Dedicated Insurance Professionals you know and trust...like Family
Issue No. 47

October 29,  2013

 


 

 

TACT, Steadfast Amidst Change

Helping You FIELD Your Options

 

For the first time in American history, all Americans can begin shopping for quality health coverage without being denied or charged more because they have a pre-existing condition.

 

The Health Insurance Marketplace is a way for uninsured Americans and their families to purchase health insurance in one place.  Coverage begins as early as January 1, 2014 for people enrolling by December 15, 2013.   

 

"For years, the financial, physical or mental health of millions of Americans suffered because they couldn't afford the care they or their family needed," said U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius.  "But thanks to the health care law, all of that is changing.  The launch begins a new day when health care coverage will be more accessible and affordable than ever before."

 

TACT welcomes the change as needed for Americans. Coverage offered through the Marketplace includes a range of options so consumers can pick a plan that best meets their needs, the needs of their family, and their budget. 

 

Information has been mailed out to participating TACT members and prospects. We want consumers to know that they can find and compare options, check if they qualify for lower costs, and get covered. But, in the midst of all that is changing, TACT remains steadfast in coverage, quality and competitive pricing.

 

Education and understanding is key in this new environment. Thankfully, you have a partner in TACT. Let us answer your questions. Let us help you field your options.

 

 

You are a partner in health care decision making and you are partnered with a coverage provider that is thriving amidst pending change.

 

 

Now serving ALL of Texas Agriculture -

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TACT - Dedicated Insurance Professionals
you know and trust...like Family.  

 

 

 

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 White House to Adjust Health Care Penalty Deadline Guidance 

 

Breaking News October 23 - White House said Wednesday that it plans to push back the deadline requiring Americans to purchase health insurance. The date by when Americans would be penalized for not having signed up for health insurance could be "slid" back by as much as six weeks, administration officials told NBC News. It was not immediately clear Wednesday whether the adjustment to a cornerstone of the Affordable Care Act would need to be approved by Congress or could be done by the Department of Health and Human Services administratively. As the law stands now, individuals are expected to begin the application process via HealthCare.gov by Feb. 15 to avoid a financial penalty when the March 31 deadline hits. But under the prospective change, individuals will be expected to have started enrollment by March to avoid incurring the penalty.
 

Read more from NBC News

 

 

 

 

 

 

 The New Marketplace

Common Concern - Vision and Dental

  

 

The Affordable Care Act - new options, easier coverage, affordable options, but what about Vision and Dental Coverage?

 

The goal of health care reform is to extend benefits to more Americans for better health. Many are wondering how the ACA will impact their lives and the traditional insurance benefits they have enjoyed.

 

We want to make sure you have the facts about dental and vision coverage in relation to the ACA, so you can maintain the coverage you and your employees need. 

 

You can keep dental and vision plans with a stand-alone carrier. Large employer mandateLarge employers can offer whatever dental or vision benefits they choose. So you can keep the dental and vision plans you have.

 

According to new ACA regulations released July 2, 2013, larger employers offering benefits to employees have until 2015 to meet the ACA employer-mandate insurance obligation. The requirement to offer and report on Minimum Essential Coverage (MEC) or pay a penalty was deferred until 2015. MEC does not include dental or vision insurance.

 

Small employer and individual requirements. Beginning Jan. 1, 2014, insurers are required to offer Essential Health Benefit Packages (EHBPs) to individuals and employers of fewer than 50 eligible employees that choose to provide benefits. EHBPs include pediatric dental and vision, typically up to age 19.

 

key points (in most states):

  • Within the exchange, the medical plan can exclude dental if the exchange offers a stand-alone dental plan providing the required pediatric dental benefits.
  • In the private market, the medical plan can exclude dental if the medical carrier is reasonably assuredthat individuals have obtained pediatric dental benefits through a certified stand-alone dental plan.
  • No purchase of pediatric dental is requiredif it is offered in an exchange on a stand-alone basis. This means you can buy your family dental outside the exchange.
  • Traditional pediatric orthodontia coverage may not be available in state exchanges or EHB packages. Currently only orthodontia declared medically necessary (for example, coverage related to a cleft palate condition) would be covered as an EHB. Children currently undergoing a traditional orthodontia treatment program that extends beyond 2013 may be impacted significantly if their coverage is moved to an EHB or exchange plan. Some plans may offer additional options with pediatric orthodontia coverage, but benefits and providers may differ from existing plans.

