How to Choose the Right Type of Life Insurance

Choosing the right type of life insurance can be confusing, but it’s also an important decision. Here are some guidelines that can help you narrow down your best life insurance options.

You should consider term life insurance if:

You need life insurance for a specific period of time. Term life insurance enables you to match the length of the term policy to the length of the need. For example, if you have young children and want to ensure that there will be funds to pay for their college education, you might buy 20-year term life insurance. Or if you want the insurance to repay a debt that will be paid off in a specified time period, buy a term policy for that period.

You need a large amount of life insurance, but have a limited budget. In general, this type of insurance pays only if you die during the term of the policy, so the rate per thousand of death benefit is lower than for permanent forms of life insurance. If you are still alive at the end of the term, coverage stops unless the policy is renewed or a new one bought. Unlike permanent insurance, you will not typically build equity in the form of cash savings.

If you think your financial needs may change, you may also want to look into “convertible” term policies. These allow you to convert to permanent insurance without a medical examination in exchange for higher premiums.

Keep in mind that premiums are lowest when you are young and increase upon renewal as you age. Some term insurance policies can be renewed when the policy ends, but the premium will generally increase. Some policies require a medical examination at renewal to qualify for the lowest rates.

You should consider permanent life insurance if:

You need life insurance for as long as you live. A permanent policy pays a death benefit whether you die tomorrow or live to be over 100.

You want to accumulate a savings element that will grow on a tax-deferred basis and could be a source of borrowed funds for a variety of purposes. The savings element can be used to pay premiums to keep the life insurance in force if you can’t pay them otherwise, or it can be used for any other purpose you choose. You can borrow these funds even if your credit is shaky. The death benefit is collateral for the loan, and if you die before it’s repaid, the insurance company collects what is due the company before determining what’s goes to your beneficiary.

Keep in mind that premiums for permanent policies are generally higher than for term insurance. However, the premium in a permanent policy remains the same no matter how old you are, while term can go up substantially every time you renew it.

There are a number of different types of permanent insurance policies, such as whole (ordinary) life, universal life, variable life, and variable/universal life. For more details, see our articles on the specific types of policies.

Flood Prevention Tips

Rain and warming temperatures could cause flooding, check out some things every homeowner can do to avoid flood damage, from Roy Spencer, owner of Perma-Seal Basement Systems.

Before the Flood

All it takes is a few inches of water to cause major damage to your home and its contents.

MORE: Flood Resources

1. Shovel/remove the snow away from your foundation and siding.
2. Make sure your sump pump discharge hose is free/clear and not frozen.
3. Check that the battery on your backup pump is charged.
4. Clear your window well drains, sewer drains and any landscaping drains in your yard.
5. Even if you’ve never had water in your basement, be sure to check carefully for any moisture that may find its way in due to possible expansion of small cracks.
6. Place important papers/documents in a watertight container and keep them close. Take the container with you if evacuating or place in a high and dry location if sheltering in place.
7. Identify and move electronics and other expensive items (computers, televisions, phone systems, area rugs, expensive furniture) on lower levels of the home and elevate if possible to keep them dry.

 

After the Flood

1. Take photographs of damage throughout the building and around the property. Assess stability of plaster and drywall. Bulging or swelling ceilings indicate damage. Press upward on drywall ceilings. If nail heads appear, drywall will need to be re-nailed but can be saved.
2. Check foundation for any loose or missing blocks, bricks, stones or mortar.
3. Empty basement water at a rate of about one-third per day to avoid structural damage to foundation by rapid pressure change.
4. Clean and disinfect heating, air conditioning and ventilation ducts before use to avoid spread of airborne germs and mold spores. Use fans and sunlight to dry out interior spaces. Remove all wet carpets, curtains and fabrics. Allow to air dry completely.

Prevent Frozen Pipes

When water freezes, it expands. That’s why a can of soda explodes if it’s put into a freezer to chill quickly and forgotten. When water freezes in a pipe, it expands the same way. If it expands enough, the pipe bursts, water escapes and serious damage results.

