Pages

• ACA Health Care Reform – Obamacare Introduction
  • 10 Essential Mandatory Benefits + CA Benefits
    • Clinical Trials
    • Laboratory Charges
    • Mental Health – An Essential Benefit
      • CA Mental Health Parity AB 88 (1999) & SB 855
        • Federal Parity
        • Individual Therapy
          • Mental Health – Outpatient – Therapist – Medicare
          • Native American Talking Circle
      • Resources – Mental Health
        • Autism
        • Blame – Your fault or being scapegoated?
          • Being Misunderstood? Non Verbal Communications
          • Sales & Relationship Rejection
          • Toxic and Controlling People
            • Enmeshment – unclear boundaries
            • Inhospitality
            • Meme’s on Better Relationships
        • Co Dependency
        • FSP Full Service Partnership
        • Lanterman – LPS – Conservatorship
          • Gravely Disabled – What exactly is it? Definition? Criteria?
          • IMD – Institute for Mental Disease
          • Medical Care – Court’s Permission 7 Point Letter
          • Murphy Conservatorship
            • Competence to Stand Trial
          • Probate Regular Conservatorships
        • Laura’s Law – Court Mandated Mental Health Treatment
        • Organizing, Hoarding, & Cluttering
    • Prescriptions Drugs – Rx
      • Bronze Plan – How are Drugs Reimbursed?
      • Is my prescription on the formulary – approved list?
        • Pain Management, Optoid Crisis, Mental & Physical Theraphy
    • Preventative Care & Wellness Programs
      • Corona Virus – How does Insurance Cover it?
      • Preventative Care – Wellness Visit – Medicare
      • Wellness – Kaiser Programs
        • Nutrition & Weight
  • 80% Medical Loss Ratio (MLR)
    • Actuarial Value
    • CA Insurance Rate Regulation
      • Premium increases? Why are they always going up?
        • Financial Impact of Health Care Reform on Premiums
          • Cadillac Tax
          • Risk Corridor – Reinsurance – Adjustment
        • Proposition 45 Rate Regulation 2014 – Historical – Didn’t Pass
  • Heath Reform Upheld as a tax NFIP vs Sebillius
    • California vs Texas Supreme Court – ACA unconstitutional
  • Mandate Penalty no health insurance for California
    • §5000 A – Requirement to maintain Health Insurance
      • Minimum Essential Coverage
        • QHP – Qualified Health Plan Standards & Definition
    • 10 Reasons that you need Health Insurance
      • Medical Bankruptcy
    • Employer Mandate for Health Insurance ACA 4980 h
      • 6056 – w -2 – etc Reporting
        • ERISA Employee Retirement Income Security Act — 1974
          • SPD Summary Plan Description
        • HR – PEO Support ADP Payroll Services & Alternatives
        • Paid Family Leave Act Federal & CA
      • Mandate – Employee Definition?
        • FTE – ALE Full Time & Equivalent Employees
      • Penalties – Employer Mandate MEC – Solutions?
    • Health Sharing Ministries – Not Protected by Insurance Guarantees
    • Lawfully Present – Public Charge – Immigration Status
  • Metal Levels – Platinum, Gold, Bronze – Silver & Enhanced
    • Definitions – Glossary
      • OOP -Out of Pocket Maximum – Participating or Not? Deductibles & Co- Pays
    • Enhanced Silver 94, 87, 73 Cost-sharing reductions
    • HSA Health Savings Accounts
      • Employer Equal Contributions for employees?
    • Provider – Doctor & Hospital Finder
      • Buy Travel & International Insurance – Geo Blue – Insubuy
        • Blue Shield PPO Out of State & Country
      • Doctor Lists MAPD, Medi Gap
        • Cedar’s Sinai Insurance Plans Accepted
        • Health Care Partners – Optum – Plans accepted – we can help
        • THIPA Torrance Memorial Hospital IPA
        • UCLA Medicare Advantage Plans Accepted?
