An undetermined number of employees are expected to be laid off in the wake of the rehabilitation order by state of Michigan’s OFIR for the insurer American Community Medical.

Based out of Livonia, American Community is one of Michigan’s’ oldest insurance companies.

Due to ongoing financial problems, the company was placed on rehabilitation on April 8th, 2010.

Rehabilitation is corporate reorganization under Chapter 81 of the Michigan Insurance Code.

There are at least 280 people were employed there in 2009.

If you are an American Community policyholder you do have options.  If you would like to review your options please don’t hesitate to give us a call.

Related Posts:

American Community Medical Rehabilitation Michigan

Originally posted 2010-04-25 18:03:30. Republished by Blog Post Promoter

Originally posted 2009-08-27 05:06:08. Republished by Blog Post Promoter

Area Agency on Aging

800-852-7795   800-803-7174

Macomb County Deptartment of Senior Services

586-469-6313

Recipients of Medicare from Social Security can enroll  Medicare Part D (prescription benefit) which began January 1, 2006.    Low income persons below 150% of poverty (currently $1197 per month income for one, $1604 for two) can receive “extra help” from Social Security (800-772-1213), at reduced or no premium.  For advice about which provider to choose call the Area Agency on Aging’s Medicare/Medicaid Assistance  Program (800-852-7795 or 800-803-7174) or the Dept of Senior Services (586-469-6313) or Social Security (1-800-MEDICARE 800-633-4227), or see http://www.medicare.gov

Originally posted 2009-07-28 07:00:59. Republished by Blog Post Promoter

The simplest answer to this question is NO.  According to Privacy Rights Clearinghouse you need to know the following:

Insurance companies. MediCal and Medicare are government health plans and can require a Social Security number. Most insurers providing individual health insurance policies cannot require your Social Security number. However, they might refuse to issue a policy if you don’t provide your Social Security number.

A new Mandatory Insurer Reporting Law (Section 111 of Public Law 110-173) requires group health plan insurers to report SSNs in order for Medicare to coordinate payments with other insurance benefits. The law was enacted in late 2007 but became effective on January 1, 2009. As a subscriber (or spouse or family member of a subscriber) to a group health plan arrangement, your SSN will likely be requested in order to meet the requirements of this law if this information is not already on file with your insurer. Similarly, individuals who receive ongoing reimbursement for medical care through no-fault insurance or workers’ compensation or who receive a settlement, judgment or award from liability insurance (including self-insurance), no-fault insurance, or workers’ compensation will be asked to furnish information concerning their SSN.

For more information about this law see:

• http://www.cms.hhs.gov/MandatoryInsRep/

Originally posted 2010-03-31 05:48:14. Republished by Blog Post Promoter

A co-payment is a fixed-dollar amount that you are responsible for paying for a particular medical service. For example, many plans have $35 co-payments for doctor’s visits. This means it only costs you $35 to see a doctor. Most individual Michigan health insurance plans offer doctor co-pays between $35-$50

Originally posted 2009-07-31 18:36:34. Republished by Blog Post Promoter

Frequently Asked Questions

A short-term extension of COBRA health insurance premium subsidies for involuntarily terminated employees has been approved.

Now, employees terminated from April 1 through May 31, 2010, will receive the 15-month, 65% federal premium subsidy. Prior to this extension, March 31, 2010 was the cut-off date.

President Obama is urging lawmakers to extend the COBRA premium subsidy through the end of the year. The Senate is currently working on this new extension.

The Focus Group will keep you posted of any upcoming changes to the COBRA subsidy as they become present.

UPDATE:
The latest extension applies to anyone who involuntarily lost a job between April 1 and May 31 of this year. The subsidy lasts for 15 months from when coverage begins. (COBRA coverage typically lasts 18 months; in some cases it can be extended to 36 months.) To qualify for the subsidy, you must apply for coverage within 60 days of losing benefits, not be eligible for Medicare and not be eligible for any other group health plan, such as one offered by a new job or by a spouse’s employer.

You can get additional information at http://www.dol.gov/COBRA or by calling a Department of Labor benefits advisor toll-free at (866) 444-3272.

NOTE: There is a possibility that the COBRA extension could be opened up to those who lose their jobs after June.  We’ll keep you posted.

UPDATE 5/27/2010

It looks as if House Democrat leaders have released a scaled-down version of the H.R. 4213 bill.  Under the revised bill health benefits and COBRA subsidies will now be extended through November 30, 2010 instead of December 31, 2010.

