Did you have time to read the 1,990 page healthcare bill that was recently passed through Congress? Have you since wondered about the impact that massive bill will have on the average American, health insurance providers, business owners and YOU? If yes, then join the Young Professionals of Chicago as we host a panel of diverse health care professionals that will be discussing current healthcare reform and taking questions on the impact of the United States' new healthcare policy. The distinguished panelists will also provide some insight and clarity into what this massive bill means for individuals like you. There will also be an opportunity for open networking with other young professionals before and after the discussion.
Obamacare in Pictures: Visualizing the Effects of the Patient Protection and ...The Heritage Foundation
“Obamacare in Pictures: Visualizing the Effects of the Patient Protection and Affordable Care Act” shows in detail the impact of the sweeping health care law for Americans.
Did you have time to read the 1,990 page healthcare bill that was recently passed through Congress? Have you since wondered about the impact that massive bill will have on the average American, health insurance providers, business owners and YOU? If yes, then join the Young Professionals of Chicago as we host a panel of diverse health care professionals that will be discussing current healthcare reform and taking questions on the impact of the United States' new healthcare policy. The distinguished panelists will also provide some insight and clarity into what this massive bill means for individuals like you. There will also be an opportunity for open networking with other young professionals before and after the discussion.
Obamacare in Pictures: Visualizing the Effects of the Patient Protection and ...The Heritage Foundation
“Obamacare in Pictures: Visualizing the Effects of the Patient Protection and Affordable Care Act” shows in detail the impact of the sweeping health care law for Americans.
Got Healthcare? Affordable Care Act PP (July 2013)Kevin Kane
The Affordable Care Act presentation that Citizen Action of Wisconsin presents with around the state. How the ACA impacts you and how to talk about it.
While the health care reform bill is a step in the right direction, medicare for all or single payer is what is really needed to control costs and insure all.
This gives a good base knowledge of where the current insurance industry is, a timeline of when certain mandates go into effect and a simplified description of the mandats being launched on Sept 23, 2010.
Got Healthcare? Affordable Care Act PP (July 2013)Kevin Kane
The Affordable Care Act presentation that Citizen Action of Wisconsin presents with around the state. How the ACA impacts you and how to talk about it.
While the health care reform bill is a step in the right direction, medicare for all or single payer is what is really needed to control costs and insure all.
This gives a good base knowledge of where the current insurance industry is, a timeline of when certain mandates go into effect and a simplified description of the mandats being launched on Sept 23, 2010.
Delegate Jeannie Haddaway-Riccio's Health Care Presentation 09/16/09Karena Dixon
Presentation on Health Care Reform as presented by Delegate Jeannie Haddaway-Riccio at the Talbot GOP Health Care Forum on Wednesday, September 16th, 2009.
May also be viewed at:
www.votehaddaway.com
This up-coming workshop at the Financial Planning Association of New York's Financial Fitness Workshop highlights the basics of Medicare and Medicaid, and attempt to inform the public of the many changes in the government's pipeline for these programs.
Powerpoint from Greg Matis at Community ForumKPCWRadio
Greg Matis, Senior Counsel for Intermountain Healthcare, presents information on the Affordable Care Act at the KPCW and Intermountain Park City Medical Center Community Forum on Healthcare Reform. December 2, 2013. These slides are referred to in an accompanying podcast.
ACA: A Step Toward Healthcare For All (Dr. John Cavacece, DO)Zach Jarou
Presented to the American Medical Student Association (www.AMSA.org) at Michigan State University's College of Human Medicine (MSU CHM) on Tuesday, March 20, 2012
Health care update jan-2016-american-health care-groupMary Hagan
The latest information about health benefits for employers, human resource professionals, caretakers, Medicare recipients, and more.
Contact Erin Hart if you would like this presentation at your school, office, or community group.
Hosted by the United States Department of Health and Human Services and Small Business Majority. This webinar focused on what the new healthcare law, the Affordable Care Act, means for Kentucky small businesses. It focused on both federal and state provisions to help local small business owners understand how the law will affect them.
The pending Healthy Ohio 1115 Medicaid waiver would require nearly all non-disabled adults on Ohio Medicaid to pay premiums. If approved by the federal government, the waiver would result in a greater number of uninsured Ohioans as well as increased Medicaid administrative costs and complexity.
Speakers include:
* Tara Britton, Public Policy Fellow, The Center for Community Solutions
* Nita Carter, Project Director, UHCAN Ohio
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
2. Setting the Stage...Why the ACA?
“All told, health insurers have been involved in more than four hundred
corporate mergers since 1996, according to antitrust lawyer David Balto, a
former Federal Trade Commission policy chief.”
- Deadly Spin by Wendell Potter p 136
The near total collapse of competitive and dynamic health insurance markets
has not helped patients...an absence of competition in health insurance
markets is clearly not in the best economic interests of patients.”
