Steve Taich is our Health Care Insurance member. Steve tackled the difficult subject of Health Care Insurance and the Affordable Care Act (ACA). Now that the ACA is been in effect for one year, some participants are seeing a reduction in their insurance premiums, but that may come at the expense of an increase in the deductible amount they have to pay within the year. Some of the PRO members mentioned that their premiums dropped significantly and several gave example of how their insurance increased. Some of the increases are due to items that have been mandatorily required to be covered that used to be optional. Steve mentioned that insurance companies basically function to process invoices and negotiate prices. Currently most people are receiving less coverage for more money with $3,000 to $6,000 per year deductibles.
Steve described a system known as “Reasonable and Customary” which defines how much a facility receives for their billed amount for services. There is also another mechanism called “Check Master” which influences the payments. Health providers are rated on a scale and one of the factors has to do with their ability to make improvements in the condition for which they are providing services. The whole ACA issue is very complex and it is necessary to have a professional like Steve to guide through the process. Also the deadline is approaching to make coverage decisions for this year. Remember Steve Taich and Assured Insurance Solutions when you hear your associates mention that they have questions about their health care insurance or they need to secure a policy for this year.