The reasons for the scale down is an effort by Democratic leaders to get the measure approved before Congress breaks for the Memorial Day weekend.

The estimates from the Congressional Budget Office puts the price tag at around $144 billion.  This includes cuts on unemployment benefits and COBRA subsidies.  It was nearly $200 billion.

So, with opposition coming from fiscal conservatives, both Democrat and Republican, the measure will be difficult to pass by Memorial Day.

If you may lose your COBRA benefits on May 31, remember, in certain states insurance companies can impose a waiting period for pre-existing conditions if there is a lapse in coverage greater than one day.  Be sure to check with your local broker to confirm.

UPDATE 6/2/2010

It seems that the Dems were concerned about getting enough votes to get the Jobs bill passed.  In order to garner the votes, they had to drop the COBRA Subsidy or 65% discount over concerns about short term deficits and political considerations.

The same Democrats who claimed to take the moral high ground when it came to Health Care Reform are the same ones now leaving thousands of Americans without health insurance.  Was it not these Democrats who claimed the reason for reform was to insure all Americans had affordable Health Care Insurance?

What does this mean for me?

It means that if you lose your job starting now, you will no longer qualify for the 65% discount COBRA subsidy.  You would be required to pay the full price of your COBRA Health Insurance.

Is there a chance that the 65% discount will go longer than 15 months?

No.  That is a common misunderstanding.  The extension was only for those who recently lost their jobs.  Not those who were coming to the end of their 15 months.

What Next?

The most prudent thing to do is to find a new family health insurance plan immediately.  Depending on your state, you do not want a lapse in coverage.  Especially if you have pre-exisiting conditions.  Insurance carriers can exclude pre-exisiting conditions if there is a lapse in coverage.

If you have questions about your options, please don’t hesitate to comment below or contact The Focus Group at 888.320.5388.

RELATED INFO

• FAQs On The COBRA Premium Reduction Extension Provisions
• COBRA Fact Sheet
• COBRA Subsidy Extension Beyond 15 months
• Alternative to COBRA Insurance
• When should I take COBRA

Originally posted 2010-05-04 07:04:41. Republished by Blog Post Promoter

Health insurance reform council to help reduce costs for citizens, businesses.

Governor Jennifer M. Granholm today established a Health Insurance Reform Coordinating Council within state government to identify steps that must be taken to ensure that Michigan citizens reap the full benefits outlined in the Patient Protection and Affordable Health Care Act signed into law by President Obama.

The council will be chaired by Michigan Department of Community Health (DCH) Director Janet Olszewski.

The governor’s executive order creates an Office of Health Insurance Consumer Assistance within the Office of Financial and Insurance Regulation (OFIR) and an ombudsman to help provide consumers with information regarding health care insurance, assist with the filing of complaints, and to ensure compliance with laws and regulations relating to health care insurance.

READ MORE

Originally posted 2010-04-13 11:08:52. Republished by Blog Post Promoter

Wondering what health insurance companies are going to offer individual insurance on a guaranteed basis once an individual exhausts their cobra coverage?

Until 2014 it looks as if Michigan residents have one choice for guaranteed issue.  BCBS of Michigan.  While other companies such as Aetna, Assurant, Humana, Golden Rule, and Cigna will eventually follow suit.  It is doubtful that they will do so prior to the deadline in which the law states you can no longer be denied for a pre-existing condition.

It remains to be seen if health insurance companies get creative.  By creative, let’s say you cannot be denied for pre-existing condition, but you can be denied due to credit history?  Or similar to auto insurance, your premium is determined by your credit history instead of you health history?

If one thing remains consistent, private companies will find a way to survive legislation…Wow, now that we are completely off track….

If you currently have COBRA health insurance, THAT DOES NOT mean you are guaranteed coverage as of 2010.  You must still pass underwriting guidelines in order to get coverage.  This is a common misconception.

According to recent news, the state of Michigan will be creating a Michigan High Risk Pool by the end of the year.  The benefit to Michigan residents will be that those who currently do not qualify for traditional coverage will have something to fall back on.  You will have more options with the high risk pool, instead of just choosing for BCBS of Michigan.

If you have questions about upcoming changes in the State of Michigan, contact one of our brokers at 888.320.5388.

