The IAA One Minute Blog

With President Obama's second term now underway, insurers are expressing their concerns over the individual mandate portion of the President's health reform law.

What is the Individual Mandate?

The individual mandate portion of the health reform law requires U.S. citizens to have insurance coverage that meets the minimum standards set as part of the health insurance exchanges. This includes guaranteed access to affordable coverage, essential benefits and other consumer protections. The legislation imposes a tax penalty on individuals (with some exceptions) who do not purchase coverage.

A New "Mandate Plus"

Insurance companies are telling the Obama administration that the individual mandate's penalties for not buying health insurance, won't be enough as they are phased in over two years--only $95 when penalties start in 2014, much less than it actually costs to buy insurance. Furthermore, everyone with pre-existing conditions have to be accepted right away.

Insurance agencies claim there needs to be more incentive to get healthy people to sign up for coverage. Without having those who are already in good health sign up for health insurance, insurance premiums could shoot through the roof when sick customers get added to health coverage.

This has led to insurance companies and policy experts saying that other ideas should go hand-in-hand with the individual mandate to make the system work and be more affordable. This would be a "mandate plus". Some ideas for the mandate plus are:

• Late enrollment fees for those who don't sign up in a given time frame.
• Preventing late enrollees from fully benefiting from the law's pre-existing condition provisions.
• Banning late enrollees from opting into the most generous insurance plans.
• Eliminating some of the costliest insurance regulations in the health law, such as the excise tax on insurance premiums, the community rating tax, and the essential benefits mandate that forces insurers to provide services that consumers wouldn't otherwise buy.
• Waiting periods for those who opt out of coverage.

America's Health Insurance Plan (a trade group for health insurance companies) asked the Department of Health and Human Services to impose measures on its own, saying that HHS has the power to keep the health insurance market stable the first two years the mandate takes effect. HHS officials will not say whether they're actively considering the proposed measures, but have asked for suggestions in the past.

When the mandate is in full strength in 2016, people will pay a penalty of $695 or 2.5% of their income, whichever is greater.

What IAA has to Say

Not knowing what the future of health coverage holds can be pretty scary. That's why Insurance Administrator of America is here to provide you with updates and guide you through any changes you or your business may experience. Remember, with IAA one call does it all.

Interested in reading more about the PPACA? Click here and here.

With the New Year comes new information on the Patient Protection and Affordable Care Act (PPACA). Insurance Administrator of America is here with updates on the PPACA.

New Rules on Family Coverage

On December 31, 2012, the Obama administration stated that though employers must offer health insurance to their employees and their dependents, employers will not be subject to penalties if the family coverage offered is unaffordable. The Internal Revenue Service (IRS) says that an employer's obligation is to provide affordable insurance to their full-time employees. The new rules do not offer a guarantee of affordable insurance for a worker's children or spouse.

For employers to avoid a tax penalty, the government said employers with 50 or more full-time employees must offer affordable insurance. The IRS has said that "coverage for an employee under an employer-sponsored plan is affordable if the employees' required contribution for self-only coverage does not exceed 9.5% of the employees' household income." The same does not apply to the worker's contribution for family coverage.

An employer could avoid paying a penalty by offering individual plans to workers that are considered affordable under the law, but setting family coverage higher. Employees would get coverage for themselves that would only cost 9.5% of their income at most, but employers would ask them to pay a higher rate for covering dependents.

This new rule provides a strong incentive for employers to put money into insurance for their employees, rather than their dependents.

Transitioning Into Play or Pay in 2014

By 2014, employers must "play or pay,"  meaning that they must offer full-time employees affordable health insurance or pay a penalty. The IRS is allowing transition relief to employers under certain circumstances:

• Transition Relief for Fiscal Year Plans: For an employer that as of December 27, 2012, offers health coverage through a plan that operates on a fiscal year, transition relief is available. The employer will not be subject to a potential payment until the first day of the fiscal year plan starting in 2014.
• Transition Relief for Applicable Large Employer Determination in 2014: Rather than be required to use the full 12 months of 2013 to measure whether a company has 50 full-time employees, an employer may measure using any six consecutive month period in 2013.
• Transition Relief for Measurement Periods for Stability Periods Starting in 2014: Employers intending to use the "look back" measurement method for determining full-time status for 2014 will need to begin their measurement periods in 2013 to have corresponding stability in 2014. The IRS and Treasury Department recognize that employers intending to adopt a 12 month measurement period and in turn, a 12 month stability period, will face time constraints in doing so. Due to transition relief, employers may adopt (for 2014) a transition measurement period that is shorter than 12 months, but no less than six months and that begins no later than July 2013.

