of a posting in the Federal register. The protections provided to individual policy holders under HIPAA law are reiterated via HHS, CMS and HCFA regulations outlined on page 22 of the “Protecting Your Health Insurance Coverage” booklet available for download at the CMS.gov site here.

Want to know the best part? I just heard from Bill and after contacting Governor Nikki Haley and his insurance company and reading to them section 2742 of Public Law 104-191 his insurer has decided to keep his policy in force because he has a chronic illness. Bill just told me the following: “Steve, the company decided to keep me active. Since it is a chronic illness. Until this illness kills me. Battle #1 is won. Now the hard part. You literally saved me. Thank you so much.” Those are the greatest words I have ever heard in my 20 year career as a licensed health insurance broker. I couldn’t be a happier man today!

UPDATE #1) On November 15, 2013 Bill Elliot joined Sara Marie Brenner who covered this story in the Washington Times on November 14, 2013 to discuss how he was able to use HIPAA – Public Law 104-191 – section 2742 to require his insurer to reinstate his cancelled policy without increasing his premium or his deductible. Click the MP3 icon below to listen to the replay:

UPDATE #2) On November 13, 2013 Rocky D had me on his show on AM1340 WQSC for a follow up to explain how Bill was able to keep his policy. Click the MP3 logo below to listen to the replay: 

UPDATE #3) On November 15, 2013 I joined the Chicks On The Right on 93.1 FM WIBC to discuss the latest Obamacare disaster created by the president and Bill Elliot’s policy reinstatement. Click the MP3 logo below to hear the replay:

UPDATE #4) Bill Elliot return to Washington Times reporter Sara Marie Brenner’s radio show to discuss the good news that his doctor has informed him he is now in full remission and the bad news that he is now being audited by the IRS. Fast forward to the 22:00 mark on the Sound Cloud file. 11/27/13

UPDATE #5) On November 27, 2013 Bill joined Rocky D again on South Carolina’s AM1340 WQSC. The good news? Bill is now in full remission thanks in large part to the life saving treatment he was able to continue receiving because his illegally cancelled policy was restored. The bad news? He is now being audited by the IRS and they are now coming after ME all the way back to 2003.

Update #6) On December 11, 2013 Bill Elliot joined Sara Marie Brenner again on her radio show to reveal breaking news that the IRS actions taken against him are now resolved thanks to his Congressman and a Democrat Senator. Most importantly he reveals that his Congressman informed him that the IRS action taken against him and myself were ordered “from the top”. Listen:


Update # 7) Thanks to the fine folks at the Emmy award winning television program “Facing Life Head-On” who took an interest in our story, I had the pleasure of finally meeting Bill Elliot in person today. When the episode airs I will post it here.

Bill Elliot and Yours Truly

Update #8) It is with a grateful heart that I send my sincerest THANK YOU to U.S. Senator Mark Kirk and his staff for resolving the actions taken against me by the IRS. I also wish to thank Denise Cattoni and all of my fellow Illinois Tea Party patriots who made Senator Kirk aware of the IRS actions taken against me. I am so happy that my friend Bill Elliott and I can both now say that our ordeal with the IRS is OVER. I am eternally grateful to all who took an interest in our story and who gave us emotional support. To my attorney William J. Sneckenberg I also send my sincerest thank you for his competent and professional advice.

IRS debts resolved 3 26 14
Update #9) Credit where credit is due

I am eternally grateful to the following bloggers and reporters who comprise the ‘New Media’ for linking to this story and performing the job that Barack Obama’s old Praetorian Guard media still refuses to do:

“BigFurHat” at IownTheWorld.com The trendsetter who started it all.
Daniel Greenfield of FrontPageMag.com
Arlen Williams of WeAreGulagBound.com who pushed the story out and detailed it’s movement via Storify.
Drudge Report
Eric Sheiner at CNSNews
“Zip” of WeaselZippers.net
Fran Eaton at Illinois Review
Jim Hoft of GatewayPundit.com
“Dr John” of FloppingAces.net
Madeleine Morgenstern at The Blaze
Nation.FoxNews.com
John Hayward at Breitbart.com
Tom Tillison at BizPacReview.com
Thomas Lifson at AmericanThinker.com
Mark Steyn at NationalReview.com
Investors Business Daily
Dianny at AllTheRightSnark
Herman Cain on the Herman Cain radio show
Clark Barrow at CainTV
John Hawkins at RightWingNews.com
PoorRichardsNews.com
FreeRepublic.com
Sard at TheRightPlanet.com
PatDollard.com

Patterico.com
Tammy Bruce radio show clip at TammyBruce.com
The Right Pundit at HapBlog.com
Judson Phillips at TeaPartyNation
Instapundit at PJMedia
FireAndreaMitchell
Michael Becker at TheMinorityReport.com
ChampionNews.net
Ulysses S. Arn at USofArn
Emily Hulsey at IJReview
IDeb at NiceDeb.com
Jeff Dunetz at TruthRevolt.org
Lily Dane at at TheDCClothesline
Scared Monkeys
Wintery Knight
Prison Planet
Janet at NewsDeskInternational
YouViewed
BeforeItsNews
PatriotUpdate
RedFlagNews
TheRightCurmudgeon
GodLikeProductions
NothingButTruth

Steve Straub at
TheFederalistPapers
USGovernmentPortal

IronicSurrealism
News.Silobreaker
JewsNews
Austin Petersen at
TheLibertarianRepublic
StripersOnline

PaulBarksdale.com
Debra Heine at
TheSteadyDrip
CapeAnnConnection

Khier Casino at OpposingViews
Lily Dane at TheDailySheeple
KateNews2Day
ThePoliticalForums
Deanna Fisher at VictoryGirlsBlog
WorldNewsViews
DebatePolitics
PeoplesPolitics
ClashDaily
Sara Noble at IndependentSentinel
BarracudaBrigade
ReclaimOurRepublic
BloodThirstyLiberal
Phineas at SisterToldjah
PatriotsBillboard
RanchersNet

TheSiliconGrayBeard
ExchangeGoldForCash
AViewFromTheBeach
DailyPundit
ClassWarWatch
Joe Newby at Examiner.com

If I missed you contact me and I will list you. Thank you all!

Barack Obama is the greatest LIAR since the father of the LIE

Now let me address a lie that president Obama and other members of the Democrat party have been repeating ad nauseum since 2008. President Obama said over and over again “health insurance companies can raise your premiums when you get sick” and “health insurance companies can cancel your coverage when you get sick”. The truth is that Public Law 104-191 has prohibited such actions by any insurer for more than 17 years, long before Obamacare was ever written. To add insult to injury, the president told the following LIES during a joint session of congress. Watch what he said below:

Really Mr. president? Here’s the truth from Politifact the Chicago Sun Times and Fox News. Watch their coverage below:

Then there was the LIE the president told about his own mother. In 2008 and again in the film created for Barack Obama entitled “The Road We’ve Traveled” narrated by Tom Hanks. Watch him tell this lie in the video below:

In the book “A Singular Woman: The Untold Story of Barack Obama’s mother” by journalist Janny Scott. Scott reviewed letters from the president’s mother – Anne Dunham – to CIGNA (the insurance company), and revealed the dispute was over disability coverage, not health insurance coverage. Disability coverage helps replace lost wages due to an illness. This story had absolutely nothing to do with her health insurer refusing to pay her medical bills. In fact, she had excellent health insurance, the hospital billed her health insurer directly and her health insurer paid her medical bills, less her deductible and applicable co pays.

