Reform Timeline for Medicare and Health Insurance

Prescription Drug Discounts:

Effective Jan. 1, 2011, under the health care reform legislation, enrollees who fall in the so-called "Part D donut hole," an annual gap in Medicare Part D prescription drug coverage, will get a 50 percent discount on covered non-generic prescription medications. Additional savings on both generic and non-generic prescriptions will be phased in over the next ten years until the "donut hole" is entirely closed by 2020.

Free Preventive Care for Seniors:

Effective Jan. 1, 2011, seniors who receive Medicare will become eligible for additional preventive services at no out-of-pocket cost. These services will include one wellness check each year and the development of personalized plans for preventing illness.

Improving the Quality and Efficiency of Health Care:

Effective Jan. 1, 2011, the legislation provides for a new Center for Medicare & Medicaid Innovation to begin testing ways of delivering care to patients to improve the quality of care and develop ways to reduce the cost of health care for Medicare, Medicaid, and the Children's Health Insurance Program (CHIP). By Jan. 1, 2011, HHS will present a national strategy aimed at improving the quality of government health care.

Preventing Unnecessary Hospital Readmissions:
Effective Jan. 1, 2011, the Community Care Transitions Program will aid high-risk Medicare recipients who have been released from the hospital by coordinating care and connecting patients to community services to avoid unnecessary readmissions.

Bringing Down Costs In Health Insurance:

Beginning Oct. 1, 2011, the Independent Payment Advisory Board will begin developing and presenting proposals to Congress and the president to protect and improve benefits for enrollees and keep the Medicare Trust Fund alive and well. Its goal is to eliminate waste, find ways to reduce the cost of health care, improve health outcomes and make quality care more accessable for Medicare enrollees.

Increasing Access to Services:

Effective Oct. 1, 2022, the Community First Choice Option will allow states to offer home and community-based services as an alternative to institutional care to the disabled through Medicaid.


Community Health Centers:

Effective 2011, the new legislation allows for new funding to help communities build and expand community health centers and broaden the services they offer, with the aim of providing service to an additional 20 million patients across the U.S.

New Accountability for Insurance Companies

Reducing Premiums:

Effective no later than Jan. 1, 2011, at least 85% of all premiums paid into large employer plans must be spent on health benefits and care quality improvement. At least 80% of all premiums paid into individual and small employer plans must be spent on health services and quality improvement. The Affordable Care Act requires insurance companies to spend more on patients and less on administrative costs or return money to consumers through rebates.

Addressing Overpayments and Strengthening Prescription Drug Coverage
Effective Jan. 1, 2011, the new law will begin gradually eliminating overpayments to companies that provide Medicare Advantage. Currently, insurance companies receive, on average, more than $1,000 more per person than Medicare Part A. This results in increased premiums for recipients as well as increased costs overall. Medicare Advantage recipients will continue to receive their Medicare benefits, while insurance companies that provide high quality care will receive bonus payments.


2012 Health Care Reform Timeline for Improving Quality and Reducing Costs


Linking Quality of Care to Payment:

Effective Oct. 1, 2012, health care reform legislation will require the Value-Based Purchasing program (VBP) to begin offering financial incentives to hospitals to improve the quality of the care they provide. Performance reports will be available to the public and will include measurements of a hospital's effectiveness at treating heart attacks, heart failure and pneumonia. In addition, the reports will include information about a facility's surgical care, their rate of hospital-borne infections and patients' ratings.

Integrated Health Systems:

Effective Jan. 1, 2012, doctors will receive incentives to come together to form "Accountable Care Organizations" that will allow doctors to better coordinate patient care, improve the quality of care they deliver, help prevent illness and reduce unnecessary admissions. Organizations that effectively improve care and save money will be entitled to some of the money they have saved.

Reducing Overhead:

Beginning Oct. 1, 2012, the health care industry must begin working toward standardizing billing and adopting and implementing practices that ensure secure, confidential, electronic exchange of health information.

