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IPS / Lighthouse Insurance Group Blog: medical insurance

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Do your vacation or work plans include traveling outside the U.S.?  

Do any of these scenarios sound like you?
  • “We are going on a 7 day cruise”
  • “We are hosting an exchange student this fall”
  • “My 20 year old son will be studying abroad next semester”
  • “A group from church is going to Honduras to help build a school”
  • “My niece’s soccer club is participating in a tournament in the U.K. next month”
  • “My employer is sending me to Japan to work for the next 3 months”
  • “My 12th grade daughter is going to France with the French Club”
  • “The Kiwanis Club is going to Africa to distribute eyeglasses”
  • “My band is going to work on a cruise line this summer”
If you plan to travel, have you ever thought about what might happen if you were injured or became seriously ill while in a foreign country?  What if the severity of your injury or illness required you to be flown home or to another country by air ambulance for specialized treatment?  Most medical insurance plans will not cover this exposure.  

We offer a variety of travel medical plans offered by the International Medical Group to fit most any international travel...whether it is one person for a few days, an entire group of people going for weeks or months, or to cover a person visiting the United States from another country.

Click here or call us at 800-220-5582 for more information on International Travel Medical Insurance.  You will be amazed at the low cost of peace of mind can be!


As an independent insurance agency we strive to provide our clients with the solutions and plans to bring you low cost, innovative health insurance plans. We have recently added HealthPlus to our portfolio of insurance carriers. Whether you are an individual looking for your own coverage, an employer looking for coverage for employees or you are looking for a plan for your family HealthPlus can help. HealthPlus is consistently ranked among America’s best insurance carriers by providing exceptional service, unsurpassed clinical and service quality and has earned consistently high marks from the National Committee on Quality Assurance rating #1 in overall rating of health plans, doctors, specialists and the ability of providing care quickly.  All HealthPlus Signature individual plans are health care reform compliant which includes essential health benefits with no medical underwriter or pre-existing condition exclusions.   HealthPlus has always been the right plan for a healthier you and has had to make very few changes to plans and policies to comply with changing regulations.  All plans are sold off the healthcare marketplace exchange to consumers through independent insurance agents. 

Call Bobbie Ajamy at 1-800-220-5582 or contact us online with your health insurance questions or to get a quote.

image of health care reform signPosted with permission of the author:
Karl W. Albrecht, CEBS, President - Action Benefits

For the most part, Michigan finally dislodged itself from the on-again/off-again battle with winter in May. Spring reminds us of all the promises of the summer to come, and those unfinished to-dos we abandoned in the fall. Each May brings fleeting glimpses of beautiful ghosts from times and places long since gone. Scattered in massive clutches along country roads, flowering lilacs mark the corners where a home or farm once stood.

This spring, America is waking up and paying attention to things many had ignored. The specific details and impact of the 2010 health reform legislation will soon be felt by Joe Average, and the rhetoric of what the law will or will not do is becoming progressively irrelevant. People are nervous. Nervous people make nervous voters, and nervous voters make for nervous (and very testy) politicians. Reform is taking shape all around us and what actually occurs, not what was promised, is how America will judge the Affordable Care Act (ACA).

In a perfect world, rearranging 20 percent of the U.S. economy would be a massive and daunting task—incredible challenges, inevitable surprises, and political difficulties would be a given—yet, with the solid popular support of the people and thoughtful bipartisan cooperation, America could handle a challenge of such magnitude with a minimum of pain. We have none of that with the ACA.

The ACA is Supreme Court tested and, as the law of the land, it's moving forward at the fastest speed it can muster. Do not lose sight of this fact. As would be expected with any legislation this large, the sailing is anything but smooth. One key area where the law will progressively struggle is on the financial side. Any financial miscalculations or errors (something of a given with federal budgets) run straight into a purse tightly held by a cynical and fairly sour-minded Congress. The ACA was sold to America with firm assurances as to its total cost, and Congress clearly intends to hold Washington to its word.

Sensing Danger

In 1996, 53-year-old Michigan native Lou Kasischke set out to climb Mount Everest. Prior to his climb, Lou spoke to a large group of Blue Cross agents about the challenges he was training for. His training turned out to be a critical factor in the battle he would face for his life on Mount Everest. On that terrible day in May of 1996, eight climbers from his group perished on Everest. Lou shared the post-climb story of the tragedy with a second group of agents two years later, and it is a gripping one. This story was also told in great detail by Lou’s climbing companion, Jon Krakauer, in his famous book “Into Thin Air.”

