Well Workplace University – Level 2 Certification

Onward and upward!  WELCOA does a great job to enable individuals to really learn what is necessary to lead a wellness campaign for a firm.

Having completed Level 1 and Level 2 training,  I plan on completing the last Level 3 courses before the end of the year.

As health insurance costs continue to rise, employers will place more emphasis on controlling future costs through wellness.  Moreover, in 2011 our government will be providing eligible firms “wellness grants” to promote wellness in the workplace.  This means that employers will look to find capable individuasl to help them build and monitor an ongoing wellness program.  A “results oriented” program instead of a “passive join 24 hour fitness if you want”.

Low participation does little to change health care costs, so employers must provide “financial incentives” to employees who reach their goals.  Employees will not be forced into a wellness program, but financially encouraged.  Since healthy lifestyles to not change overnight, employees will have to be educated  on an ongoing basis about diet, exercise, stress, smoking, obesity, plus benchmark their current way of life to show measurable lifestyle changes from participating in a wellness program.

Healthier employees do reduce health claims, workers’ comp claims, and sick days.  What about offering time off for “health days”, instead of “sick days”?  Get involved with wellness with me!

Studies Find Health Care Costs Rising

Recent studies cited by the Los Angeles Times,  The Dallas Morning News and The Milwaukee Centinel all indicate that health care costs have more than doubled over the last decade, with cost increases expected to average 9% over the next year.  Some of the factors for the high increases are an aging workforce, large medical claims and changes brought by healthcare reform, such as the requirement that dependents can remain on their parents plans to age 26.    It is expected that employees will shoulder the lion’s share of the increases  as employers, in an effort to control their expenses in a down economy, will shift the increases to their employees or reduce the benefits and increase the deductibles on revised plans for their employees.

Health Insurance for Children – What Now?

Effective today, individual health insurers cannot deny coverage to children with pre-existing conditions.  As a predictable reaction to this change in federal law, CIGNA, Health Net Anthem and Aetna have stopped selling individual health plans to children.

 What can be done for children who need              insurance now???

 For those children who are currently covered by a child only health plan, they will remain covered as long as premium payments are made on a timely basis.  The carriers will not rescind coverage.  For those children who will need coverage as of 9-23-10, Legislation has recently been passed in California that would block California insurers from denying coverage to children with preexisting conditions, but would let them charge significantly higher premiums to those who don’t sign up during open enrollment periods each year and impose surcharges on those who try to abuse the system by dropping coverage when children are healthy. This legislation would limit how much children with preexisting conditions would have to pay if they signed up during open enrollment.  Carriers that refuse to participate would face penalties.

 This bill, AB 2244, is pending signature by Gov. Schwarzenegger. He is expected to sign the bill.

HELP CALIFORNIA KEEP HEALTH CARE PLAN CHOICES!!

Your help is urgently needed now! There are two bills pending now in the state legislature that would establish the California Health Benefit Exchange.  If signed into law, these bills, AB1602 and SB 900, could create major problems with the individual and small group markets in our state as well as cripple consumer choice and negatively impact our state’s already chronic budget deficit.

This pending legislation gives the California Exchange Board the authority to create the structure of the new agency with little guidance and no legislative oversight or accountability. This Exchange would:

·         Exempt senior staff from the state’s civil service laws, regulations and pay caps.

·         Provides no fiduciary duty to the Board or senior staff and allows them to make decisions without personal liability for their actions for an agency that could potentially handle coverage for 4-9 million Californians and premiums of $20-$40 billion annually.

 ·         Allows the Board to act without transparency and exempts the Exchange from the California Public Records Act and Administrative Procedures Act. 

 ·         The Board can meet in private and adopt rules without public comment and enter into contracts without following state procurement guidelines.

 ·         Allows the Board to establish a budget and raise revenue through assessments outside of the normal legislative budget process or controls.

 ·         Allows the Board to select how many and what kind of insurance products individuals and businesses may purchase.

 We urge you to contact Governor Schwarzenegger to oppose passing this legislation!  Please click  here to let our State Government know this legislation is NOT in the best interest of California citizens!

TIPS ON THE INDIVIDUAL APPLICATION PROCESS

When the Obama Administration’s health reform laws take full effect in 2014, insurance carriers will no longer be able to deny coverage to adult individuals with preexisting medical conditions. Until then, there are federally funded high-risk pools. To qualify for these, you have to be without insurance for six months and you must show you have applied for and been denied insurance in the private market.

If you have a preexisting condition and can’t qualify for the high-risk pools, it’s a smart idea to at least check out the plans available within the private insurance market. “Don’t assume if one insurer rejects you that they all will,” says Anthony Wright, executive director of Health Access California, a statewide advocacy group.   By being a smart consumer you can improve your changes of obtaining coverage. Below are suggestions that we hope will help you in finding individual coverage:

Eligibility Laws
If you’ve exhausted your  COBRA and or CAL COBRA benefits available after leaving a job, federal law guarantees you a HIPAA policy from private insurers if you apply for one within 63 days from loss of other coverage.  Please make sure to retain a copy of the prior carrier’s “Certificate of Creditable Coverage” as proof that you did have coverage and that the loss of coverage occurred within 63 days of the application date.

Underwriting

In California carriers can review your health history, age and gender in order to determine the premium to be charged if you have a history of certain medical conditions.    The carriers are looking for those applicants that may potentially charge a large amount in claims costs.   The carriers also subscribe to a service that tracks your prescription drug records, the MIB Group.  You can request a copy of your 5 year usage history at http://www.mib.com/html/request_your_record.html.

Carefully answer the application

In order to determine the premium to be charged, the carrier’s application will ask many questions about your health.  Please remember to fully answer only the question asked.  Underwriters are looking to see if a medical situation has been resolved, or there are upcoming charges or procedures that may indicate a large expense.  Remember that omitting information may actually cause the coverage to be rescinded.  Sometimes the carriers will schedule a telephone interview in order to gain a better understanding of your medical history, so it is best if you have a copy of your medical records with you during the call, so you don’t have to try to remember all the details, which may be a costly mistake.

Manage your health

Of course it is always best for you to try to maintain optimum health, not only for obtaining health insurance, but to maintain your quality of life.  If a medication is working don’t change it unless there is a generic available.  Lose weight, exercise. Commit to a healthy lifestyle.  

Ask your medical provider to review your records and correct any inaccuracies and update your health history.  Not only will this effect a health insurance application, it is important to have all records be accurate for medical and legal reasons.

Work with a knowledgeable agent

The current insurance atmosphere is in a state of flux, with many changes to happen over the next few years.  Talk to someone in the field for help.  You can contact the National Assn. of Health Underwriters’ website, http://www.nahu.org or you can contact our office at (888) 474-6627   for assistance with the application process.