So now that the "Public Option" is dead & the Medicare "Buy In Option" is dead and the Democrats have now passed their 'Historic"  Health Care "reform" bill in the Senate. What's next?  Well, it's now a 3 Step Process. I will attempt to outline these steps below:

1.) The Senate bill could go directly to the House for consideration. At that time, the House could decide to give it a "Yes" or "No" vote right then and there. This is not likely though, because the bill coming to them for a majority vote is MUCH different than what was sent to the Senate.
2.) What is most likely going to happen is that the Senate Bill will go to a "Conference Committee". This would mean that a select group of Congressmen from both chambers would meet once AGAIN "behind closed doors" in an attempt to reconcile both bills in to one MASSIVE bill.
3.) From there, a finished bill would have to be voted on in both chambers. The House will go first and then the Senate.  Afterwards, the bill would be sent to the President's desk for a signature.

Since the Democrats Super Majority has been eliminated by the election of Senator Scott Brown from Massachusetts. The Democrats are no longer able to shove through their bill against the will of the majority of Americans. This being the case, they are now seeking to use the "reconciliation process" (a.ka. "the nuclear option) to pass select "pieces" of their health care "reform" bills. However, thanks to Senator Jim Demint and his team of Patriots this attempt will fail as well due to a little known loophole that could allow them to offer an indefinite number of amendments during the reconciliation process.

It is for this reason that in my informed opinion, the Democrats health care "reform" bills are now OFFICIALLY DEAD! They will now be FORCED to go back to the drawing board and begin the process of reform on a BI PARTISAN and TRANSPARENT basis JUST LIKE THE PRESIDENT PROMISED IT WOULD BE BEFORE THE PROCESS BEGAN!

Why did the Democrats entire health care "reform" process fall apart EVEN THOUGH THEY MAINTAINED A SUPER MAJORITY? Before I even begin detailing their nightmarish process of incompetency and blatant partisanship, let me first expose a little piece of information that the Democrats DO NOT want you to know. If we were to simply cut the $760 BILLION in annual waste that exists in our current Health Care system, we could provide EVERY SINGLE ONE of the 46 Million Uninsured a Gold Plated Health Care plan that would make the CEOs of Blue Cross Blue Shield GREEN with envy. Oh, and it would only cost us HALF of the aforementioned $760 BILLION. So WHY in GOD's NAME do the Democrats want to spend $2.4 TRILLION over the next 10 years to cover the 46 Million Uninsured AND also MANDATE the purchase of GOVERNMENT APPROVED HEALTH INSURANCE? Because it's not about health care, it's about Tyranny.

The massive 2074 pg. Senate Health Care reform bill is called the Patient Protection Affordable Care Act and Harry Reid SWEARS it's "deficit neutral" and that it "protects" Medicare. Even though he planned to expand Medicare to Americans as young as age 55. This was a "trade off" that took place when the Public Option was FINALLY killed on December 9, 2009 and replaced with the now equally dead Medicare "Buy In Option". Did I mention that Medicare is already BANKRUPT with a $43 Trillion deficit as of January 2008? Maybe this is why Timothy Geithner, Kathleen Sebelius, Hilda  Solis and Michael Astrue were less than encouraging in their troubling 2009 annual report on Social Security & Medicare. Did I also mention that in order to GET Medicare at age 55 they were planning on charging $7,600 a year in premiums to each enrollee at a cost to Tax Payers of more than $1 TRILLION? I'm glad that's Dead. But wait! The bill still cuts Medicare by $500 BILLION! Here's the BEST PART of these bills! No health care "Hope" or "Change" begins until 2014! In fact, the only thing that begins is HIGHER TAXES for all of us who actually pay taxes and who most likely ALREADY HAVE OUR OWN HEALTH INSURANCE!

Even before the "Public Option" provision in the Senate bill was killed, there was a provision in the bill for States to "opt out" of the Government Health Insurance option. I wonder if this is because they actually READ the 3rd, 4th, 5th, 9th or 10th Amendment of our Constitution which clearly prove that these bills are UNCONSTITUTIONAL? Remember when Speaker Pelosi said that the bill will "not add ONE dime to the deficit"? I can only assume that she "mis-spoke" because these bills will add MILLIONS OF DIMES TO OUR DEFICIT. In fact, they are Ponzi schemes that would make Bernie Madoff look like a philanthropist! These bills are economy KILLERS, Small Business KILLERS and Middle Class destroyers! Equally troubling is the fact that those who have been chosen to represent our best interests apparently have NO IDEA that we have NO MONEY to pay for this! We have now amassed a $12 TRILLION National Deficit. With this reckless spending comes consequences. The Inflation Institute outlines exactly what those consequences will be below in their short but powerful film:

By the way, if you think EITHER of these bills will cost less than $2.4 Trillion, you might want to do your own due diligence like the CATO Institute did. John Boehner tells us ALL ABOUT these bloated pieces of Govt. special interest payola on America's News Room:  

An even better assessment was made on 10/30/09 by Constitutional Attorney Mark Levin of the Landmark Legal Foundation. This could be the reason why the Wall Street Journal called the House bill "The Worst Bill EVER". Worse yet! These bills literally commit HARD TYRANNY on the American citizen BY IMPRISONING AMERICAN CITIZENS FOR UP TO 5 YEARS if they don't BUY HEALTH INSURANCE! Oh yeah it's in there! I have a natural aversion to fine print. So I've taken the Liberty of "blowing up the IRS code" (pun intended).

Want more proof? Here's some clarification on the fine and prison time clauses directly from Congress http://bit.ly/25P0Y0. One of the most enjoyable videos I have seen in a LONG time is the one where Speaker Pelosi was asked by an intrepid reporter if she felt it was "fair" to imprison people who do not buy Health Insurance. Always nice to see a politician squirm when questioned about their OWN LEGISLATION!

How are former Health Care reform activists responding to this? Watch MSNBC's Dylan Ratigan Yell at Congresswoman Debbie Wasserman Schultz (D-FL) as she tries to "spin" the truth about the health care "reform" bills.

Even the Patron Saint of health care "reform" Dr. Howard Dean is now saying KILL THIS BILL!

Keith Olbermann goes a step further and states "I will got to jail before I buy Obamacare Insurance!" KILL THIS BILL!

