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A Castle Group Health Inc Blog
Health and Life Insurance

New Guarantee issue health insurance law in Illinois

Effective June 1, 2009,  Illinois has a new law taking effect regarding children being able to stay on their parents coverage until Age 26, as long as the child is not married.    

This law change is well known and documented in Illinois, but there is a component of the law that is not very well known.  Carriers are being very tight lipped about it.   To my knowledge, I have not seen any carrier sending out it's sales force of agents, any documentation on the subject.    

Under the new law, and subject to some yet undefined interpretation, NO DEPENDENT CHILD CAN ...<< MORE >>

COBRA and the Stimulus Bill - 2009

Q. Does the Economic Stimulus have anything to help me with Health Insurance costs?

If you were laid of since September 1, 2008, or in 2009, the answer is Yes.

The House of Representatives on a 246-183 vote Friday gave final approval to a massive economic stimulus bill that would provide a 65% federal COBRA premium subsidy for nine months for employees who are laid off between Sept. 1, 2008, and Dec. 31, 2009.

The legislation, among other things, would require employers to locate employees laid off since Sept. 1, 2008, who declined COBRA to tell them they have a new right to opt for the coverage with the government picking up 65% of the premium. Seems easy, but there are complications. The subsidy is financed to the employer through a reduction of employer taxes on wages. The employer must then pass that savings on to you.

Individuals would have 60 days after receiving the notification to sign up for the coverage. The subsidy would apply to COBRA premiums starting March 1. The subsidy, though, would not be available to individuals with annual adjusted gross incomes exceeding $125,000 or couples with incomes over $250,000.

The Senate has approved the legislation, H.R. 1, and awaits the President Obama’s signature.

Not only does this not help small business, but in the long run, it doesn’t really help laid off employees from big business. If you delay getting private insurance, at a lower cost now, because you are enticed into the subsidized COBRA, you might not have the opportunity to purchase insurance, 9 months out. A pregnancy, knee injury, counseling, or medication might make you ineligible down the road. This is a bill that benefits insurance companies, drug companies, and hospitals. If the money was given to you as a voucher, you could decide to purchase the most cost effective option for your family.

(This law will not apply to companies that have less than 20 employees and are not subject to COBRA)

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Outsourcing Healthcare- with a free vacation to boot! Medical Tourism coverage.

The announcement hit my desk like a brick on Waterford Crystal.    If you like this idea, you better think twice next time you complain about highly skilled jobs being lost here in the US and shipped overseas. 

Last week Anthem of Wisconsin announced a pilot program to administer your healthcare overseas.    Instead of having your knee replaced at Milwaukee General , Anthem will fly you and a companion, to an internationally certified hospital overseas for your healthcare.  That's right, your HMO location might be in Mumbai, India.   Ok, ok, it's not for HMO's, and it's not mandatory, but the possibilities are there.

Here's how it works, and these are quotes: 

Once a member decides that he/she may be interested in receiving care overseas, and the member is determined to be a viable medical tourism candidate, an Anthem case manager will begin working with the member. The case manager will coordinate all steps of the medical tourism process; all medical arrangements are handled for the member; all travel arrangements are booked and paid for, both for the patient and a travel companion; and all related medical tourism charges (travel and medical) are covered.  The case manager will also make arrangements for any necessary post-operative care on the member's return to the United States.  Employees who elect to use the international benefit will receive care for their non-emergency procedures at Joint Commission International (JCI) accredited facilities at lower out-of-pocket costs. For example, the U.S. retail price for knee replacement surgery is approximately $70,000, while the same procedure costs approximately $8,500 in India. Therefore, this pilot has the potential to result in thousands of dollars in savings for the employer and member.

Maybe the timing of this is a bit suspect, but this might turn into an interesting trend.  

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How do I know what good coverage is when comparing health policies?


The magic question!  Believe it or not, we do believe that there are some simple ways to narrow the search. When shopping for health insurance, remember that you are looking for protection, not to save $10.  


Here’s a quick check list. 



  • Start with coverage, not the deductible or premium. 

  • Insist on coverage for ...<< MORE >>

What is a COCC? Why do I need it? Why is it important?

A COCC is a Certificate of Creditable Coverage.  This is the proof that you need to provide when you change carriers to prove that you had coverage.   When you leave employment, or your employer changes carriers, a child or spouse drops off coverage, you will receive a COCC.  It is very important for you to hold on to this document for a period of 18 months.  When you change group/employer sponsored health carriers, the law mandates that your new carrier provide credit for your preexisting conditions if you have had continuous coverage for the past 18 months or more.  Many individual plan carriers provide the same credit if you have prior, uninterrupted coverage.     

If you are changing individual coverage, a certificate of creditable coverage is not issued.  Even so, group and individual carriers frequently offer credit for preexisting conditions if you had prior coverage.  Bottom line on this subject is to keep a good record of who was covered, during what periods of time.

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Michelle's Law (HR 2851) -Student Medical Leave

On October 9, 2008,  President Bush signed into law a requirement that insurance policies allow college students who are on their parents health plan to take a medical leave of absense of up to 12 months.  This new law DOES NOT TAKE EFFECT until October 9th, 2009.   

Under current law, if a child lost full time student status, the child would also lose eligibility for coverage under a parents health plan.  

Several states had already passed this provision, check with your local carrier or broker to see if your State already has this legislation in effect. 

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Q. - There has been a lot talk about insurance companies going under. How do I know if my insurance is at risk?

Insurance companies whose primary business is health carry securities on their balance sheet that are shorter term in nature than a company whose primary business is life insurance or property and casualty.   Health insurance carriers take the $1 in and immediately pay out $0.80 of that dollar.   Life insurance companies take in a dollar with the intention of paying out the claim at a much later date.   Health Insurance companies are far more liquid and flexible with their portfolio thus they, for the most part are not affected by the long term debt obligations, tied to ...<< MORE >>

Why should I have health insurance? I am young, healthy and take no medications.


It’s understandable in a tight economy that many young adults today do not find value in having health insurance. The odds are in your favor that if you don’t have health insurance and save your premium that you’ll be ok. The odds are also in your favor if you ...<< MORE >>

What is a pre existing condition and why do health carriers worry about this? When Applying for coverage, do I need to tell the insurer or the agent about a medical issue, and what can happen if I don’t?

What is a pre existing condition and why do health carriers worry about this? When Applying for coverage, do I need to tell the insurer or the agent about a medical issue, and what can happen if I don’t?

The dreaded ‘preexisting condition clause’ is huge implied threat to most people getting ...<< MORE >>

Why are expectant fathers not eligible for health coverage with individual coverage?


Many people don’t realize that MEN can be declined for being pregnant. No, we aren’t talking about something on the Oprah show, we are talking ‘average Joe’. If you are about to be the father of a yet born child, you are not insurable.

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