Delaware Health Insurance Exchange Guide - Zane Benefits

Delaware Health Insurance Exchange Guide

This guide provides an overview of the Delaware Health Insurance Exchange including the history of the exchange, how the exchange will operate, and exchange information for Delaware residents and small businesses.

Delaware Health Insurance Exchange - Introduction

As an overview, beginning in 2014 as part of the Affordable Care Act (ACA), health insurance coverage for individuals and small businesses will become available through new state health insurance exchanges (also called?health insurance marketplaces).

Most importantly, the key tax credits (e.g. the small business healthcare tax credits) and tax subsidies (e.g. individual health insurance tax subsidies) will only be available for coverage purchased through a state health insurance exchanges.

All states have three options for setting up a state health insurance exchange for 2014:

1. Build a state-based exchange,

2. Enter into a state-federal partnership exchange, or

3. Default to a federally-facilitated exchange.

Delaware has entered into a state-federal partnership exchange. Delaware will manage all plan management and consumer management functions, meaning they will approve and regulate all insurance plans, and provide enrollment assistance and customer service.

The Delaware Health Insurance Exchange will open October 1, 2013, with coverage beginning January 1, 2014.

Delaware Health Insurance Exchange - History

According to the Delaware state website (www.delaware.gov), in December 2012 Delaware was the first state to receive conditional approval from the Department of Health and Human Services (HHS) to operate a state-federal partnership exchange. Delaware?s decision to create a state-federal partnership was driven by a state analysis focused on finding the most cost effective way for the state to maintain control of the Exchange. A partnership model allows for less financial risk to the state, while helping to maintain in-state knowledge for coordinating coverage and seamless transitions among Exchange plans and major public coverage programs such as Medicaid.

Click here for more information on exchange planning efforts in Delaware.

Delaware Health Insurance Exchange - What Is It?

The Delaware Health Insurance Exchange will be an online marketplace where Delaware individuals, families, and small businesses can compare health plans and select a plan that fits their needs and budget. Starting in October 2013, Delaware residents will be able to access information about all the plans available through the Exchange.

According to Senator Tom Carper ?individuals and small businesses in Delaware will gain the same purchasing power as large companies, and be able to compare, shop for, and choose insurance plans in an online marketplace that best meets both their health and financial needs.?

A key part of the Delaware Health Insurance Exchange is that eligible individuals and families will be able to access individual premium tax subsidies, capping the cost of their premium between 2% to 9.5% of income. Eligibility is based on household size and income (up to 400% FPL). The Exchange will also screen for Medicaid and public assistance programs.

According to an estimate by healthcare.gov, approximately 71,955 or 10% of Delaware?s non-elderly residents are uninsured, of whom 61,846 (86% of these) may qualify for either tax subsidies to purchase coverage in the Marketplace or for Medicaid, if Delaware participates in the Medicaid expansion.?

The Delaware Small Business Health Options Program ?SHOP? Exchange will be available for small businesses who do not offer employer sponsored insurance. Per federal guidelines, in 2014 employers will be able to select one plan to offer to their employees; in 2015 and onward, small businesses will be able to let their employees choose coverage from a number of plans. The SHOP Exchange will be available for small businesses with the principal place of business located in Delaware, or with employees who work in an office in Delaware.

An estimated 100,000 Delawareans will be eligible for coverage through the Exchange in 2014. According to the Delaware Department of Health and Social Services Secretary Rita Landgraf, about 35,000 are expected to participate.

Delaware Health Insurance Exchange - What Plans Will be Available?

All plans offered through the Delaware State Partnership Health Insurance Exchange will meet the ACA definition of a Qualified Health Plan (QHP). The plans will be offered by level of coverage for essential health benefits (EHB), to allow consumers to compare plans on an "apples to apples" basis. The four "metal" levels are: Bronze (plan pays 60%), Silver (plan pays 70%), Gold (plan pays 80%) and Platinum (plan pays 90%).

According to the Delaware Health Care Commission, the state will complete its review of QHPs and stand-alone dental plans and make recommendations for certification by July 31, 2013.

The online consumer portal for the Delaware Health Insurance Exchange is expected to be launched in late summer 2013.

Delaware Health Insurance Exchange - Role of Insurance Professionals & Navigators

The Delaware Health Insurance Exchange will follow federal guidelines for insurance professionals selling policies through the Exchange.

