Dedicated Insurance Professionals you know and trust...like Family
Issue No. 48

November 12,  2013

 


 

 

 

TACT is preparing for pending changes as needed for Americans. Health care 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 mailed to participating TACT members and prospects has been done in an effort to let YOU, as a consumer, know that you can find and compare options. 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.  

 

 

 

Extending a Warm Welcome

 TACT Welcomes New Member

  

 

TACT staff and board welcomes  Associated Cotton Growers in Crosbyton, TX, Manager Heethe Burleson, to the Trust! If you do business with Associated Cotton Growers or see Mr. Burleson, please give a personal welcome! We appreciate your participation and want to remind you that YOU are our business.

 

Welcome!

 

 

 

 

 The New Marketplace

Change and Concern

 

Extended Coverage Addressed

  

 

The government shutdown and what seems to have become a political fight over implementation of a new health care law are generating confusion in America. Amid the politics, many Americans are wondering what effect these changes will have on them.

 

It would be nearly impossible to understand everything within the 2,000-some pages of the Patient Protection and Affordable Care Act (ACA), also known as Obamacare, which, as of Oct. 1, intends to make health insurance widely available and more affordable for people, requiring health care plans to cover most anybody at regulated premiums, regardless of preexisting conditions.

 

As time ticks away towards the Jan. 1, 2014, the deadline for healthcare open enrollment, many consumers are faced with several questions. To better educate and help better understand the questions at hand, we have searched government-sponsored websites online (mainly www.healthcare.gov) for information.

 

Findings certainly don't even begin to scratch the surface of every possible situation or person involved, but the few key points below will hopefully clear up some confusion. 

 

How will the Affordable Care Act extend health care coverage in 2014?

 

* Individual mandate: Mandates that all Americans maintain a minimum level of health coverage or face a tax penalty.

 

* Insurance exchanges: Creates state-based health insurance Exchanges and provides federal premium tax credits and cost-sharing subsidies to assist low- and moderate-income individuals without affordable employer-sponsored insurance in obtaining health coverage.

 

* Medicaid expansion: Expands Medicaid up to 133 percent of federal poverty level. (Texas refuses to expand.)

 

* Employer mandate: Mandates, for the first time, that employers with 50 or more full-time equivalent employees offer coverage or pay tax penalties.

 

Who is eligible for insurance benefits under ACA?

 

According to www.obamacarefacts.com, most anyone can buy private health insurance through insurance exchanges, except for those who don't file income taxes, including illegal immigrants and those with little or no income. They are not eligible to receive government subsidies and are not penalized. Exemptions include undocumented immigrants, prisoners and members of some religious groups (Amish people, for example) if social security benefits have been customarily declined.

 

What is "a qualifying plan," according to the ACA?

 

A "qualifying plan" is one that provides the essential insurance benefits, which include emergency services, hospitalizations, laboratory services, maternity care, mental health and substance abuse treatment, outpatient or ambulatory care, pediatric care, prescription drugs, preventive care, rehabilitative and habilitative (helping maintain daily functioning) services and vision and dental care for children, according to www.obamacarefacts.com. Starting in 2014, the ACA largely requires individual plans to provide the aforementioned essential health benefits and cover pre-existing conditions. The law also limits how much premiums can vary based on age.

 

What will happen if my plan doesn't meet ACA standards?

 

If you are on the TACT Plan, it exceeds "ACA"!

 

What are the penalties for choosing to go without insurance?

 

According to www.healthcare.gov, most people must have health coverage in 2014 or pay a penalty of $95 per adult, $47.50 per child (up to $285 per family), or 1 percent of their income, whichever is higher. This fee increases every year.

 

How are businesses affected by ACA?

 

The law does not require employers to provide health insurance, however, any employer with 50 or more full-time equivalent employees that doesn't provide this coverage must pay a fee. Employers that do provide coverage must meet the minimum ACA "qualifying plan" requirements.

 

TACT wants you to know that as an owner of YOUR insurance, we are here to answer any questions you may have and will help walk you through. As a consumer, you are encouraged, as individuals and businesses, to take a moment and go online to www.healthcare.gov, navigate the website and take a more in-depth look at ACA and how it affects your particular situation.

 

 

 

 

 

 

 

 

 Healthcare In The News

Obama explains that when he told Americans they could keep their healthcare plans, "period," under the Affordable Care Act, he actually meant the promise was conditional.