Why Pipes Burst

Surprisingly, ice forming in a pipe does not typically cause a break where the ice blockage occurs. It’s not the radial expansion of ice against the wall of the pipe that causes the break. Rather, following a complete ice blockage in a pipe, continued freezing and expansion inside the pipe causes water pressure to increase downstream — between the ice blockage and a closed faucet at the end. It’s this increase in water pressure that leads to pipe failure. Usually the pipe bursts where little or no ice has formed. Upstream from the ice blockage the water can always retreat back towards its source, so there is no pressure build-up to cause a break. Water has to freeze for ice blockages to occur. Pipes that are adequately protected along their entire length by placement within the building’s insulation, insulation on the pipe itself, or heating, are safe.

Regional Differences

Generally, houses in northern climates are built with the water pipes located on the inside of the building insulation, which protects the pipes from subfreezing weather. However, extremely cold weather and holes in the building that allow a flow of cold air to come into contact with pipes can lead to freezing and bursting.

Water pipes in houses in southern climates often are more vulnerable to winter cold spells. The pipes are more likely to be located in unprotected areas outside of the building insulation, and homeowners tend to be less aware of freezing problems, which may occur only once or twice a season.

Pipes in attics, crawl spaces and outside walls are all vulnerable to freezing, especially if there are cracks or openings that allow cold, outside air to flow across the pipes. Research at the University of Illinois has shown that “wind chill,” the cooling effect of air and wind that causes the human body to lose heat, can play a major role in accelerating ice blockage, and thus bursting, in water pipes.

Holes in an outside wall where television, cable or telephone lines enter can provide access for cold air to reach pipes. The size of pipes and their composition (e.g., copper or PVC) have some bearing on how fast ice forms, but they are relatively minor factors in pipe bursting compared with the absence of heat, pipe insulation and exposure to a flow of subfreezing air.

When is it Cold Enough to Freeze?

When should homeowners be alert to the danger of freezing pipes? That depends, but in southern states and other areas where freezing weather is the exception rather than the rule (and where houses often do not provide adequate built-in protection), the temperature alert threshold is 20°F.

This threshold is based upon research conducted by the Building Research Council at the University of Illinois. Field tests of residential water systems subjected to winter temperatures demonstrated that, for un-insulated pipes installed in an unconditioned attic, the onset of freezing occurred when the outside temperature fell to 20°F or below.

This finding was supported by a survey of 71 plumbers practicing in southern states, in which the consensus was that burst-pipe problems began to appear when temperatures fell into the teens. However, freezing incidents can occur when the temperature remains above 20° F. Pipes exposed to cold air (especially flowing air, as on a windy day) because of cracks in an outside wall or lack of insulation are vulnerable to freezing at temperatures above the threshold. However, the 20°F temperature alert threshold should address the majority of potential burst-pipe incidents in southern states.

Mitigating the Problem

Water freezes when heat in the water is transferred to subfreezing air. The best way to keep water in pipes from freezing is to slow or stop this transfer of heat.

Ideally, it is best not to expose water pipes to subfreezing temperatures, by placing them only in heated spaces and keeping them out of attics, crawl spaces and vulnerable outside walls. In new construction, proper placement can be designed into the building.

In existing houses, a plumber may be able to re route at-risk pipes to protected areas, although this may not be a practical solution. If the latter is the case, vulnerable pipes that are accessible should be fitted with insulation sleeves or wrapping (which slows the heat transfer), the more insulation the better. It is important not to leave gaps that expose the pipe to cold air. Hardware stores and home centers carry the necessary materials, usually in foam rubber or fiberglass sleeves. Better yet, plumbing supply stores and insulation dealers carry pipe sleeves that feature extra-thick insulation, as much as 1” or 2” thick. The added protection is worth the extra cost.

Cracks and holes in outside walls and foundations near water pipes should be sealed with caulking to keep cold wind away from the pipes. Kitchen and bathroom cabinets can keep warm inside air from reaching pipes under sinks and in adjacent outside walls. It’s a good idea to keep cabinet doors open during cold spells to let the warm air circulate around the pipes. Electric heating tapes and cables are available to run along pipes to keep the water from freezing. These must be used with extreme caution; follow the manufacturer’s instructions carefully to avoid the risk of fire, and check to make sure the product conforms to UL 2049. Tapes and cables with a built-in thermostat will turn heat on when needed. Tapes without a thermostat have to be plugged in each time heat is needed, and may be forgotten.

