Top Legal and Financial Services in Redding, CA
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Springleaf Financial Services
By robin2013 April 03, 2013
This office is staffed by nasty harpies. ...read more
Margy Wenham Insurance Services
By erinwhite October 05, 2012
My mother is very hard of hearing and gets confused easily at the age of 87. Margy spent over an hour with her and me to explain the Medicare coverage she had and what was the best policy for her this year. She was great! My mother was happy and I know the coverage she has is the best available. Thanks! ...read more
Margy Wenham Insurance Services
By erm9821 August 29, 2012
My mom is 84 and hard of hearing. Margy spent the time with her to go over her Medicare Supplemental insurance coverage, and did so in a clear and understandable manner. My mom loved her. Thanks! ...read more
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What you need to know about Covered California
What You Need to Know about California's Exchange - Covered California One of the more important parts of the Affordable Care Act (ACA) are new, state-run, competitive health insurance ‘marketplaces’ also known as “Exchanges.” California’s health insurance marketplace is known as “Covered California.” This is where individuals and small businesses will be able to purchase private health insurance for 2014. Individuals and small businesses will still, however, still be to purchase plans through agents, brokers and directly through health insurance carriers just as they do today. How Affordable Care Act will Effect California Individuals and Families In the in the hopes of making coverage more affordable, many individuals seeking health insurance may get financial assistance or a subsidy to purchase health insurance plans from Covered California. The amount of assistance will be determined by an individual’s or families’ income level in relation to the Federal Poverty Level (FPL). Applicants with annual incomes between 134% and 400% of the Federal Poverty Level (FPL) will receive a subsidy. Those with an FPL under 134% FPL may be eligible for Medi-Cal. Regardless of a subsidy, by law the ACA requires that all California individuals and family members have qualifying health insurance in 2014. Enrollment in health plans effective in 2014 will begin on October 1, 2013 and end on March 31, 2014. This open enrollment period is generally the only time individuals will be able to obtain coverage for 2014 - either through Covered California or in the private market. There are, of course, certain life-changing events that allow for enrollment outside of open enrollment; e.g., the loss of a job, death of a spouse or birth of a child. Such events may allow a special enrollment period within sixty (60) days of the event. When an individual files their taxes they’ll need to show that they have some type of health coverage (an employer’s plan, an exchange plan, a Medicare or Medicaid plan) – unless they qualify for an exemption. If they don’t have coverage, they’ll pay a tax penalty that will get bigger over time. In 2014 the penalty will be $95.00 or 1% of taxable income, whichever is greater and capped at $285.00 per family. By 2016, it will jump sharply to $2,085 per family, or 2.5% of taxable income, whichever is greater. Individuals will pay penalties of $95 in 2014 that will climb to $625 in 2016. The Affordable Care Act's Effect on California Employers Covered California will also host a marketplace specifically designed for small businesses known as the ‘Small Business Health Options Program’ (SHOP). According to the ACA, ‘Small Business’ is defined as a company with 1-100 employees. However, the states have been given until January 1, 2016 to change the size of their Small Business market to 1-100 employees. For 2014, Covered California has therefore deemed those with 1 to According to the Affordable Care Act (ACA), there are three (3) provisions effective in 2014 that are the responsibility of the employer to implement in order to ensure compliance. The provisions are as follows: 1. Play-or-Pay: Starting on January 1, 2014, the ACA will require “Applicable Large Employers”– presently, companies that have employed an average of 50 or more full-time and/or full-time equivalent (FTE) employees during the preceding calendar year—to offer affordable health plan coverage to full-time employees (and to their dependents) or face a penalty if an employee receives federally subsidized coverage from Covered California. So as to afford employers sufficient time to extend coverage to dependents, employers will not be subject to penalties in 2014 for not offering dependent coverage if it takes steps in 2014 towards complying with this requirement. 2. Tax Reporting by Applicable Large Employers: Beginning in 2014, Large Employers were to file a return with the IRS that reports the terms and conditions of the health care coverage provided to the employer’s full-time employees. Recently, however, the IRS has backed-off on this reporting requirement. The first information returns will now be filed in 2015. The IRS will use this information to verify employer-sponsored coverage and the ACA’s penalty provisions for Large Employers. Every Employer Must Provide Specific Written Notice to their Employees by October 1, 2013 or Risk $100 Per Day in Penalties for their Non-Compliance The ACA requires that all employers subject to the Fair Labor Standards Act to provide all employees with a written notice about health insurance Covered California/the Exchange (known in our state as Covered California). By October 1, 2013 