History Rewritten

(as per speech given November 4)

   

 

 

For the second time in a week, President Barack Obama backtracked on his promise to Americans that they could keep their health insurance plans under Obamacare, telling a group of activists on Monday that what he had really meant was that Americans could keep their healthcare plans "if it hasn't changed since the law passed." 

  

Speaking at an Organizing for Action health care summit in Washington, D.C., Obama revised a signature mantra of his stump speeches during the Obamacare debate and the 2012 campaign in which he repeatedly said that under Obamacare, "If you like your plan, you can keep your plan." 

 

In 2009, the President even cut off the possibility of modifiers to that plan. In a speech to the American Medical Association, he stated, "If you like your healthcare plan, you'll be able to keep your healthcare plan, period. No one will take it away, no matter what."

In his Monday speech, however, the promise took on newfound nuance. "Now, if you have or had one of these plans before the Affordable Care Act came into law and you really liked that plan, what we said was you can keep it if it hasn't changed since the law passed,"

 

Obama said. "So we wrote into the Affordable Care Act, you're grandfathered in on that plan. But if the insurance company changes it, then what we're saying is they've got to change it to a higher standard.

 

"They've got to make it better, they've got to improve the quality of the plan they are selling. That's part of the promise that we made too. That's why we went out of our way to make

 

In addition to the malfunctioning HealthCare.gov website, millions of Americans have been receiving cancellation notices from their health insurance providers since Obamacare went into effect in October. Mainstream media outlets and personalities-from the Washington Post to MSNBC's Chuck Todd-that were some of Obama's fiercest defenders the last four years have called him out on this falsehood, even admitting in hindsight that they were skeptical of Obama's signature claim.

 

Obama attempted his first rewrite of history last Wednesday in his healthcare speech at Boston's Fanueil Hall after Health and Human Services Secretary Kathleen Sebelius was grilled in front of Congress and apologized for Obamacare's rollout, which she conceded was a "debacle." 

 

"For the vast majority of people who have health insurance that works, you can keep it," Obama said last week in Boston. Obama then said that Americans who were receiving cancellation letters merely had "substandard" insurance plans. 

 

 

 

 

 

Looking Ahead

Texas Prepares to Shutter High Risk Insurance Pool

 

 

By David Maly

Texas Tribune, October 18, 2013

 

At the end of the year, Texas' high-risk insurance pool for the state's sickest residents will close and participants will have to find coverage in the federal health insurance marketplace created under the Affordable Care Act.

  

At year's end, Texas will shut down its high-risk insurance pool for some of the state's sickest residents, pushing participants to find private coverage in the federal health insurance marketplace created under the federal Affordable Care Act. And patient advocates say those participants should focus on making the transition sooner rather than later to ensure that they don't experience a lapse in coverage or lose access to current health care providers and services.

 

"Pool policyholders who are in the middle of treatment will especially need to be sure the network offered by their replacement health plan includes their treatment team," Steven Browning, executive director of the Texas Health Insurance Pool, said in an email.

 

The high-risk pool is financed mainly by patient premiums and assessments paid by health insurance companies and HMOs, along with some funding from federal grant programs. Since 1998, it has provided high-priced coverage to Texans with pre-existing conditions who can't find coverage elsewhere. The state has deemed the high-risk pool obsolete, as the Affordable Care Act prohibits insurance companies participating in the federal marketplace, which launched on Oct. 1, from denying coverage to Texans with pre-existing conditions. Gov. Rick Perry signed Senate Bill 1367 in June, scheduling the pool's abolishment.

 

The pool will close Jan. 1, and the 23,000 people currently participating in the pool must sign up for coverage on the insurance exchange by Dec. 15 or find coverage elsewhere to avoid a lapse in care.

 

Browning said the pool is making ample efforts to inform its policyholders of the closure and Dec. 15 deadline, including posting information on its website, sending letters and emails and making phone calls. There should be adequate time for those in the pool to get enrolled in a plan by Dec. 15, he said, and the pool is encouraging its patients to use a health insurance agent to sign up for coverage.

 

"In our various communications to policyholders, and on our website, we are stressing the importance of carefully evaluating the provider networks of the health plans in which they are interested, to be sure they retain adequate access to their physicians and hospitals," Browning said.

 

With many of the health plan options in the federal marketplace being cheaper than the high-risk pool and covering additional benefits, Stacey Pogue, a senior policy analyst for the left-leaning Center for Public Policy Priorities, said the situation presents an opportunity for Texans in the pool.

 

"I think that people are going to have many more options and many better options in the marketplace than they do in the health pool today," Pogue said. "There is not going to be a person who will be better off financially outside the pool than they would be if the pool stayed open."