- 2010 AMA President Dr. J. James Rohack
Andrew F. Bennett
865.712.5711
3. Setting the Stage...Why the ACA?
2000 -2008
Premiums for employer sponsored groups increased 97%
Premiums for individual plans increased 90%
Insurance company payments to providers increased 72%
Medical Inflation only increased 39%
Wages grew 29%
Overall Inflation grew 21%
● Medical inflation only grew a little bit over the regular inflation rate.
● Premiums grew at nearly 2.5 times the rate of medical inflation.
Andrew F. Bennett
865.712.5711
4. Setting the Stage...Why the ACA?
● 2007 - Medical Debt was a key reason for 62% of personal bankruptcy
filings.
● 2008 - Over a million personal bankruptcy filings
● A lack of coverage contributes to about 45,000 people dying prematurely
every year.
● 2000 - 2008 - The top 10 for profit health insurance companies paid their
CEO’s nearly $700 million (combined).
● In 2009 alone WellPoint had 39 executives exceed $1,000,000 in
compensation.
● All from “Deadly Spin” by Wendell Potter
Andrew F. Bennett
865.712.5711
5. What changed prior to 2014
• Some preventative care covered at 100%
– Immunizations / Flu Shots
– Blood Pressure / Cholesterol Screenings
– Mammograms / Colonoscopies
– Type II Diabetes Screening
– Obesity Screening & Counseling
– Tobacco Use Screening
Andrew F. Bennett
865.712.5711
6. What changed prior to 2014
• More Preventative Care for Women
– Annual well woman visits
– Screening for gestational diabetes
– Testing for HPV (human papillomavirus)
– Counseling for sexually transmitted infections
– Counseling and screening for HIV
– Contraception methods and counseling
– Breastfeeding support, supplies, and counseling
– Screening and counseling for interpersonal violence
Andrew F. Bennett
865.712.5711
7. What has happened so far
• Children up to age 26 can remain on their parent’s policies
• Lifetime limits have been eliminated
• Appeals to insurance company decisions are now handled by an independent party
outside of the insurance company (no longer an internal appeals board).
Andrew F. Bennett
865.712.5711
8. As of Jan 1, 2014
• Guaranteed Issue – You cannot be refused
• “Pre-Existing” conditions riders can no longer be applied to policies
–You cannot be refused a policy.
–You cannot be rated (i.e. charged more).
–You policy cannot have exclusion riders (i.e. they don’t cover some injuries,
illnesses, etc that may be due to the pre-existing condition).
Andrew F. Bennett
865.712.5711
9. As of Jan 1, 2014
• For the same policy an older age group cannot be charged more than three times
the premium of a 21 year old
• Excess premiums charged by companies have to be returned (80% of premiums
collected have to go to health care benefits or improving health care, not
administrative costs or profit)
Andrew F. Bennett
865.712.5711
10. As of Jan 1, 2014
• The individual mandate – the requirement is to have health insurance. The
requirement is not about purchasing on the marketplace
• The requirement is to have what is called a “Qualified Health Plan.”
• A Qualified Health Plan has 10 “Essential Benefits.”
Andrew F. Bennett
865.712.5711
Your Family Health Insurance Agent
11. Ten Essential Health Benefits (EHB’s)
1. Ambulatory Patient Services
2. Emergency Services
3. Hospitalization
4. Maternity and Newborn Care
5. Mental Health & Substance Abuse Disorder Services
6. Prescription Drugs
7. Rehabilitative Services and Devices
8. Laboratory Services
9. Preventative & Wellness Svcs/Chronic Disease Mgmt
10. Pediatric Services including oral & vision
Andrew F. Bennett
865.712.5711
As of Jan 1, 2014
12. •Penalties (higher of the two)
– 2014 - $95 per adult and $47.50 per child (maximum of $285) or 1% of
income
– 2015 - $325 per adult and $162.50 per child (maximum of $975) or 2% of
income
– 2016 - $695 per adult and $347.5 per child (maximum of $2085) or 2.5% of
income
Andrew F. Bennett
865.712.5711
As of Jan 1, 2014
13. Who is eligible for help?
Family size 1 2 3 4
Family
Income
$ 11,490 $ 15,510 $ 19,530 $ 23,550
$ 45,960 $ 62,040 $ 78,120 $ 94,200
Anyone is free to purchase outside the online marketplace, but you must purchase inside the marketplace to be
eligible for a subsidy.
The household income must be between 100 % - 400% of the federal poverty level.