Worse yet, the president described his mother as an indigent woman who was ‘pretty much drained of her resources.’ The truth is Anne Dunham received a base pay in 1995 of $82,500, plus a housing allowance and a car, to work in Indonesia for Development Alternatives Inc. of Bethesda. Today, adjusting for inflation, that salary would be equivalent to $123,500. This is far from indigent. Today, the Washington Post rightfully gives this story ‘Three Pinocchios”

What about the woman who the president said had her cancer treatment denied because of acne? Well, as you may have guessed by now, that too is a lie. According to ABC News, “President Obama’s description that Beaton’s ‘insurance company canceled her policy because she forgot to declare a case of acne’ is not accurate.

As Robin Lynn Beaton’s congressman, Rep. Joe Barton, R-Texas, testified, the Blue Cross/Blue Shield letter “informed Ms. Beaton that an investigation into her claims for benefits resulted in the company reviewing her medical records in which they discovered that she has misinformed them on several pieces of information. One of them was that she did not list her weight accurately, and the other, that she had failed to disclose some medication she had taken for a preexisting heart condition.”

Blue Cross discovered the previous condition after her visit to the dermatologist for acne but her insurance was not canceled because she didn’t declare a case of acne.”

By now, you may be asking. ‘Who are you to call the president of the United States a liar?’ Let me answer that. I have been a multi-state licensed health and life insurance broker for nearly 20 years now. I have also served as a Subject Matter Expert for multiple business journals around our great country.

One of the biggest challenges I’ve had to deal with  throughout the years has been trying to secure coverage for people with preexisting conditions who obtain their health insurance on the individual market. They represent 10% of the American insured.

I’ve never had to worry about preexisting conditions with the other 90% of American insured who get their health insurance through an Employer Sponsored Group plan. Why? Because the same Public Law 104-191 “HIPAA” has protected them against being denied health insurance because of preexisting conditions for more than 17 years.


Because government legislators did not apply this law to individual health insurance policies, you can be labeled as “uninsurable” when you apply for an individual health insurance policy if you have one or more preexisting conditions. That being said, who should we truly blame for the fact that you can be denied coverage for a preexisting condition? Is it the insurance company’s fault? Or are they simply following a law that was written by government law makers who did not include HIPAA portability protection for the millions of Americans who purchase health insurance on their own in the individual market?

Because there are no HIPAA portability protections for individual policy holders, this uninsurable status can last for many years and sometimes for life depending on the specific preexisting condition you have been diagnosed with. Some of the preexisting medical conditions that  render an applicant uninsurable on an individual policy are: Heart Attack, Stroke, Diabetes, Cancer,  Lupus, Multiple Sclerosis, Muscular Dystrophy, Degenerative Arthritis and a host of other preexisting conditions. In addition, there are applicants who have a combination of controlled preexisting conditions but since they have more than three “ratable conditions” they are also labeled uninsurable.

Does this mean then that there was some truth in the stories the president told about preexisting conditions? No, he is still a liar. In fact, during the last 2 decades of my career as a health insurance broker I have never been unable to offer someone health insurance coverage, regardless of the severity of their preexisting conditions. In fact, I once secured legitimate major medical health insurance for a woman who was dying of cancer in the hospital. How did I do it? Simple, I am an informed American. I know the laws that were already in place to protect consumers. Laws that were passed long before the president’s health care ‘reform’ law was passed in 2010.

The truth is even if you have lost your employer sponsored group health insurance coverage and/or have exhausted a COBRA continuation plan you too can obtain guaranteed issue health insurance on an individual basis that will provide coverage for your preexisting conditions seamlessly from day one. Your options are as follows:

1.) If you have a Corporate tax i.d. number you can purchase a small group health insurance policy from most insurance carriers. With this scenario, a minimum of 2 people (often husband & wife) who work for the same corporation can apply for a small group health insurance policy. Those who are HIPAA qualified will receive coverage for their preexisting conditions immediately. Even those who are not HIPAA qualified will receive coverage for their preexisting conditions after a maximum period of 12 months. Be sure to read the outline of coverage for the Small Group plan you are applying for to make sure it provides coverage for your preexisting condition before you apply.

2.) Some States, like Colorado, provide what is known as a “Self Employed Group of One”. In these States, you do not even need to have another person to comprise a “Group Health Insurance Plan”. To find out how your state defines Small Group health insurance visit this site:  http://www.statehealthfacts.org/comparetable.jsp?cat=7&ind=350

3.) Enroll in your states High Risk Health Insurance Pool. 35 States provide them. CLICK HERE to see if your state does. In our home state of Illinois the risk pool is called the Illinois Comprehensive Health Insurance Plan (ICHIP). ICHIP is a state health benefits program and not an insurance company. Persons must qualify for coverage, but in most cases if the applicant is coming off an exhausted qualified COBRA continuation plan from a prior employer sponsored group, their preexisting conditions will be covered from day one (provided again that those conditions are a covered expense on the ICHIP policy). ICHIP (and all insurance risk pools) are by no means entitlement programs. They do indeed require you to pay a monthly premium. Nothing in this life is free. To find out if your State has a state sponsored High Risk Health Insurance Pool visit http://www.naschip.org/states_pools.htm

2014 update Thanks to Obamacare, state High Risk Pool insured members are also losing their coverage all over the country and will be forced into the Obamacare exchanges where many of them will pay more for coverage and be exposed to much more out of pocket. Most especially if they do not qualify for a subsidy.

4.) If you live in one of the 10 States that have an “Individual Market Guaranteed Issue Mandate” you are guaranteed Health Insurance coverage for preexisting conditions from a variety of Health Insurance carriers that operate within that state. For example, in the state of Ohio, there are 20 Health Insurance carriers that must by law “Guarantee Issue” 4% of their block of business to people with preexisting conditions during an annual ‘Open Enrollment’ period. During this annual period, each health insurance carrier must report to the Ohio Department of Insurance as to whether or not they have “met their 4% Guaranteed Issue quota”. Once they have met their 4% quota, any future applicants with preexisting conditions are then referred to one of the other health insurers operating in Ohio who have not met their 4% quota and are then guaranteed coverage from that carrier. Did you know that Ohio has never maxed out the 4% quota for all carriers? Never. And, everyone has access to coverage for preexisting conditions in the state of Ohio.

