Obama Health Care Far from a "Done Deal"

Posted on August 15, 2011 by Tom Schober

Atlanta's 11th Circuit Federal Court of Appeals recently struck down a key requirement of Obamacare that would have required all Americans to pay for health insurance from birth through age 65 or face tax penalties.

This action comes amidst a number of other contradictory court decisions relating to the new law, all of which make it likely that this matter will only finally become resolved if and when the U.S. Supreme Court agrees to take and decide the case.

Keep posted.
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Healthcare Reform, The New Law - Snippet #1 - Children

Posted on May 18, 2010 by Tom Schober

The Patient Protection and Affordable Care Act of 2010 became law on March 23. It was immediately followed by the Health Care and Education Tax Credits Reconciliation Act of 2010. These two laws make up what is now known as "Health Care Reform." In a series of articles, I intend to acquaint you with the most significant provisions of these acts which cover well over 2,000 pages. Each will be a snippet of what the laws contain.

The new laws have provisions that relate directly to children. In that regard, some treat children as such if they are under 19 years of age. Other sections relate to children who are under 26 years of age. So it is important to see what age applies to the various sections. In addition, there are numerous applicable dates at which time each section takes effect. I will try to show you how each works.

Two sections relating to children will take effect September 23, 2010. Depending on the plan, that probably will mean they will take effect on October 1, 2010. These sections provide coverage for dependent children on their parents' plans until they turn age 26 and also prohibit insurance companies from rating a plan based upon pre-existing conditions of children under age 19. It appears from the initial regulations that have been drafted that the word "dependent" does not mean the same as a dependent for tax purposes. It appears to be much broader. So if you have a child who has graduated from college and needs unsurance coverage, he or she may be elgible to be on your plan until they turn age 26. That is very important for most families.

That second issue, the fact that pre-existing conditions are ignored for children, will make it much easier for families with children who have serious health issues to remain in plans with affordable costs after the applicable date.

As you can see, these are complicated issues. If you have questions, please feel free to contact me and I will be happy to discuss them with you. I will also be putting up additional snippets in the days to come!
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Contemplating Group Health Coverage Post Sale of Business

Posted on July 13, 2009 by Todd Goodwin

A common, but important, mistake that business owners make when selling their business is failing to adequately investigate what their and their spouse's health coverage will be after the sale of the business.  Obviously, many prior owners will sell their business before they are eligible for Medicare leaving them facing the high costs of obtaining private individual insurance if their spouse is not covered under another group plan.

Commonly, as a potential solution, the prior owners will negotiate to stay on with the new owners as consultants under a consulting agreement or as employees under an employment agreement with the proviso that they be added to the new owner's group health plan until the prior owners are eligible for Medicare or some other pre-negotiated timeframe. 

 

The new owners under an agreement will simply add the prior owners onto the new owner's group health plan thinking that the prior owner, now consultant or employee, will be covered. However, (i) most group policies will not provide health coverage for consultants and (ii) most group policies contain provisions which require the employee to work a minimum number of hours per week to be eligible for benefits. Many prior owners are under the false assumption that if their employment agreement or consulting agreement says that they are covered that they don't have to worry. That is not the case.

It is important for both the buyer of a new business and the seller to contemplate early on in the deal negotiations the need for the Seller's health coverage post closing. It also very important to discuss in detail with the new owner's group health provider what coverage is available and what the specific requirements are to make sure that the prior owner has coverage.

 
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