Both climbers spoke of the incredible dangers and challenges they faced every moment on the mountain. When a sudden storm trapped them near the summit, Krakauer ended up lost in pitch blackness as night fell and temperatures plunged. Fearful he would freeze to death, he attempted to make his way to base camp by inching along the ice in total darkness. Part way down, he reflexively came to a sudden stop. Even though he could not see anything, he could “feel” a massive void in front of him and he didn't dare move. He survived the bitter night, and dawn confirmed that his instincts had saved his life. He was perched at the edge of an immense drop-off down the side of Everest, and certain death. The void he could only feel was, in fact, very real.

We all know that perception can be reality, but eventually reality will exert its rightful place. A CNN poll from May corroborates a long line of previous polls showing a lack of popular support for the ACA, with 54 percent of respondents opposing it. Politically speaking, this doesn’t generate soaring optimism. When it comes to the ACA, Americans are feeling a void, and time will soon tell whether this fear is justified or not.

The Messaging Onslaught

ACA proponents strongly contend that a lack of understanding is driving the poor public support. Funding to promote the law was not included in the legislation, and requests to Congress for additional monies for this purpose didn’t get far. This financial challenge has led the Department of Health and Human Services (HHS) to find private entities to promote the law, and to raise money for them.

HHS Secretary Kathleen Sebelius is both a cheerleader and fundraiser for Enroll America, whose purpose is to educate and sell Americans on the details of the ACA. Enroll America is a private organization launched by Families USA Executive Director Ron Pollack, and was approved as a nonpartisan 501(C)3 organization by the IRS in late 2011. (No, I don’t know if they received enhanced IRS scrutiny.) In early 2013, Anne Filipic left the White House Office of Public Engagement and replaced Pollack as its president. Enroll America’s Managing Director, Chris Wyant, directed the President’s 2012 election efforts, as head of eastern Ohio field operations. Impeccably connected politically, they also have a broad-based Board of Directors and an Advisory Board, which includes the National Association of Health Underwriters (NAHU).

A government official coordinating donations to a private entity, while concurrently quarterbacking that private entity's focus, is not a violation of any law. However, should donations be culled from those directly regulated by the same governmental entity, then there’s an issue. Discussing the “opportunity” to donate to a regulated organization creates the perception of a shakedown. Some are suggesting this is precisely what is happening now, and Congress is probing.

Raising money to fill gaps not addressed in the law is not a sign of strength. Efforts like this are likely to grow as more gaps are exposed, and Congress is not likely to suddenly warm to the idea of writing large checks beyond what the law requires.

Selling Reform to a Wary, and Frequently Weary, Public

The Democratic Steering and Policy Committee has developed an extensive guide for members to bone up on ACA talking points. Timelines, key information, sound bites and other analysis are all organized to give political leaders what they need to drive support and defend the ACA, but will politicians running for office actively support it? As more leaders of the reform effort speak up and call it a “train wreck,” or “beyond comprehension” (and then proceed to retire), legislators left behind are becoming progressively more worried. How will they react should large numbers of constituents speak out against the impact of the ACA?

Washington’s Credibility and Trust

Whether the issues with the IRS remain as low-level distractions or bloom into a full-blown scandal, it hurts the overall message. The public’s perception and trust in government institutions, like the IRS, is critical. The intimate role government plays handling confidential personal information and the sensitive functions they perform with the ACA, demand a high level of trust. Should the IRS appear to be less the impartial revenue collector and more a political operative, the challenges will grow enormously!

Will the messaging convince America that the ACA is a good thing? Not on its own. The rhetoric is becoming less effective, and actual consumer experiences will take center stage very soon. A smooth, surprise-free implementation is the only cure for the remarkably steady and negative polling numbers since the passage of the ACA. Provided that overall participation, functionality and “user experience” on the new marketplaces go well, and the rates are competitive, America will embrace the ACA. The spin from both sides about Armageddon or Rapture will be settled over the next few months!

Insurance Planning Service is a Trusted Choice agency.  We can help answer the questions you have or help you find the right insurance for your home, auto, business, life or health.  Contact us on the web or call us today at 800-220-5582.