Pelosi's Bill will also cut $500 BILLION in Medicare. What will that do? Listen to Senate Minority Leader Mitch McConnell on 11/17/09

Congressman Ed Whitfield (Kentucky) lists some other "ugly truths" about Pelosi's "health care reform" bill (also on 11/17/09):

Did I also mention that Senator Barbara Mikulski's (Maryland Democrat) bill that designates ABORTION AS PREVENTATIVE CARE just passed in the Senate as well?  This is MADNESS! You may be asking yourself. HOW DID THIS BILL GET PASSED? Well at first it was hopeful that AT LEAST A FEW Democrats would have a 'crisis of conscience" and vote against the Senate bill. However, their guilty conscience was quickly appeased with MILLIONS & MILLIONS of YOUR TAX DOLLARS. First, there was the $300 MILLION bribe to Senator Mary Landreiu (which is now known as the new "Louisiana Purchase"). Senator Landreiu was very public about her lack of support for the health care bill. She even told the press that "I can not be bought" But after she received YOUR MILLIONS for her State, she quickly changed her vote.

Then there was the "Nebraska Purchase" to Senator Ben Nelson. He was the last "holdout" in the Senate. First, the Whitehouse threatened to close Offutt Air Force Base in Nelson's home state if he did not vote "Yes". Once this threat was exposed in the media, the Democrats chose to fall back on the tried and true negotiation tactic known as "PAYOLA". After Senator Nelson & Senator Reid spent 13 hours behind closed doors. Senator Nelson (a former staunch advocate against funding abortions with tax dollars) ALL OF A SUDDEN changed his vote to a "YES". Why? Because his State would now be EXEMPT FROM PAYING ANY ADDITIONAL MEDICAID COSTS ASSOCIATED WITH THE PASSAGE OF THIS BUREAUCRATIC MONSTROSITY! Funny how a MILLIONS OF YOUR TAX DOLLARS can "ease the conscience" of your elected officials! How exactly can President Obama state that he "will not increase taxes on the middle class" if he allows these massive 1,990 & 2074 paged TRAIN WRECKS to pass? Does he not know what American's think about these bills? Did he not here us in Washington D.C on the steps of our nation's capitol at the "KILL THE BILL" rally on November 5, 2009?

OR at the Code Red Rally on December 15, 2009?

JUST LOOK at all the new TAXES nestled deep in side these massive bills! Not to mention the $6.7 BILLION in new Premium Taxes!
Employer Mandate Excise Tax (Page 275): If an employer does not pay 72.5 percent of a single employee’s health premium (65  percent of a family employee), the employer must pay an excise tax equal to 8 percent of average wages.  Small employers (measured by payroll size) have smaller payroll tax rates of 0 percent (<$500,000), 2 percent ($500,000-$585,000), 4 percent ($585,000-$670,000), and 6 percent ($670,000-$750,000).
Individual Mandate Surtax (Page 296): If an individual fails to obtain qualifying coverage, he must pay an income surtax equal to the lesser of 2.5 percent of modified adjusted gross income (MAGI) or the average premium.  MAGI adds back in the foreign earned income exclusion and municipal bond interest.
Medicine Cabinet Tax (Page 324): Non-prescription medications would no longer be able to be purchased from health savings accounts (HSAs), flexible spending accounts (FSAs), or health reimbursement arrangements (HRAs).  nsulin excepted.
Cap on FSAs (Flexible Spending Accounts) (Page 325): FSAs would face an annual cap of $2500 (currently uncapped).  Increased Additional Tax on Non-Qualified HSA Distributions (Page 326): Non-qualified distributions from HSAs would face an additional tax of 20 percent (current law is 10 percent).  This disadvantages HSAs relative to other tax-free accounts (e.g. IRAs, 401(k)s, 529 plans, etc.)
Denial of Tax Deduction for Employer Health Plans Coordinating with Medicare Part D (Page327): This would further erode private sector participation in delivery of Medicare services.
Surtax on Individuals and Small Businesses (Page 336): Imposes an income surtax of 5.4 percent on MAGI over $500,000 ($1 million married filing jointly). MAGI adds back in the itemized deduction for margin loan interest. This would raise the top marginal tax rate in 2011 from 39.6 percent under current law to 45 percent—a new effective top rate.
Excise Tax on Medical Devices (Page 339): Imposes a new excise tax on medical device manufacturers equal to 2.5 percent of the wholesale price. It excludes retail sales and unspecified medical devices sold to the general public.
Corporate 1099-MISC Information Reporting (Page 344): Requires that 1099-MISC forms be issued to corporations as well as persons for trade or business payments. Current law limits to just persons for small business compliance complexity reasons. Also expands reporting to exchanges of property.
Delay in Worldwide Allocation of Interest (Page 345): Delays for nine years the worldwide allocation of interest, a corporate tax relief provision from the American Jobs Creation Act
Limitation on Tax Treaty Benefits for Certain Payments (Page 346): Increases taxes on U.S. employers with overseas operations looking to avoid double taxation of earnings.
Codification of the “Economic Substance Doctrine” (Page 349): Empowers the IRS to disallow a perfectly legal tax deduction or other tax relief merely because the IRS deems that the motive of the taxpayer was not primarily business-related.
Application of “More Likely Than Not” Rule (Page 357): Publicly-traded partnerships and corporations with annual gross receipts in excess of $100 million have raised standards on penalties.  If there is a tax underpayment by these taxpayers, they must be able to prove that the estimated tax paid would have more likely than not been sufficient to cover final tax liability. How will ALL of these new taxes affect us? Forbes Magazine does a GREAT job of breaking it all down.

Senator Jim DeMint (R-S.C.) pointed out some VERY DISTURBING language in the Senate health care bill during floor remarks on 12/21/09. First, he noted that there are a number of changes to Senate rules in the bill--and it's supposed to take a 2/3 vote to change the rules! And then he pointed out that the Reid bill declares on page 1020 that the Independent Medicare Advisory Board cannot be repealed by future Congresses! This is unprecedented legislation that is tantamount to TYRANNY!
 

With all of the aforementioned evidence stacked against the health care bills. Senate Democrats STILL say Republicans are "evil" for opposing it. My favorite video showing the Democrat's "righteous indignation" towards Republicans was the recent drunken tirade by Max Baucus from the floor of the U.S. Senate. That's right, I said DRUNKEN tirade from the floor of the US Senate:



Democrats have made it clear that they believe that health care is a "Fundamental Right". However, no one seems to be discussing the "fundamental rights" we LOSE under both of these bills. In fact, if it were not for Patriotic American Tax Paying Citizens voicing their INFORMED dissent at Town Hall Meetings across the country AND the ONE MILLION NINE HUNDRED EIGHTY SIX THOUSAND Patriots who showed up in Washington D.C. on 09/12/09. President Obama and a Democrat controlled House & Senate would have MOST DEFINITELY passed HR3200 in it's original UGLY form!

Regarding the "America's Healthy Choices Act". All you need to do is read Section 2203 entitled "Guaranteed Issue and Renewal For Insurance Plans" (starting on Page 19). In this section we enter in to what I like to call "Lawmaker La La Land" where not only must an Insurance company COVER ALL APPLICANTS REGARDLESS OF PRE-EXISTING CONDITIONS, but they also are PROHIBITED from charging ANYTHING EXTRA because of pre-existing conditions. For those that have no idea how health insurance works (like those in the Senate who actually wrote this ridiculous legislation) please read this Wall Street Journal article of 8/12/09.

