Margy Wenham Insurance Services, Inc - Serving California Since 1991

A recent article in Forbes magazine concluded that the Affordable Health Care Act (ACA), will increase underlying insurance rates for younger men by an astounding average of 97 to 99 percent, and for younger women by an average of 55 to 62 percent.  This is clearly contrary to what most television news networks have been reporting and the public announcement by the U.S. Department of Health and Human Services (HHS) that premiums offered in the exchanges will be “lower than originally expected.”  So how can the conclusions of Forbes and the HHS be reconciled? Well first, the Forbes article was based on a Manhattan Institute’s analysis of the numbers HHS relied upon. They compared the cheapest plan available to 27-year-olds pre- and post-ACA. They then compared the cheapest plan available to the average exchange participant, and to the typical 40-year-old pre-ACA.    And based on those two comparisons, it is clear insurance premiums have increased dramatically sin...

California’s Exchange – Covered California One of the more important parts of the Affordable Care Act (ACA) are new, state-run, competitive health insurance ‘marketplaces’ also known as “Exchanges.”  California’s health insurance marketplace is known as “ Covered California .”  This is where individuals and small businesses will be able to purchase private health insurance for 2014.  Individuals and small businesses will still, however, still be to purchase plans through agents, brokers and directly through health insurance carriers just as they do today. How ACA Effects California Individuals and Families In the  in the hopes of making coverage more affordable, many individuals seeking health insurance may get financial assistance or a subsidy to purchase health insurance plans from Covered California.  The amount of assistance will be determined by an individual’s or families’ income level in relation to the Federal Poverty Le...

The U.S. Department of Health and Human Services (HHS) is developing a final rule on the essential health benefits that individual and small-group plans must cover as part of the 2010 healthcare reform law. The “ Essential Health Benefits Bulletin ” as issued by Department of Health and Human Services’ (HHS’s) Center for Consumer Information and Insurance Oversight (CCIIO) on December 16, 2011 has concluded under the Affordable Care Act that the mandated all health insurance plans are required to offer a core package of items and services known as “Essential Health Benefits (EHBs).”  HHS has identified 10 ESB categories: (1) ambulatory patient services; (2) emergency services; (3) hospitalization; (4) maternity and newborn care; (5) mental health and substance use disorder services, including behavioral health treatment; (6) prescription drugs; (7) rehabilitative services and devices; (8) laboratory services; (9) preventive and wellness services and chronic disease management; and ...