Health InsuranceThe Affordable Care Act (aka Obamacare) expands the Medicaid system and provides income-based subsidies for individuals purchasing insurance on the Health Insurance Marketplace.  It raises government revenue to pay for these expansions and subsidies through new taxes and fees.  Several new taxes were discussed in our recent blog article posted on January 8, 2013.  But there are even more sources of revenue that are about to hit your wallet.  These are intended to raise additional funds over the next 10 years and will likely begin to appear as increased costs to your health insurance.

Comparative Effectiveness Research Fee.  This fee will fund the “Patient-Centered Outcomes Research Institute”, or PCORI, which is a nonprofit center created by the ACA.  It is a new government-sponsored organization that will research the effectiveness, risks and benefits of various medical treatments.  IRS will charge health insurance companies $1 per insured member per year during 2013 and $2 per member per year from 2014 to 2019.

Federal Insurance Premium Tax.  This is a tax that will begin to be charged to health insurance companies in 2014.  Based on premiums written in the preceding year, the new Federal Premium Tax is intended to raise $8 billion in revenue for the government in 2014 with that amount increasing in subsequent years.

Reinsurance Fee / Contribution.  Beginning in 2014 and running through 2016, health insurance companies will be required to pay an annual $63 fee to the US Department of Health and Human Services for each covered member.  This is intended to fund insurers that incur excessive claims costs for enrollees who purchase individual coverage, either through or outside of the Health Insurance Marketplace.

Marketplace Fee.  A tax equal to 3.5% of the monthly premium on individual and small group health plans will be paid by health insurance companies participating in the state or federal Health Insurance Marketplace beginning in 2014.  This fee is intended to make the Marketplace self-supporting by January 2015. (Michigan is one of 31 states that have opted out of a state-run Marketplace.)

Risk Adjustment Fee.  Beginning in January 2014 an annual fee of $0.96 per insured member will be collected from health insurance companies on their individual and small group plans.  It is intended to pay for administrative expenses and to pay carriers that insure more members who are likely to have high-claim costs.

High Cost Health Plan Excise Tax.  40%!  You read that correctly!  A 40% tax will be assessed on the value of employer-provided health benefits that exceed certain thresholds – the so-called “Cadillac” plans.  The tax will lower the tax exclusion for employer-provided benefits and will be an incentive for employers to offer cheaper, less generous health insurance policies. 

Each of these fees or taxes may sound like small amounts when viewed individually.  But, collectively, they add up big – to the tune of $540 billion over the next decade to help offset the huge costs associated with the Affordable Care Act.  One could reasonably guess that these fees and taxes will be passed down from the insurance companies to the policyholders in the form of higher premiums.  We understand that some insurance companies will be displaying these fees and taxes as separate items on their premium invoice.

The basic goal behind the Patient Protection and Affordable Care Act (“ObamaCare”) is that every American would have medical insurance.  While this goal is admirable, it comes at a very high cost that will likely affect most Americans – even those who are already insured.

First, a snapshot of the American population as it relates to health insurance.  Approximately 84% of Americans are currently covered by some form of medical insurance –be it an individual plan, an employer-sponsored plan, Medicare or Medicaid.  This leaves about 16% without medical insurance.  Roughly 6% of the 16% are not eligible for ObamaCare benefits leaving 10% of the American population as the real target of the new law.  It is designed to get the 10% (about 37 million people) on board, insured, and paying into the system. 

This 10% is made up of people who are not covered by health insurance for a variety of reasons.  Some have the means to pay for their own medical expenses and choose not to purchase health insurance.  Others feel they’re healthy and don’t perceive a need for health insurance.  Quite possibly the largest uninsured group are those who cannot afford the high cost of buying health insurance.