employers must give notice of the exchange to each employee. The notice must provide a description of Covered California, including contact information; a statement that employees may qualify for a tax credit to pay for the Exchange covered if the employer’s plan does not provide minimum value (i.e., when the share of benefit costs do not equal or exceed 60% of the costs of coverage); A statement regarding the financial and tax consequences of purchasing coverage and that the employee would have to forego the employer-paid portion of the premium (if any) if he did went into the Exchange. Every employee hired after October 1, 2013 must be given notice immediately within 14 days of their date of hire. There are two "Model Notices" that have been developed by the U.S. Department of Labor: One is for employers who presently offer of insurance to their employees (PDF); the other is for employers who do not (PDF). Both can be found by clicking on the links located in the prior sentence. And while the Department of Labor developed two model notices, there is no legal requirement that an employer use either - only that they whatever notice is used that it sufficiently describe the benefits of the exchange to the employee. The Department of Labor as also provided written guidance regarding their obligation to notify all employees about the exchange in "TECHNICAL RELEASE 2013-02. a. Most Employers are Subject to FLSA: The FLSA applies only to employers whose annual sales total $500,000 or more or who are engaged in interstate commerce. You might think that this would restrict the FLSA to covering only employees in large companies, but, in reality, the law covers nearly all workplaces. This is because the courts have interpreted the term interstate commerce very broadly. For example, courts have ruled that companies that regularly use the U.S. mail to send or receive letters to and from other states are engaged in interstate commerce. Even the fact that employees use company telephones or computers to place or accept interstate business calls or take orders has subjected an employer to the FLSA. b. Failure to Comply May Result in a Significant Penalty: ACA has a $100 a day general “non-compliance” penalty. This general penalty requires employers to correct compliance failures within 30 days of discovery or self-report a $100 a day penalty for failing to comply on IRS Form 8928 for each day the employer failed to comply with a PPACA mandate. So failing to provide notices can get expensive. ____________ To stay informed about Covered California, how it evolves and the other issues that effect individual and group health insurance in California, visit www.GetCoveredCAInsurance.com or contact Margy Wenham Insurance Services, Inc. at Margy@MargyWenhamInsurance.com. ...read more
By Margy Wenham Insurance Services September 10, 2013
U.S. Chamber of Commerce Urges HHS to Keep Health Benefits Affordable
The U.S. Department of Health and Human Services (HHS) is developing a final rule on the essential health benefits that individual and small-group plans must cover as part of the 2010 healthcare reform law. The “Essential Health Benefits Bulletin” as issued by Department of Health and Human Services’ (HHS’s) Center for Consumer Information and Insurance Oversight (CCIIO) on December 16, 2011 has concluded under the Affordable Care Act that the mandated all health insurance plans are required to offer a core package of items and services known as “Essential Health Benefits (EHBs).” HHS has identified 10 ESB categories: (1) ambulatory patient services; (2) emergency services; (3) hospitalization; (4) maternity and newborn care; (5) mental health and substance use disorder services, including behavioral health treatment; (6) prescription drugs; (7) rehabilitative services and devices; (8) laboratory services; (9) preventive and wellness services and chronic disease management; and (10) pediatric services, including oral and vision care. The Essential Health Benefits Coalition (EHBC), whose membership includes the National Retail Federation, and the U.S. Chamber of Commerce, and America's Health Insurance Plans, are urging HHS to not adopt such a broad and all-inclusive definition of ESBs. The EHBC has concluded that these benchmark options are misguided, not based on strong medical evidence and would keep coverage unaffordable and out of reach for many small employers and individuals. (See the December 31, 2012 Letter from Neil Trautwein, Chairman, Essential Health Benefits Coalition, Vice President, Employee Benefits Policy Counsel National Retail Federation U.S. Department of Health and Human Services.) The EHBC is therefore urging the HHS to consider an approach that balances reasonably comprehensive benefits with affordability for employers and individuals. Otherwise, the Essential Health Benefits as presently defined would make health coverage more expensive for employers and individuals to purchase and make jobs more difficult for employers to create. In other words, EHBC is urging HHS the Affordable Health Care Act of 2010 to at least consider one of its primary mandates – the affordability of health care. About the Author: Margy Wenham has been working as an independent insurance agent for over twenty (20) years in Redding, California. She represents most major insurance carriers and can be reached by calling 530.221.0955, emailing her at MargyWenhamInsurance@gmail.com or by going to her website located at www.MedicareSupplementByMargy.com. ...read more
By Margy Wenham Insurance Services January 24, 2013
How Can You Help Prevent Future Medicare Fraud?