      • Medicare Assignment – Doctor Participating or Not?
      • Narrow Lists? Fewer MD’s than before?
        • Continuity of Care same doctor chronic illness if you change plans
        • Emergency Room – Obligation to treat uninsured patients
        • MD says they accept Blue Shield – must they?
      • Negotiated Rates – Balance Billing? Transparency
  • Open Enrollment & Special Enrollment
    • Get Instant Health Insurance Quotes California
    • Special Enrollment Periods Covered CA & Direct with Broker
      • Federal Qualifying Events, Triggers CFR §155.420 conical
        • MD not in Network? Right to Special Enrollment?
        • Move – New County, State or Back in USA
  • Pre-Existing Conditions – No more!
• Appeal & Grievances?
  • Appeals & Grievances Medicare
  • Covered CA Appeals
  • Grace Periods? NEVER get cancelled Non-Pay!!!
    • Automatic Premium Payments – Benefits and Advantages
    • Grace Periods – How long? Premiums Due? Subsidy Pay Back?
      • Narrow Networks – 3 month grace period
    • Pay ALL premiums – even if you lose subsidy
    • Paying Back Premiums to get reinstated?
    • Was the cancellation legal? Web Visitor Q & A
      • How to properly terminate coverage
      • Never got bill?
        • USPS Informed Delivery – Proof you never got the bill?
  • Insurance Application Disclosures – Table of Contents only
    • Disclosures – Application
      • Mistake? Deadline to Report?
    • Rescission ACA prohibitions
      • Fioretti v Mass General Life
  • Last Minute Application? When does coverage start?
  • Medical Necessity – reasonable and necessary
    • Independent Medical Review
      • Right to review your Medical Records
  • Plain Meaning Rule – Read the policy 3 times
    • EOC Evidence of Coverage Value and how to find
      • 30 Day Free Look – Right to view EOC
    • Maxims of Law – Proverbs
    • Unlawful Practise of Law
      • Law – Other than Insurance
        • CA Vehicle Code – no index
          • Chargeable Car Accident?
          • Is it ok to drink in a limo, bus, uber or taxicab?
        • Civil Law – no index
          • Appeals – to a higher court
          • Copy Right Law
          • Res Judicata – Double Jeopardy – File two claims?
          • Tenant’s – Renters Rights
        • Criminal Law
          • ADW count as a strike?
          • Factual Finding of Innocense
          • Judy Meyer for Judge
            • Office Party – Janis Barquist for Judge
          • Perjury – What is the definition?
            • Lie Detector – Admissable?
          • Restraining Order – Protective Persons Violation – Aid & Abetting
            • Legal Papers – Definition
            • Libel, Slander LaShon Ha-Ra
          • Types of Probation and Violation
    • What is hearsay? Someone else said on the phone?
• Contact Us & License Info
  • 17 Reasons to use Steve Shorr Insurance
    • Biography – Steve Shorr
      • Eric – Navy going away party
      • Lt. Paul S. Shorr US Army – Korea
      • Non Insurance Websites
        • Croatia July 2021
        • Princess Louise
        • Tennis Links
        • Web Design
          • Home Page Mock Up
          • Portfolio
    • Purchase Tutoring, Research & Education
    • Testimonials – “Yelp” Reviews
  • Set a Meeting
    • Meeting – Expectations – Terms of Service
      • Privacy Statement
        • Privacy – HIPAA
          • CA Privacy Laws
          • Email Privacy
          • Telemarketing Harassment? Unsolicited Email?
        • Visitor Agreement
          • Records Retention?
• Covered CA Tax Credits – Subsidies APTC & Rules
  • MAGI – Modified Adjusted Gross Income – Line 37* Now 7 or 8b
    • Income Chart – Line 8b 1040 Covered CA MAGI
      • Household Definition – Who counts?
