Myths from Official Government and Respected Sources SBA

Hi,

I haven’t been blogging much lately.  I feel that it’s better to just update or add a new webpage for the current information on how to get coverage under Health Care Reform or Life, Long Term Care, Medicare that wasn’t affected.   Here’s an update on the situation about the government or their entities misinforming the public and preventing any corrections.  This is a copy of the email I’m sending to Covered CA.

10.24.2013

Gentlemen,

 I posted a link on Covered CA’s Facebook page, to my webpage with the PCIP and Mr. Mip brochure application and now I’ve been blocked from commenting.  My posting was in response to a visitor’s comment that one could not get any coverage if they had a pre x in the past.  The post was certainly NOT advertising, as PCIP failed and Mr. Mip will soon be moot, if not now, due to the 3 month pre x period.

 Sometime back, I went to a Town Hall led by Congresswoman Janice Hahn, where the Rep. from the SBA stated that under current law, one could not get ANY coverage at all if they had a Pre X condition and that Small Biz could be denied for Pre X.  When I raised my hand to correct this, I was rudely informed by an aide that I couldn’t interrupt the SBA.  In addition, the rep. from Small Biz Majority sent me an email that one must NEVER interrupt anything from a well-respected Congresswoman.   I’ve asked for a refund of my last campaign donation, as Ms. Hahn’s office never contacted me for further information, as promised on AB 1672 or Mr. Mip.

When I went to the Covered CA licensing seminar in Culver City, several of the questions that were answered were incorrect.  I have not had a response from Covered CA on those emails.   I did get a response to the new definition of Employer from the Facebook page though.

 Maybe Health Care Reform would be working better, if the legislature understood current law and practice and if the public was not deliberately misinformed, in violation  of our trust in our leaders and law.

 I will be posting a copy of this letter to my blog, where you are welcome to respond.

 Steve

Be careful, many of the myths and misinformation are coming from official sources.  I saw an example at a seminar today.  If a LICENSED agent did this, there would be severe repercussions, even the loss of their license for 3 years.  There are also penalties if ANY person…misrepresents coverage.

Highlighted and bookmarked pdf  CA.law.misinterpretation  780.et.seq

The CA Dept. of Insurance is very concerned about unlicensed persons helping the public get enrolled and the potential for fraud when they ask for  your personal information.  CHCF 7.15.2015

Excerpts from SBA Fact Sheet

For the first time, individuals and business owners are able to make side-by-side comparisons to find a plan that fits their budget and that’s right for their families, businesses, and employees.

Quote Engines showing prices and comparisons for families and business have been on mine and dozen of  other agent websites for years.

CA Law since 1992 AB 1672 Insurance Code 10705  (5) (d) (1) requires agents and insurers if requested  to show all plans offered by the carrier the agent is presenting.

The exchange will not be showing all the plans being marketed, as some carriers did not choose to be in the exchange or the exchange didn’t think they qualified.

“80/20” rule requires that at least 80% of premium dollars collected by insurance companies for individuals and small employers must be spent on benefits and quality improvement.

This is good…. but it was pretty much the case in CA for years, with Insurance Companies being mandated to inform the public of their loss ratio. (Citation to follow)   More on Medical Loss Ratio in Health Care Reform

On October 1st, individuals and small businesses can buy affordable benefit plans by enrolling in the new Individual and Small Business Health Insurance Options Program (SHOP) Marketplaces.

I don’t know if we can call this misrepresentation… but all the plans offered in the exchanges, must also be offered outside the exchange, so why not let the public know?  Also, this is from the SBA whose mission is

The voice of small business on Capitol Hill since it was created in 1976, the Office of Advocacy works to protect, strengthen and represent the interests of the nation’s small businesses within the Federal Government. (http://www.sba.gov/about-sba)

So, wouldn’t you think they would support the Small Biz Insurance Agents rather than telling the public to go to the exchange and bypass Small Biz?  Congress recognizes the value of agents.  Especially since there is no extra charge!

The slide show did mention that agents had a role in the SHOP program for Employer Groups.

There was other misinformation presented at the seminar that I went to, but I don’t have it in print.

The SBA said that Small Biz currently could be DENIED coverage if there were Pre Existing conditions,

this is not true.  AB 1672 10705 (g)

They also said that the SHOP program required two or more employees.

Covered CA states on their website:  Covered California is developing a marketplace specifically designed for small businesses with one to 50 eligible employees. http://www.coveredca.com/small_businesses.html  See our blog for citation showing that a single owner – sole proprietor is an employee under AB 1083

When I asked for clarification on sole proprietor businesses, the representative from www.SmallBusinessMajority gave me an incorrect and condescending reply. She also stated both verbally and in writing that I should never bring up anything wrong in front of an elected public official.  I’m not posting that email, as I expect a retraction.  I also asked for the exact citation as to why the representative thinks my reading of Black Letter  law is incorrect.

The public official is not being named as I am NOT making any formal complaints and the public official had two staff members ask me about AB 1672.  Google recognizes me in the top 5 unpaid listings for this law, at least until I started this new website and haven’t finished all the 301 redirects.  The public official specifically told a staff member to contact me next week for further clarifications.

On the other hand it’s been reported –

Michael Lujan was very explicit in 2 presentations to CAHU and LAAHU, an EE is someone who is listed on a DE9C.  Sole Proprietors and partners are normally not on a DE9C.  The sole prop and partner can be included in a group plan IF they have at least one W2 EE listed on the DE9C.

On the www.SmallBusinessMajority.org website they tell you that if you currently do not have coverage and have Pre X conditions to check out PCIP.  They don’t tell you that PCIP STOPPED writing new business back in March

Nor do they mention MR MIP, which the SBA implied did not exist, as they said there was presently no way for uninsurable individuals to get coverage.

I will grant that keeping a website up to date is tough.  My new website allows for comments on every page.  If you see something that needs correction or clarification, please let me know.

I trust the SBA and www.SmallBusinessMajority.org will make the corrections on their website and before they make any further presentations.  I will send their representative a copy of this post.

I welcome any corrections or explanations anyone might have.  I do ask that if any “FACTS” law or regulations are mentioned,  that the URL to the law… be given for the post to be approved.

 

 

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  1. […] our opinion that under Health Care Reform that ONE employee business, even if it’s just the owner can get GROUP coverage.  There is  some dissenting opinion.  We’ve sent a email to Covered CA for […]

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