 Adults need their own dental and vision coverage, too. EHBPs from medical carriers likely will cover only members of pediatric age (under age 19 in most states). With these plans, adults would need to purchase dental and vision plans separately for themselves and dependents age 19 and older. This means that family members may have different benefit plans, networks and insurance carriers.

  

No flexibility offered in public exchanges for dental and vision. Employers and individuals exploring benefit options through a state exchange or private marketplace should review the plan design carefully to understand the coverage options. Plan choices will be limited, and employers will not be able to customize plans.

Plans in an exchange may not be cheaper than those offered by an insurance carrier in a private exchange market. Premiums probably will be based on limited criteria instead of utilization trends that are typically used from within an employer's industry or claim experience. Since insurance carriers will be charged by state and federal administrators to participate in exchanges, these fees likely will be included in the premium costs.

 

 

 

 TACT offers Benefit Plans for both

Dental (Plan) and Vision (Plan).

 

TACT has partnered with Benefit Groups to offer all TACT members dental and vision benefits programs that provide care through a vast network of providers. Specific information can be viewed by visiting here.

 

Contact the TACT office for enrollment information. Vision is standard with existing policies. Information for dental open enrollment will be mailed out in December. Plans begin January 1. 

 

 

 

 

Looking Ahead

Obamacare

Law Leaves Doctors Uncertain

 

 

By Becca Aaronson

Texas Tribune, October 18, 2013

As consumers weigh coverage options available in the newly launched federal health insurance marketplace, three of the largest medical associations in Texas have raised concerns about the uncertainty of provider networks offered by health plans in the marketplace.

 

The Affordable Care Act requires most people to carry health insurance beginning in 2014. While some states received federal financing to set up a state-run health insurance marketplace, Texas chose to participate in the federal marketplace, which offers dozens of health plans and sliding-scale tax credits to help poor individuals and families in Texas purchase coverage. Since the marketplace launched on Oct. 1, technical glitches have plagued the federal website and made it difficult for consumers to create accounts and compare health plans.  

 

The Texas Medical Association, Texas Hospital Association and Texas Academy of Family Physicians said many physicians and hospitals have also been unable to determine which health plans offered in the marketplace include them in their provider networks

 

"Physicians, they just want to know who's walking through their door and what kind of coverage they're going to have," said Lee Spangler, vice president of medical economics at the Texas Medical Association. "They'd like that uncertainty to be settled."

 

Many insurance companies participating in the marketplace have created health plans with provider networks based on existing contracts with physicians and hospitals, and did not contact those providers to sign new contracts or ask if they were willing to participate in the new health plans, according to the associations. As a result, many providers do not know which of the health plans offered in the marketplace will pay them for services. Read the entire story here.

 

 

 

 

 

Agriculture News
  
Progress on Farm Bill Commended by Ag Group
  

 

portions reported by American Farm Bureau October 15, 2013 -

 

Congressional leaders' moving forward on negotiations to resolve differences between the Senate and House versions of the 2013 farm bill is a commendable step but much more remains to be done, according to the American Farm Bureau Federation.

 

Overall, both the Senate and House bills provide an adequate food and farm safety net for consumers and farmers.

 

 The American Farm Bureau reports two overarching concerns related to the Senate-House conference on the farm bill are ensuring that permanent law is not repealed and a complete, unified bill continues

 

"For some time, the threat of reinstatement of the long-outdated policies of the 1938 and 1949 acts has served as strong motivation for Congress to enact new farm bills," AFBF President Bob Stallman said. "Repealing those acts and making the 2013 farm bill commodity title permanent law could make it difficult in the future to generate sufficient political pressure to adjust the commodity safety net provisions should conditions in production agriculture change."

 

AFBF noted that if the farm bill expires after five years, other important farm and rural programs covered in different titles are at risk of not being reauthorized.

"Over the last two years, leadership of both Ag Committees have demonstrated their ability to forge bipartisan compromise to achieve a new five-year farm bill that meets farmers' and ranchers' needs while also contributing significant savings to reduce our federal deficit," said Stallman. "We only see these savings if Congress gets the bill done," Stallman added.