2014 Update This concept is such a good idea that in June of 2011 HHS – the Health & Human Services department – finalized new rules  regarding preexisting conditions adopting this concept for years 2014 and beyond. Beginning in 2014 there will be two national “Open Enrollment” periods for all Americans to obtain guaranteed issue coverage regardless of preexisting conditions. Those two periods are from January 1st of 2014 to March 31st of 2014 and from November 15th – January 15th 2015. Outside of those two “Open Enrollment” periods you will not be able to obtain coverage for preexisting conditions on an individual or family policy unless you qualify for ‘Special Enrollment” period.

Whilst adopting Ohio’s plan will help to inhibit ‘Adverse Selection’ and provide an impetus for consumers to maintain health insurance between “Open Enrollment” periods. Make no mistake. ‘Adverse Selection’ will still exist because the fine for not purchasing health insurance is far less expensive than actually purchasing health insurance. If this fine amount is not increased, ‘Adverse Selection’ will still continue. This coupled with ‘Community Rating’ – charging young people much more for health insurance will lead to what we in the industry call a “Death Spiral. And, since there is nothing in the PPACA that states health insurance must continue to offer products within the PPACA “Health Insurance Exchange Marketplace” 2015 could end up being a very bad year for the health insurance industry and most importantly for their policy holders.

5.) Even if you are totally disabled and no longer able to work because of a debilitating medical condition, you can apply for one of our country’s MANY safety nets called SSDI (Social Security Disability Income) and with it early Medicare benefits. Learn more @ www.disabilitysecrets.com

In case you missed that information, let me reiterate. 45 States in our Union provide guaranteed insurability to individual health insurance applicants, regardless of preexisting conditions for decades before the ‘Patient Protection and Affordable Care Act’, a.k.a. “Obamacare”. This is not what we were told by the president. 

In addition to the aforementioned existing legal options to pursue Guaranteed Issue Health Insurance for those with preexisting conditions. There are also over 1,200 “free” (subsidized by taxpayers and philanthropists) health clinics around the United States. Click free” clinics in your State to find more information. If your situation is dire, Federal EMTALA law mandates that you must be treated without discrimination at your local emergency room.

If your child has a preexisting condition and you are at or below the Federal Poverty Level you are further entitled to the Federal SCHIP program, which is an extension of our Medicaid system. To find out if you qualify click here. If you do qualify be sure to see if your State has any money left. Some States like Arizona recently terminated their SCHIP program because the entitlement rendered them BANKRUPT

Many States like Illinois have already dramatically expanded their Medicaid programs to include Tax Payer funded health insurance for low income adults , women who are currently pregnant and women who have been diagnosed with Breast or Cervical cancer. All of these benefits are provided to those without health insurance. In fact, in the state of Illinois, our All Kids Covered plan quite literally provides “free” health insurance to ALL indigent kids including the 75% of recipients who are illegal aliens. Thanks to Obamacare Medicaid Expansion we are about to drive our Illinois Medicaid system into a fiscal death spiral by adding on and expected 800,000 new recipients and being forced as state taxpayers to cover half of the cost of the ‘Woodwork” population. Those who were always eligible for Medicaid but never bothered to enroll. They will be forced to enroll via the Federal health insurance purchase mandate beginning on 1/1/14. On January 30, 2012, the Civic Federation released its “Budget Roadmap”. In it, they highlight the fact that Illinois state officials now believe that the Illinois Medicaid program will have between $21 and $23 billion in UNPAID bills by 2017.

The President’s “Patient Protection and Affordable Care Act’ will make that Medicaid debt exponentially worse. Not just in Illinois but around the country in states that choose to further expand Medicaid. Medicaid is the worst and most dangerous health care program ever devised by man. Without reform, I truly fear for the lives of the 17 million Americans that the CBO predicts will be auto enrolled onto this program beginning in 2014.

Back in 2010 I spoke the TRUTH about preexisting conditions at the 2010 Chicago Tax Day Tea Party rally:

Please Note: The vast majority of health insurance carriers that underwrite Individual Health Insurance plans DO INDEED provide coverage for many preexisting medical conditions (such as Hypertension, Hyperlipidimia, Gastric Reflux, Asthma, etc.) and have done so for many year. Providing of course that these conditions are well controlled by diet or medication AND you duly disclose these preexisting conditions on your health insurance application. This is important to know now because the president’s temporary PCIP – ‘Preexisting Condition Insurance Plan’ already ran out of money and has ceased further enrollment as of March 5, 2013

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If you lost your health plan there are alternatives to Obamacare.

If you are one of the millions of Americans who have received a health insurance policy cancellation notice due to to the PPACA – “Patient Protection & Affordable Care Act” (Obamacare). You do not have to purchase the expensive “Medal” (Bronze, Silver, Gold, Platinum) plans that are offered inside the PPACA – HIX – “Health Insurance Exchange Marketplace”. If you are one of the lucky few who have actually been able to access the HealthCare.gov web site you already know that the cheapest plan available – the “Bronze” plan – exposes couples and families to $12,700 in out of pocket risk each year. And that is if you stay within the limited PPO or HMO networks that these “Qualified Health Plans” offer. We still do not know the risk exposure if you seek treatment outside of these networks. One thing is for certain, your out of pocket risk exposure will be greater out of network.

Whilst it is true that if you qualify you may be better off buying a ‘subsidized’ health insurance plan inside the HIX. Many of us in the “middle class” do not qualify for these subsidies. For we make more than 400% above the Federal Poverty Level. That stated, if your 2013 MAGI – Modified Adjusted Gross Income – (income after taxes and retirement contributions) is less than the following:

$46,960 for an individual
$62,040 for a couple
$78,120 for a family of three
$94,200 for a family of four
$110,280 for a family of five
$126,360 for a family of six

you will qualify for OPM – ‘Other Peoples Money’ – to artificially lower the high cost of PPACA “Qualified Health Plans”. Obama administration officials refer to this money as a ‘subsidy’. Keep in mind, those who are just below those aforementioned levels may still stay pay more in premium than they would for a plan purchased outside the HIX. Find out if you qualify for a ‘subsidy’ by running your own quotes using my private carrier links below:

To run your own quotes for subsidized PPACA “Qualified Health Plans” from Humana click the banner below:

To run your own quotes for subsidized PPACA “Qualified Health Plans” from Aetna click the banner below:

To run your own quotes for subsidized PPACA “Qualified Health Plans” from Blue Cross Blue Shield of Illinois click:

Please note: There is one major difference between my online quote engines and the HealthCare.gov web site. Mine actually work!

Options for those who make more than the aforementioned income levels

Two of the largest health insurers in the nation made a decision early on not to offer ‘Qualified Health Plans” inside the HIX in most other states. Those health insurance carriers are United HealthOne and Assurant Health.

Although these two carriers must still adopt all 10 of the new federally mandated “Essential Health Benefits”  in 2014 (they already include 6-8 of them depending on the plan). And, they must also offer guaranteed insurability (no preexisting conditions) to all applicants during two ‘Open Enrollment” periods next year. 1/1/14 to 3/31/14 and 10/15/14 to 12/7/14. The deductible and coinsurance arrangements that they offer to their clients can be different than the standard deductible and coinsurance arrangements included with the “Medal” plans offered inside the HIX but only until December 30, 2013.