Narrowing the Health Care Gap:

Effective in March, 2012, federal health programs must begin collecting and reporting racial, ethnic and language data in order to aid in understanding and combating existing health disparities. This data will be reported to the Secretary of Health and Human Services to be used to identify and fight disparities in health care.

Expanding Access to Affordable Care

New Options for Long-Term Care:

Effective Oct. 1, 2012, the new health care reform legislation will create a voluntary long-term care insurance program to be known as CLASS that will provide monthly benefits to adults who become disabled.

For more information in Florida regarding health care and health insurance, click here.

Florida Auto Insurance Information

Florida Auto Insurance Information


Florida Insurance Quoter is pleased to provide auto insurance in Florida. We offer low cost auto insurance options online even if you have a less than perfect driving record, have never been insured before, have let your policy lapse, or have had your coverage suspended or revoked.

We’ve provided some information below that we hope will be helpful in answering some of the more common questions we’ve received from our customers.
Mandatory Minimum Level of Coverage

Florida’s minimum coverage is $10,000 Personal Injury Protection (PIP) and $10,000 Property Damage Liability (PDL) as long as you have a valid Florida tag, even if the vehicle is in another state or inoperative. There are no exemptions in the law. Additionally, if you have been involved in an accident, or have been convicted of certain offenses, you may be required to purchase Bodily Injury Liability (BIL) coverage.
Frequently Asked Questions Regarding Florida Auto Insurance
What is “Personal Injury Protection” (PIP) insurance?

PIP is coverage that will compensate a loss due to injury regardless of who is charged with causing the crash. PIP applies to bodily injury to you, relatives who live in your home, and passengers who are not required to have PIP, as well as licensed drivers who drive your vehicle with your permission. PIP insurance also protects you if you are injured as a pedestrian or bicyclist as long as the injury is caused by a crash involving a motor vehicle.
What is “Property Damage Liability” (PDL) insurance?

This coverage pays for damages you or members of your family cause (and are liable for) to other people’s property in a crash involving a motor vehicle.
What is “Bodily Injury Liability” (BIL) insurance?

Bodily Injury Liability coverage pays for serious and permanent injury or death to others when you cause a crash involving your automobile. Your insurance company will pay for injuries up to the limits of your policy and provide legal representation for you if you get sued. In particular, your company pays for injuries caused by you or members of your family who live with you, even if they were driving someone else’s vehicle. It may also cover others who drive your automobile with your permission. This coverage also provides you with legal defense in the event you are sued by the injured party.

What if I fail to keep insurance on my vehicle that I have registered in Florida?
The Department of Highway Safety and Motor Vehicles is authorized to suspend your driving privilege, including your vehicle tag and registration, for up to three years or until proof of Florida insurance is provided, whichever is first.

If my driving privilege is suspended because I am not properly insured, is there a penalty to reinstate my license?
Yes. A reinstatement fee of $150 up to $500, for subsequent violations, must be paid and you must provide proof of current Florida insurance.
What if you’re currently driving without coverage?

For a more detailed view of how your policy will look, fill in out instant quote tool online here.

WellCare, United, others cheat Fla. kids program

MIAMI -- Four private health insurers who wrongly claimed they spent millions on patient care in the state's children's health care program also provided coverage to patients in Florida's controversial Medicaid privatization program.

AmeriGroup Florida, Inc., Vista Health Plan, United Healthcare and WellCare were required to spend at least 85 percent on medical services under the State Children's Health Insurance Program in an effort to ensure for-profit companies are not lining their pockets with state funds instead of spending it on patient care.

If an insurer spends less, it must refund 50 percent of the shortfall to the state. Florida health officials should have received $3.1 million in refunds between 2003 and 2007, according to a report by the Department of Health and Human Services' inspector general.

The Associated Press obtained the insurers names as part of a public records request.

United Healthcare spokesman Tyler Mason said in an email that all participating plans with the state program provide quarterly reports for review to ensure payment accuracy and reconcile any issues based upon the contracted Medical Loss Ratios agreement.