 

As with many ag organizations, the Farm Bureau continues to stand firmly behind the inclusion of the nutrition title in the farm bill.

 

"A farm bill without a meaningful nutrition title will make it difficult, if not impossible, for the House and Senate to reach agreement on a final version that can be signed by the president," said Stallman, urging conferees to move forward on a unified farm bill that continues the "marriage" between the nutrition and farm communities.

 

Recent Report:

(Reuters) - House and Senate negotiators were set to meet for the first time last week to work on the new $500 billion U.S. farm bill, more than a year past due and repeatedly delayed by House Republican plans for steep cuts in food stamps for the poor. 

 

The bill is also expected to cut funding for conservation programs but expand by $1 billion a year the federally subsidized crop insurance program, which now costs around $9 billion annually.

 

"Depending on the House and Senate schedules, the first, formal conference meeting could be scheduled as early as this week," said an aide to House Agriculture Committee chairman Frank Lucas. Under congressional protocol, Lucas will chair the conference committee formed to write a compromise bill between the House and Senate versions.

 

If Congress is not in session, the negotiators may not meet until the following week, said two other congressional staff workers.

 

The first meeting of House and Senate conferees is a milestone that marks the final round of work on major legislation. Commonly, a final version emerges within a few weeks.

 

 

  

 

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 Healthful Hint

  

Cold and Flu Season Has Arrived

 

 In times of cold and flu season many of us get sick with viral infections. Runny nose, sneezing, coughing, body aches, fever, chills and general malaise seem to be the hallmark of these. The infections themselves are usually short-lived and make us miserable in the process. The prodrome lasts a day or two followed by worsening symptoms.

 

Many people come to the physician at this point usually saying, "I have a sinus infection" and in actuality they are correct. But what we can do about it is limited and designed to treat the symptoms not the cause. With the exception of the Influenza viruses, we have little treatment against the viral infection itself. There are a wide variety of respiratory viruses that circulate in our community every year.

 

The virus has been acquired via droplets sneezed into the air or inoculated by a contaminated finger into an eye or nose. Respiratory viruses love tissue found in the nose, sinus passages, throat and airways and are pretty effective and efficient agents of disease. They carry little luggage, infect the host's own cells and uses the host's own machinery to reproduce itself. The whole process of viral replication is fascinating, complex and well organized. But equally amazing are the body's mechanisms designed to fight these attacks. Have you ever wondered just how the body recognizes something foreign, like a viral particle, instead of itself? How does it recognize a cell of it's own that has been infected by a virus? Have you ever wondered how the millions of proteins are produced to stop the immediate infection and then provide immunity to the host that can often last a lifetime?

 

Most cold symptoms are gone by 4-7 days. Help your body with rest, fluids and nutrition. While infectious, you will be spreading virus with your coughing and sneezing. Try to limit droplet spread by covering the mouth when you cough or sneeze; or better, do these under your shirt or into an elbow. Wash your hands with soap and water frequently and keep your fingers out of your eyes and nose. Stay away from populated areas like school, work, grocery store and airplanes until your symptoms have calmed down. Chose not to visit a pregnant woman, newborn, elderly or anyone whose immune system is compromised or has serious disease.

 

Of course, not everyone is the same. Come see a physician if 1) symptoms drag out for longer; 2) fever that doesn't respond to acetaminophen or ibuprofen; 3) predominance of one major symptom, like a really sore throat; 4) stiff neck; 5) appearance of a rash; 6) trouble breathing; 7) suspect influenza infection, and 8) anything odd or other concern that you might have. There is nothing at all wrong with consulting. This is why physicians spend years and years training. They are trained to recognize and distinguish the common from the more serious disease.

 

 

Texas Ag Coop Trust Health Plan 

At TACT, we realize the only way we could fight healthcare costs was to quit focusing on the health costs and start focusing on the health issues.

 

TACT offers onsite wellness screenings and our contracted nurse has been making onsite visits doing flu shots in the Lubbock and Panhandle area. TACT encourages you to talk to your physician about the benefits of this year's flu vaccine and decide whether taking it is right for you.