Congressman Mike Rogers of Michigan spoke with such passion at a Senate hearing this week regarding President Obama's Health Insurance "reform". After actually READING the bills, he had some genuine concerns and he was not afraid to voice them and boy did he EVER voice his concerns!

For those of you old enough to remember Jack Webb, you will thoroughly enjoy his thoughts on President Obama's plans here:

This is clearly NOT the way to "reform" our health care system. In fact, BOTH parties (and most American's) feel that something has to be done. The question is, what is the best course  of action?  There are still those who actually believe that a "Single Payer" system would be the best option. The President does not agree, although he clearly stated his support for such a system prior to his election. 

Nevertheless, we still definitely need health care reform on many levels and if Government must play a part, there are intelligent things they can do. Here’s where they can actually help:

If you are a business owner, self-employed or an employee of a company that is not offering medical coverage though your employer, you may have to undertake the frustrating, daunting and time consuming task of purchasing health insurance on your own. If this is the case, there are certain things that you can do become an informed consumer so you can ensure that you are purchasing the type of health insurance coverage you really need at a price you can afford.

When you purchase a health insurance plan, it is important that you balance four important variables:
wants, needs, risk and cost, before you spend your money.

Although you may "want" a health plan that offers you 100% coverage and a $5 Copay for prescription medications, you may not "need" this type of health plan if you are healthy, take no medications and do not have any significant health related "risk" factors.

Since a 100% health plan will "cost" significantly more than an 80/20 Plan, it may not be in your best interest to pay higher monthly premiums for 100% coverage if you are currently healthy.

Although no one knows exactly when they will actually use their insurance coverage, considering these four key variables prior to purchasing a health plan is a good rule of thumb.

It is also critical for health insurance consumers to understand that all plans, even 100% Plans, have some form of coverage limitations. Knowing what your policy DOES NOT cover, is more important than knowing what it DOES cover.

The following is a list of 10 key questions that should help health insurance consumers to better understand the coverage limitations of the plans they are considering purchasing. Make sure you ask your insurance agent these questions BEFORE purchasing a health insurance policy. 

1. What insurance company do you represent and are you a "captive" agent, "independent" agent or an insurance "broker?" "Captive" agents represent ONE insurance company's products only.

An "independent" agent or insurance "broker," on the other hand, typically represent many quality insurance carriers and can sell a variety of different insurance products without any contractual restrictions.

BEWARE!  Dealing with a "captive" agent may limit your choices, since these agents can only sell that particular insurance company's health plans.

2. What is the plan's calendar year Deductible and would I have to pay a separate deductible for each family member if everyone in my family became ill at the same time? The majority of health plans have a per person calendar year deductible, for example, $250, $500, $1,000, or $2,500. Some plans are designed so in a "worse case scenario" only two family members will have to pay their deductible in any given calendar year.

BEWARE! Some plans will require each person in the family to pay their calendar year deductible. This can be a huge financial burden if everyone in the family was involved in an accident or if members of the family became ill at the same time.  Many plans have a separate drug deductible before the plan will pay for any medications. Make sure you know what deductibles you will be responsible for before you buy a health plan.

3. What is the plan's Coinsurance percentage and what Stop Loss Number is this percentage based on?  

These percentages are typically based on a specific dollar amount, known as the "stop loss number." Here's where it get's tricky. Quite often, health insurance plans have different "stop loss numbers". I have seen some plans that have a "stop loss number" as low as $2,000 and as high as $25,000 or some with none at all. 

Let's figure out the insured's maximum out of pocket on an 80/20 plan that has a $1,000 deductible and an 80/20 split of the first $5,000 ("stop loss number.")

$1,000 + 20% of $5,000 ($1,000) = A Maximum Out of Pocket of $2,000. 

Now, let's figure out the insured's maximum out of pocket on an 80/20 plan that has a $250 deductible and a $10,000 "stop loss number."

$250 + 20% of $10,000  ($2000) = A Maximum Out of Pocket of $2,250. (Note: Total does not include any separate "service deductibles" or access fees. Many low quality plans also have these.) 

Again, after this brief 80/20 cost sharing with the insurance company, also know as a the coinsurance percentage split, most major medical plans will pay 100% of in-network covered charges up to the Lifetime Maximum amount that is specified in the policy.

BEWARE! Some policies on the market are sold with NO stop loss, but still list a coinsurance percentage. Therefore if you purchase an 80/20 with no stop loss, you will actually be paying 20% of all of your medical bills each calendar year. So unless you want to be responsible for 20% of all of your bills, make sure you find out what the "stop loss number" is BEFORE you purchase a health plan!

4. What is the plan's Maximum Out Of Pocket Expenses per year? This expense is a total of all deductibles, plus all coinsurance percentages, plus all applicable "access fees", "service deductibles" or other "fees" outlined in your policy.

BEWARE! Quite often agents neglect to tell prospects about hidden fees, so make sure you have a good grasp on the basics, like deductibles, coinsurance & stop loss numbers. Always ask about additional "fees" BEFORE you purchase the plan!

5.  What is the plan's Lifetime Maximum Benefit if I become seriously ill and does the plan have any "per illness" maximums or caps? The majority of health insurance plans have a two million or five million dollar Lifetime Maximum Benefit. The Lifetime Maximum Benefit is the maximum amount the insurance company will pay if you or someone in your family becomes seriously ill.  

BEWARE! Some policies will stipulate that there is a maximum benefit cap of $100,000 per illness. This means that you would have to develop many separate and unrelated life-threatening illnesses costing $100,000 or less to qualify for the five million dollar Lifetime Maximum Benefit. Mega Life & Health, Midwest National Life a.k.a. Health Markets, formerly U.I.C.I., endorsed and promoted by the National Association for the Self Employed (N.A.S.E) and the Alliance for Affordable Services are known for selling "schedule" plans with "per illness caps."

6. Is the plan a Schedule Plan, in that it only pays a certain amount for a specific list of procedures? Some health plans only pay a specific dollar amount for certain procedures, despite the fact that the procedure often cost more than the plan stimulates.

BEWARE! Mega Life & Health, Midwest National Life a.k.a. Health Markets, formerly U.I.C.I., endorsed and promoted by the National Association for the Self Employed (NASE) and the Alliance for Affordable Services are known for selling "schedule" plans.

7. Does the plan have unlimited doctor copays or is there a limited number of doctor copay visits allowed each year? Many quality plans have no limit on the number of times you can use your doctor copay.

BEWARE! Several plans have a limit of how many times you can go to the doctor each year for a Copay. Quite often, the limit is 2-4 visits per year.