Letting the Water Run

Letting a faucet drip during extreme cold weather can prevent a pipe from bursting. It’s not that a small flow of water prevents freezing; this helps, but water can freeze even with a slow flow.

Rather, opening a faucet will provide relief from the excessive pressure that builds between the faucet and the ice blockage when freezing occurs. If there is no excessive water pressure, there is no burst pipe, even if the water inside the pipe freezes.

A dripping faucet wastes some water, so only pipes vulnerable to freezing (ones that run through an unheated or unprotected space) should be left with the water flowing. The drip can be very slight. Even the slowest drip at normal pressure will provide pressure relief when needed. Where both hot and cold lines serve a spigot, make sure each one contributes to the drip, since both are subjected to freezing. If the dripping stops, leave the faucet(s) open, since a pipe may have frozen and will still need pressure relief.

If You Suspect a Frozen Pipe

If you open a faucet and no water comes out, don’t take any chances. Call a plumber. If a water pipe bursts, turn off the water at the main shut-off valve (usually at the water meter or where the main line enters the house); leave the faucet(s) open until repairs are completed. Don’t try to thaw a frozen pipe with an open flame; as this will damage the pipe and may even start a building fire. You might be able to thaw a pipe with a hand-held hair dryer. Slowly apply heat, starting close to the faucet end of the pipe, with the faucet open. Work toward the coldest section. Don’t use electrical appliances while standing in water; you could get electrocuted.

Going on a Trip

When away from the house for an extended period during the winter, be careful how much you lower the heat. A lower temperature may save on the heating bill, but there could be a disaster if a cold spell strikes and pipes that normally would be safe, freeze and burst.

A solution is to drain the water system. This is the best safeguard. With no water in the pipes, there is no freezing. This remedy should be considered even when the homeowner is not leaving but is concerned about a serious overnight freeze.

To drain the system, shut off the main valve and turn on every water fixture (both hot and cold lines) until water stops running. It’s not necessary to leave the fixtures open, since the system is filled mostly with air at that point and not subject to freezing. When returning to the house, turn on the main valve and let each fixture run until the pipes are full again.

Source: Institute for Business and Home Safety. IBHS is a national nonprofit initiative of the insurance industry to reduce deaths, injuries, property damage, economic losses and human suffering caused by natural disasters.

Weather-weary New Jerseyans are bracing for another round of winter weather

Weather-weary New Jerseyans are bracing for another round of winter weather. Forecasters say Winter Storm Hercules should hit sometime Thursday and could drop several inches across the state before it exits early Friday. The precipitation is initially expected to be light, but will likely intensify by early Thursday evening. And temperatures should drop into the low single digits by Friday night, with subzero wind chills likely in most areas. Winter storm warnings were issued for northern Jersey, where 6 to 12 inches of snow is expected, while winter storm watches were issues for central and southern areas, which could get 3 to 7 inches. Those advisories will be in effect Thursday afternoon to Friday morning. Strong, gusty winds are expected with the storm, meaning travel could be treacherous. New Jersey Transit has announced that it will cross-honor all tickets on Thursday.

 

(MORE: Check the Complete Forecast for Winter Storm Hercules)

Forecasts call for up to 8 inches of snow in N.J. this weekend

winterstorm

Another disruptive, but not disastrous, winter storm is expected to impact New Jersey this weekend, dropping several inches of snow across parts of the state and hindering travel Saturday, forecasters say.

Light snow is expected to overspread the state Saturday morning, picking up in intensity as the day progresses before changing over to a wintry mix or plain rain in some areas, where enough warm air infiltrates the atmosphere.

Forecasts call for between two and eight inches of snow in New Jersey by Sunday morning, with the higher amounts expected west of Interstate 287, though the majority of the state should see some fresh powder. Since this morning, the National Weather Service has become more bullish on snow, upping their potential totals, particularly in northern New Jersey.

Whatever falls won’t have trouble sticking.

“It should be fairly cold at the onset. Temperatures are going to be in the teens and twenties, so everything that does fall will stick evenly on all surfaces because of the cold temperatures,” said Nick Troiano, a meteorologist at Hackettstown-based weather firm WeatherWorks.