Agents and brokers will be permitted to enroll individuals and small businesses in a qualified health plans (QHPs) through the Exchange, and receive any commissions directly from the carriers as they do today. The agent or broker must meet requirements including an agreement, training, and registration.

Navigators will provide a specialized level of outreach and assistance to at-risk populations in the state. It is anticipated that $600,000 will be provided for the Delaware navigator program.?Additionally, Delaware will also have Marketplace Assisters (MPAs) trained and certified to provide outreach and customer assistance.?Both MPAs and Navigators will be under supervision of the state.

Click here for more information about Delaware?s agent and broker involvement.

Note: This should not be taken as legal or tax advice.

Source: http://www.zanebenefits.com/blog/bid/298302/Delaware-Health-Insurance-Exchange-Guide

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Boy Waiting for Lungs Happy for Sarah Murnaghan

Jordan Peterson is 10 years old, suffers from cystic fibrosis and is on the pediatric lung transplant waiting list -- just like Sarah Murnaghan, the Pennsylvania girl who received a lung transplant Wednesday after her family successfully sued to make her more likely to get lungs from an adult donor.

Medical and legal experts have criticized the judge for sidestepping Organ Transplantation and Procurement Network policy, but Jordan is just happy to see another cystic fibrosis kid get a lucky break.

"I'm very happy for her 'cause, you know, she needed 'em more than I did, and she was on a ventilator and she was dying, so I was definitely really happy for her," Jordan told ABCNews.com from Houston, where his family relocated in September 2012 to be within a few hours of Texas Children's Hospital. They're originally from Fargo, N.D., but since Jordan's doctors are in Houston, they needed to be nearby in case donor lungs became available.

Although the nation has been focused on Sarah for the past few weeks, other patients awaiting organ transplants have been left to watch the story unfold and wonder what it means for them.

Dr. Sander Florman, who directs the Mount Sinai Recanati/Miller Transplantation Institute, said his patients awaiting liver and kidney transplants have already asked whether legal action might be the best way to get the organs they need.

Girl, 10, Wins Court Battle, Gets Lung Transplant Watch Video Mom on Lung Transplant: 'New Beginning for Sarah' Watch Video Girl, 10, Denied Lung Transplant Due to Age Policy Watch Video

"I said, 'It wouldn't be fair for you to do this and be successful,'" Florman said. "Go promote organ donation. ... That's what all physicians should be telling people, what the judge should be telling people."

On the flip side, Dr. Alan Reinach, a pulmonologist who works at Holy Redeemer Health System outside Philadelphia, said patients have neither asked him nor his colleagues about how Sarah's case would affect them.

Sarah's family argued that the so-called Under 12 Rule, an organ transplant policy, had been unfairly pushing Sarah to the bottom of the adult lung transplant waiting list because it required adult lungs to be offered to adults before they could be offered to anyone younger than 12.

Learn more about how the Under 12 Rule works, what the OPTN decided to change about it

Her lawyers convinced federal Judge Michael Baylson on June 5 that the Under 12 Rule was discriminatory, prompting a temporary restraining order against Health and Human Services Secretary Kathleen Sebelius to prevent her from enforcing it for Sarah.

Baylson's ruling forced OPTN to create a second organ transplant database entry for Sarah with a fake birthday to trick the system into thinking she was 12 years old. On June 12, she got her transplant, which involved having the adult lungs resized to fit her 10-year-old body. It's the 11th lung transplant from a donor older than 18 to a child younger 12 since 1987.

Although Jordan's father, Dan Peterson, said he understood Sarah's situation was dire, it prompted him to ask Jordan's doctor questions about how the ruling would affect other people on the waiting list. Would it "reshuffle the deck?" he wondered. It's still not clear.

But Jordan had different questions.

"The press used the term 'end stage cystic fibrosis,'" Peterson said. "His biggest question was about that and when that was going to hit him."

But when she got lungs and was doing well after surgery, Jordan was relieved.

"He was thrilled," Peterson said. "His next words were 'OK, I'm next.'"

Source: http://abcnews.go.com/Health/child-lung-transplant-waiting-list-happy-sarah-murnaghan/story?id=19405015

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What Emily Post Can't Teach Us About 'Netiquette'

True story: When I was in middle school, my mother sat my brother and me down at the dining room table to give us lessons from Emily Post's big blue bible called Etiquette. Fold your napkin when you leave the table. Start with the silverware on the outside and work your way in. A lot of those lessons still apply today. But you know what we don't need? Those century-old tropes being applied to how we live our digital lives.