This means that their prices are inherently lower than the “Medal” plans sold inside the HIX for those who do not qualify for OPM – Other Peoples Money (subsidies). And, the out of pocket expenses don’t have to be $12,700 for a couple or family. Because these two carriers have made the decision to stay out of the HIX around the country. They are both able to make the following commitment to potential new policy holders who purchase any of their health insurance plans before 12/31/2013.

If you purchase a health insurance policy from either of these two carriers prior to 2014 you will not lose or have to change that health policy and you will not receive a premium increase until December 30, 2014. You will also be able to design your own policy with your own deductible, co pay and other policy features, including HSA (Health Savings Account) qualified plans that after 2014 will be designed by the federal government.

Watch United HealthOne make this promise here.

Run your own quotes for 2013 health insurance plans from United HealthOne by clicking their logo below:

http://www.a1insuranceaz.com/images/carriers/united-health-one.png

Run your own quotes for 2013 health insurance plans from Assurant Health by clicking their logo below:
Lastly, if you do not have any serious preexisting conditions, you can save a lot of money if you purchase a Temporary health insurance policy for a period of one year. These health insurance policies do not cover preexisting conditions so they are less expensive than permanent health insurance policies. And, since the PPACA mandates that all health insurance policies cover preexisting conditions during two national “Open Enrollment” periods next year. 1/1/14 – 3/31/14 and 10/15/14 – 12/7/14. You can now safely purchase temporary health insurance knowing that when your one year Temporary policy ends you will qualify by Federal law for any other health insurance policy available on the market regardless of preexisting conditions.
Please note: Temporary health insurance plans are considered ‘non qualified’ plans. So you must figure the 1% of your MAGI penalty (TAX) that you will be required by the IRS to pay in addition to the cost of these health plans. Even with that small fine included, you may very well come out ahead with Temporary health insurance. To shop for inexpensive Temporary health insurance plans click the banner below:
If you can not purchase Temporary health insurance in your area using the above link please use the link below:

http://www.smedleyinsurancegroup.com/images/health-care-reform-quick-quotes.jpg

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‘Substandard plans’ Mr. President? Here is proof that you are lying once again.

After President Obama was forced to finally admit that he was not telling the truth when he promised repeatedly “if you like your plan, you can keep your plan. No one will take it away from you, period.” The latest ‘spin’ from the president  is “most people can keep their plans and those who lose them will be getting a better plan for a lower price to replace the substandard plan they have now” from the ‘old market‘. A market that HHS secretary Kathleen Sebelius referred to as ‘The Wild West‘. As if the current individual and family market is some wild unregulated market where consumers can be abused by unscrupulous carriers offering ‘skinny‘ or ‘shoddy‘ plans. Nothing could be further from the truth. The evidence below will prove that the president is lying to the American people once again.

Below I will link actual policy termination letters from four of my existing clients who hold individual health insurance policies from Blue Cross Blue Shield of Illinois. The last names and policy numbers have been redacted in order to protect the privacy of these clients per 1996 HIPAA law.

Click here to download Stephen’s Obamacare termination letter.
Click here to download Robert’s Obamacare termination letter.
Click here to download Kathleen’s Obamacare termination letter.
Click here to download Michael’s Obamacare termination letter.

When you review their current health insurance policy outlines of coverage. Tell me, do these plans look like ‘unregulated plans‘ from a market similar to the ‘Wild West‘? Are these ‘skinny’ plans or ‘substandard plans’?

Please note that each of these policies offer 100% coverage for in network covered charges after an aggregate ‘common family’ deductible has been satisfied. The size of each of their family deductibles is listed in their current outlines of coverage, also included in each PDF document.

Worse yet, these health plans that are being canceled now are NON “Grandfathered” plans. These are health plans that have nothing to do with the “Grandfathered clause” that the president says he included in Obamacare which would allow people to ‘keep their plans’ if they were purchased before Obamacare was passed on March 23, 2010. These plans were purchased after March 23, 2010. In other words, NON “Grandfathered” plans. These are plans that HHS required insurers to redesign as of 9/23/2010 and then sell to consumers under Obamacare. These plans already include 9 out of the 10 ‘Essential Health Benefits‘ including the policy design changes listed below that were mandated as of 9/23/10. This means they are NOT substandard plans and they are also not ‘grandfathered’ plans.

Coverage of Children
If a policy makes available dependent coverage of children, the policy will make such coverage available for your children who have not attained age 26 regardless of the presence or absence of the child’s financial dependency, residency, student status, employment, or any combination of those factors. In addition, the policy will not deny or restrict coverage of such children based on eligibility for other coverage.

Rescissions
Coverage under the policy, with respect to an individual, will be canceled retroactive to the effective date of coverage if the individual (or a person seeking coverage on behalf of the individual) performs an act, practice or omission that constitutes fraud, or makes an intentional misrepresentation of a material fact, as prohibited by the terms of coverage. At least 30 days advance written notice will be provided before any such cancellation.

Lifetime Maximums
Benefits that are considered essential benefits (as that term is defined in the Affordable Care Act and applicable regulations) will not be subject to any lifetime limit on the dollar value of such benefits for any individual.

Preexisting Condition Waiting Period
A preexisting condition waiting period will not apply to enrollees who are under 19 years of age.

Annual Benefit Maximums
Although under the Affordable Care Act a restricted annual limit on the dollar value of essential health benefits (as that term is defined in the Affordable Care Act and applicable regulations) may be applied prior to 2014, benefits under this policy that are considered essential health benefits will not be subject to any annual limit on the dollar value of such benefits for any individual.

These are plans that were designed by HHS and HHS is now requiring insurers to cancel these plans in order to force these policyholders to pay higher premiums in order to subsidize the high cost of Obamacare. Besides all of these changes that HHS required insurers to redesign as of 9/23/2010, the following 65 ‘free’ preventative care tests & exams were also mandated under Obamacare to be added to all plans as of 9/23/10.

Please also note that in every case, the PPACA compliant ‘replacement plans’ offered to these clients are priced higher and in most cases much higher than what they are paying now. However, they’re not just priced higher, they expose these clients to a much higher out of pocket risk each year. Up to $12,700 for a couple and a family. Below are the outlines of coverage for each PPACA compliant alternative plan offered to these clients:

The Blue PPO Bronze 005. Click here to view the outline of coverage.
The Blue Bronze PPO 006. Click here to view the outline of coverage.
The Blue Choice Silver PPO 003. Click here to view the outline of coverage.

The Blue Choice Bronze PPO 005.
 Click here to view the outline of coverage.

The Blue Choice Bronze PPO 006. Click here to view the outline of coverage.

Lastly, regarding president Obama’s other statement that the ‘old market’ was a largely “unregulated market” where consumers could be taken advantage of by the ‘big insurance companies‘. Whilst there were a few bad players in the market before the PPACA was passed, the health insurance market was highly regulated. In fact, you can click here to see how Blue Cross’s HSA qualified plan (the same plan the aforementioned clients hold today) was designed long before the PPACA was signed into law. Tell me does that policy, designed in 2009 look like a ‘skinny’, ‘substandard’ plan? Once again, the president’s rhetoric does not match the facts. Then again, has it ever?