As a result, travel woes could be widespread, according to AccuWeather.

By Stephen Stirling/The Star-Ledger 

Thanksgiving travel delays seem likely as winter storm barrels toward N.J.

It’s going to be a wet Wednesday in New Jersey. (AccuWeather.com)

A deadly winter storm that hammered the West will arrive over New Jersey by Thanksgiving, likely making a cold, wet mess of holiday travel plans before blowing out to sea, forecasters said today.

But for the glass-half-full crowd, here’s a grain of decent news: Meteorologists believe most of the state will see only rain and be spared the weather system’s snow-producing potential.

That won’t be the story for everywhere, though. For those north of Route 78 — especially in the western portions of the state — snow, ice and sleet are likely in the mix, said Walter Drag, a metrologist with the National Weather Service in Mount Holly.

There may be some air travel delays, Drag said. And as the precipitation arrives Tuesday and lasts into Wednesday, that rain will not be doing any favors for drivers. There could be heavy downpours at times all along the Route 95 corridor, with somewhere between 1 to 3 inches of rain falling on most of the East Coast, he said. Add to that heavy winds, and the busiest travel week of the year could get ugly.

“A pretty potent situation,” Drag said.

The snow is expected to be worst in the Appalachian Mountains, meaning travel through parts of Central Pennsylvania and Upstate New York may be treacherous.

And it may mean a nasty mix for northwestern New Jersey. The forecast this evening called for a chance of snow Tuesday morning there, then gradually changing to sleet by evening, Drag said. There could be some freezing rain lingering into the evening, with snow showers possible Wednesday night, he said. Thanksgiving should be dry.

There’s a chance the storm’s track could change the forecast and drop a rain-snow mix on the state, Jim Bunker, another meteorologist at the weather service’s Mount Holly office, said earlier in the day. No matter what, people should prepare, he said.

“The biggest thing is, if folks are planning to travel to higher elevations like to the Poconos, make sure they have good snow tires or chains, and make sure they check the road conditions before leaving,” Bunker said.

There’s a potential that drainage issues in rainy areas could lead to road flooding, he added.

“It’s common sense that with this significant weather coming, there could be travel delays,” Bunker said. “So folks need to pay attention to what’s going on with the forecast.”

Star-Ledger staff writer Tom Wright-Piersanti contributed to this report

Don’t forget your pets. Learn how to develop an emergency plan for your animals. This includes, what to do, what to bring, where to go, and who to contact
– Information regarding Pet Preparedness www.readypetsgo.org

 

Ryan Hutchins/The Star-Ledger

© 2013 NJ.com. All rights reserved.

Obama Care: Article 2

OVERVIEW

A non-profit Patient-Centered Outcomes Research Institute is established, independent from government, to undertake comparative effectiveness research.[45] This is charged with examining the “relative health outcomes, clinical effectiveness, and appropriateness” of different medical treatments by evaluating existing studies and conducting its own. Its 19-member board is to include patients, doctors, hospitals, drug makers, device manufacturers, insurers, payers, government officials and health experts. It will not have the power to mandate or even endorse coverage rules or reimbursement for any particular treatment. Medicare may take the Institute’s research into account when deciding what procedures it will cover, so long as the new research is not the sole justification and the agency allows for public input.[46] The bill forbids the Institute to develop or employ “a dollars per quality adjusted life year” (or similar measure that discounts the value of a life because of an individual’s disability) as a threshold to establish what type of health care is cost effective or recommended. This makes it different from the UK’s National Institute for Health and Clinical Excellence.

Creation of task forces on Preventive Services and Community Preventive Services to develop, update, and disseminate evidenced-based recommendations on the use of clinical and community prevention services.[45]

The Indian Health Care Improvement Act is reauthorized and amended.[45]

Chain restaurants and food vendors with 20 or more locations are required to display the caloric content of their foods on menus, drive-through menus, and vending machines. Additional information, such as saturated fat, carbohydrate, and sodium content, must also be made available upon request.[47] But first, the Food and Drug Administration has to come up with regulations, and as a result, calories disclosures may not appear until 2013 or 2014.[47]