 

 

  
 
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In This Issue
White House to Adjust Health Care Penalty Deadline Guidance
The New Marketplace - A Common Concern
Obamacare Law Leaves Doctors Uncertain
Farm Bill News
Cold and Flu Season Has Arrived
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Facebook Feature 
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Contact Us
Texas Ag Coop Trust
1802 East 50th St., Ste. 107
Lubbock, TX 79404
806-747-7894

  

Texas Ag Coop Trust
Officers, Board of Trustees
 
Kimberly Tullo-Holcomb
TACT Executive Director
Lubbock, TX
 
George Reed, Chairman
United Farm Industries
Plainview, TX

Gregg Allen, Secretary
Olton Grain Coop
Olton, TX
 
Bret Brown, Treasurer
Sunray Coop
Sunray, TX

Jim Turner
Dalhart Consumers Fuel Association
Dalhart, TX
 
Paul Wilson
United Cotton Growers
Levelland, TX

Cary Eubanks
Slaton Coop Gin
Slaton, TX

Dean Sasser
Farmers Coop Elevator
Levelland, TX



 

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Health Care Consumer Resources

Helping You Field Your Options

 
  
 

The Health Insurance Marketplace is designed to make buying health coverage easier and more affordable. Starting in 2014, the Marketplace will allow individuals and small businesses to compare health plans, get answers.

  

The Marketplace is a new way to find quality health coverage. It can help if you don't have coverage now or if you have it but want to look at other options. Most Americans will be eligible to use the Marketplace. Learn more about Marketplace eligibility.

  

Consumer Resources

A number of different resources are available to help consumers find Marketplace coverage.  They can get more information through HealthCare.gov or CuidadoDeSalud.gov.   Consumers can participate in online web chats or speak with trained customer service representatives, with translation services available in 150 languages.  Community health centers, Navigators and other assisters are available in local communities to provide in-person help with coverage choices.  Many local libraries will help consumers learn about their options and hundreds of Champions for Coverage, which are businesses and organizations all across the country, are helping people learn about their options and enroll in affordable coverage.

  • Contact by phone: Our consumer call center is open 24 hours a day 7 days a week at 1-800-318-2596 toll free (TTY: 1-855-889-4325). Assistance is available in 150 languages.
  • By mail: Health Insurance Marketplace
                 Dept. of Health and Human Services
                 465 Industrial Blvd.
                 London, KY 40750-0001
  • In person: visit localhelp.healthcare.gov to find in-person assistance near you.
  • Enroll online at HealthCare.gov

Affordable Coverage Options

Data released shows consumers will be able to choose from an average of 53 health plans in the Federally-facilitated Marketplace, and the vast majority will have a choice of at least two different health insurance companies - usually more.  Premiums nationwide will also be around 16 percent lower than originally expected - with about 95 percent of eligible uninsured living in states with lower than expected premiums - before taking into account financial assistance.  Nearly 6 in 10 uninsured Americans could get insurance for $100 or less, with financial assistance and expanded access to Medicaid.

  

Small Businesses

The Marketplace includes a Small Business Health Option Program (SHOP), designed for small employers with 50 or fewer full-time equivalent employees. The SHOP will allow small employers a choice of a quality health insurance plans and let them make side-by-side comparisons to choose a plan that's right for their business and employees.

Employers buying health insurance through the SHOP may also qualify for a Small Business Health Care Tax Credit to help defray their premium costs.  Hundreds of thousands of small businesses with fewer than 25 employees have already received a tax credit of up to 35 percent of their health insurance costs. And beginning in 2014, this tax credit will be worth as much as 50 percent of the employer's contribution to premiums.  Small businesses can reach the dedicated SHOP Marketplace call center at 1-800-706-7893, Monday through Friday, 9am to 7pm EST.

 

TACT, in the midst of  launched change, finds itself in a unique position of being able to offer the highest quality of insurance and service at the same great rates to which you are already accustomed. We encourage you to field your options but allow us to help you understand them. Remember, with TACT, YOU are our business.


 

What can we do to help you? What questions do you have?  We are here to answer your questions.

 

  

 

  

 TACT - Dedicated Insurance Professionals
  you know and trust...like Family. 
 

 

Next Issue: November 12, 2013
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