2014 is the year that some of the most visible changes will take effect.  This is the year that a “Health Insurance Exchange” is to be operating in each state and every eligible American citizen will be required to be covered by medical insurance or pay a fine – the so-called “insurance mandate”.  The exchange will be a place, likely a website, where people can visit and view the pricing of all insurance companies that have been approved to sell their health insurance product on the exchange.  All insurance companies selling via the Exchange are required to offer the four levels of coverage mandated by ObamaCare.  (In case you’re wondering, you read that correctly…you and everyone in the entire country will have the same identical four choices of insurance coverage and, in a nutshell, the difference between the four plans is how much you are willing to pay out of pocket for your medical care.  Insurance plans will pay 60%, 70% 80% or 90% of your eligible medical expenses.)  The only choices then become (1) which level of coverage you want, and (2) the buyer’s preference of insurance company.  The goal of the Exchanges is to simplify the health insurance to an experience that it is similar to buying a can of beans off the store shelf.  As we currently understand it, there will be NO agents involved to coach you through the buying process with Exchanges – only “Navigators” who will be unlicensed state employees, or Federal employees in those states that refuse to operate their state Exchange.  So far, only 19 states have agreed to establish their own Exchange.

With the estimated cost of ObamaCare pegged at $1 trillion over the next decade, and the majority of the targeted group of people being unable to afford it, one might begin to wonder who pays for it.  Here are some of the things that may reach into your pocket to help fund ObamaCare – most of them beginning in 2013.  These are in addition to the tax changes that affected most working Americans on January 1st

  • New Medicare Tax.  There are two.  (1) The Medicare payroll tax will increase from 1.45% to 2.35% (that’s 62%) for individuals earning $200,000 or families earning $250,000. (2) A new Medicare tax on unearned income tax will apply to things like capital gains, interest, dividends, annuities, royalties, rents, etc. at a rate of 3.8% for individuals earning $200,000 or families earning $250,000.  This could apply to capital gains from the sale of certain homes.  Together, these are expected to raise $210 billion.
  • New Fees.  Pharmaceutical companies and the Health Insurance Industry will begin paying fees in 2014 ranging from 8% to 13.9% of revenues.  Expected to raise $107 billion.  It would seem reasonable to expect these fees to be passed along to the consumer.
  • Penalties / Fines.  Individuals who do not purchase health insurance and certain employers who do not offer health insurance to their employees will have a fine imposed with the intent of reducing the number of people without insurance.  Expected to raise $65 million.
  • Excise Tax on “Cadillac” Plans.  Beginning in 2018, if an employer provides a robust health insurance plan for its employees and pays a premium that exceeds $10,200 for individuals or $27,500 for families, a 40% tax will be imposed on the insurance company that sold the plan where the premium that exceeds these amounts.  Again, just an assumption, but one could guess that the insurance company will pass this added cost along to the employer and, if the employees share in the cost of their health insurance, this tax could be paid by the employee.  (These premium levels are not indexed for inflation!)  Expected to raise $32 billion.
  • Increased Penalty for HSA Distributions.  If you have a High Deductible Health Plan and fund the high deductible with a Health Savings Account, you used to pay a 10% penalty on non-allowable purchases using the HSA.  A provision in the PPACA doubled the penalty to 20% beginning in 2011.  Expected to raise $1.4 billion.
  • New FSA limits.  Through 2012, an employer was able to contribute an unlimited amount into an employee’s Flexible Spending Account (FSA).  Beginning in 2013, there is a tax-free cap of just $2,500.  Like the new tax on Cadillac plans, this places an additional restriction on employer-provided health insurance benefits.   Expected to raise $13 billion.
  • New Excise Tax on Medical Devices.  ObamaCare imposes a new 2.3% tax on manufacturers and importers of many medical devices (certain medical equipment, prosthetic devices including replacement knees, hips, etc.).  Expected to raise $20 billion.
  • Medical Expense Deduction.  If you pay a high amount out-of-pocket medical expenses and itemize deductions when calculating your income tax, the threshold increases from 7.5% of income to 10% of income in 2013. 
  • Tax on Tanning Salons.  Beginning in 2010, ObamaCare imposed a new 10% tax on indoor tanning services.  Expected to raise $3 billion.

 Whew!  While none of these things affect everyone, and while each may seem like small pieces, collectively this is how the Federal government intends to pay for ObamaCare…all to make sure that 10% of the population gets health insurance.

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Lighthouse Group Main Office in Grand Rapids, MI
Mailing Address | P.O. Box 530009, Livonia, MI 48153

Phone: 734.421.9900 | Toll Free: 800.220.5582 | Fax: 734.421.9911

Also serving these Detroit area communities in Michigan: Livonia, Farmington Hills, Ann Arbor, Southfield, Plymouth, Canton, Westland, Northville, Novi, Dearborn, South Lyon & Walled Lake