States can apply for a ‘State Plan Amendment” to expand family planning eligibility to the same eligibility as pregnancy related care (above and beyond Medicaid level eligibility), through a state option rather than having to apply for a federal waiver.[48][49][50]

[edit]

Effective June 21, 2010

Adults with existing conditions became eligible to join a temporary high-risk pool, which will be superseded by the health care exchange in 2014.[42][51] To qualify for coverage, applicants must have a pre-existing health condition and have been uninsured for at least the past six months.[52] There is no age requirement.[52] The new program sets premiums as if for a standard population and not for a population with a higher health risk. Allows premiums to vary by age (4:1), geographic area, and family composition. Limit out-of-pocket spending to $5,950 for individuals and $11,900 for families, excluding premiums.[52][53][54]

[edit]

Effective July 1, 2010

The President established, within the Department of Health and Human Services (HHS), a council to be known as the National Prevention, Health Promotion and Public Health Council to help begin to develop a National Prevention and Health Promotion Strategy. The Surgeon General shall serve as the Chairperson of the new Council.[55][56]

A 10% sales tax on indoor tanning took effect.[57]

[edit]

Effective September 23, 2010

Insurers are prohibited from imposing lifetime dollar limits on essential benefits, like hospital stays, in new policies issued.[58]

Dependents (children) will be permitted to remain on their parents’ insurance plan until their 26th birthday,[59] and regulations implemented under PPACA include dependents that no longer live with their parents, are not a dependent on a parent’s tax return, are no longer a student, or are married.[60][61]

Insurers are prohibited from excluding pre-existing medical conditions (except in grandfathered individual health insurance plans) for children under the age of 19.[62][63]

All new insurance plans must cover preventive care and medical screenings[64] rated Level A or B by the U.S. Preventive Services Task Force.[65] Insurers are prohibited from charging co-payments, co-insurance, or deductibles for these services.[66]

Individuals affected by the Medicare Part D coverage gap will receive a $250 rebate, and 50% of the gap will be eliminated in 2011.[67] The gap will be eliminated by 2020.

Insurers’ abilities to enforce annual spending caps will be restricted, and completely prohibited by 2014.[42]

Insurers are prohibited from dropping policyholders when they get sick.[42]

Insurers are required to reveal details about administrative and executive expenditures.[42]

Insurers are required to implement an appeals process for coverage determination and claims on all new plans.[42]

Enhanced methods of fraud detection are implemented.[42]

Medicare is expanded to small, rural hospitals and facilities.[42]

Medicare patients with chronic illnesses must be monitored/evaluated on a 3-month basis for coverage of the medications for treatment of such illnesses.

Companies which provide early retiree benefits for individuals aged 55–64 are eligible to participate in a temporary program which reduces premium costs.[42]

A new website installed by the Secretary of Health and Human Services will provide consumer insurance information for individuals and small businesses in all states.[42]

A temporary credit program is established to encourage private investment in new therapies for disease treatment and prevention.[42]

All new insurance plans must cover childhood immunizations and adult vaccinations recommended by the Advisory Committee on Immunization Practices (ACIP) without charging co-payments, co-insurance, or deductibles when provided by an in-network provider.[68]

[edit]

Effective January 1, 2011

Insurers must spend 80% (for individual or small group insurers) or 85% (for large group insurers) of premium dollars on health costs and claims, leaving only 20% or 15% respectively for administrative costs and profits, subject to various waivers and exemptions. If an insurer fails to meet this requirement, there is no penalty, but a rebate must be issued to the policy holder. This policy is known as the ‘Medical Loss Ratio’.[69][70][71][72]

The Centers for Medicare and Medicaid Services is responsible for developing the Center for Medicare and Medicaid Innovation and overseeing the testing of innovative payment and delivery models.[73]

Flexible spending accounts, Health reimbursement accounts and health savings accounts cannot be used to pay for over-the-counter drugs, purchased without a prescription, except insulin.[74]

[edit]

Effective September 1, 2011

All health insurance companies must inform the public when they want to increase health insurance rates for individual or small group policies by an average of 10% or more. This policy is known as ‘Rate Review’. States are provided with Health Insurance Rate Review Grants to enhance their rate review programs and bring greater transparency to the process.[75][76]

[edit]