        • Claimed as a dependent Household Definition f 2
        • Family Members? vs Household Question 15 A MC 262
        • Married Couples Household definition f 4
        • Not Claimed as Tax Dependent – Household Definition F 1
        • Not filing a return – nor claimed as a dependent f 3
    • Table of Contents – Details of Income, Deductions & Expenses for MAGI
      • Alimony – From a Divorce Settlement
        • Child Support – Adoption – Tax Credit
          • Child Support – End – Military Service
        • Married – Must File Jointly, Single, etc? Filing Status?
      • Capital Gains & Dividends
        • Rental Income? Line 17 Home Mortgage Interest
          • 1031 Exchange – Investment Property – Rental Units
        • Sale of Home Capital Gains
      • Clergy – Housing Allowance?
        • Charitable Donations
      • Debt Cancellation? Foreclosure?
      • Educational Credits – Student Loan Interest
      • Gambling Income & Losses – Other Income Line 21
      • Medical Expense Deduction – Line 40 Individual
  • Place Holder – No Index
    • 2021 Rates & Benefits – average 0.6% premium increase
    • Create Account for Covered CA from access code
      • Covered CA Agent Appointment Instructions
    • Native American – Indian – Chumash – Lakota – Aho
  • Report a Change – How & When – Especially Income
    • Conditional Eligibilty
    • Fudging the Income or Deductions?
    • Proof of Income – Accepted Documents
    • Who can sign an application?
  • Tax Credits & Subsidies Introduction
    • 1095 A & FTB 3895 Covered CA Statement of Subsidy & Proof of Coverage
      • #1095 B Confirmation of Employer, Medi-Cal & Non Covered CA Coverage
      • 1095 C Large Employer Coverage
    • 8962 Premium Tax Credit APTC Form attaches to Form 1040
      • IRS 12 c letter – need to file 8962 Premium Tax Reconcilation
      • Medi Cal – Income Drop? Tax or Subsidy Pay Back?
      • VITA FREE help – Covered CA Warning Memo
    • APTC Advance Premium Tax Credit – Subsidies – Introduction
      • APTC Subsidies in Health Care.Gov Upheld – King v Burwell
      • Premium Subsidy Now or Tax Time?
        • Credit APTC at tax time if not requested when you enroll?
        • Tax Loss – Negative MAGI Income – Medi Cal? Subsidies?
      • Premium Subsidy to 600% FPL + Mandate Penalty?
    • Tax Credit Calculation? CFR 1.36 B-3
      • Affordable Health Coverage? 9.86% Family Glitch
      • Age 65 – Tax Credits?
      • Estimated Income Change – Covered CA not paying enough subsidies?
• Employer Health Plans – Introduction
  • AB 1083 – PPACA – CA law to comply with Federal Law
    • 90 Day Maximum Waiting Period?
      • Late Enrollee – Triggers – Qualifying Events
    • Definitions Health Care Reform
      • EmployER Definition – Health Care Reform
        • 1099 vs Employee & Other Defintions
          • Telemarketing Training
        • EmployEE Definition
          • Bona Fide Employer-Employee Relationship – non spousal
          • Dependent Definition – Up to Age 26
            • Add Newborn baby deadline 30 days
            • Registered Domestic Partners – Spousal Health Coverage?
    • Grand Mothering SB 1446 – Unbelievable Rate Increases! Historical
    • Insurance Company requirements AB 1083
      • Employer Group Association Plans – Trump’s Executive Order – CA prohibition
      • Health & Safety Code Requirements Insurance Companies must Follow!
    • Participation & Contribution Requirements
      • Documents to show bonafide Employer in business
        • Fictitious Business Name
      • Enforcement – Participation – Recertification – Actively @ Work
        • Actively @ Work Corona Virus Quarantine?
        • Why enroll in your Employers Group Health Plan?
          • Employer Group or Individual Coverage?
          • FAQ's for Owners & Employees?
      • Management Carve Outs
        • Common Ownership – Affiliated Companies – Corporations
        • Salary Discrimination §2716 – Not enforced
        • Similarly Situated Employees
      • Special Annual Open Enrollment – NO Rules!