8. Does the plan offer Prescription Drug Coverage and if it does, what type of coverage? Some plans offer prescription drug benefits on both generic and brand name medications right away. Other plans will require you to pay a separate outpatient prescription drug deductible before you can obtain your prescription medication for a Copay.

BEWARE! Today, many plans offer NO outpatient prescription drug Copay options. Typically, these plans only provide the insured with a discount prescription card which only offers the insured a 10-20% discount on prescription medications. This can lead to catastrophic out of pocket expenses to the insured.

9. Does the plan have any reduction in benefits for Organ Transplants and if so, what is the maximum the plan will pay out for an organ transplant? The majority of quality major medical plans treat organ transplants as any other illness. This means that the insurance company will cover the insured until the Lifetime Maximum Benefit of the plan is reached. Again, in most cases, this Lifetime Maximum is five million dollars. You should accept no less than one million dollars of coverage for Organ Transplants.

BEWARE! Today, some plans only pay a $100,000 maximum benefit for organ transplants. Plans that offer limited organ transplant coverage are extremely risky, since organ transplant procedures often range in the neighborhood of $350-$500K. In addition, it is not uncommon for a transplant patient to need a second organ transplant. Keep in mind, that the $100,000 maximum payment for organ transplants on many plans also includes the cost of expensive anti-rejection medications. If you have an organ transplant, you will quickly reach the $100,000 maximum benefit, which means that you will be required to pay for costly anti-rejection medication out of pocket. This can lead to catastrophic out of pocket costs to the insured.

10. Does the plan have any separate "services deductibles" or "access fee" for each hospital admission or for each outpatient test? Some plans, like Assurant Health's "CoreMed" plan have a separate $750 hospital admission fee for the first three days of each hospital stay. These hospital admission fees may also be called "Access Fees" on other policies. Typically the insured is responsible for paying these access fees for each hospital admission in addition to their calendar year health plan deductible.

Many plans also have a separate deductible for emergency room visits. These deductibles are in place to discourage policyholders from using the emergency room as a doctor's office. Typically, these ER deductibles are waived if the patient is admitted to the hospital. 

BEWARE! "Access fees" and "service deductibles" are separate from your plan's calendar year health plan deductible. Be aware that many plans now have benefit "caps" or "access fees" for out-patient services, such as, physical therapy, speech therapy, chemotherapy, radiation therapy, etc. These "benefit caps" could be as little as $500 for each out-patient treatment, which will leave the insured responsible for the remaining balance that is over $500.

Again, "access fees" are additional fees that you may have to pay per treatment before the insurance company will pay the provider.  These fees can quickly add up. For example, if you need to have 40 outpatient chemotherapy treatments, and you must pay a $250 "access fee" per treatment, you would have to pay an additional 40 x $250 = $10,000.

Remember, purchasing a health plan is the most important purchase you will ever make. Insist that your insurance agent explain to you exactly what your health plan does and does not cover and take the time to read the "fine print" in the plan brochure and ask questions about terminology you don't completely understand.

In addition, when you receive your health insurance policy in the mail, don't just detach your insurance cards and place them in your wallet or purse and then throw your insurance policy in your desk drawer or filing cabinet. Take the time to sit down and read your policy page by page.

Once you receive your policy, you have a 10-day free look period, so if your coverage is not what you thought you purchased, you have time to call the insurance company and cancel the policy without incurring any fees.

Finally, if your being pitched a health plan that seems too good to be true (e.g. all pre existing conditions are covered, the plan is significantly cheaper than all other plans) contact your state's Department of Insurance BEFORE you buy the policy. Your state's Department of Insurance can tell you if the insurance company is registered in your state and can also tell you if there have been any complaints against that company that have been filed by policyholders.

Remember, if you suspect that your being scammed or you think the agent is trying to sell you a fraudulent insurance policy, (e.g. you have to become a member of a union to qualify for coverage) your state's Department of Insurance can also check to see if any prior disciplinary action has been previously taken against that agent.

Whatever decision you make in regards to your health insurance, please always remember to heed the following words of wisdom.  

• "If it sounds too good to be true, it probably is!" ..........and
• "If you only buy on price, you get what you pay for!"

About the author: C. Steven Tucker, is the President of Small Business Insurance Services, Inc. He is a multi-state licensed insurance broker who has been serving the Small Business community and Self-Employed for 15 years. C. Steven has served as a Subject matter expert for the Wall Street Journal and Fortune Small Business Magazine and hosts his own internet radio show, entitled, "Health Insurance 101." He is also touted for being a consumer watchdog against greedy insurance companies, insurance scams and unscrupulous agents on Twitter.

United Health Care now offers the "Continuity" plan. The "Continuity" plan is a concept enacted by the CEO of United Health Care & its subsidiary Golden Rule Insurance company. The concept is a brilliant one indeed because one of the greatest challenges to all health insurance brokers is the struggle to maintain "Guaranteed Insurability" for clients who have been diagnosed with a host of conditions such as Diabetes or Cancer. The onset of either one of these illnesses (and many more) will render one "uninsurable" on the individual major medical market. This can become a very serious problem if one looses their employer sponsored group coverage and can not either afford their State's risk pool coverage, or they do not live in a State that provides a State Insurance Risk Pool. 
 
The "Continuity" plan resolves this problem by allowing insurable consumers to purchase any plan that United Health Care/Golden rule offers at only 20% of the normal required premium for that plan. Consumers can purchase this plan whilst they are covered by an employer sponsored group health insurance plan that offers them Guaranteed Insurability. Whilst the consumer is still insured by their employer sponsored group plan the United Health Care policy of their choice goes in to a "dormant" state. In other words, the policy remains in force as long as the insured pays only 20% of the required monthly premium for that product.  

The moment that the consumer looses employer sponsored group coverage, or is faced with a hefty Cobra continuation premium. They can then elect to "awaken" the policy out of its "dormant" state and the policy will then begin to cover them on a Guaranteed Insurability basis without the need for underwriting. This means that if a consumer were to develop a major medical condition that would render them uninsurable on the individual major medical market whilst the "Continuity" plan was in its "dormant" state, their pre existing conditions would continue to be covered seamlessly from day one once the consumer elects to "awaken" their "Continuity" coverage. Once the policy is "awakened" the insured would now have to pay the entire monthly premium required to maintain that individual health insurance policy. But as anyone in the industry knows, individual policies often require a fraction of the premium that is required to maintain a Cobra continuation plan. 

Once the insured has retained another employer sponsored group plan that provides Gauranteed Insurability (presumably by securing another employment position) then the policy goes back in to its "dormant" state and the premium is subsequently reduced to only 20% or the required monthly premium. Essentially this concept allows any consumer to "float" in and out of employer sponsored group coverage whilst also maintaining the all important "Guaranteed Insurability" clause so valuable to those who have been rendered "uninsurable" on the individual major medical market. For more about this brilliant concept click here.