Effective January 1, 2012

Employers must disclose the value of the benefits they provided beginning in 2012 for each employee’s health insurance coverage on the employee’s annual Form W-2’s.[77] This requirement was originally to be effective January 1, 2011, but was postponed by IRS Notice 2010–69 on October 23, 2010.[78] Reporting is not required for any employer that was required to file fewer than 250 Forms W-2 in the preceding calendar year.[79]

New tax reporting changes were to come in effect. Lawmakers originally felt these changes would help prevent tax evasion by corporations. However, in April 2011, Congress passed and President Obama signed the Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011 repealing this provision, because it was burdensome to small businesses.[80][81] Before PPACA businesses were required to notify the IRS on form 1099 of certain payments to individuals for certain services or property over a reporting threshold of $600.[82][83] Under the repealed law, reporting of payments to corporations would also be required.[84][85] Originally it was expected to raise $17 billion over 10 years.[86] The amendments made by Section 9006 of PPACA were designed to apply to payments made by businesses after December 31, 2011, but will no longer apply because of the repeal of the section.[81][83]

[edit]

Effective August 1, 2012

All new plans must cover certain preventive services such as mammograms and colonoscopies without charging a deductible, co-pay or coinsurance. Women’s Preventive Services – including: well-woman visits; gestational diabetes screening; human papillomavirus (HPV) DNA testing for women age 30 and older; sexually transmitted infection counseling; human immunodeficiency virus (HIV) screening and counseling; FDA-approved contraceptive methods and contraceptive counseling; breastfeeding support, supplies and counseling; and domestic violence screening and counseling – will be covered without cost sharing. [87] This is also known as the contraceptive mandate.[64][88][89]

[edit]

Effective by October 1, 2012

The Centers for Medicare & Medicaid Services (CMS) will begin the Readmissions Reduction Program, which requires CMS to reduce payments to IPPS hospitals with excess readmissions, effective for discharges beginning on October 1, 2012. The regulations that implement this provision are in subpart I of 42 CFR part 412 (§412.150 through §412.154).[90] Starting in October, an estimated total of 2,217 hospitals across the nation will be penalized; however, only 307 of these hospitals will receive this year’s maximum penalty, i.e., 1 percent off their base Medicare reimbursements. The penalty will be deducted from reimbursements each time a hospital submits a claim starting Oct. 1. The maximum penalty will increase after this year, to 2 percent of regular payments starting in October 2013 and then to 3 percent the following year. As an example, if a hospital received the maximum penalty of 1 percent and it submitted a claim for $20,000 for a stay, Medicare would reimburse it $19,800. Together, these 2,217 hospitals will forfeit more than $280 million in Medicare funds over the next year, i.e., until October 2013, as Medicare and Medicaid begin a wide-ranging push to start paying health care providers based on the quality of care they provide. The $280 million in penalties comprises about 0.3 percent of the total amount hospitals are paid by Medicare.[91]

[edit]

Effective by January 1, 2013

Income from self-employment and wages of single individuals in excess of $200,000 annually will be subject to an additional tax of 0.9%. The threshold amount is $250,000 for a married couple filing jointly (threshold applies to joint compensation of the two spouses), or $125,000 for a married person filing separately.[92] In addition, an additional Medicare tax of 3.8% will apply to unearned income, specifically the lesser of net investment income or the amount by which adjusted gross income exceeds $200,000 ($250,000 for a married couple filing jointly; $125,000 for a married person filing separately.)[93]

Beginning January 1, 2013, the limit on pre-tax contributions to healthcare flexible spending accounts will be capped at $2,500 per year. [94][95][96]

[edit]

Effective by August 1, 2013

Religious organizations that were given an extra year to implement the contraceptive mandate are no longer exempt. Certain non-exempt, non-grandfathered group health plans established and maintained by non-profit organizations with religious objections to covering contraceptive services may take advantage of a one-year enforcement safe harbor (i.e., until the first plan year beginning on or after August 1, 2013) by timely satisfying certain requirements set forth by the U.S. Department of Health & Human Services.[97]

[edit]

Effective by January 1, 2014

 

 

Maximum Out-of-Pocket Premium Payments Under PPACA by Family Size and federal poverty level.[13] (Source: CRS)