The investigation comes as Florida is poised to expand a five-county Medicaid program statewide. Health advocates have criticized the state's lax oversight of the for-profit companies in the Medicaid pilot program, especially as news comes that the same insurers erred in other Florida health programs. Patients in the pilot complained they couldn't get appointments and were denied medications.

AmeriGroup, Vista and WellCare eventually dropped out of the Medicaid pilot, claiming they couldn't turn a profit. United is serving patients in Duval, Baker, Clay and Nassau counties after exiting Broward.

But after Gov. Rick Scott signed bills expanding the program statewide, experts say these companies and others will be clamoring for lucrative state contracts.

Supporters say the bills injected sorely needed accountability into the program, including a yearly, independent audit.

The bills don't require plans to spend certain percentages on patient care and administrative costs, but instead require them to repay profits over 5 percent to the state. To make sure you're covered correctly, have the lowest health rates in the state, contact us here.

Read more: http://www.miamiherald.com/2011/07/27/2333356/wellcare-united-others-cheat-fla.html#ixzz1TV77diGR

Florida Consumer Chief Backs Double-Digit Hikes for Allstate

Florida’s consumer advocate says Allstate’s two Florida home insurers are among the state’s best run and deserve double-digit rate increases along the lines they have requested.

The Allstate units, Castle Key Insurance Co. and Castle Key Indemnity Co., which insure 266,000 homes, are seeking average rate increases of 31.2 percent and 35.7 percent, respectively. With their 800 agents, the two companies represent the fourth and sixth largest home insurers in the state.

At a recent public hearing, the insurers found unexpected support from the state’s Office of Insurance Consumer Advocate. Steve Alexander, actuary for the consumer office, said that out of the 47 Florida-exclusive insurers providing homeowners insurance in the state, the two Allstate insurers are among the most efficient when it comes to costs. “They have some of the lowest expenses in the state, which I think is a real plus,” he said.

He also applauded their willingness to do business in Florida with all the risk that entails, when they could be earning a guaranteed quarter of a point on a one-year U.S. Treasury bond.

Alexander recommended that Castle Key Insurance Co.’s proposed 31.2 percent increase be reduced to 23.7 percent. He also recommended that Castle Key Indemnity’s proposed 35.7 percent increase be increased to 46.9 percent on the basis that it be phased in over a two year period

Within his recommendation, Alexander suggested that Castle Key receive no increases for debt service or contingency fees, he did recommend a profit component of 10 percent, which is slightly higher than the nine percent sought by the companies. He also recommended a 1.5 percent factor for general expenses and a 5.1 percent factor for acquisition and overhead expenses.

Bonnie Gill, vice president for Castle Key, said double-digit rate increases are needed to shore-up the insurers’ claims paying ability in the event of single or multiple-year storms. She said that even without any recent major losses, the companies are not raising enough cash. At the same time, by law, the Florida Hurricane Catastrophe Fund is also scaling back the amount of reinsurance it can offer companies.

“With our ongoing losses since 2006, we don’t have enough money to cover claims,” Gill said, adding that the companies combined surplus dropped by three percent last year.

Gill said that due to the state catastrophe fund’s scaling back, the companies had to spend $143 million to secure $900 million in private reinsurance, a price tag that represented more than half of the companies’ annual premiums.

OIR Actuary Bob Lee noted that Castle Key used the new AIR-12 hurricane model, which was recently approved by the Florida Commission on Hurricane Loss Methodology, which had an effect on the companies’ exposure.

Shantelle Thomas, senior actuary for Castle Key, defended the AIR model’s use. “We believe the new model is the best to date and that it should be considered in the rates,” she said.

Earlier this year, the Castle Key insurers announced they would no longer write new business. Thomas said the companies are considering a number of other underwriting changes depending on the results of the hurricane season, its loss experience, and a review of credits to policyholders for taking steps to strengthen their homes. To make sure you have the lowest insurance costs and best coverage, contact us here.

Feds Moving on Health Care Law, Gov. Scott Not Budging

Federal regulators charged with implementing the Affordable Care Act stated Monday they are trying to work with states to start up the law’s health care "exchanges" -- exchanges are one-stop consumer markets for buying insurance.