    • Premium – Rating Factors
  • AB 1672 – (1992 to 2013) Small Group Guaranteed Issue Historical
    • Carrier Requirements Historical
    • Definitions – Historical
  • Carriers – Companies
    • Aetna
    • Blue Cross – Anthem
      • Administrative, Renewal & Wellness Tools
        • Anthem Pay Forward – Get Cash Backs
        • Employer Portal
        • PPO – HMO – Network Options
        • Rx Prescription Information
      • Anthem Blue Cross Dental
    • Blue Shield
      • Administrative
      • Blue Shield Dental
    • California Choice – Multiple Companies ONE Bill
    • Health Net
      • Administrative, Wellness & Renewal Tools
        • Provider Networks & Tele Doc
    • Kaiser Permanente – New Enrollment
      • Administrative Tools & Info
    • Oscar
    • Self Funded Plans – Ben E Lect
    • Sharp Health Plan
    • SHOP – Covered CA for Small Business
      • Dental
    • Sutter Health 2021
    • United Health Plan
      • Administration & Wellness
  • COBRA – Right to Keep your Employer Group Health Coverage
    • California Cal-COBRA 36 months total coverage
      • Out of State or self insured Employer
  • Dental, Vision, Supplemental
    • Supplemental – Cancer
  • Quotes Employer Group – California – Instantly
    • Broker of Record Letter We can help with your coverage no extra charge
  • Tax Credits Small Business §45 R
    • IRC §106 Health Insurance Deduction for Employers & Employees
      • Schedule C – Self-Employment Income – Line 12
        • Employee Business Expense Unreimbursed
        • Hobby or Business?
        • Home Office Deduction
    • Section §105 -HRA Health Reimbursement
      • IRC §106 FAQ's – Individual Plan Reimbursement? Cash in Lieu of Benefits
      • Wrap Plans HSA HRA now allowed legal history
    • Section 125 – POP Plan Employee Contributions are Tax Deductible
      • §125 Cafeteria Plan – Full Benefit
• Individual & Family Health Insurance CA
  • Companies – Carriers
    • Blue Cross – Anthem
      • Blue Cross Dental
      • Grandfathered Plans – April 2020
        • Grand Fathered Plans What does that mean?
    • Blue Shield 2021 PPO & Trio
      • 2021 Trio HMO ACO
      • Blue Shield Dental & Vision
      • Member Portal – How to set yours up
    • Health Net 2021 Individual Information & Enroll
    • Kaiser Permanente
      • Kaiser Medical Financial Assistance Program (MFAP)
      • Pay Premium ONLINE? Member Services
    • Oscar Health Insurance
    • Sharp Health Plan
    • Sutter Health 2021
      • Pharmacy
    • Western Health Advantage
  • Dental & Vision for Adults and Mandatory Pediatic as an essential benefit
    • Covered CA Dental
    • Dental Implants
    • Vision
• Life, Disability, Long Term Care & Retirement
  • Disability Income – Pay Check Protection
    • SDI State Disability Insurance
      • SDI for Business Owners
        • CARES Act
          • SBA CoronaVirus Loans
      • SDI State Disability Benefits Taxable?
      • Unemployment Compensation – Can’t find job – Corona Pandemic
        • Unemployment Compensation? MAGI Income?
  • Estate Planning
    • Beneficiary under 18? Is that permitted? Grandchild coverage?
    • Estate & Gift Taxes
      • Coverdell Education Savings Account
        • 529 College Savings
      • Gift Income?
    • Living Trust
      • Bank Accounts into a Trust?
      • Charitable Remainder Trust
      • Executor – Successor Trustee – What are the duties?
      • Sample – Example California Will – Where does your stuff go?
        • Health Care Directives
        • Probate
        • Will Contests – Disinherit a child
      • Special Needs Trust
    • Proposition 13 Lower Property Tax on Inheritance
  • Life Insurance
    • Business – Key Man Life
    • Find a lost or missing Life Insurance policy
      • Life Settlements – Sell your unwanted policy
    • Rated – Surcharged Policies
      • Final Expense – Almost Guaranteed Issue
    • Term Life Instant Quotes – How much do you need?
