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Paul Cholak - Principal
Licensed Insurance Agent

877-734-3884   

September 2017 - In This Issue:

We Offer:
  • Individual and Family Health Insurance (Affordable Care Act)
  • Health Plans for Medicare Beneficiaries
  • Life Insurance
  • Pre-Need Funeral Arrangement Plans
  • Final Expense Insurance
  • Life Insurance for Diabetics and Other Hard-to-Insure Individuals
  • Annuities
  • Dental and Vision Care Coverage
  • Supplemental Health Insurance
  • Prescription-Only Drug Plans
  • International Travel Medical Insurance
  • Disability Insurance
  • Short-Term (Recovery) Care Insurance
  • Long-Term Care Insurance
  • Pre-paid Legal and Identity Theft Plans
About our Principal,  
Paul Cholak


Paul holds resident (Florida) and non-resident life, health and annuity licenses in 31 other states and is registered to sell individual and SHOP plans on the Federal Facilitated Marketplace.  He also has a Florida pre-need sales agent license,
 
In addition, he's also appointed to sell Prepaid Legal Expense and Identity Theft Plans.

He has many years of benefits experience and has been Director of Employee Benefits for large companies, as well as a benefits consultant with major consulting firms.

Paul negotiated the first labor contracts that included the concept of "reasonable and customary" reimbursement and also implemented the first group dental insurance plan.  

He knows all aspects of individual and family health insurance and has extensive experience with group plans, as well.

He's available 24/7 and stays in touch with his customers before and after they've made their insurance purchase.  He's always available to help customers who have claims or other problems with their coverage or have any questions about their policies.

He's a recipient of the prestigious Albert Nelson Marquis Lifetime Achievement Award and been listed in Who's Who in America, Who's Who Registry of Business Leaders and Who's Who in Finance and Industry. Early in his career he was identified as one of the Emerging Leaders in America. 

He's a member of Phi Beta Kappa and other national honorary societies and organizations such as Omicron Delta Kappa. He's also an Ambassador with the Boca Raton Chamber of Commerce. He's a graduate of certificate programs from a number of prestigious institutions, been invited to speak at corporate and university training programs, been featured in articles in national books and magazines, and is also a published author.   
 

Trump Administration Plans To Make Payments for ACA
As reported in last month's newsletter, President Trump has threatened to withhold making payments to fund Cost Share Reduction Plans (CSR's) which are available to those making at least 100% of the Federal Poverty Limit (138% in states that have expanded Medicaid) up to 250%.  No official announcement has been made as of the date this newsletter is being written, but a White House official said on August 16 that such payments would be made for August and recent press reports have said that such payments will also be made for September.  However, there is no commitment to make payments beyond then.

According to the Congressional Budget Office and as reported by the Associated Press on August 16 the following would happen if the President cuts off funds for CSR's:
  • Consumers who now qualify for tax credits to offset their monthly premiums would be largely shielded from the estimated 20% jump in the cost of a standard "silver" plan, because ACA subsidies would generally increase to cover such subsidies. But middle-class households that make too much to receive help with their premiums would face a big hit.
  • Depending on factors like their income and age, some subsidized customers would be able to take their higher premium tax credits and buy a generous "gold"  level plan for about the same money, or a "bronze" plan for much less (or nothing).
  • Some insurers would decide to exit the market rather than re-jigger premiums for 2018 at the last minute.  That would leave areas of the country that are home to about 16 million people with no insurance on the health care marketplace for individual policies.  Rural communities are at greater risk.
  • About 1 million people would become uninsured right away, but more people would be covered.
President Trump has threatened to withhold payments as a means to spur Republicans to take some kind of action on repealing/replacing Obamacare, but his action would adversely affect those who come close or relatively close but do not qualify for subsidies, and these people are a significant portion of the President's support base.  This situation creates a difficult political situation for the President should he choose to withhold payment.
 
Cost Sharing Reduction subsidies are authorized in the Affordable Care Act, but Congress has never specifically passed an appropriations bill to pay for these subsidies.  As a result, a group of Republicans filed a lawsuit in 2014 claiming that these subsidies were unconstitutional because they were not funded by Congress.  A District Court judge agreed and ordered a halt to the payments but suspended the order to allow the government to appeal.  The case is pending before the US Court of Appeals for the District of Columbia circuit.
 
Meanwhile, Senator Lamar Alexander ( Republican-Tennessee), the Chairman of the Senate Health Committee, has said he plans to hold hearings in September with a view to producing bipartisan legislation that would stabilize insurance markets and provide money for the subsidies. 
Florida Blue Offers Off-Marketplace Open Enrollment Starting October 1
Open enrollment for 2018 on the Federal Exchange/Marketplace begins November 1 and ends December 15. Individuals who want tax subsidies will have to apply for an on-Exchange plan and must make their decision by December 15 in order to have their plan effective January 1.

Carriers are permitted to establish different open enrollment dates for non-tax subsidized plans bought directly from the carrier. In prior years Florida Blue has started off-Exchange open enrollment on October 1 and ended such enrollment on the same date on-Exchange open enrollment ended. They are beginning off-Exchange open enrollment on October 1 again this year. To our knowledge all other carriers in Florida who offer off-Exchange plans have followed the federal on-exchange open enrollment period dates.

As previously reported, neither Aetna, Coventry, United Healthcare nor Humana will be offering either on- or off-Exchange plans in Florida for 2018, so consumer choices will be even more limited than previously.  We've also heard that Molina will be increasing premiums substantially and that AvMed, which only offers plans off the Exchange, will also be announcing substantial increases.

In general, individuals buying plans outside of open enrollment (either on or off the Exchange) will need to have a qualifying life event, must have had coverage at least one day within the 60 days prior to the event, and will have to submit acceptable proof in order to be eligible to buy a plan outside of open enrollment.

The following article was written by Rachel Bluth and published in the Kaiser Health News .

Single-payer health care is still a controversial idea in the U.S., but a majority of physicians are moving to support it, a new survey finds.

Fifty-six percent of doctors registered either strong support or were somewhat supportive of a single-payer health system, according to the  survey  by Merritt Hawkins, a physician recruitment firm. In its 2008 survey, opinions ran the opposite way--58 percent opposed single-payer. What's changed?
Red tape, doctors tell Merritt Hawkins. Phillip Miller, the firm's vice president of communications, said that in the thousands of conversations its employees have with doctors each year, physicians often say they are tired of dealing with billing and paperwork, which takes time away from patients.

Read the Entire Article here
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