Archive for February 1st, 2013

Survey Of Out-Of-Network Billed Charges Brings Health Care Pricing Into Focus

Friday, February 1st, 2013

SurveyofBilledChargesOONProviders

Ah Ha! The Root Cause Of High Cost Health Care Finally Exposed! – Greedy Insurance Companies!

Friday, February 1st, 2013

A story in today’s LA Times describes in rare detail why US healthcare is insanely expensive.  It’s not due to malpractice lawsuits, patients who expect too much, high-tech medicine or burdensome regulations. No, it’s the result of insurance industry bureaucracy and greed. While many consumers have long suspected that, hard evidence has been elusive.  Now, an investigation by the Los Angeles Times has turned up that hard evidence.

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IRS: Cheapest ObamaCare Family Plan Will Cost $20,000

Friday, February 1st, 2013

(CNSNews.com) – In a final regulation issued Wednesday, the Internal Revenue Service (IRS) assumed that under Obamacare the cheapest health insurance plan available in 2016 for a family will cost $20,000 for the year.

Under Obamacare, Americans will be required to buy health insurance or pay a penalty to the IRS.

The IRS’s assumption that the cheapest plan for a family will cost $20,000 per year is found in examples the IRS gives to help people understand how to calculate the penalty they will need to pay the government if they do not buy a mandated health plan.

The examples point to families of four and families of five, both of which the IRS expects in its assumptions to pay a minimum of $20,000 per year for a bronze plan.

“The annual national average bronze plan premium for a family of 5 (2 adults, 3 children) is $20,000,” the regulation says.

Bronze will be the lowest tier health-insurance plan available under Obamacare–after Silver, Gold, and Platinum. Under the law, the penalty for not buying health insurance is supposed to be capped at either the annual average Bronze premium, 2.5 percent of taxable income, or $2,085.00 per family in 2016.

In the new final rules published Wednesday, IRS set in law the rules for implementing the penalty Americans must pay if they fail to obey Obamacare’s mandate to buy insurance.

To help illustrate these rules, the IRS presented examples of different situations families might find themselves in.

In the examples, the IRS assumes that families of five who are uninsured would need to pay an average of $20,000 per year to purchase a Bronze plan in 2016.

Using the conditions laid out in the regulations, the IRS calculates that a family earning $120,000 per year that did not buy insurance would need to pay a “penalty” (a word the IRS still uses despite the Supreme Court ruling that it is in fact a “tax”) of $2,400 in 2016.

For those wondering how clear the IRS’s clarifications of this new “penalty” rule are, here is one of the actual examples the IRS gives:

“Example 3. Family without minimum essential coverage.

“(i) In 2016, Taxpayers H and J are married and file a joint return. H and J have three children: K, age 21, L, age 15, and M, age 10. No member of the family has minimum essential coverage for any month in 2016. H and J’s household income is $120,000. H and J’s applicable filing threshold is $24,000. The annual national average bronze plan premium for a family of 5 (2 adults, 3 children) is $20,000.

“(ii) For each month in 2016, under paragraphs (b)(2)(ii) and (b)(2)(iii) of this section, the applicable dollar amount is $2,780 (($695 x 3 adults) + (($695/2) x 2 children)). Under paragraph (b)(2)(i) of this section, the flat dollar amount is $2,085 (the lesser of $2,780 and $2,085 ($695 x 3)). Under paragraph (b)(3) of this section, the excess income amount is $2,400 (($120,000 – $24,000) x 0.025). Therefore, under paragraph (b)(1) of this section, the monthly penalty amount is $200 (the greater of $173.75 ($2,085/12) or $200 ($2,400/12)).

“(iii) The sum of the monthly penalty amounts is $2,400 ($200 x 12). The sum of the monthly national average bronze plan premiums is $20,000 ($20,000/12 x 12). Therefore, under paragraph (a) of this section, the shared responsibility payment imposed on H and J for 2016 is $2,400 (the lesser of $2,400 or $20,000).”

Who Are We To Believe? DOL or The IRS?

Friday, February 1st, 2013

Department of Labor (DOL) has issued certain rules regarding     “affordability”. Wednesday this week the Internal Revenue Service     (IRS) issued their own rules on the same subject. Both are at odds with each other. So who are we going to believe?

DOL definition of affordable mandates the cost must be 9.5% or less  of the employee’s gross income (Safe Harbor).

The IRS now says, in a memorandum issued Wednesday, that a plan is affordable only if the cost is 8% or less of a household’s adjusted gross income.
Is this a case of one hand not knowing what the other hand is doing?

Editor’s Note: This is great! Pick and choose your decision based on the “source” you like the best. Very old strategy employed before with dealing with the Texas Department of Insurance – keep calling the department and talk to as many as you can until you get the answer you are looking for and then say “Would you please put that in writing and send me an email confirming our conversation!”