Health Care Reform: Fitting into the Puzzle

Not sure how you fit into the Health Care Reform puzzle? Navigating Health Care Reform can be tricky, but luckily, you have Sweeney & Sweeney Insurance to help you along the way! Contact one of our certified, friendly, and knowledgeable agents today with your questions and concerns. We’re always ready and willing to help!

Q: What is the household income eligibility requirement?

A: Americans with household income of 100% to 400% of the Federal Poverty Level (FPL) are eligible. For example:

100% FPL- individual $11,490, family of four $23,550
400% FPL- individual $45,960, family of four $94,200.

Q: Do the credit amounts vary by income?

A: It is a sliding scale that comes into effect here. If you fall on the lower end of the FPL percentage spectrum, you can expect more help from the government than someone closer to 400% FPL.

Q: What is the exchange?

A: You can think of the exchange as a marketplace to purchase insurance. Exchanges are new organizations that are being created to provide a more organized and competitive way to purchase health insurance. Consumers can view several options and easily compare rates and coverage details.

Q: Will Agents be participating in the Health Care Reform?

A: Agents and Brokers have the choice to become Certified Health Care Reform Agents, to have the opportunity to better serve our community and help them get the best coverage available.

Q: What if I already have an individual health plan?

A: When the new law comes into effect in January 1, 2014, all current plans will no longer exist. Your options are to either be moved to a plan that is closest to your current plan or you may call Sweeney & Sweeney Insurance to go over your options in the Exchange, as you may qualify for a tax credit.

Recipes to Make your Thanksgiving Easier

I know that, at least in my family, it can be a struggle to get everything put together and cooked on Thanksgiving day, with that darn turkey taking up oven space all day. Being able to make up a few awesome side dishes the night before could seriously come in handy. I scrounged up a few tasty recipes that can be ready-to-go come Turkey Day!

Green Beans with Almonds – Especially for the holidays, when everything is already stressful enough, simplicity is key. Just a little fresh garlic, lemon zest, olive oil, and chopped almonds to give his modest side dish some flare.

Bleu Cheese and Pine Nut Puffs – This is an awesome alternative to tradition dinner rolls.

Herb- and Goat Cheese-Stuffed Mushrooms – Who doesn’t love stuffed mushrooms? These sound extra delicious!

Mashed Potatoes with Savory Thyme Granola – Personally, I think these would be better without the granola, but everything else about them sound incredible. I just don’t think crunch in my mashed ‘taters sounds very appealing.

Cheesy Garlic Rolls – I don’t know about you, but I don’t think there are two more wonderful things in the world than garlic and cheese. Another awesome twist on traditional dinner rolls.

Swiss Corn Bakes – These are like little quiches of cheesy deliciousness.

Butterhead Salad with Smoky Ranch – The real delight here is the recipe for the ranch. You could toss it with any of your favourite salad ingredients.

Hope these tasty, quick treats help to make your holidays a little less stressful. Pass the recipes around to your guests for some extra help!

Top Holiday-Related Accidents

The holidays are right around the corner! Along with all that merriness, cheer, and celebration can also come accidents. Around the holidays is one of the most accident-prone times as people are distracted and stressed. As I say over and over, knowledge is power, so here is a list of the most common accidents that occur around the holidays, so that you and your loved ones can be aware and prepare.

Did you know that poisonous plants are actually all around right now? Mistletoe, holly berries, poinsettias, Jerusalem cherry, and amaryllis are all dangerous when swallowed. Make sure to keep these away from where pets and children can get ahold of them. If they do get consumed, call poison control immediately.

Electrical fires are also common around this time of year as people try to over-use extension cords. You should use a Ground Fault Interrupter (GFI) to prevent electrical shocks and don’t plug in more than 3 strands of lights into a single extension cord, as a good rule of thumb. Also, keep cords out from underneath rugs, as this is also a common cause of fires.

Open fireplaces can cause trouble if not properly taken care of. Always make sure to have your chimney inspected at the beginning of the season before use; make sure you have a grate or screen in front to keep stray embers inside the fireplace, where they belong; and remember that only one artificial log should be used at a time. And if things do get out of hand, always use a fire extinguisher or sand. NEVER water.

Home cooking fires are also prevalent as there tend to be many things going on at once during the holidays. Take extra care to make sure all things flammable are away from the stove.