Not every transition relief item applies to everyone, so if you have any further questions about transition relief; please reach out to IAA.

What IAA has to Say

With all the new rules and regulations, IAA understands that the PPACA can be confusing at times. IAA is here to keep you informed on the PPACA and any other healthcare issue. Remember, with IAA one call does it all.

Want to read more blog posts on the PPACA? Click here and here.

On December 30, 2012, Secretary of State Hillary Clinton was admitted to a New York hospital for treatment for a blood clot. Clinton's blood clot stemmed from a concussion suffered earlier in December. Insurance Administrator of America is here to inform you on what blood clots are and how to prevent them.

What is a Blood Clot?

Blood has the seemingly impossible job of flowing smoothly and continuously for an entire lifetime, but quickly forms a clot when bleeding occurs. Blood clots  form when the blood coagulates from a liquid to a solid. Blood clots that form in response to an injury or cut are beneficial, stopping potentially dangerous bleeding. Blood achieves this through complex interactions between substances in the blood and blood vessel walls.

Blood clots can also form abnormally, causing a heart attack, stroke or other serious medical problems. If a clot forms inside a blood vessel and stays there, it is called a thrombosis. How serious a blood clot is depends on where it is and why it has formed.

Why Blood Clots Form

Blood clots can occur under many different circumstances. There are three major conditions in which a blood clot might occur:

1. Injury: Fractures, severe muscle injury and major surgery involving the abdomen, pelvis, hips or legs, can damage the inner lining of the vein causing it to form a blood clot. Inflammation and immune response can have the same effect.
2. Immobility: Being immobile can cause sluggish or slow blood flow.
3. Hypercoagulation: Certain conditions and medications can make the blood thicker or more likely to clot than normal.

Risk factors for blood clots are:

• High blood pressure
• Family history of blood clots
• Diabetes
• Pregnancy
• Stroke
• Recent surgery
• Prolonged sitting
• Circulation problems
• Heart problems

Symptoms and Solutions

Blood clots can form in many different ways and in many different places. Clinton's blood clot formed in the vein behind her ear, but she had another blood clot previously that formed behind her knee. That is why it is important to learn the general symptoms of a blood clot:

• Shortness of breath
• Pressure, fullness or a squeezing pain in the center of your chest lasting more than a few minutes
• Pain extending to your shoulder, arm, back, teeth or jaw
• Sudden weakness or numbness of your face, arm or leg
• Sudden difficulty speaking or understanding speech
• Sudden blurred, double or decreased vision
• Swelling, redness, numbness or pain in the arms or legs
• Intense burning or throbbing in your palms or soles
• Chronic headaches or dizziness

Of course, there are preventative measures that people can take:

• After you have had surgery or been on bed rest, the sooner you can get up and move, the better.
• Avoid sitting for prolonged periods of time.
• Change your lifestyle by losing weight, lowering high blood pressure, stop smoking, and exercising regularly.

What IAA has to Say

Blood clots can be helpful, but they can also be very dangerous. IAA wants you to take precautions in everyday life to help prevent something like this happening to you. IAA wants you to remember that while blood clots are serious, they are also treatable. Stay healthy!

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With snow on the trees and Christmas lights strung up outside, winter can be very pretty. What isn't so pretty are all the health issues  that can crop up this time of year.

Exercising in Winter Weather

Cold weather can discourage even the most motivated athlete. Exercising outside during winter is possible; you just have to take extra precautions.

One mistake you can make while exercising in cold weather  is dressing too warmly. Exercise generates a considerable amount of heat--enough to make you feel it's much warmer than it really is. Once the sweat starts to dry, you feel chilled. The solution--dress in layers that you can remove as soon as you start to sweat and then put back on as needed:

1. Put on a layer of synthetic material which draws sweat away from the body.
2. Add a layer of fleece or wool for insulation.
3. Top that layer with a waterproof, breathable, outer layer.

Stop and go activities, such as mixing walking with running, can make you more vulnerable to the cold if you repeatedly work up a sweat and then become chilled.

Another important tip to try to work into a winter workout routine is doing the second half of the workout with the wind at your back. You are less likely to get chilled, especially if you've worked up a sweat. Also, try to exercise in the heat of the day between 1 and 4 o'clock in the afternoon.

Be Aware of Frostbite and Hypothermia

It is dangerous to exercise outdoors when the temperature or wind chill factor exceeds minus 20°F, according to the National Safety Council. Working out or even being outside in these temperatures for an extended period of time, could cause hypothermia or frostbite.