To see a list of Frequently Asked Questions (FAQ's) relating to Health Insurance, click here.

About the author: C. Steven Tucker, is the President of Small Business Insurance Services, Inc. He is a multi-state licensed insurance broker who has been serving the Small Business community and Self-Employed for 15 years. C. Steven has served as a Subject matter expert for the Wall Street Journal and Fortune Small Business Magazine and hosts his own internet radio show, entitled, "Health Insurance 101." He is also touted for being a consumer watchdog against greedy insurance companies, insurance scams and unscrupulous agents on Twitter.

Note: This policy may not be available in some states.

Since there are so many ideas on the table as to how to reform our Nations Health Care System, it is difficult to know  what the right course of action is. Most especially when you are on the outside looking in. Recently ABC's 20/20 program  did an in depth study of this issue. The result of which clearly outlined the problems with the U.S. Health Care System  and what needs to be done on a National scale  in order to truly reform our Health Care System. If you have not seen the  20/20 episode entitled "Sick in America"  with John Stossel. Please take the time to watch all 6 videos and the short but  insightful documentary films below. It will take about 45 minutes of your time but it is well  worth it to know what's  really going on and what can be done right now to truly reform the U.S. Health Care system.  Most importantly it can all  be done without spending Trillions of U.S. Tax Payer Dollars. In fact, it will SAVE us money!

Sick in America" (Part 1 of 6)

"Sick in America" (Part 2 of 6)

"Sick in America" (Part 3 of 6)

"Sick in America" (Part 4 of 6)

"Sick in America" (Part 5 of 6)

"Sick in America" (Part 6 of 6)

A common example used to further the cause of adopting a Single Payer system in the United States is to point out how well it is working in countries such as France and Canada. 20/20 touches on this in the above episode. However, very few have done a more in depth study of Canada's Single Payer system than documentary film maker Stuart Browning. For even more about what is really going on with the Canadian  health care system please watch his short but very informative documentary videos below. Again, well worth your time.
 

What's it like JUST TO SEE A DOCTOR with Canada's Single Payer System? Watch Steven Crowder's hidden camera video:

Health Broker - Rick Baker (featured in the above film) asks you to help stop Congress from adopting Canada's system by signing the petition at www.freeourhealthcarenow.com Please help secure your rights to your own health care choices.

Why is Rick so passionate about his plea for your help in stopping the adoption of a Government Run Health Care System for all Americans? Because certain "progressive" states have already adopted such State Run Health Care Systems. Take a look at what happened to Barbara Wagner who was a victim of the "Oregon Public Health Insurance Plan". When Government runs ANYTHING it's all about price containment and not the Health & Welfare of the Patient.

Medical care in the United States is derided as miserable compared to health care systems in the rest of the developed world.  Economists, government officials, insurers and academics alike are beating the drum for a far larger government role in health care.  Much of the public assumes their arguments are sound because the calls for change are so ubiquitous and the topic so complex.  However, before turning to government as the solution, some unheralded facts about America's health care system should be considered, says Scott W. Atlas, a senior fellow at the Hoover Institution and a professor at the Stanford University Medical Center. 

Americans have better survival rates than Europeans for common cancers:

• Breast cancer mortality is 52 percent higher in Germany than in the United States, and 88 percent higher in the United Kingdom.
• Prostate cancer mortality is 604 percent higher in the United Kingdom and 457 percent higher in Norway.
• The mortality rate for colorectal cancer among British men and women is about 40 percent higher.

Americans have better access to treatment for chronic diseases than patients in other developed countries:

• Some 56 percent of Americans who could benefit are taking statins, which reduce cholesterol and protect against heart disease.
• By comparison, of those patients who could benefit from these drugs, only 36 percent of the Dutch, 29 percent of the Swiss, 26 percent of Germans, 23 percent of Britons and 17 percent of Italians receive them.

Lower income Americans are in better health than comparable Canadians:

• Twice as many American seniors with below-median incomes self-report "excellent" health compared to Canadian seniors (11.7 percent versus 5.8 percent).
• Conversely, white Canadian young adults with below-median incomes are 20 percent more likely than lower income Americans to describe their health as "fair or poor."

Americans spend less time waiting for care than patients in Canada and the United Kingdom:

• Canadian and British patients wait about twice as long -- sometimes more than a year -- to see a specialist, to have elective surgery like hip replacements or to get radiation treatment for cancer.
• All told, 827,429 people are waiting for some type of procedure in Canada.
• In England, nearly 1.8 million people are waiting for a hospital admission or outpatient treatment.

Source: Scott W. Atlas, "10 Surprising Facts About American Health Care," National Center for Policy Analysis, Brief Analysis No. 649, 3/24/09 http://www.ncpa.org/sub/dpd/index.php?Article_ID=17770

 
Because of how the Single Payer System is designed, citizens of England & Canada have NO WHERE NEAR the choices that we as American citizens do. As a matter of fact, until very recently (2005) it was simply not possible for a Canadian citizen to pay for their own health care or to purchase private medical insurance that would "bump them up the long waiting list" for medical treatments. The reason Canadian citizens now have the right to do so (and it is still limited) is a direct result of long hard battles (many that are still being fought) that have been waged by brave Canadian citizens like Dr. Jacques Chaoulli who took his clients case all the way to the Canadian supreme court and won! Dr. Chaoulli (http://www.healthcoalition.ca/chaoulli.html) and his patient, George Zeliotis, launched their legal challenge to the Canadian government's monopolized healthcare system after waiting more than a year for hip-replacement surgery.
 
Canada's high court found for the plaintiffs and in doing so issued the following statement: "The evidence in this case shows that delays in the public healthcare system are widespread, and that, in some serious cases, patients die as a result of waiting lists for public healthcare. The evidence also demonstrates that the prohibition against private health insurance and its consequence of denying people vital healthcare result in physical and psychological suffering that meets a threshold test of seriousness." Furthermore, Justice Marie Deschamps said, "Many patients on non-urgent waiting lists are in pain and cannot fully enjoy any real quality of life. The right to life and to personal inviolability is therefore affected by the waiting times."

To see a list of Frequently Asked Questions (FAQ's) relating to Health Insurance, click here.

About the author: C. Steven Tucker, is the President of Small Business Insurance Services, Inc. He is a multi-state licensed insurance broker who has been serving the Small Business community and Self-Employed for 15 years. C. Steven has served as a Subject matter expert for the Wall Street Journal and Fortune Small Business Magazine and hosts his own internet radio show, entitled, "Health Insurance 101." He is also touted for being a consumer watchdog against greedy insurance companies, insurance scams and unscrupulous agents on Twitter.