Andrew F. Bennett
865.712.5711
14. Financial Assistance Available
Income Level Premium as a Percentage of Income
Up to 133% of FPL 2 % of income
133% - 150% 3-4% of income
150% - 200% 4-6.3% of income
200% - 250% 6.3 - 8.05% of income
250% - 300% 8.05 - 9.5% of income
300% - 400% 9.5% of income
Andrew F. Bennett
865.712.5711
15. Online Marketplace
• Subsidies
– Income and family sized base
– Premium set on parent(s), up to three children (under 21), and those children
between 21 to 26 yrs of age
– Subsidy set on total number of children
• Subsidies will be paid directly to insurer OR can be claimed at end of year on tax
return
Andrew F. Bennett
865.712.5711
16. Financial Assistance Available
Cost Sharing – Provides
assistance with:
• Deductibles
• Co-insurance
• Co-Pays
Cost Sharing is ONLY available in
Silver Plans
Andrew F. Bennett
865.712.5711
Family Size Maximum Income Allowed
1 $28,725
2 $38,775
3 $48,825
4 $58,875
5 $68,925
6 $78,975
7 $89,025
17. Your Current Plan
• Grandfathered till your renewal date in 2014
–At that point your plan will need to contain all ten essential health benefits in
order to qualify as a “Qualified Health Plan.” (QHP)
Information on this slide changed in the fall of 2013 when insurance companies
cancelled millions of people’s plans. The insurance companies always cancelled certain
policies when they didn’t deliver enough profit, but they used the smoke screen of the
ACA to cancel many more than usual. There was a public outcry when the
cancellations came out. The President back-pedaled and said people could keep their
old plans till 2015, however it was the insurance companies, not the ACA that led to
the 2013 cancellations. All those policies could have been grandfathered till 2014.
Andrew F. Bennett
865.712.5711
18. Online Marketplace
• State Based, State & Federal Partnerships, Federally Facilitated
• TN is a Federally Facilitated Marketplace
• Carriers in TN will be BlueCross/BlueShield, Humana, and Cigna (Chattanooga Area
only), and CHA (Community Health Alliance). For 2015 Assurant will join the
Marketplace in Tennessee (branded as “Time”).
Andrew F. Bennett
865.712.5711
19. Online Marketplace
• CHA (The Community Health Alliance) is a non-profit health insurance company
that was created with low cost government loans. Due to a loss of competition in
the health insurance industry (see slide 2) it was expected that each state would
create a new non-profit. Lobbying dried up the funding and only 20+ new
insurance companies were created to replace the over 400 that had disappeared
due to mergers.
Andrew F. Bennett
865.712.5711
20. Online Marketplace
• Policies will be color coded based on “actuarial value” (i.e. mathematically
computed numbers based on national trends, averages, and broadbased data).
– Catostrophic
• Under 30 years old
• Lower Premiums
• Higher Deductibles
• Everything is cost shared except for preventative medicine
– Bronze 60% / 40%
– Silver 70% / 30%
– Gold 80% / 20%
– Platinum 90% / 10%
Andrew F. Bennett
865.712.5711
21. Online Marketplace
● Eligibility
○ Household income must be between 100% and 400% of FPL (federal poverty
level)
○ Individual’s must be either Citizens of the United States or have
documentation proving they are “legally present.” (permanent resident visa,
etc).
Andrew F. Bennett
865.712.5711
22. Online Marketplace
Exemptions
• Religious exemptions (i.e. your religion requires you to abstain from the health
Andrew F. Bennett
865.712.5711
Your Family Health Insurance Agent
insurance system)
• Financial exemption – if private insurance is too expensive, if you do not qualify to
purchase in the online marketplace, and you are not eligible for medicaid you will
not be fined (i.e. poor people will not be fined for being poor).
• Native American Indian Tribes have separate programs and will be exempted
although they are free to participate if they would like.
23. Online Marketplace
• What is included in income?
– Wages, Salary, Tips
– Net income from self-employment
– Unemployment Compensation
– Social Security income (including disability)
– Alimony
• What is NOT included in income:
– Child Support
– Worker’s Compensation
– Gifts
– SSI (Supplemental Security Income)
– Veteran’s Disability
Andrew F. Bennett
865.712.5711
24. Employer Mandate
• Pushed back till 2015
• Based on the number of full time equivalent employees
– 30 hours a week is one “equivalent” full time employee
• 1 employee equivalent works 30 hours a week
• 2 employees working 15 hours a week = 1 full time equivalents
• 2014 & 15 States can decide if a “small business” has less than 50 employees or
less than 100
• 2016 Federal definition 50 or fewer
• Exchanges are not for large businesses
Andrew F. Bennett
865.712.5711
25. SHOP Exchange
• Small Business Health Options Program
– For small business where employer mandate does not apply.
– Tax Credits will apply only if they enroll in 2014.
Group Coverage is nearly always more expensive than individual (many times 20%
more for similar coverage). The shop gives individual pricing with bundled billing.
(restrictions apply). Those savings are without tax credits.
Andrew F. Bennett
865.712.5711
26. Other Resources
• Healthcare.gov
• KFF.org (Kaiser Family Foundation)
• NAHU.org
Andrew F. Bennett
865.712.5711