Hypothermia occurs when a person's core body temperature falls below 95°F. Symptoms include:

• Intense shivering
• Slurred speech
• Loss of coordination
• Fatigue

Frostbite is a serious skin injury caused by freezing and occurs when the skin and body just underneath it freezes. The skin becomes very cold, then numb, hard, and pale.

Frostbite typically affects smaller, more exposed areas of your body: cheeks, ears, nose, hands, and feet. The symptoms and signs of frostbite are:

• A slightly painful, prickly or itching sensation
• Red, white, pale or grayish-yellow skin
• Hard or waxy looking skin
• A cold or burning feeling
• Numbness
• Clumsiness due to muscle or joint stiffness

Because the affected area becomes numb, you may not realize you have frostbite until someone else points it out.

The Seasonal Flu

Winter also brings the dreaded flu that can have people in bed for longer than they like. Flu like symptoms include:

• Fever
• Cough
• Sore throat
• Runny or stuffy nose
• Body aches
• Headaches
• Chills
• Fatigue

Take precautions this winter to try and stop the flu from affecting you:

• Wash your hands frequently, using soap for at least 15 seconds.
• Avoid close contact with people who are sick.
• Clean frequently handled objects to keep them free of germs.
• Covering your mouth and nose when you cough or sneeze.
• Keep your hands away form your eyes and mouth.

Each year more than 200,000 people are hospitalized due to the flu, according to the Centers for Disease Control.

What IAA has to Say

Take precautions this winter to ensure your safety and health. Insurance Administrator of America knows that winter can be a healthy time for everyone, if they just took defensive measures to combat the cold! Have a safe and fun time outside.

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With 2013 coming closer and closer, that yearly weight loss goal is fast approaching as well. While diets have become a trendy New Year's goal, do they really help? Insurance Administrator of America has some interesting information that might have you thinking twice when creating your New Year's resolutions.

Diet vs. Lifestyle Changes

Multitudes of people make the resolution each year to lose weight. Although many diets claim to help you lose weight quickly and easily, they often lead to malnutrition and only temporary weight loss. The answer to the weight loss solution might be making lifestyle changes.

According to the American Council on Exercise (ACE), only about 5 percent of dieters successfully keep off the weight. Most dieters regain a third of their weight within one year and almost all of the weight in three to five years. When you reach a weight loss goal on a diet, it is likely that you would stop dieting and then the weight will pile back on. According to the Centers for Disease Control (CDC), a slow and healthy approach makes you more likely to maintain your weight loss. When you reach a weight loss goal through a healthy lifestyle change, these changes become a permanent part of your life.

When you compare a diet to lifestyle changes, you'll find that one leads to deprivation and danger, while the other leads to improved health and better choices. With lifestyle changes, your food and beverages choices remain unrestricted; you can eat or drink anything you want in moderation. By eating healthy and appropriate foods, you can maintain your physical and mental health.

Making the Commitment

If you're looking to lose weight for the long haul, you must make a commitment to permanently change certain aspects of your lifestyle. Here are some ways to help keep your commitment to making healthy lifestyle changes:

• Create a Motivation Board: A motivation board gives you a visual reminder of the lifestyle changes you need to make to achieve your weight loss goal. On a piece of poster board, create visual representations of your goals and outcomes. Then display the board where you will see it frequently.
• Share Your Goals: Sharing your weight loss intentions with friends and family can help motivate you. It gives you a sense of accountability to someone other than yourself.
• Identify Certain Factors: Identify the factors that are keeping you from making healthy changes in your life. Create a plan to avoid or reduce those distractions.
• Buddy Up: Buddy up with a friend or family member with diet and weight loss resolutions. Then share your ideas, plans, and successes regularly.
• Reward Yourself: To reinforce your success, build in a reward system. The best treats are not food related.

Most resolutions are abandoned by February because they are too big or too overwhelming. Choosing the right resolutions, and then planning for them, can make a world of difference.

Give yourself permission to be human. No matter how committed you are, you will occasionally overeat. Accept that these things happen and get right on track.

What IAA has to Say

According to the CDC, healthy weight loss isn't about a "diet" or "program," it's about an ongoing lifestyle that includes long-term changes in daily eating and exercise habits. IAA knows that making healthy lifestyle changes can be difficult, but it is well worth it when you meet your goals. This year, make the commitment to lose the diet and start making some lasting changes. IAA wishes you and yours a healthy and happy New Year.

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