But they said they will install a federal health care exchange if a state refuses to set one up on its own.

The news carries weight for Florida, because Gov. Rick Scott, who first came onto the political scene as a staunch opponent of the federal overhaul of health care signed into law by President Barack Obama last year, is not moving from his stance that state agencies should not begin implementing the law.

The health care exchanges -- scheduled to be in place by January 2014 -- are touted as a more transparent way for individuals to compare health insurance policies’ coverage and prices online, over the phone or in person. They can be set up by the states themselves, done locally or regionally, or operated by a nonprofit, or can be done in partnership with the federal government.

States will be in charge of selecting plans in the exchanges, but they must meet minimum coverage and quality standards set forth by the federal Health and Human Services agency. Those standards are scheduled to be released later this year.

HHS officials said the guidelines for the exchanges give states enough flexibility to adjust the federal exchanges to their unique circumstances, but the final say on what plans qualify will remain in federal hands.

“In terms of setting up an exchange and meeting minimum standards, those would still apply,” said Steve Larsen, HHS director of the Center for Consumer Information and Insurance Oversight.

The proposals and claims of flexibility for states did not thaw Scott’s position on the law, or its implementation.

“As proposals, we are not about to change our policy to start implementing Obamacare,” Scott spokesperson Lane Wright said.

Under the law, states must get approval from HHS for their exchange plan by January 2013, but a conditional approval can be given if a state is on track to be ready to implement its exchange plan by January 2014.

Larsen held out hope that states would get on board and begin to lay the groundwork for the exchanges; he stated the federal government would be ready to step in and impose an exchange system if a state did not do so.

“If a state on January 2013 has not received approval or conditional approval, then we would be able to have an exchange in place by 2014,” Larsen said.

Yet most states are trying to avoid the federally imposed exchanges.

Two federal judges have declared the Affordable Care Act’s individual mandate, which imposes a tax or penalty on individuals who do not obtain health insurance, unconstitutional. One of those rulings came from a Pensacola judge in a lawsuit filed by Florida and 25 other states against the health care law. The Atlanta 11th Circuit Court of Appeals heard oral arguments in the case last month but has yet to issue a decision. In a separate lawsuit, the 6th Circuit Court of Appeals upheld the individual mandate as constitutional last month.

The issue will likely be settled by the U.S. Supreme Court, but in the interim, states opposed to the Affordable Care Act are caught between readying themselves for it, or counting on its cancellation by the courts.

“All we know is that a (federal judge) in Florida has ruled it unconstitutional, so we’re not going to be implementing it,” Wright said.

Scott stated in February, after the ruling in the Florida case, that he did not anticipate the law being upheld and he would not move to implement it until its legal fate was settled. He insisted that Florida would be ready if the law was deemed constitutional, despite the lack of preparation.

“I personally always believed it was going to be repealed. We are not going to spend a lot of time and money with regard to trying to get ready to implement it,” Scott said at the time. To make sure your coverage for your health is up to date and affordable. go to our site.

Florida Homeowners Coverage Problems Resolved?

It is the biggest gamble - homeowners insurance in Florida time at the helm of state government, one still condemned as reckless, irresponsible and a disaster waiting to happen.

Indeed, average property insurance premiums in Florida have fallen 16 percent since the Legislature approved a Crist-led reform package in the governor's first month in office in 2007.

And Citizens, the state-run insurer that is now Florida's largest insurer, has seen its reserves more than triple, making it more able to pay off storm damages.

The changes are dramatic when contrasted with what confronted the state just a few years ago, when runaway insurance costs were considered the No. 1 problem facing Florida.

From 2003 to 2006, average property insurance premiums nearly doubled, going from $949 to $1,635 annually, according to the state Office of Insurance Regulation.

More double-digit increases were forecast in 2007 and beyond as insurance companies sought to make up for nearly $40 billion in losses from eight hurricanes and four tropical storms that hit Florida in 2004 and 2005.


To make sure your florida homeowners coverage is up to date, please contact us here.