Originally posted 2010-05-07 09:08:11. Republished by Blog Post Promoter

Lap Band Surgery  in Michigan for patients not covered by health insurance typically costs between $12,000 and $25,000.  The biggest factor affecting cost is your region and your surgeon.

If you are in a large metropolitan area, such as Detroit, costs trend towards the higher end.  Although Oakwood Healthcare System offers a cash price of $15,000.  Oakwood Healthcare has several locations throughout Michigan.  Great Lakes Weight Loss of Michigan offers a price of $10,700.

Lap-Band surgery in Michigan is sometimes covered by health insurance depending on the insurance company and your policy.  Some healthcare plans exclude any type of weight loss surgery regardless of the circumstances.  Quite often in Managed care plans or HMO insurance.

What should be included in the cost of lap band surgery?

• Intitial consultation with the surgeon for screening and explanation of options, risks, and benefits of the surgery
• The fee should include hospital facility fees annd the anesthesiologist’s services
• Some doctors include membership in a support group
• Your routine follow up visits for up to a year after surgery

Additional Costs of Lap-Band

• After the first year follow up visits typically cost between $35 – $200 each
• Complications post-surgery can add to the overall cost. Minor complications can be several hundred dollars.  While major complications that require hospitalization can can easily cost tens of thousands of dollars.
• Some patients require plastic surgery to remove extra skin after rapid weight loss
• Some patients require special vitamins and meals which can add up to hundreds of dollars

Are there discounts for Lap-Band surgery?

If you pay for the surgery out of pocket you may be eligible for tax breaks if the cost of the surgery is high enough in relation to your income.  This is essentially a discount if you qualify, it could potentially increase your tax return.  However for the surgery it is strictly dependent upon your Michigan surgeon.

Which hospitals provide Lap Band Surgery in Michigan?

Certanly there are more, but these are some of the more well known facilities that offer Lap Band Surgery

• Henry Ford Hospital – a center of excellence offering roux-en-y gastric surgeries, both open and laparoscopic, as well as laparoscopic adjustable gastric banding surgery
• Oakland Bariatirics – perform several surgical procedures for morbid obesity, including laparoscopic adjustable banding
• Port Huron Hospital – perform lap band adjustable gastric banding system, also known as lap band surgery

Related Information:

Financing Lap Band Surgery in Michigan

NOTE:  Any company mentioned is not a solicitation for business.  Nor is it a recommendation to use their services.  We received no compensation.

Originally posted 2010-04-27 05:55:41. Republished by Blog Post Promoter

Health Insurance can be one of the most frustrating things to shop for.  Trying to understand deductibles, co-pays, co-insurance.  As if you didn’t have enough things to do in your day.  Now you have to try and navigate all this insurance jargon.

With the ever increasing precense of the internet, more and more people are taking the do-it-yourself route when it comes to shopping for insurance.  Whether it’s for their car, their home, or their medical coverage, they enjoy the ease of getting multiple quotes in one place.  I myself have shopped for insurance this way.

I own a small business unrelated.  I was without health insurance.  Prior to getting in to the insurance field, I experienced first hand the frustation of shopping for health insurance.  I would choose the cheapest plan that looked great, office visits, decent deductible.  Only to get a bill from my doctor later, going WTH?  I tried going through a broker.  Maybe my first clue should have been him requesting me to come to his house to discuss coverage.  That plan sucked too.  Of course I didn’t know it until I had to use it.

And there in lies the frustration with health insurance.  While it serves it’s purpose in keeping us financially secure.  My expection of what I was purchasing was not inline with what I was actually getting.

So when I say it’s up to you.  What I mean is that it’s important to ask the right questions.  What does the coverage do if X happens?  What about Y?  If I get cancer is that included in the coverage I purchased?  What about prescription coverage.  I see that it’s included, but do I need to get approval before I go to the pharmacist.

By asking all the right questions up front you can alleviate some of the frustration that you run into on the back end.  Of course when you shop online, who are you going to talk to?  Well, there is a reason why they have a talk to live support on most insurance websites.

Make sure you do you due diligence. If it seems confusing consult a licensed agent.  While most of the time your dealing with guys/gals who are hounding you because of a quote request.  It’s amazing how helpful they will be answer questions when you are calling them.  Agents know their stuff.  Thats why they have a license.  Good luck!

Originally posted 2009-07-09 04:40:56. Republished by Blog Post Promoter