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ATTENTION Main Stream Media. Regarding Obamacare. I TOLD YOU SO!

Back on August 3rd, 2013 I wrote a piece exposing what I stated then will soon happen to millions of Americans if we do not support the Tea Party and Republican lead effort to defund Obamacare. In that piece, I stated when President Obama promised – “If you like your plan, you can keep your plan and no one will take it away from you, period” he was not telling the truth. Watch President Obama make this false promise below:

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Below I will link to some real world examples of what is beginning to happen because the Obamacare “Health Insurance Exchange Marketplaces” opened on 10/1/13 and were funded (once again) by Republicans in the most recent Continuing Resolution on the evening of October 16, 2013.

Below I will link actual policy termination letters from four of my existing clients who hold individual health insurance policies from Blue Cross Blue Shield of Illinois. The last names and policy numbers have been redacted in order to protect the privacy of these clients per 1996 HIPAA law.

Click here to download Stephen’s Obamacare termination letter.
Click here to download Robert’s Obamacare termination letter.
Click here to download Kathleen’s Obamacare termination letter.
Click here to download Michael’s Obamacare termination letter.

Please also note that in every case, the PPACA compliant ‘replacement plans’ offered to these clients are priced higher and in most cases much higher than what they are paying now. However, they’re not just priced higher, they expose these clients to a much higher out of pocket risk each year. Up to $12,700 for a couple and a family. Below are the outlines of coverage for each PPACA compliant alternative plan offered to these clients:

The Blue PPO Bronze 005. Click here to view the outline of coverage.
The Blue Bronze PPO 006. Click here to view the outline of coverage.
The Blue Choice Silver PPO 003. Click here to view the outline of coverage.

The Blue Choice Bronze PPO 005.
 Click here to view the outline of coverage.

The Blue Choice Bronze PPO 006. Click here to view the outline of coverage.

Notice the out of pocket costs with each of those plans? Every one of them has a higher out of pocket risk to this client than the risk his family assumes now and all of them are more expensive than what he pays now. With the exception of the “Bronze PPO 006″ plan which more than DOUBLES his family’s out of pocket risk exposure on his current “HSA 100%” plan.

Secondly, here is a sample copy of a letter that my Humana individual and family policy holders are now receiving. They too are now being forced into the Obamacare exchanges either on 12/31/2013 or on 12/31/2014 depending on when they purchased their health plan.  Notice that this client’s Obamacare replacement plan will triple his premium.

Thirdly, here is a sample copy of a letter that my Aetna clients are already receiving. These clients are now losing their individual and family health insurance plans. They too will be forced into an Obamacare compliant plan as of 12/30/2013 or 12/31/2014 where the cheapest – “Bronze” plan – will expose a couple or a family to a $12,700 out of pocket risk exposure each year for in network covered charges.

Fourthly, about a month after I penned my original piece on August 3rd, other Blue Cross associations all over the country began sending our their policy termination letters. You can see the Independence Blue Cross policy termination letter if you click here.

Click here to read another policy termination notice and Obamacare compliant replacement letter from Regence Blue Shield of Nebraska. Pay particular attention to $12,700 annual out of pocket expense risk that this family will now face when they are forced to switch to an Obamacare compliant “Bronze” plan on 12/30/2013. Notice that their premium doubled as well.

One thing you can be sure of, all Individual and Family health plans sold in Illinois by Blue Cross Blue Shield, Humana and Aetna after March 23, 2010 a.k.a. ‘non-Grandfathered’ plans will be terminated and replaced with an Obamacare compliant plan either by 12/31/2013 or by 12/31/2014 depending on when you purchased the plan. Also, since the aforementioned June of 2010 ruling was a federal ruling, this will be the case for any carrier who offers plans inside the exchanges in all other states as well.

Millions of individual and family health insurance plans have already been terminated and 16 million more Americans will soon lose their individual health insurance plans because of Obamacare.

CBS: A charter member of the Main Stream Media finally reports on 2 million Americans who have already lost their health plans:

CBS: They finally report on the true cost of Obamacare approved health insurance:

CBS News: Also reporting on hundreds of thousands losing their health insurance plans because of Obamacare:

CBS News: “Obamacare resulting in dropped coverage and higher premiums.

NBC News: Consumers facing sticker shock and policy cancellation notices due to Obamacare.

Kaiser Health News: Thousand of consumers getting insurance cancellation notices due to health law changes.

NBC News: Thousands getting health insurance cancellation notices.

NBC News: Half a million Californians losing their health insurance plans because they don’t comply with Obamacare.

The worst part about all of this is that NBC News is now reporting that President Obama knew, as early as July of 2010 that millions of Americans would lose their health insurance plans because of his health care law:

Below is a photocopy of a page of the federal register that proves that the Obama administration knew in 2010 that millions of Americans would lose their Individual & Employer Sponsored health insurance plans because of Obamacare. This regulation was written on purpose so that millions of existing policy holders would be forced to purchase health insurance inside the exchanges instead. The forced addition of millions of these policyholders – all who were assured by president Obama that they could ‘keep their plan‘ – will lower the cost or further subsidize the high cost of insuring sick people who will most certainly be purchasing subsidized health insurance inside the exchanges. In other words this was a deliberate action taken by HHS and a direct violation of the president’s promise.

Proof

President Obama is also falsely referring to these canceled plans as “substandard plans” from the ‘old market’. Nothing could be further from the truth. These plans were designed in large part by his health care law. All individual plans sold since 9/23/2010 already include 8 out of the 10 “Essential Health Benefits” that he states must be “added’ in January of 2014 in order to make them ‘better’. In fact, my clients who selected Maternity coverage with Blue Cross Blue Shield of Illinois already have 9 out of the 10 “Essential Health Benefits”. Yet the President’s health care law requires that these plans must also be terminated and replaced with even more expensive plans in 2014. The evidence in this post prove that these plans are far from ‘substandard’ plans from the ‘old market’.

Remember, president Obama also promised rates would go down by $2,500? Watch him make that promise here:

San Jose Mercury News: Two time Obama voters shocked to receive policy cancellation notices and massive premium increases.

You can run your own Obamacare compliant rates by clicking on my Blue Cross Blue Shield of Illinois quote engine below:

If you’re not in Illinois, you can run your own Obamacare approved rates using my Humana quote engine here:

Please note: There is one major difference between my online quote engines and the “Health Insurance Exchange Marketplace” at HealthCare.gov. Mine actually work!

Months after I penned that original article – on August 3, 2013 – a flagship member of the main stream media – NBC – finally confirmed in their article entitled  Thousands get health insurance cancellation notices“ that I was indeed speaking the truth and not a ‘fear-mongerer’, ‘racist’ or ‘liar’ as I have been labeled repeatedly by our ‘friends on the Left’ since writing that piece.