Christmas tree fires are most commonly due to a tree being too close to a heat source (i.e. a space heater or fireplace). Also make sure that if you get your tree from a lot, they cut off at least a ¼ inch disk from the bottom of the tree so that your tree will absorb the water.

Home heating fires are one of the most common accidents, especially caused by space heaters. Make sure that they are kept far away from flammable material and always turn it off when you leave the house.

Over 5000 Americans went to the hospital in 2007 for holiday decorating related falls. Make sure you’re using a stable ladder on a level surface and that you have someone there to help spot you should anything go awry.

Here’s hoping you have now been well-armed with information and that your holiday season goes along safely and cheerfully. Happy pre-holidays from everyone here at Sweeney & Sweeney!

Top 10 ACA Points You Should Know

Are you wondering what the different parts of the ACA really mean? Straight from Blue Shield, here are the top 10 key issues you should know about.

1. Guaranteed Issue – No one will be denied healthcare due to health, age, gender, or other issues including pre-existing conditions.

2. The Individual Mandate – All individuals will be required to have coverage that qualifies as the minimum essential by January 2014, or risk paying a tax penalty.

3. Grandfathered Plans – People who have healthcare plans that were in effect prior to March 23, 2010, can keep their plans if they want. The only caveat is they are not subject to the ACA’s requirements.

4. New Marketplaces – Marketplaces (Exchanges) have been created as a place for people to explore and compare different health plans. You can access this marketplace directly through brokers and individual carriers just as before.

5. Open Enrollment – This Open Enrollment period began on October 1, 2013 and ends March 31, 2014.

6. Essential Health Benefits – All non-grandfathered plans for individuals and small businesses will include the following 10 categories:

Ambulatory patient services
Emergency services
Hospitalization
Maternity and newborn care
Mental health and substance use disorder services, including behavioural health treatment
Prescription drugs
Rehabilitative and habilitative services and devices
Laboratory services
Preventive and wellness services and chronic disease management
Pediatric services, including or and vision care

7. Metal Level Plans – All non-grandfathered health plans offered to individuals and small businesses will be required to provide coverage at a “metal level”—Platinum (90%), Gold (80%), Silver (70%), and Bronze (60%)—based on the actuarial value (E.g. With a gold plan, the Insured pays 20% of health care costs, while the plan covers 80%).

8. Federal Subsidies – Subsidies will be available starting 2014 for those whose annual income is between 134% and 400% of the Federal Poverty Level (FPL) and who meet the guidelines. Subsidies will help lower the costs of both premiums and out-of-pocket costs. Those who fall less than 134% below the poverty level may be eligible for Medi-Cal. Tax credits will also continue to be available to small businesses with 25 or less full-time equivalent employees to help cover the costs of providing coverage.

9. ACA Taxes – Taxes covering the ACA will start January 1, 2014. Click here for a downloadable copy of the ACA tax fact sheet

10. Play-or-Pay – As of January 1, 2014, the ACA requires companies over a certain size to offer affordable health coverage to full-time employees and their dependents or face paying a penalty if an employee receives federally-subsidized coverage through the Exchange.

Health Care Reform: The Bill at a Glance

With the government also shutting down, I think many people have forgotten that Tuesday was also the start of Open Enrollment for the Affordable Care Act. I know many people have been confused about exactly what the ACA (A.K.A. Obamacare, PPACA, Health Care Reform) is. There has been much confusing media coverage, and people spreading around incorrect information. I just want to take a minute to give you a basic breakdown of what the bill entails.

No one will be turned down for coverage due to pre-existing conditions, any longer.
The age ceiling for young adults being covered on their parents’ health plans has been raised to 26.
You may have the ability to modify the way you pay for your coverage by adjusting your monthly premium payments with your deductible.
You may qualify for a premium tax credit.
Free preventative care.
Choose the best doctor for you within your plan.
Women’s health preventative care is also 100% covered.

These are just a few of the many new changes included with the Affordable Care Act. Call today to schedule your appointment to come in and get enrolled! We’ll help you find the best plan for you and your family or you and your employees! For more information on the Reform, check out our past blogs: Women’s Health Care, Pre-Existing Conditions, Improved Coverage Options, Q & A, Premium Assistance Calculation, Employer Mandate Delayed, Young Adults, Small Business Tax Credits, Individual Tax Credits, Getting Covered, Small Business, Health Insurance Plans at a Glance, Questions Answered, and many more.