Seniors caught between cancer and the cost of treatment

Seniors caught between cancer and the cost of treatment

Seniors caught between cancer and the cost of treatment and get help from the Florida Insurance Quoter.


Advancements in the treatment of cancer have led to chemotherapy now being available in pill form, as opposed to the traditional intravenous administration.
But because Medicare Part D plans are permitted to charge exorbitant copayments for the newest cancer drugs, which can run into the tens of thousands of dollars per year, many seniors may be forgoing life-saving treatment.

New research suggests that because of the sky-high cost of these drugs, one in six such beneficiaries elects not to fill his prescriptions. Medicare officials have not been able to determine whether these patients are getting older and less expensive drugs or whether they are abandoning their treatment altogether.

For their part, Medicare insurance companies point the finger at the pharmaceutical companies, who they say are gouging a vulnerable segment of the population. In fact, some of these “blockbuster” drugs were developed using taxpayer-funded research. Predictably, big pharma blames the insurance industry for charging a higher co-payment for drugs than for some other medical services.

Still others fault the entire program, which allows insurers to place certain costly drugs in a higher tier than others and charge copayments of 25 percent of the cost of the medication. These “specialty tier” drugs are not covered by Medigap. “This is a benefit design issue,” said Avalere Health president Dan Mendelson, according to the Associated Press. Currently, there are no plans to restructure Medicare Part D.

For more on cancer, see:

Seniors fear cancer and Alzheimer’s

Health update: New 'virtual' colonoscopy

Costly Provenge gets Medicare seal of approval

Advancements in the treatment of cancer have led to chemotherapy now being available in pill form, as opposed to the traditional intravenous administration.
But because Medicare Part D plans are permitted to charge exorbitant copayments for the newest cancer drugs, which can run into the tens of thousands of dollars per year, many seniors may be forgoing life-saving treatment.

New research suggests that because of the sky-high cost of these drugs, one in six such beneficiaries elects not to fill his prescriptions. Medicare officials have not been able to determine whether these patients are getting older and less expensive drugs or whether they are abandoning their treatment altogether.

For their part, Medicare insurance companies point the finger at the pharmaceutical companies, who they say are gouging a vulnerable segment of the population. In fact, some of these “blockbuster” drugs were developed using taxpayer-funded research. Predictably, big pharma blames the insurance industry for charging a higher copayment for drugs than for some other medical services.

Still others fault the entire program, which allows insurers to place certain costly drugs in a higher tier than others and charge copayments of 25 percent of the cost of the medication. These “specialty tier” drugs are not covered by Medigap. “This is a benefit design issue,” said Avalere Health president Dan Mendelson, according to the Associated Press. Currently, there are no plans to restructure Medicare Part D.

For more on cancer, see:

Seniors fear cancer and Alzheimer’s

Health update: New 'virtual' colonoscopy

Costly Provenge gets Medicare seal of approval


WASHINGTON BUREAU -- The U.S. Government Accountability Office (GAO) says Internal Revenue Service (IRS) top managers must do more to ensure smooth implementation of the Patient Protection and Affordable Care Act (PPACA).
IRS officials are not doing enough to ensure on-time and on-target implementation of the 47 PPACA provisions that it will be responsible for complying with through 2018, James White, a GAO director, writes in a report summarizing the GAO's findings.

“While implementation for some provisions is years away, making improvements to the planning process now would reduce risks and might minimize future problems,” White says.

To ensure compliance, the IRS “must improve aspects of its planning, particularly at an agencywide or strategic level,” White says.

The RS has defined strategic-level goals and project plans in multiple documents but has not integrated the goals or plans, White says.

White says the GAO has given briefings to members of Congress and their staff on its findings, starting June 8, in response to lawmakers' concerns that the IRS would not be able to properly implement PPACA provisions on their effective dates.

In its briefings, GAO officials have said that the IRS management team has not developed a timeline for developing performance measures and collecting associated data.

The IRS also has not provided a cost estimate for all of PPACA, and the risk management framework does not assure that all risks, especially strategic-level risks, are identified and analyzed, White says.