    • Universal Life Insurance
  • Long Term Care Nursing & Home Health Care
    • §1035 Exchange of Annuities or Life Insurance for Long Term Care Planning
    • 7 Activities of Daily Living ADL
      • CA Law – Long Term Care
      • Nursing Homes – Assisted Living – Finding and Selecting the best ones
    • Employer Groups – Long Term Care
      • Benefits from Employer LTC are not taxable §104
        • Tax Qualified LTC Policy
    • Medi Cal – Long Term Care & Nursing Home Estate Recovery – Strategic Planning
    • True Freedom – Home Health Care ONLY Coverage
  • Retirement Planning
    • Annuities & MAGI Income Taxation Exemption
      • Jackson National
      • Private Annuities
      • TSA-Teacher Retirement Plans – Tax Sheltered Annuities
        • Divorce & STRS – State Teachers Retirement Plan
    • Business – Employer Sponsored Retirement Plans
      • 401 K
        • FAQs
      • Secure Choice -CA State Run Retirement System
      • Selling and Valuation of an Insurance Practice?
      • SEP – Simplified Employee Pension
    • IRA – Individual Retirement Account
• Medi-Cal – CA Version of Medicaid
  • Contact Info – Enroll ONLINE Medi-Cal
    • Cal Fresh – SNAP – Food Stamps – WIC
    • Enroll ONLINE Los Angeles
  • Eligibility Criteria for Medi-Cal – MAGI Income
    • Aged and Disabled Federal Poverty Level Program
      • IHSS In Home Supportive Services
      • Part B Medicare Premium paid by Medi Cal
      • Share of Cost – Medically Needy – What is it?
      • Social Security Disability – SSDI
        • California Teachers & Social Security Disability
      • SSI – Supplemental Security Benefits – Automatic Medi Cal
        • DAC Disabled Adult Child – Keep Medi Cal – Retirement
          • Disabled Children – over 26 – stay on parents insurance
          • Representative Payee
    • FAQ’s Table of Contents – Conical
      • Effective Date? Temporary Instant ID Card
      • Mistake – Dealing through 3rd Parties – What counts as MAGI?
      • Monthly or Annual Income Qualification for Medi Cal
      • Notification when you make too much $$$ for Medi-Cal
      • Premiums for Medi-Cal?
        • C-CHIP County Children’s Health Initiative Program
      • Release Medi-Cal get Covered CA
    • Pregnant Women – Medi-Cal Eligibility – MCAP to 322% FPL
      • Cancer Breast & Cervical Program BCCTP
      • Infertility
  • Full Scope Medi-Cal – Benefits & Coverages
    • Denti Cal & Vision
    • Dual Coverage? Medi-Cal & Individual Private or Employer Plans?
      • Dual Coverage – Who pays 1st? Collect Twice? Individual Plans
      • Medicare – Dual Coverage – Subrogation
    • HMO – Managed Care Providers
      • Cal Medi Connect – Medi-Cal & Medicare – Medi Medi Dual Eligible D SNP
      • Health Net Solutions
      • LA Care – Medi Cal & Covered CA
        • Anthem Blue Cross
        • Care 1st – Blue Shield – Promise
        • Kaiser Medi-Cal
      • Molina Health Care
  • Redetermination? Renewals? Verification
    • Bank Statement Review
    • Don’t want Medi-Cal for the kids – redetermination form?
    • MC 216 Income & Expense Definitions
    • MC 262 Long-Term Care Medi-Cal Renewal
• Medicare – Introduction
  • Fraud, Scams, Waste & Abuse
    • Risk Adjustment Fraud Bumping up illness to get more $$$
  • Health Care Reform & Medicare?
    • California Single Payer Cal Care AB 1400
    • Taxes to Fund Medicare
      • Additional Medicare Tax
      • Threats to cut Medicare?