Insurers are prohibited from discriminating against or charging higher rates for any individuals based on gender or pre-existing medical conditions.[98]

Impose an annual penalty of $95, or up to 1% of income over the filing minimum,[99] whichever is greater, on individuals who are not covered by an acceptable insurance policy; this will rise to a minimum of $695 ($2,085 for families), or 2.5% of income over the filing minimum,[99] by 2016.[19][100] Exemptions to the mandatory coverage provision and penalty are permitted for religious reasons or for those for whom the least expensive policy would exceed 8% of their income.[101]

Insurers are prohibited from establishing annual spending caps.[42]

In participating states, Medicaid eligibility is expanded; all individuals with income up to 133% of the poverty line qualify for coverage, including adults without dependent children.[19][102] As written, PPACA withheld all Medicaid funding from states declining to participate in the expansion. However, the Supreme Court ruled, in National Federation of Independent Business v. Sebelius, that this withdrawal of funding was unconstitutionally coercive, and that individual states had the right to opt out of the Medicaid expansion without losing pre-existing Medicaid funding from the federal government. As of July 10, 2012, the governors of five states: Texas, Florida, Mississippi, Louisiana, and South Carolina, had announced that they would decline to participate in the Medicaid expansion.[103]

Two years of tax credits will be offered to qualified small businesses. In order to receive the full benefit of a 50% premium subsidy, the small business must have an average payroll per full-time equivalent (“FTE”) employee of no more than $25,000 and have no more than 10 FTEs. For the purposes of the calculation of FTEs, seasonal employees, and owners and their relations, are not considered. The subsidy is reduced by 3.35 percentage points per additional employee and 2 percentage points per additional $1,000 of average compensation. As an example, a 16 FTE firm with a $35,000 average salary would be entitled to a 10% premium subsidy.[104]

Impose a $2,000 per employee penalty on employers with more than 50 employees who do not offer health insurance to their full-time workers (as amended by the reconciliation bill).[30]

For employer sponsored plans, set a maximum of $2,000 annual deductible for a plan covering a single individual or $4,000 annual deductible for any other plan (see 111HR3590ENR, section 1302). These limits can be increased under rules set in section 1302.

The CLASS Act provision would have created a voluntary long-term care insurance program, but in October 2011 the Department of Health and Human Services announced that the provision was unworkable and would be dropped, although an Obama administration official later said the President does not support repealing this provision.[105][106][107][108]

Pay for new spending, in part, through spending and coverage cuts in Medicare Advantage, slowing the growth of Medicare provider payments (in part through the creation of a new Independent Payment Advisory Board), reducing Medicare and Medicaid drug reimbursement rate, cutting other Medicare and Medicaid spending.[44][109]

Obama Care: Article 1

The Patient Protection and Affordable Care Act (PPACA, commonly called Obamacare (or the federal health care law), is a United States federal statute signed into law by President Barack Obama on March 23, 2010. Together with the Health Care and Education Reconciliation Act, it represents the most significant regulatory overhaul of the U.S. healthcare system since the passage of Medicare and Medicaid in 1965.

PPACA is aimed primarily at decreasing the number of uninsured Americans and reducing the overall costs of health care. It provides a number of mechanisms—including mandates, subsidies, and tax credits—to employers and individuals in order to increase the coverage rate. Additional reforms are aimed at improving healthcare outcomes and streamlining the delivery of health care. PPACA requires insurance companies to cover all applicants and offer the same rates regardless of pre-existing conditions or gender. The Congressional Budget Office projected that PPACA will lower both future deficits and Medicare spending.

On June 28, 2012, the United States Supreme Court upheld the constitutionality of most of PPACA in the case National Federation of Independent Business v. Sebelius

Office Open Saturday 11-03-12

Due to the large number of requests from the impact of Hurricane Sandy, our office in Somerset will open Saturday November 3rd. Hours: 9AM -1PM
13 Clyde Road, Suite 202, Somerset, NJ 08873

Calls will be answered from both our phone lines: 732.246.1330  and 973.274.0500

Huricane Sandy

We hope everyone is safe and sound after Hurricane Sandy ripped through our state last night! Our agency is open and available to process any claims you might have. Let us facilitate. 732.246.1330

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