Healthcare Bill Hit Parade!!

[Zoom-boing]

Navy, Care and JReeves -- thanks to all of you for explaining 'government-ese and insurance-ese' to those of us, ah, less proficient in it.

 

[Care4all]

so long as the ratio of the
18 premium for family enrollment (or enrollments) to
19 the premium for individual enrollment is uniform


That verbiage means insurance premiums for employers are to be charged by the individual.

this means that insurance companies CAN NOT charge employers a higher rate, for the family members of the individual, that's all...so even if the wife has a preexisting condition like diabetes, the insurance company CAN NOT charge the employer a higher risk rate for the family member than the discounted rate the employer negotiated for his own employees...

that's all it means.

Can you kindly post where this section refers to pre-existing conditions?

By family en16
rollment (such as variations within categories and
17 compositions of families)

 

[jreeves]

this means that insurance companies CAN NOT charge employers a higher rate, for the family members of the individual, that's all...so even if the wife has a preexisting condition like diabetes, the insurance company CAN NOT charge the employer a higher risk rate for the family member than the discounted rate the employer negotiated for his own employees...

that's all it means.

Can you kindly post where this section refers to pre-existing conditions?

By family en16
rollment (such as variations within categories and
17 compositions of families)

Where is that defined as pre-existing conditions?

Compositions of families would lead me to believe it means the make up of a family.

 

[Navy1960]

illegal aliens ARE NOT aliens navy? do you think aliens are ILLEGAL aliens?

If a person does not meet either the Green Card or Substantial Presence Test, then that person is classified as a non-resident alien.
Definition:Resident Alien vs Nonresident Alien

When the United States incarcerates criminal aliens--noncitizens
convicted of crimes while in this country legally or illegally--in
federal and state prisons and local jails, the federal government bears
much of the costs.

Short answer Care, yes I do think the term can mean illegal Alien as defined by the Federal Govt. When the bill is ambigious at best as to meaning and it exludes sections of the act that define status as well as leave that up to the commissioner, then yes I do.

 

[Care4all]

Can you kindly post where this section refers to pre-existing conditions?

By family en16
rollment (such as variations within categories and
17 compositions of families)

Where is that defined as pre-existing conditions?

Compositions of families would lead me to believe it means the make up of a family.

Family enrollment, such as variations within the categories and compositions of families, leads me to believe that no matter the variations of family members insurance needs, they can not be charged more than the individual with the group policy discount can be charged...

 

[Navy1960]

ILLEGAL ALIEN: An "illegal alien" is a foreigner who (1) does not owe allegiance to our country; and (2) who has violated our laws and customs in establishing residence in our country. He or she is therefore a criminal under applicable U.S. laws.

The term "illegal alien" is used by U.S. citizens who believe that non-citizens entering our country must comply with our immigration laws.

The term "illegal alien" is predicated upon U.S. immigration law which requires foreigners entering the U.S. to comply with our country's rules and laws regarding entry into, and residence within, our country.

 

[jreeves]

By family en16
rollment (such as variations within categories and
17 compositions of families)

Where is that defined as pre-existing conditions?

Compositions of families would lead me to believe it means the make up of a family.

Family enrollment, such as variations within the categories and compositions of families, leads me to believe that no matter the variations of family members insurance needs, they can not be charged more than the individual with the group policy discount can be charged...

Here maybe this will help, I will define a few words to give meaning....
substitute the parenthesis meaning for the word...

so long as the ratio(the proportional relation) of the
18 premium(price paid for coverage) for family enrollment (or enrollments) to
19 the premium(price paid for coverage) for individual enrollment is uniform(the same),

 

[jreeves]

Where is that defined as pre-existing conditions?

Compositions of families would lead me to believe it means the make up of a family.

Family enrollment, such as variations within the categories and compositions of families, leads me to believe that no matter the variations of family members insurance needs, they can not be charged more than the individual with the group policy discount can be charged...