  • Medi Gap – Supplement Plans – non conical
    • Anthem Blue Cross
    • Blue Shield – Medi-Gap – Any Medicare Provider
    • Guaranteed Acceptance – Medi-Gap – Supplemental Plans
      • Birthday Rule
      • Loss of Employer Coverage
      • MAPD Trial Period – Come back to Medicare and Medi-Gap
      • Medical Questions – Underwriting – If not in Guaranteed Issue Period?
      • Medicare Advantage Reduces Benefits, Co Pays, increase in premium
      • Turn Age 65 or newly enrolled in Part B
    • No more plan F? Only G? MACRA
  • Medicare Advantage Plans – Part C
    • Anthem MediBlue Plus
      • Application Instructions
      • SNP Anthem Blue Cross
    • Blue Shield 65 Plus – Inspire HMO 2021
      • Dental & Vision
      • Provider Directories, Search Tools & Instructions
      • Trio Medicare – Blue Shield – Sacramento
    • Enrollment Dates for MAPD – Medicare Advantage
      • Residency – CA, USA – Which State?
        • Outside of USA – Meet Deadline – Web Visitor Q & A
      • Under 65 disabled & Medicare Qualified
    • Marketing Rules
      • Best Plan can’t say it in Medicare Advantage
      • Obscure Medicare Health Plans – Not in CA
        • Motion Picture Industry Pension & Health Plan
        • Northup Grumman Medicare Supplements? & LACERA
        • Veteran’s Benefits
      • Scope of Appointment – Telephone & Face to Face Meetings
      • Star Ratings – Medicare Advantage
    • Togetherness – Loneliness Social Determinants of Health
    • United Health Care
  • Part D Rx Prescriptions
    • Blue Cross Rx
    • Blue Shield Rx
    • Donut Hole – Coverage Gap
    • Maximus Appeals LEP Late Enrollment Penalty
      • Employer Credible Coverage
    • Premiums for those with High Income Parts D Rx & B Doctor Visits
    • Shop & Compare Tools Part D Rx
      • Part D Rx Low Income Subsidy – LIS – Extra Help
        • Price Comparisons
    • UHC – Part D Rx
  • Seminar – Medicare Information ONLINE
    • ONLINE Account for Medicare & Social Security
    • Original Medicare & Medi-Gap – Supplement vs Medicare Advantage MAPD
  • What’s Covered in Part A Hospital & B Doctor Visits?
    • Chiropractic – Medicare A & B – MAPD
    • Dental under Medicare is very limited
    • Diabetes
    • Durable Medical Equipment
    • End Stage Renal – Kidney Failure
      • under 65 End Stage Renal can I buy an policy – ObamaCare, Covered CA, Health Care.gov – direct from Insurance Company?
    • Enroll ONLINE for Medicare Part A Hospital & B Doctor Visits
      • Part A Hospital rules for zero premium
        • LAUSD Medicare Qualification
      • Part B – Doctors – How to sign up – Benefits
        • Medicare need if covered by Employer Plan? Retiring?
          • Employer Deduction for Medicare Premiums?
        • Part B Late Enrollment Penalty
          • Covered CA waiver Part B Penalty
          • Ex Pats Medicare if not USA resident
    • Hearing Aids
    • Part A & B Technical Code Sections
    • Physical therapy – occupational speech
    • Skilled Nursing SNF & Home Health What Medicare Pays
      • Hospice Coverage – Medicare
    • Sleep Studies, CPAP etc
• Site Map
• Social Security – Retirement Benefits
  • How are Social Security retirement benefits taxed?
    • How are Social Security Benefits reduced if you are working?
    • Optimum Age to start taking benefits 62 – 70?
      • CPA take on Retirement
    • Social Security Benefits MAGI Income
  • Survivor – Death Benefits
• zHistorical & Agent Info
  • Pay the bill? ID Card or Policy # ? SNAFU
  • SNAFU’s 2015

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