I have been an insurance broker in the state of Illinois for the past 15 years and I have seen first hand what happens when an over burdened, tax funded, Government controlled, entitlement program like Medicaid is offered to those with incomes well into the middle class.

Last year, SCHIP covered about 7 million low-income children and Medicaid covered an additional 23 million. This year, 2009, the U.S House of Representatives passed the H.R.2 SCHIP Expansion Bill which adds another 6.5 million children to Medicaid.

In fact, according to U.S. Census Bureau data, 42 million children will now be eligible. The bill also allows States to receive federal reimbursement for adding more immigrant children and pregnant immigrant mothers, and removes the 5 year waiting period now required for legal immigrants to be eligible. This would enable immigrants to become eligible for health benefits the moment they get here.

Currently, the present income eligibility cap is $44,000 for a family of 4. The new bill raised the Medicaid limit to $66,000. New York will even include families who earn $88,000 and other states allow families to subtract from their income calculation what they spend on rent or mortgage or heating or food or transportation. This means that  children in some families who have incomes well over $100,000 will now be eligible.

With the median U.S. household income around $50,000, 60% of U.S. households still earning less than $62,000.  This means that 3 out of 5 American households will now qualify for free health care for their children. It also means that the other 2 out of 5 household will have the burden of paying for all of this!

Let's take a look to see how some of these programs are doing. Click here to read about the Medicaid "expansion" program enacted in my home State, Illinois, by our recently impeached and now infamous Democratic Governor Rod Blagojevich.

In fact, Blago was so "generous" that he expanded these Medicaid entitlement programs to include a defunct "All Kids Covered" plan, a defunct "Mom's & Babies" plan and an equally defunct "Family Care" plan.

These entitlement programs were designed to provide FREE health insurance coverage to all low income women who are currently pregnant (Mom's & Babies) and all children - here legally or ILLEGALLY (All Kids Covered) but they were also to provide FREE health insurance to all low income mothers of children who are insured under the "All Kids Covered" program (Family Care).

Now, one does not need to study actuarial science to quickly conclude that these types of entitlement expansion programs simply can not continue to work without massive and endless influxes of tax payer dollars. In fact, the State of Illinois is currently $1.5 Billion (yes, that's BILLION) behind in payment of claims to medical practitioners who have already provided treatment to program recipients. Furthermore, submitted claims by unpaid practitioners have accrued a potential liability of $81 million in interest due to payment delays over the past 8 years.

Read more about the problems with claims payments here. 
Update: As of January 2009 a moratorium has been placed on the sliding scale portion of the Illinois Family Care and the Mom's & Babies program. One can only wonder why. Could it be due to lack of funding?

Illinois had been lauded as the "Flagship" state for all others to follow regarding the expansion of the Medicaid entitlement programs. If this is the template for all others to follow, then god help us all, or at least those of us that actually fund the Medicaid system through our hard earned tax dollars.

Weighty decisions such as expanding the Medicaid system to virtually "All Kids" regardless of their actual need, simply can not be made based entirely on emotion! Prudent decision makers must weigh the desire to help all mankind against fiscal REALITY. There simply is not enough money to provide such irresponsible expansions of the Medicaid program.

This is the real reason why President Bush vetoed the SCHIP program after the $780,000,000,000 (BILLION) "Porkulus Maximus" Bailout Bill passed in the Senate which was pushed hard by the Democratic Party. Of course, despite the caution of conservatives in the Republican party, the SCHIP bill did pass both the House and
Senate in 2009.

But how can we afford to pay for such entitlement programs? Should we limit these programs to those that truly cannot afford to purchase individual health insurance on the open market? How will we determine who is deserving of such entitlements (e.g. legal residents of this country who actually qualify during a legitimate needs assessment.)

What about personal responsibility? Should we also pay for the middle class if they can afford to purchase health insurance on their own?

Expansion of these entitlement programs to the middle class may be well meaning, but it is undoubtedly a fiscally irresponsible act that will end up crippling the already over burdened system.

We might not feel the direct impact of this now, but we most certainly will when all of the "Baby Boomers" start entering the Assisted Living and Long Term Care arena. Should we just let Boomers who don't have the forethought to purchase Long Term Care insurance off of the financial hook while taxpayers shoulder the burden?  

Today, those of us who are in need of health insurance have many options to choose from and, contrary to popular belief many of these options are priced very affordably.

An integral part of being personally responsible is that you take the time to explore ALL of your options so you can fiscially sound decisions BEFORE leaning on a an already over burdened Medicaid system.

If you have other options, you should never leave any decisions up government bureaucrats, especially your healthcare.

To see a list of Frequently Asked Questions (FAQ's) relating to Health Insurance, click here.

About the author: C. Steven Tucker, is the President of Small Business Insurance Services, Inc. He is a multi-state licensed insurance broker who has been serving the Small Business community and Self-Employed for 15 years. C. Steven has served as a Subject matter expert for the Wall Street Journal and Fortune Small Business Magazine and hosts his own internet radio show, entitled, "Health Insurance 101." He is also touted for being a consumer watchdog against greedy insurance companies, insurance scams and unscrupulous agents on Twitter.

I have been a multi state licensed health and life insurance broker for almost 15 years now. One of the biggest  challenges I have had to deal with through the years has been trying to help the uninsurable. Unfortunately in most  states if you have one of a host of "pre-existing" medical conditions you are labeled as uninsurable on an individual  health insurance policy. In most states this uninsurable status lasts for many years and sometimes for life depending on  the specific pre existing condition you have been diagnosed with. Some of the pre existing medical conditions that  render an applicant uninsurable for ten years or more are: Heart Attack, Stroke, Diabetes, Cancer, Lupus, Multiple  Sclerosis, Muscular Dystrophy, Degenerative Arthritis and a host of other pre existing conditions. In addition, there are  applicants who have a combination of controlled pre existing conditions but because they have more than three  "ratable conditions" they are labeled uninsurable. For example, with many carriers an applicant who has Hypertension  & Hyperlipidimia but is also overweight falls under the "3 strikes your out" rule and is labeled uninsurable. Or an  applicant may have two of the aforementioned controlled conditions and is not overweight but is a smoker and is  then labeled uninsurable also. Or an applicant who has asthma but also smokes falls in to the same uninsurable  category with many carriers.

These are just a few examples of conditions or "combo conditions" that can render an applicant uninsurable. The question then becomes, what do I do now? Who will insure me against the catastrophic medical bills that I may face in the future? Who will help me pay for the medications I currently am taking to control the aforementioned conditions? For many years depending on the state you live in you only had two options. They 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 two people (often husband & wife) who work for the same corporation can apply for a small group health insurance policy. After a period of time, or in some cases immediately (depending on how many months you have had prior health insurance coverage without a lapse) pre-existing conditions will be covered provided that they are a covered expense on the policy.