Several days before NBC finally confirmed I was right. A newspaper in California detailed the anger and frustration by two time Obama voters who were also losing their health plans and facing an increase in their family premium of $10,000 a year. You can read that California newspaper clip if you click here.

Oh and it’s not just individual and family policy holders who are losing their health insurance policies because of Obamacare. It’s employer sponsored group policy holders as well. Click here to see a copy of the California Farm Bureau Federation group policy termination letter sent to their insured members. The CBO is predicting that 14.5 million Americans will lose their health plans after 2014. I disagree. I am predicting more than 40 million Americans will lose their employer sponsored health insurance plans. I discussed why for the Fox Business television network. View the video on the Fox Business web site by clicking here:

Worse yet, those whom we count on to provide us with the care we need are also losing their health insurance plans because of Obamacare. Here is a letter that doctors and dentists in Illinois received all over the state. They too will be losing their health insurance plan as of 12/31/2013.

All of these policy holders are being forced to forfeit their existing plans and agree to accept an Obamacare compliant plan (along with the premium increases required) by December 31, 2013 or December 30, 2014 depending on when you purchase your plan. I discussed this for the Fox Business television network on 09/30/2013 the day before the Obamacare “Health Insurance Exchange Marketplace” opened.

Why is this happening now?

I will use the state of Illinois as an example. Governor Quinn had originally expected 16 health insurance carriers to offer products within the Illinois Obamacare exchange. Only 6 carriers have chosen to sell plans within the exchange. They are as follows:

Humana
Blue Cross Blue Shield of Illinois
Aetna
Coventry
Land of Lincoln Health
The Carle Foundation, a nonprofit hospital network based in Urbana

Since these carriers have chosen the option to offer a “Medal” (Bronze, Silver, Gold or Platinum) product within the exchange, individual/family health insurance plans that they have already sold in 2010, 2011, 2012 and 2013 must be terminated and replaced with a plan that conforms to the design of the “Medal” plans sold inside the exchanges. Either on 12/31/2013 or 12/31/2014 depending on when the plan was purchased. These new replacement plans must include all 10 of the federally mandated “Essential Health Benefits” and they must conform in design to the deductible and other out of pocket expenses that will be included with the “Medal” plans sold inside the exchanges.

There are however two large insurance carriers that are staying out of the new Obamacare “Health Insurance Exchange Marketplace” in Illinois and most other states. Those carriers are United HealthOne and Assurant Health.

Although these two carriers must still adopt all 10 of the new federally mandated “Essential Health Benefits” and they must also offer guaranteed insurability (no preexisting conditions) to all applicants during ‘Open Enrollment” periods in 2014. The deductible and coinsurance arrangements that they offer to their clients can be different than the standard deductibles and coinsurance arrangements that will be offered in the exchanges until December 30, 2014.

This means that their prices will be inherently lower than the “Medal” plans sold inside the exchanges. And, the out of pocket expenses don’t have to be $12,700 out of pocket for a couple of a family as is the case with the cheapest “Bronze’ plan sold inside the Obamacare “Health Insurance Exchange Marketplace”. This is most especially true for individuals with MAGI – Modified Adjusted Gross Incomes – higher than 400% above the Federal Poverty Level. Those income levels would be anyone who makes less than the following income levels:

$46,960 for an individual
$62,040 for a couple
$78,120 for a family of three
$92,200 for a family of four
$110,280 for a family of five
$126,360 for a family of six

Those Americans will receive NO taxpayer funded ‘subsidy’ to artificially lower the high cost of the expensive Obamacare Qualified Health Plans that will be sold within the new ‘Health Insurance Exchange Marketplace”.

Because these two carriers are staying out of the Obamacare exchanges around the country. They are both able to make the following commitment to potential new policy holders. If you purchase a health insurance plan from either of these carriers prior to 2014 you will not lose or have to change that health plan and you will not receive a premium increase until December 30, 2014. You will also be able to design your own plan with your own deductible, your own co pay and other policy features that after 2014 will be designed by the federal government.

Watch United HealthOne make this promise here.

Run your own quotes from United HealthOne by clicking on their logo below:

http://www.a1insuranceaz.com/images/carriers/united-health-one.png

Run your own quotes from Assurant Health by clicking on their logo below:
It’s not just health plans that have been terminated. Health insurers have also been terminated.
It’s not just health plans that have been terminated. We’ve lost 13 carriers as well. In July of 2013 we lost the 13th individual health insurance carrier since Obamacare passed. See this insurance company’s exit letter here. The other individual health insurers who have pulled out of the individual health insurance market since the passage of Obamacare are as follows:

1.) American National
2.) American Republic > 35,000 people LOST their health plans when American Republic exited the market. Hundreds of jobs were lost as well.
3.) American Medical Security
4.) American Community Mutual
5.) Standard Life & Accident
6.) Principle Financial
7.) nHealth
8.) World Insurance
9.) Unicare
10.) Guarantee Trust Life < One of my clients in Naperville, Illinois who received that letter lost her plan during Breast Cancer treatment!
11.) Coventry
12.) Physicians Benefit Trust
13.) Independence Holding Group

Obamacare is creating a massive insurance monopoly. These smaller carriers that I used to be able to offer to my clients, the carriers with the good prices are now gone. They are being gobbled up by the larger carriers. We now have only a handful of health insurance carriers left in the country. Think about it, you know this. Look at the exchange plans and see if you can find more than 5 carriers who are offering plans.

Eliminating health insurance carriers and creating a taxpayer funded monopoly is not ‘competition’. It is a monopoly and nothing drives up prices like a monopoly. Period.

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Why Are Health Insurance Premiums Still Increasing After The PPACA?

The Obama administration and more specifically HHS Secretary Kathleen Sebellius is repeatedly stating that the reason 14 million health insurance policies are being terminated as of December 30, 2013 is because these policies are ‘skinny plans’ or plans that have large coverage ‘gaps’. She has also stated that the individual and family health insurance market is the ‘Wild West’. In other words a largely unregulated market where consumers can be taken advantage of by unscrupulous insurance companies offering plans that are unregulated and harmful. This could not be further from the truth. Below are the mandated coverage requirements that have already been placed in force upon all policies sold on the market since 9/23/2010 under the PPACA – Patient Protection and Affordable Care Act (Obamacare). In other words, these policies are already PPACA compliant. Yet it is these policies, sold after 9/23/2010 that are being canceled all over the country even though they are already PPACA compliant!

It is also because of the addition of all of the PPACA mandated policy changes listed below that premiums have increased so significantly (as Table 1 illustrates) since 9/23/2010. As you examine all of the mandated coverage parameters below, think for yourself, does this look like the “Wild West”? An unregulated market of limited benefit plans where consumers can be taken advantage of? In fact, it is far from it.