The GAO is recommending that the commissioner of Internal Revenue move to define program goals and develop a project plan in one document that effectively integrates all aspects of the program.

The GAO also is recommending that top IRS managers document a schedule for developing performance measures that link to program goals and develop a more complete cost estimate that is consistent with the GAO Cost Estimating Guide.

Top managers also should modify and document the IRS risk management approach, to have more assurance that all risks, including strategic-level risks for the program, “are identified and analyzed, and that mitigation options are assessed,” White says.

The GAO acknowledges that the IRS management team has generally followed leading practices in planning to implement the PPACA provisions, White says.

The GAO also acknowledges that top IRS leadership has been involved; that cost estimates for information technology projects have specified ground rules and assumptions, data sources, and supporting calculations; and that work has started on compliance controls.

White notes that risks are being identified and analyzed at the individual project level.

OTHER COVERAGE THE IRS ROLE IN IMPLEMENTING PPACA FROM NATIONAL UNDERWRITER LIFE & HEALTH:
IRS Gives Nonprofit Plans, Hospitals More Time to Comply with PPACA
PPACA: IRS Starts to Design Health Plan Quality Research Fee
PPACA: IRS Looks at Group Health Definitions
IRS Might Issue ACO Guidance
PPACA Stars at IRS Budget Hearing

To make sure you are up to date on this and all medicare information, contact us at here

Take Care Of Your Health

It's time to take charge of your health! Schedule an appointment with your health care provider to discuss what preventive health services you need and when you need them.

You may also want to start a campaign in your community (i.e. a faith-based setting, workplace, school, or civic group) to encourage others to make an appointment for a check-up or health screening on National Women's Check-Up Day (the day after Mother's Day each year) or National Men's Health Week (the week before Father's Day each year).

Why are Check-Ups Important?

Regular health exams and tests can help find problems before they start. They also can help find problems early, when your chances for treatment and cure are better. By getting the right health services, screenings, and treatments, you are taking steps that help your chances for living a longer, healthier life. Your age, health and family history, lifestyle choices (i.e. what you eat, how active you are, whether you smoke), and other important factors impact what and how often you need services and screenings.

To make sure you have the most savings in health insurance, contact us at

Florida Federal Judge Declares Individual Mandate and the Reform Law Unconstitutional Appeal to Supreme Court Likely

PPACA Still the Law of the Land

Since the individual mandate is not effective until 2014, the court’s ruling has no immediate impact and does not affect ongoing implementation of the PPACA. Unless and until the Supreme Court decides otherwise, the law remains in effect.

CIGNA is continuing its PPACA implementation and remains compliant with those provisions already effective.

On Jan. 31, 2011, Florida U.S. District Court Judge Roger Vinson, declared the "individual mandate" of the Patient Protection and Affordable Care Act (PPACA) unconstitutional, ruling the government cannot require Americans to purchase health insurance starting in 2014. Vinson concluded that, "Because the individual mandate is unconstitutional and not severable, the entire act must be declared void."

The Department of Justice will appeal the decision in this case, which was filed in March 2010 by Florida and joined by 25 other states. The constitutionality of the individual mandate is expected to eventually be decided by the Supreme Court.

In December 2010, a Virginia federal district court decided against the individual mandate, but didn't declare the entire law unconstitutional. Two earlier decisions in Virginia and Michigan found the mandate constitutional. Other cases are pending while several other lawsuits have been dismissed.

Under the PPACA, starting in 2014, individuals must be enrolled in a health insurance plan that meets basic minimum standards. Health care exchanges, also starting in 2014, will provide a new insurance marketplace where individuals and small businesses can buy qualified health benefit plans.

Next Steps

It's still unknown if the Supreme Court will agree to bypass the federal appeals courts and hear the appeal of one of the federal court decisions. It's likely to be some time before there's a final decision. For updated information as the case progresses, please visit www.floridainsurancequoter.com

For more information or to see if your health policy is current with health care reform visit us at www.floridainsurancequoter.com.