Here maybe this will help, I will define a few words to give meaning....
substitute the parenthesis meaning for the word...

so long as the ratio(the proportional relation) of the
18 premium(price paid for coverage) for family enrollment (or enrollments) to
19 the premium(price paid for coverage) for individual enrollment is uniform(the same),

In addition, pre-existing conditions are clearly covered by Sec.111 here it is...

18 SEC. 111. PROHIBITING PRE-EXISTING CONDITION EXCLU19
SIONS.
20 A qualified health benefits plan may not impose any
21 pre-existing condition exclusion (as defined in section
22 2701(b)(1)(A) of the Public Health Service Act) or other23
wise impose any limit or condition on the coverage under
24 the plan with respect to an individual or dependent based
25 on any health status-related factors (as defined in section
VerDate Nov 24 2008 12:51 Jul 14, 2009 Jkt 000000 PO 00000 Frm 00019 Fmt 6652 Sfmt 6201 C:\TEMP\AAHCA0~1.XML HOLCPC
July 14, 2009 (12:51 p.m.)
F:\P11\NHI\TRICOMM\AAHCA09_001.XML
f:\VHLC\071409\071409.140.xml (444390|2)
20
1 2791(d)(9) of the Public Health Service Act) in relation
2 to the individual or dependent.

 

[Care4all]

illegal aliens ARE NOT aliens navy? do you think aliens are ILLEGAL aliens?

If a person does not meet either the Green Card or Substantial Presence Test, then that person is classified as a non-resident alien.
Definition:Resident Alien vs Nonresident Alien

When the United States incarcerates criminal aliens--noncitizens
convicted of crimes while in this country legally or illegally--in
federal and state prisons and local jails, the federal government bears
much of the costs.

Short answer Care, yes I do think the term can mean illegal Alien as defined by the Federal Govt. When the bill is ambigious at best as to meaning and it exludes sections of the act that define status as well as leave that up to the commissioner, then yes I do.

but the part you quoted specifically said LEGAL ALIENS navy?

11 SEC. 242. AFFORDABLE CREDIT ELIGIBLE INDIVIDUAL.
12 (a) DEFINITION.—
13 (1) IN GENERAL.—For purposes of this divi14
sion, the term ‘‘affordable credit eligible individual’’
15 means, subject to subsection (b), an individual who
16 is lawfully present in a State in the United States

 

[Care4all]

Family enrollment, such as variations within the categories and compositions of families, leads me to believe that no matter the variations of family members insurance needs, they can not be charged more than the individual with the group policy discount can be charged...

Here maybe this will help, I will define a few words to give meaning....
substitute the parenthesis meaning for the word...

so long as the ratio(the proportional relation) of the
18 premium(price paid for coverage) for family enrollment (or enrollments) to
19 the premium(price paid for coverage) for individual enrollment is uniform(the same),

In addition, pre-existing conditions are clearly covered by Sec.111 here it is...

18 SEC. 111. PROHIBITING PRE-EXISTING CONDITION EXCLU19
SIONS.
20 A qualified health benefits plan may not impose any
21 pre-existing condition exclusion (as defined in section
22 2701(b)(1)(A) of the Public Health Service Act) or other23
wise impose any limit or condition on the coverage under
24 the plan with respect to an individual or dependent based
25 on any health status-related factors (as defined in section
VerDate Nov 24 2008 12:51 Jul 14, 2009 Jkt 000000 PO 00000 Frm 00019 Fmt 6652 Sfmt 6201 C:\TEMP\AAHCA0~1.XML HOLCPC
July 14, 2009 (12:51 p.m.)
F:\P11\NHI\TRICOMM\AAHCA09_001.XML
f:\VHLC\071409\071409.140.xml (444390|2)
20
1 2791(d)(9) of the Public Health Service Act) in relation
2 to the individual or dependent.

ok.

this says they have to cover you....with preexisting conditions.

but the other is saying, you can't charge relatives a HIGHER rate than the negotiated discounted group rate of the individual spouse, no matter their category (high risk category, medium high risk category?) which could legitimately call for a higher premium...

the family is locked in to the individual's discount rate, no matter what, is how i read it, STILL Jr!

this was speaking about price

 

[jreeves]

Here maybe this will help, I will define a few words to give meaning....
substitute the parenthesis meaning for the word...

so long as the ratio(the proportional relation) of the
18 premium(price paid for coverage) for family enrollment (or enrollments) to
19 the premium(price paid for coverage) for individual enrollment is uniform(the same),

In addition, pre-existing conditions are clearly covered by Sec.111 here it is...