Emily Post's great-great grandson Daniel Post Senning disagrees; just published a guide for online etiquette called Emily Post?s Manners in a Digital World: Living Well Online. And it is... well, it's a little silly. From the introduction:

Photo sharing itself is a huge topic. The etiquette of tagging and posting raises questions about what's respectful, and whether to ask permission before posting.Facebook, Twitter, LinkedIn?I'll talk a look at the major sites and their manners and subcultures. Online gaming is one of the biggest internet communities around, with its own rules of engagement. Dating is fast on its heels, though, and we'll talk about the art of finding love online. Never far from anyone's mind (thanks to that smartphone!) is work. Navigating job interviews that might pull up your Facebook page right then and there and avoiding accidental Twitter overshares are just a few of the things that are part of what it means to assess and be smart about digital appropriateness in the workplace today.

A few questions come to mind after reading that. First, what is LinkedIn subculture? Is it like weird Twitter but for professionals? Second, is this how Martha Stewart will navigate Match.com?And if the line about that smartphone didn't kill you, let's get into Senning's know-how on a couple of familiar platforms for those who don't, well, know how:

On how to find something: Need to know something or how to do something? The Google search is a new norm for finding out anything instantly.

On tweeting: Be sure to engage in the back-and-forth of the Twitter conversation.

On friending someone on Facebook: In real life it can be impossible to ignore someone who is reaching out to you. Maybe this is why Facebook changed the option.

On emailing: As a general rule, don?t open e-mails that don?t have a subject line.

On leaving voicemails: Model the behavior you?d like to see in others. (Editor's note: please do not leave voicemails).

Senning's not necessarily wrong, and his advice isn't totally misguided. It just reads with a detachment that you'd expect from someone who doesn't really use the internet at all. You could easily imagine your grandmother sitting in front of a giant old desktop computer reading the book through a pair of horn-rimmed glasses on the tip of her nose, nodding sincerely.

We've had the internet long enough that interacting online is turning into a natural thing. Hey, most people don't even lie about online dating anymore. There's no a separate set of instructions for living a life on the internet and living a life outside of that. It's all the same: Be respectful. Be yourself. No punch-backs. If anyone should understand that, it's the people who wrote the book on etiquette in the first place.

Image credit: Shutterstock/Everett Collection

Source: http://gizmodo.com/what-emily-post-cant-teach-us-about-netiquette-513423651

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Achy-breaky breakup: Billy Ray Cyrus to divorce

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9 hours ago

Jason Merritt / Getty Images file

Billy Ray and Tish Cyrus in 2011.

Billy Ray Cyrus' heart might be achy breaky again. The country star's wife, Tish, mother of singer Miley, filed for divorce Thursday after 19 years of marriage.

"This is a personal matter and we are doing what is in the best interest of our family," the couple said in a statement. "We ask that you respect our privacy at this time."

After the news was announced, Tish Cyrus retweeted a tweet from Christian singer Tammy Trent that read, "God never promises the absence of storms. He just promises to walk with us through them!"

Back in 2010, it was Billy Ray who filed for divorce, but the couple later reconciled. "I want to put my family back together," he said at the time on "The View."

Rumors at the time forced rocker Bret Michaels to appear on "Fox & Friends" to deny a romantic relationship with Tish Cyrus.

Tish and Billy Ray wed in 1993, the year after Miley was born. They have two other children together and both have adult children from previous relationships.

Source: http://www.today.com/entertainment/miley-cyrus-parents-divorce-three-years-after-reconciliation-6C10326370

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Sandra Bullock screens comedy "The Heat" in London

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Source: http://feeds.reuters.com/~r/reuters/USVideoEntertainment/~3/sVJ2YzXrwe4/sandra-bullock-screens-comedy-the-heat-i

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European growth still on US agenda, not as loudly

WASHINGTON (AP) ? A year after President Barack Obama made an emphatic pitch to Europe's economic powers to focus more on economic growth than austerity, much of the eurozone remains mired in or near recession. Obama's appeals have had mixed results in softening the demands on some of the most debt-ridden European nations to cut their spending.