2.) Enroll in your states insurance risk pool (if your state is fortunate enough to have one). 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 pre existing conditions will be covered from day one (provided again that those conditions are a covered expense on the ICHIP policy). However, ICHIP (and all insurance risk pools) are by no means entitlement programs. They are far from free! Premiums charged are established by law at from 125%-150% above the average rates charged individuals for comparable major medical coverage by five or more of the largest insurance companies in the individual health insurance market in that state. Suffice it to say, the premiums are far from affordable for many people. The rates for a person 50 years of age living in Chicago can range from $554 monthly for a $5,200 deductible plan to $852 monthly for a $500 deductible plan. For those who do not have a Risk Pool in their State (http://www.naschip.org/states_pools.htm) their options are then even more limited if they are labeled as uninsurable.

The two aforementioned options are legitimate Health Insurance options for the uninsurable. It is important to steer clear of the two other "options" presented to the Uninsurable. They are as follows:

1.) Discount P.P.O. network memberships that are by no means health insurance policies. We've all seen them advertised from company's like "Care Entree" or "Ameriplan" that offer "health coverage" (clever way to circumvent the words "health insurance") that will "cover" the entire family for $89 monthly! Beware of these kinds of "discount" products! Learn more in the September 23rd 2008 Issue of The Tennessean Newspaper

These kinds of discount "coverage" plans are so inexpensive because they provide nothing more than a P.P.O. re-pricing discount. This in itself is not a bad thing. However without a Major Medical or Defined Benefit health insurance policy in place one can experience catastrophic medical bills with these types of "health coverage" plans. This is the case because the average P.P.O. discount on medical procedures performed within a P.P.O. network is between 25% & 40%. For a $100 doctor office visit, this is a good deal. However, if the medical bill is $500,000 that can leave the "covered" person with as much as $200,000 in out of pocket expenses!

2.) "Defined Benefit Health Insurance Policies". These policies do indeed provide Guaranteed Issue Health Insurance coverage for the uninsurable. However, the benefits provided are severely insufficient if one were to experience a major medical illness of any kind. These benefits provide a maximum of only $1,000 a day in the hospital and will provide coverage for surgical benefits but only up to the Medicare reimbursement ratio and they provide no coverage for "facility fees" (e.g. hospital fees related to the surgery which can be exorbitant). The two most popular of these plans are available through "AIM" (Association of Independent Managers) and the "Cinergy" plans. Both plans were formerly insured by American Medical & Life Insurance company of New York and NOVA Insurance company.

CONSUMER ALERT!! As of September 28th, 2009 the AIM plans have a issued a "cease & desist" order to all agencies nationwide to stop selling their Defined Benefit Health Insurance policies because AIM no longer has an insurer. American Medical & Life Insurance company (their former primary carrier) was replaced by NOVA Insurance company earlier this year. Now, (as of September 28th, 2009) NOVA has withdrawn as their carrier leaving AIM with no Health Insurance carrier to underwrite future applications or to pay existing claims.

About the author: C. Steven Tucker, is the President of Small Business Insurance Services, Inc. He is a multi-state licensed insurance broker who has been serving the Small Business community and Self-Employed for 15 years. C. Steven has served as a Subject matter expert for the Wall Street Journal and Fortune Small Business Magazine and hosts his own Internet radio show, entitled, "Health Insurance 101." He is also touted for being a consumer watchdog against greedy insurance companies, insurance scams and unscrupulous agents on Twitter. 

This is a great day in the health insurance industry! Rarely is an insurance company held liable for improper conduct. The majority of the time the "Big Guy" takes advantage of the "Little Guy." Sadly, the "Little Guy" often has no recourse. But this is not the case as of July 24, 2008.

After many years of repeated violations of insurance conduct laws the National Association of Insurance Commissioners (NAIC) helped levy one of the largest market conduct fines in insurance history against Mega Life & Health, Midwest National Life a.k.a. Health Markets, formerly U.I.C.I. and endorsed and promoted by the National Association for the Self Employed (NASE) and the Alliance for Affordable Services. 

In my opinion, after warning consumers for years about these companies, the 20 Million Dollar Fine they received is not nearly enough and it has come much too late!

Health Markets is still slinging their garbage plans in many parts of the country and hundreds of innocent consumers who purchased a plan through the National Association for the Self Employed call me each week to tell me that they had no idea about the extreme limitations included in the "insurance coverage" provided by Mega Life & Midwest National Life. 

Many consumers were not even aware that the plans they purchased were "schedule plans" and in many instances, only paid out $100,000 per illness. Misleading? Sure. In fact, during the sales process, the emphasis seems to be on the one million or two million lifetime maximum and NOT the $100,000 per illness maximum. 

Something that many consumers also didn't understand about these plans is that many did not have a
"stop loss number." 

To understand what a "stop loss number" is exactly, let's take a look at the three main parts of a health insurance plan: 

1. Calendar year deductible: This is the amount the insured pays first, before the insurance company shares in any medical expenses that are not covered on a "first dollar" basis.
2. Coinsurance: This is the percentage the insured pays of a specific dollar amount of medical bills incurred throughout the course of each year, called the "stop loss number" before the insurance company pays $100 of the medical costs.
3.  Stop Loss Number: This is the dollar amount of medical bills that the insurance company agrees to share with you, each year, before they will pay 100%. 

The average insurance consumer is usually familiar with the deductible. Deductibles can range from $250 to $10,000. Typically, the lower the deductible, the more expensive the plan, because the insurance company is assuming a greater risk. 

The same holds true for the Coinsurance. Health plans are sold with different Coinsurance percentages. Plans can be 50/50, 70/30, 80/20, 90/10 or 100% or a variation. These numbers refer to percentages. The first number (e.g. 80/20) refers to the percentage the insurance company will pay, usually for in-network charges after the insured meets his/her calendar year deductible. The second number (e.g. 80/20) refers to the percentage the insured pays. 

These percentages are typically based on a specific dollar amount, known as the "stop loss number." Here's where it get's tricky. Quite often, health insurance plans have different "stop loss numbers". I have seen some plans that have a "stop loss number" as low as $2,000 and as high as $25,000 or some with none at all. 

Let's figure out the insured's maximum out of pocket on an 80/20 plan that has a $1,000 deductible and an 80/20 split of the first $5,000 ("stop loss number".)

$1,000 + 20% of $5,000 ($1,000) = A Maximum Out of Pocket of $2,000. 

Now, let's figure out the insured's maximum out of pocket on an 80/20 plan that has a $250 deductible and a $10,000 "stop loss number."

$250 + 20% of $10,000  ($2000) = A Maximum Out of Pocket of $2,250. (note: total does not include any separate "service deductibles" or access fees. Many low quality plans also have these.) 