Medicare fraud is a general term that refers to an individual or corporation that seeks to collect health care reimbursement under false pretenses. This can occur when Medicare is billed for services or supplies you never got. Medicare fraud is different than abuse: Medicare abuse happens when doctors or suppliers don't follow good medical practices, which leads to unnecessary costs to Medicare, improper payment, or services that aren't medically necessary. A complaint about the quality of care you got from a doctor, hospital, or other provider or facility isn't considered fraud or abuse. The Centers for Medicare Services estimates that Medicare fraud costs taxpayers tens of billions of dollars every year. Officials reported on October 2, 1012 that ninety-one people including doctors, nurses and other medical professionals were charged criminally after an investigation of Medicare fraud that involved $430 million in false billing in seven cities. The accusations include billing the government for unnecessary ambulance rides in California, writing prescriptions patients in Dallas who did not qualify for them and paying kickbacks like food and cigarettes to patients in Houston if they attended programs for which a hospital could bill. It was the government’s second big raid in recent months after a similar investigation in May involving $452 million in alleged Medicare fraud. Another case highlights of victimization of Medicare recipients in certain schemes to defraud Medicare. JerryGilman, a 68 -year-old Vietnam veteran from California, has a medical condition that often makes him dizzy and in danger of falling. His daughter, Deborah, and his doctor arranged for him to have a Hoveround motorized chair to help him with his mobility. The chair that arrived, however, was not the chair that Mr. Gilman ordered. It was smaller, flimsier, and made by an entirely different manufacturer. The daughter called Medicare and Hoveround. Both stated they couldn’t do anything as Medicare had already processed the payment for the chair. After a Medicare anti-fraud program became in involved it was learned that someone had intercepted Mr. Gilman’s order at his doctor’s office and replaced it with the less sturdy chair. Eventually, Medicare was able to correct the problem and get Mr. Gilman the correct chair. Medicare recipient Chuck Johnson of Montana received a telemarketing call offering him testing supplies for his diabetes that he didn’t want or need. Even though he was exceedingly clear with the caller that he did not want anything, charges for those supplies showed up on his Medicare statement anyway. Mr. Johnson got in touch with a Medicare anti-fraud and senior advocacy program for help to see if they could help fix the problem. Not only did his call mean that Medicare recovered money, it also opened up a broader investigation into the national organization soliciting Mr. Johnson. How should Medicare recipients detect fraud? First, always review your Medicare Summary Notice or Part D EOB. Look for charges for something you didn’t get, that you were billed twice for or they reflect services that were not ordered by you or your doctor. What do you do if you feel scammed? If you have detected suspicious or erroneous activity on your Medicare Summary Notice or Part D Explanation of Benefits (EOB), you should contact your provider or plan. If you are not comfortable calling your provider or plan or you are not satisfied with the response you get, there are agencies designed to combat this kind of fraud. In Northern California theHealth Insurance Counseling&Advocacy; Program (HICAP)isvaluable cost-free asset to available to seniors. HICAP provides one-on-one counseling service for regarding Medicare related issues - including when there is evidence of Medicare fraud. In short, awareness of exactly what your physician has prescribed and paying attention to your Medicare Summaries and EOBs for inconsistencies may prevent future Medicare Fraud. ...read more
By Margy Wenham Insurance Services December 11, 2012