 

As a condition of the pool, Texans generally pay twice the market rate for coverage, said Pogue. They'll probably see their health care costs halved in the marketplace, she said, because insurers aren't allowed to charge people with pre-existing conditions more than other consumers. The marketplace also offers tax credits to help purchase a health plan to everyone who makes 100 percent to 400 percent of the federal poverty line - $11,490 to $45,960 annual income for an individual or $22,550 to $94,200 for a family of four.

 

Pogue said health plans offered in the federal marketplace could also raise the level of care patients receive, as they must cover "essential health benefits," some of which, such as maternity care, aren't covered in the pool.

 

She doesn't expect there to be major issues with people meeting the Dec. 15 deadline either, she said, because many high-risk pool policyholders have health conditions that require them to deal with their health insurance on a consistent basis and are more likely to interact with their health care provider.

 

Lance Lunsford, vice president of communications for the Texas Hospital Association, said that if those in the pool experienced a lapse in coverage, hospitals would still be required by federal law to stabilize and secure them and would probably be able to aid them in securing additional coverage.

 

Lunsford said one of the big issues for people in the pool will probably be evaluating all the insurance options available.

 

"Their options may be wider and that may be part of one of the issues that they have," Lunsford said. "It will be about selecting the right coverage."

 

 

 

 

 

 

 

Agriculture News
  
State Passes Prop 6
  

 

 

What's Next for Water?

 

Terrence Henry State Impace Texas

November 5, 8:45 p.m. -

 

Texans overwhelmingly passed a constitutional amendment last Tuesday to jump-start financing for water projects in the state: Proposition 6. The plan will take $2 billion in surplus state money (from the Rainy Day Fund) to start a low-interest loan program for water projects in Texas. The measure had widespread support from both sides of the aisle as well as business and environmental groups. It passed with over 73 percent of the vote.

 

"I couldn't be more proud of the members of the legislature who worked in a collaborative way on a very positive agenda for planning for our future water needs," Speaker of the House Joe Straus, R-San Antonio, said at a rally celebrating the amendment's passage Tuesday evening. "But the people of Texas today validated our good work with an overwhelming vote of support." Some Libertarian and smaller environmental groups were vocally against the measure.

 

The creation of the water fund, overseen by the Texas Water Development Board, represents the first time in decades that the state has put significant money towards water infrastructure. The $2 billion approved this week will act like a down-payment on a mortgage that will allow the state to borrow billions more for hundreds of water projects outlined in its official Water Plan. Those projects aim to provide enough water to meet the state's needs over the next fifty years.

 

"The problem is, we've never funded the water plan," notes Paul Burka, Senior Executive Editor with Texas Monthly, who has spent decades covering the issue. "We've had these huge droughts but we haven't funded it at all." That is set to change after this week's vote.

"It really underscored how precarious our future is when it comes to water, and how crucial it is that we shift towards a more moderate, water-efficient future," says Luke Metzger, Director of Environment Texas, who supported the measure. Roughly a third of the funding in the programs are set to go towards conservation projects, an aspect of the plan that helped win support from many environmental groups.

 

 The Texas Water Development Board has a few years to figure out how projects will be prioritized and approved, and what kinds of projects will fit the "conservation" label.

 

Read the complete story here.

 

 

 

 

 

  

 

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 Healthful Hint

  

November - National Diabetes Awareness Month

 

Diabetes is a disease where the body is unable to produce insulin or when the body does not use insulin properly. Insulin is a hormone that your body needs to convert sugar, starches and other foods into energy. According to the Centers for Disease Control and Prevention (CDC) more than 25 million people in the U.S. have diabetes, and diabetes is the seventh leading cause of death in the United States.

When a person has diabetes, they also have an increased risk of heart attack, stroke, kidney disease, or blindness. There is no known cure for diabetes, but there is treatment. 

 

November is American Diabetes Month, a time to communicate about the seriousness of diabetes and the importance of diabetes prevention and control. National Diabetes Awareness Day is November 14. TACT offers a diabetic program that is part of your prescription drug program administered by HealthSmart. TACT encourages you to call to get information on seeking a customer service representative or visit here for more information.

 

 

 

 

 

  
 
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In This Issue
TACT Welcomes New Member
The New Marketplace -Extended Coverage Addressed
History Rewritten
Texas Prepares to Shutter High Risk Pool
State Passes Prop 6
National Diabetes Awareness Month
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Texas Ag Coop Trust
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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

Bret Brown, Secretary/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 26, 2013
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