Again, after this brief 80/20 cost sharing with the insurance company, also know as a the coinsurance percentage split, most major medical plans will pay 100% of in-network covered charges up to the Lifetime Maximum amount that is specified in the policy. 

On quality comprehensive health insurance plans, the Lifetime Maximum benefit is usually five million dollars. Typically, plans from reputable health insurance carriers do not have a "$100,000 per illness" or reduced benefits for other medical treatments, like Organ Transplants. 

Unfortunately, it is only when an unsuspecting insurance consumer develops a life threatening medical condition that they find out that on the 80/20 plan they purchased, they are responsible for paying 20% of the medical expenses up to the Lifetime Maximum (e.g. 20% of One Million Dollars or $200,000.). In addition, if they have a $100,000 per illness cap, they will also be responsible for all of the medical expenses that exceed $100,000. 

Would you buy a policy like that if it was fully explained to you? Most definitely not, and the NAIC apparently agrees. This is one of the reasons why after a 3 year, 29 state investigation, Mega Life & Health, Midwest National Life a.k.a. Health Markets, formerly U.I.C.I., endorsed and promoted by the National Association for the Self Employed (NASE) and the Alliance for Affordable Services finally got what they deserved!

For more information, you can also read a scathing Market Conduct Report, which was included in the fine to warn future innocent consumers.

If you or a loved one have fallen "victim" to any of this organizations  or have been approached by an agent selling one of these "insurance products" please feel free to contact me for help and advice.

To see a list of Frequently Asked Questions (FAQ's) relating to Health Insurance, click here.

About the author: C. Steven Tucker, is the President of Small Business Insurance Services, Inc. He is a multi-state licensed insurance broker who has been serving the Small Business community and Self-Employed for 15 years. C. Steven has served as a Subject matter expert for the Wall Street Journal and Fortune Small Business Magazine and hosts his own internet radio show, entitled, "Health Insurance 101." He is also touted for being a consumer watchdog against greedy insurance companies, insurance scams and unscrupulous agents on Twitter.

The phrase "Consumer Driven Tax Qualified Health Insurance" is being tossed around quite a bit nowadays especially  since the tax advantages of owning Tax Qualified Health Insurance has been significantly increased under the former  Bush administration. Effective December 20, 2006 President George W. Bush signed the Health Opportunity Patient  Empowerment Act of 2006, enhancing Americans' access to tax-advantaged health care savings. The law, part of the  Tax Relief and Health Care Act of 2006, provides new opportunities for health savings account (HSA) participants' to  build their funds. To read about the new adjustments Click here: http://www.treas.gov/press/releases/hp209.htm  For the 2009 IRS H.S.A. COLA (Cost of Living Adjustments) click: http://www.treasury.gov/press/releases/hp975.htm
 The 2010 IRS H.S.A. COLA Adjustments were announced on 05 14 2009. They can be viewed here: 2010 IRS HSA COLA

 One of the most popular (and lowest priced) types of Consumer Driven Tax Qualified Health Insurance vehicles is the  HSA qualified HDHP.  HSA stands for "Health Savings Account", more commonly referred to as a "Medical IRA". HDHP  stands for High Deductible Health Plan. Health Savings Accounts are a unique way to attractively manage your health  insurance  costs. They were  originally named MSA's or Medical Savings Accounts designed by Senator Bill Archer (R) of  Texas.  Bill's project was to  find a way to reduce the cost of health insurance for the self employed without sacrificing quality coverage for a  major medical illness. Bill's brilliant idea was to eliminate the parts of a Traditional Health Insurance Plan that cost the consumer the most money. These expensive benefits include outpatient doctor "co pays" and outpatient prescription "co pays". Bill approached Congress with a proposal that stated in essence that if you remove those two features and keep the major medical coverage in place you could conceivably cut the cost of your health insurance premium considerably. He was absolutely right!

To illustrate how Bill's idea works in the real world. We will use a real world example. Tony & his wife are currently paying $1,134 a month for Cobra continuation coverage from a previous group plan. In comparison, the monthly premium for an HSA qualified HDHP (High Deductible Health Plan) which covers each insured family member up to $5 million dollars is less than half of the premium that they are paying now ($481.64 monthly to be exact). This is a yearly savings of $7,828.32 or a monthly savings of $652.36. This is a significant difference. However the insured has to give up all of their outpatient co pays. Is this worth it? This was the question posed to Senator Bill Archer (R) when he approached Congress back in the late 1990's. His answer to Congress was simply "make it worth it".

The "Next Generation" HSA qualified HDHP eliminates this problem by starting your benefit period on your requested effective date. The next benefit period would not begin again until 12 months after that date. So with this design, if you were to purchase your "Next Generation" HSA qualified HDHP on December 1st, 2009, then you would not be required to pay another deductible until 12 months later on December 1st, 2010. This is a very attractive benefit for anyone considering buying an HSA qualified HDHP late in each calendar year. It is a much better "Benefit Period" design than the typical calendar year design. This benefit is only available with the "Next Generation" HSA qualified HDHP.

Please feel free to contact me if you have any questions about HSA qualified HDHP's. If you have a C.P.A. or tax advisor please make sure to ask about the tremedous tax advantages of owning an HSA.

About the author: C. Steven Tucker, is the President of Small Business Insurance Services, Inc. He is a multi-state licensed insurance broker who has been serving the Small Business community and Self-Employed for 15 years. C. Steven has served as a Subject matter expert for the Wall Street Journal and Fortune Small Business Magazine and hosts his own internet radio show, entitled, "Health Insurance 101." He is also touted for being a consumer watchdog against greedy insurance companies, insurance scams and unscrupulous agents on Twitter.

You are invited to join my New Group: http://activerain.com/groups/healthinsuranceandhealthcareforum

I created this group to start a dialogue among group members on issues concerning health insurance and health care for small business owners and self-employed individuals who are part of a small group health insurance plan or that purchase their own individual health insurance coverage.  I invite all member to share their personal experiences and stories about Health Insurance and Health Care, both good and bad. 

My goal is to bring "every day" concerns, questions and stories into the public consciousness.  I am certain that the issues and topics that we discuss in this forum will yield valuable information that you will be able to use in your everyday lives.  I believe that by sharing information and resources and exchanging ideas about these topics, we can all become more "informed" health care consumers. 

About Me: C. Steven Tucker, is the President of Small Business Insurance Services, Inc. He is a multi-state licensed insurance broker who has been serving the Small Business community and Self-Employed for 15 years. C. Steven has served as a Subject matter expert for the Wall Street Journal and Fortune Small Business Magazine and hosts his own internet radio show, entitled, "Health Insurance 101." He is also touted for being a consumer watchdog against greedy insurance companies, insurance scams and unscrupulous agents on Twitter.  

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