Source: http://www.heritage.org/research/reports/2013/10/enrollment-in-obamacare-exchanges-how-will-your-health-insurance-fare#.UmLMYB-ENzA

1) My Blue Cross Group clients have received policy renewal rate increases since the passage of the PPACA of up to 46% for the first time in 17 years. See just a few of them here. Their prior premium increases were nothing near this amount. This is not isolated to Blue Cross either. These premium increases are happening in many markets across the United States in both the Individual and Group health insurance markets because of all the PPACA mandated coverage parameters. Even though Barack Obama promised “my health care plan will save the average family $2,500 on their premium.”

And then their was this quote from Barack Obama: “It’s estimated that your employer’s premiums will fall by as much as 3,000% which means they could give you a raise.”

These premium increases are due to the fact that multiple new “Preventative Care” mandates were imposed upon all “non-grandfathered” health insurance plans as of 9/23/2010 under the PPACA (Patient Protection & Affordable Care Act). A “Non-grandfathered” health insurance plan is a plan that was purchased after the PPACA (a.k.a “Obamacare”) was signed in to law on March 23, 2010. It is 14 million of these individual and family policies that will be terminated before December 30, 2013 even though they are already ‘Obamacare compliant”. Keep in mind, that all of the charges below were mandated to be covered on all individual and family policies no later than 1/1/11 WITHOUT a co pay or DEDUCTIBLE. The entire list is as follows:

2.) Now for the policy “design” mandates. Including the requirement that all plans cover an unlimited lifetime maximum coverage amount for all insured members on policies sold after 9/23/10.
http://www.resourcebrokerage.com/BCBSupdates22510B/PPACAILInsuredNotification.pdf

3.) The recent inclusion of PPACA mandated “Essential Health Benefits” on group health plans. Among these are the following:

Starting on 1/1/14 all individual and family policies will also have to include the aforementioned 10 “Essential Health Benefits” under the PPACA. The majority of individual health plans on the market today already include 8 or even 9 out of the 10 ‘Essential Health Benefits’ that we are told they need and to not have so they have to be canceled in order not to be ‘substandard’ plans. They must also cover all preexisting conditions without proof of prior coverage. The truth is the vast majority of health insurance policies available on the individual and family market prior to the PPACA already included many of these “Essential Health Benefits”. But even for those that did not, the aforementioned facts prove that the individual and family health insurance market is far from what the Obama administration is falsely calling the “Wild West”. Both the Group and Individual and Family health insurance market has been the most regulated industry in America for decades before the PPACA was passed. It is even more regulated since 9/23/2010 and yet it these PPACA compliant individual and family policies that are being terminated on December 30, 2013. And, the plans that are being offered to these policy holders as a replacement are even more expensive according to main stream media outlets like:

CBS: A charter member of the Main Stream Media finally reports on 2 million Americans who have already lost their health plans:

CBS: They finally report on the true cost of Obamacare approved health insurance:

CBS News: Also reporting on hundreds of thousands losing their health insurance plans because of Obamacare:

CBS News: “Obamacare resulting in dropped coverage and higher premiums.

NBC News: Consumers facing sticker shock and policy cancellation notices due to Obamacare.

Kaiser Health News: Thousand of consumers getting insurance cancellation notices due to health law changes.

NBC News: Thousands getting health insurance cancellation notices.

NBC News: Half a million Californians losing their health insurance plans because they don’t comply with Obamacare.

Millions of individual and family health insurance plans have already been terminated and 16 million more Americans will soon lose their individual health insurance plans because of Obamacare.

The worst part about all of this is that NBC News is now reporting that President Obama knew, as early as July of 2010 that millions of Americans would lose their health insurance plans because of his health care law:

Below is a photocopy of a page of the federal register that proves that the Obama administration knew in 2010 that millions of Americans would lose their Individual & Employer Sponsored health insurance plans because of Obamacare. This regulation was written on purpose so that millions of existing policy holders would be forced to purchase health insurance inside the exchanges instead. The forced addition of millions of these policyholders – all who were assured by president Obama that they could ‘keep their plan‘ – will lower the cost or further subsidize the high cost of insuring sick people who will most certainly be purchasing subsidized health insurance inside the exchanges. In other words this was a deliberate action taken by HHS and a direct violation of the president’s promise.

Proof4.) The onerous PPACA mandated Medical Loss Ratios or “MLRs”. This is another reason why health insurance premiums are increasing on “Non-Grand-Fathered” health insurance plans – plans purchased after the passage of the PPACA. For full details on these I refer you to the following link from the Heritage Institute. http://www.heritage.org/Research/Reports/2010/01/Squeezing-out-Private-Health-Plans

This MLRs have left hundreds of thousands of American’s either uninsured or without the plan they had prior to the passage of the PPACA. Here is a sample letter that many of my clients received when Guarantee Trust Life insurance company ceased providing health insurance to my clients around the country in 2010.

This is exactly the opposite of what President Obama promised when he said in his speech to the AMA on June 15, 2009 “If you like your health care plan, you will be able to keep your health care plan. Period. No one will take it away. No matter what.” Watch him repeat this lie over, and over again below:

Find out the names of the carriers that have left the industry since the passage of the PPACA as well as all the other damage done to the health insurance industry since the passage of the PPACA by reading the study completed by the Galen Institute on December 1, 2011 entitled “A Radical Restructuring of Health Insurance.”

World Insurance company in Omaha, Nebraska and it’s subsidiary American Republic insurance company is the latest carrier to succumb to the PPACA’s onerous MLR – Medical Loss Ratio requirement. They have now exited the individual market due to the PPACA Medical Loss Ratios. This move left 35,000 former policy holders without their plans. Sadly, the exit of American Republic from the Individual health insurance market also left 110 former employees without a job. Read that story here. Both companies will be purchased by Celtic Insurance company of Chicago Illinois.

This is not an isolated incident in Iowa. Iowa’s Principle Financial Group also exited the health insurance market, leaving 840,000 policy holders without their health insurance plans. Principle was purchased by United Health Group. Thankfully, due to this purchase, United Health Group will be offering new coverage to those formerly insured with Principle Financial Group. Again, you can not keep your plan, even if you like it. President Obama lied. And, as these larger companies gobble up smaller companies, competition is stifled resulting in higher premiums, less choices for consumers and a rapidly growing monopoly.

Other companies that have either closed their doors entirely or stopped selling health insurance since Obamacare was signed into law are as follows:

1.) American National
2.) American Republic
3.) American Medical Security
4.) American Community Mutual
5.) Standard Life & Accident
6.) Principle Financial
7.) nHealth
8.) World Insurance
9.) Unicare
10.) Guarantee Trust Life
11.) Coventry
12.) Physicians Benefit Trust
13.) Independence Holding Group

Other carriers are slowly withdrawing State by State. Page 7 of this white paper dated September 6, 2011 from the North Carolina Department of Insurance details exactly why the majority of all health insurance carriers that offered health insurance in their State have already exited and why even more are considering doing so shortly.

Millions more Americans will lose their Employer Sponsored health insurance after 2014. This is due to the fact that the ‘fine’ (Roberts Tax) on employers – with 50 or more more full time employees – who do not offer HHS approved health insurance to their employees is only $2,000 annually. This is far less than the cost to provide health insurance. So, many employers will simply choose to pay the ‘fine’ and push their employees onto the ‘health insurance exchanges’. For the full impact of the PPACA “Roberts Tax” on Individuals, Taxpayers & Employers visit this link.