Still, the region's crisis is no longer perceived as an urgent threat to the global economy, and while the U.S. still wants Europe to temper the debt trimming and increase global demand, Obama is not expected to be as insistent with other leaders of the Group of Eight industrial nations when they meet in Northern Ireland next week.

Last year, the G-8 leaders assembled at the Camp David, Md., presidential retreat in the aftermath of European elections that represented a revolt against the austerity measures pushed by German Chancellor Angela Merkel. When Obama greeted Merkel and asked how she had been, the German leader merely shrugged. "Well, you have a few things on your mind," Obama replied then.

These days, the furor has died down, high-debt nations have been given more time to work on their fiscal cuts, and even the language has changed from "austerity" to "growth-oriented structural reforms."

"Relative to last year, things are somewhat better in that the European situation is more contained," said Matthew Goodman, a former Obama international economics adviser now at the Center for Strategic and International Studies. "The risks that people were worried about have been somewhat diminished."

The economic picture remains bleak. The eurozone economy contracted about 0.8 percent in the first quarter, compared with the same period in 2012. Among the G-8 members, Italy and France saw their gross domestic product shrink 2.4 percent and 0.4 percent respectively over the first quarter of 2012. Germany, the region's largest economy, and Britain saw modest growth in the first quarter, but still sharply lower than other G-8 members.

Russia saw annual growth of 1.6 percent in the first quarter, the U.S. grew at 2.4 percent, Canada at 2.5 percent and Japan at 4.1 percent.

"The European Central Bank continues to be too tight," said Robert Shapiro, a former commerce undersecretary who also advised former President Bill Clinton. "The debate over austerity is far from over in England or in Germany. Moreover, right under the surface of all this remains the sovereign debt crisis. It has not been resolved."

As a result, administration officials and former government economic advisers say Obama and his aides will still push European nations to moderate their austerity programs of spending cuts and tax increases in favor of more stimulus to boost growth and counter the high unemployment that still afflicts many countries in Europe, particularly Spain and Greece.

Germany and Britain have resisted some of the U.S. entreaties, arguing that heavily indebted European nations must trim deficits to restore market confidence and lower government borrowing costs.

"I think, I hope, that the Obama administration realizes that its policy messages about cooling it on the austerity and start stimulating haven't worked in Europe," said Heather Conley, director of Europe programs for the Center for Strategic and International Studies in Washington who worked in President George W. Bush's State Department. "And this has been actually an area of growing tensions underneath the surface. It's private. They don't allow these to come more publicly, but it's really been quite, you know, a point of contention."

Japan's growth, however, stands as a potential example of the benefits of raising domestic demand. Questions remain whether the efforts of Japanese Prime Minister Shinzo Abe are sustainable. So-called Abenomics have also raised worries among U.S. manufacturers that Japan's real goal is to weaken the yen as a way to gain trade advantages.

Administration officials say they believe that they can make a compelling case by using the United States as an example of how to help the economic recovery without deep budget cuts. The Obama administration responded to the recession with a massive stimulus package in 2009. Officials argue that increased economic activity and a turnaround in the housing industry have helped increase revenues and lower the deficits.

But the U.S. deficits have also been lowered through steps that could also be deemed austerity measures, including a tax increase on wealthy Americans, restoration of a payroll tax on all workers and automatic budget cuts that kicked in March.

Associated Press

Source: http://hosted2.ap.org/APDEFAULT/89ae8247abe8493fae24405546e9a1aa/Article_2013-06-14-Obama-G-8%20Summit/id-b6359295e39c420e8b21d85b92d85dc4

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Apple tells price fixing courtroom it owns 20 percent of the e-book market

Apple director Keith Moerer said in court on Tuesday that the company holds about 20 percent of the US e-book market, double the size commonly assumed. The revelation came after the Department of Justice tried to bolster its price fixing case against the company by asserting that "Apple forgot to focus on customers, that's why the iBookstore is a failure." Moerer responded that the online store has consistently held a 20 percent share since just after launching, adding that "sales grew 100 percent last year at the iBookstore and it had over 100 million customers." The government will continue trying to prove that Apple colluded with publishers like Macmillan and Harper Collins -- who settled out of court -- with testimony later today from Senior VP Eddy Cue.

Filed under: Apple

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Source: Publishers Weekly

Source: http://feeds.engadget.com/~r/weblogsinc/engadget/~3/zpCuQ5Zcqq8/

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