UPDATE: Even though Barack Obama has now delayed this onerous mandate on employers until 2015 the ramifications have already been realized in the latest jobs report with a massive increase in part time workers.

Historical precedent proves that forcing mandate after mandate and new regulation after regulation on to the health insurance industry does nothing but increase costs. In 1979 there were 252 mandates forced upon the health insurance industry, by 2007 there were nearly 1900. With the implementation of the PPACA  we have tipped the scales at nearly 2,262 mandates. Keep piling them on and costs will continue to rise.

5.) Premiums will continue to increase when the following additional PPACA imposed requirements begin on January 1, 2014

A.) The “minimum actuarial value” requirement that forces insurers to provide more financially generous coverage with fewer co-pays and deductibles.
B.) The “community rating” provision that forces young Americans to pay far more for health insurance in order to subsidize older Americans. This was included in the PPACA even though historical data points to the catastrophic failure of ‘community rating’.
C.) The “guaranteed issue” provision that forces insurers to take all comers, even if they are already sick.
D.) The “essential health benefits” mandate that forces insurers to cover health-care services that many customers wouldn’t otherwise want to pay for.

The sad truth is, even though the President promised ‘affordable health insurance for all Americans‘, many Americans will not receive health insurance at all. In fact, according to the Congressional Budget Office’s latest assessment,
30 million Americans will remain uninsured even after full implementation of the PPACA. Worse yet, 17 million more will simply be enrolled in a Government Welfare program called Medicaid. Many who do receive health insurance will receive a very large tax payer funded subsidy, which will continue to detach the consumer with the true cost of health insurance. To find out what health insurance will cost you in the PPACA ‘Health Insurance Exchanges’ click here.

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C. Steven Tucker vs. Rep. Luis Guiterrez, 3 ‘Windy City Live’ hosts & audience.

On October 14th I engaged in what I was told by ABC7 Chicago producers would be a debate on the Patient Protection & Affordable Care Act with a ‘supporter of the law’. What I did not know until I stepped on the set was that I would be debating a sitting U.S. Congressman and that I would spend most of my time trying to get a word in edgewise. Instead of discussing the merits of Obamacare or lack thereof. I spent most of my time defending the GOP, Sarah Palin, Ted Cruz, George W. Bush AND the Tea Party. Not only was I debating the Congressman I was also debating all 3 of the Windy City Live program hosts in front of a live audience filled with furloughed IRS agents and union workers. The odds were heavily stacked against me but when I had a chance to speak I spoke the truth. Even when the Congressman was filibustering, receiving support from his friends on the Left and refusing to answer direct questions.

October 19, 2013 UPDATE: Just for the record, NBC news is now confirming precisely what I said in the above ‘debate’. “Thousands get health insurance cancellation notices” – NBC. That is precisely what the Tea Party was trying to prevent.

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What will “Hope & Change” cost you in 2014 under Obamacare?

Source: http://www.heritage.org/research/reports/2013/10/enrollment-in-obamacare-exchanges-how-will-your-health-insurance-fare#.UmLMYB-ENzA

Oh and you’re going to lose your health plan. This time it’s not according to me. It’s according to NBC News. http://www.nbcnews.com/health/thousands-get-health-insurance-cancellation-notices-8C11417913

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What will health insurance cost in the new health insurance exchanges?

If you want to see just how expensive “Government approved” health insurance will be in the new health insurance exchanges. Just click on the Kaiser Family Institute’s Exchange Calculator here. Or, you can use the online Obamacare health insurance exchange “Marketplace” by clicking here. Good luck logging in though. The system crashed 90 minutes after it opened. You should see the following image when you get to the Obamacare insurance exchange ‘Marketplace”. Have fun!

exchange holding point
Now that you’ve chosen the Kaiser Calculator instead, enter the average annual income for a family of four according to the 2011 U.S. Census report. That number is $51,144.  First, look at the “unsubsidized health insurance premium“. This is the actual  premium for the health insurance. As you can see, the cost of these policies are extremely expensive. Worse yet, the cheapest plan – the Bronze plan – exposes a family to $12,700 in out of pocket risk each year. Why?  Because the “Affordable Care Act” mandates that all of  these Preventative Care benefits must be provided to the policy holder with no copay, deductible or any other out of pocket expense. Add to all of those newly mandated Preventative Care benefits, the recently added  “Essential Health Benefits” which will also now be included on all health insurance policies sold within the exchanges as of 1/1/2014.

Source: http://www.heritage.org/research/reports/2013/10/enrollment-in-obamacare-exchanges-how-will-your-health-insurance-fare#.UmLMYB-ENzA

As I have mentioned many times before, Government imposed mandates on health insurance carriers are the primary driver behind high health insurance costs. Historical precedent proves this. In 1979 there were a total of 252 mandates forced upon the health insurance industry nationwide, by 2007 there were nearly 1900. Today, there are more than 2,262 mandates. The new “Affordable Care Act” mandates will drive up health insurance costs even higher.

Still using the calculator? Take a look at how much the consumer will actually pay for their health insurance once the few, the proud, the 51% of us who still pay income taxes have subsidized their premium. The “Affordable Care Act” doubles down on what I call “Consumer Detachment Syndrome”. This ‘syndrome’ is a result of WW2 era legislation that tied health insurance to employers. Since many employers pay much of the cost of health insurance for their employees as an added benefit. Many consumers have no idea what health insurance truly costs until they lose their job and receive a COBRA continuation premium that rivals the size of their mortgage payment.

This “Detachment Syndrome” will continue with the “Affordable Care Act” since many consumers will not see these massive new tax payer subsidies when they purchase health insurance in the exchanges. Instead, they will believe that the “Affordable Care Act” magically reduced the cost of health insurance, just like the President promised. And, the burden on the tax payer will continue to increase. Sadly, there are not enough producers to tax to sustain this massive new entitlement for long. This means that the printing and borrowing will continue at the Federal level and the cost of all of this will be passed on to our children and grandchildren. Either way, the “Affordable Care Act” is unsustainable. I discussed this on the Fox Business television network:

States like Massachusetts have already developed a state -based health insurance exchange. In fact, the exchange in Massachusetts is the prototype that will be used to develop other health insurance exchanges under the PPACA. There’s only one problem, the cost to taxpayers. At last count, the Massachusetts health care overhaul initiated by Mitt Romney has cost taxpayers more than $8 Billion. The Federal tax credits provided to other states who make the catastrophic budgetary mistake to develop a state-based PPACA exchange should be equally staggering.

Still have that calculator open? Enter $30,000 for a family of four and $15,000 for an individual. As you can see, those people will not be getting health insurance. In fact, according to the latest CBO assessment, 17 million of them will receive a Government WELFARE program called Medicaid instead. Medicaid is the worst and most dangerous health care program ever devised by man. Even though the President promised “Affordable Health Insurance for all Americans.”

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