18 SEC. 111. PROHIBITING PRE-EXISTING CONDITION EXCLU19
SIONS.
20 A qualified health benefits plan may not impose any
21 pre-existing condition exclusion (as defined in section
22 2701(b)(1)(A) of the Public Health Service Act) or other23
wise impose any limit or condition on the coverage under
24 the plan with respect to an individual or dependent based
25 on any health status-related factors (as defined in section
VerDate Nov 24 2008 12:51 Jul 14, 2009 Jkt 000000 PO 00000 Frm 00019 Fmt 6652 Sfmt 6201 C:\TEMP\AAHCA0~1.XML HOLCPC
July 14, 2009 (12:51 p.m.)
F:\P11\NHI\TRICOMM\AAHCA09_001.XML
f:\VHLC\071409\071409.140.xml (444390|2)
20
1 2791(d)(9) of the Public Health Service Act) in relation
2 to the individual or dependent.

ok.

this says they have to cover you....with preexisting conditions.

but the other is saying, you can't charge relatives a HIGHER rate than the negotiated discounted group rate of the individual spouse, no matter their category (high risk category, medium high risk category?) which could legitimately call for a higher premium...

the family is locked in to the individual's discount rate, no matter what, is how i read it, STILL Jr!

this was speaking about price

Why use this verbiage?
(such as variations within categories and
17 compositions of families)
Why not say pre-existing conditions then?

If this was in relation to pre-existing conditions, why not list it under Sec.111?

 

[jreeves]

More governmental control of health care....
Sec.115
(a) IN GENERAL.—A qualified health benefits plan
6 that uses a provider network for items and services shall
7 meet such standards respecting provider networks as the
8 Commissioner may establish to assure the adequacy of
9 such networks in ensuring enrollee access to such items
10 and services and transparency in the cost-sharing differen11
tials between in-network coverage and out-of-network cov12
erage.

 

[Care4all]

In addition, pre-existing conditions are clearly covered by Sec.111 here it is...

18 SEC. 111. PROHIBITING PRE-EXISTING CONDITION EXCLU19
SIONS.
20 A qualified health benefits plan may not impose any
21 pre-existing condition exclusion (as defined in section
22 2701(b)(1)(A) of the Public Health Service Act) or other23
wise impose any limit or condition on the coverage under
24 the plan with respect to an individual or dependent based
25 on any health status-related factors (as defined in section
VerDate Nov 24 2008 12:51 Jul 14, 2009 Jkt 000000 PO 00000 Frm 00019 Fmt 6652 Sfmt 6201 C:\TEMP\AAHCA0~1.XML HOLCPC
July 14, 2009 (12:51 p.m.)
F:\P11\NHI\TRICOMM\AAHCA09_001.XML
f:\VHLC\071409\071409.140.xml (444390|2)
20
1 2791(d)(9) of the Public Health Service Act) in relation
2 to the individual or dependent.

ok.

this says they have to cover you....with preexisting conditions.

but the other is saying, you can't charge relatives a HIGHER rate than the negotiated discounted group rate of the individual spouse, no matter their category (high risk category, medium high risk category?) which could legitimately call for a higher premium...

the family is locked in to the individual's discount rate, no matter what, is how i read it, STILL Jr!

this was speaking about price

Why use this verbiage?
(such as variations within categories and
17 compositions of families)
Why not say pre-existing conditions then?

If this was in relation to pre-existing conditions, why not list it under Sec.111?

i don't know jr?

other than maybe, because not all people with preexisting conditions would be trying to get a policy on a spouse's, discounted employee plan?

and preexisting conditions of an illness is not always the only high risk categories....age is one, profession can be another....so a high risk category may not even be a preexisting condition? i dunno???

they purposefully put this crappola in obscure language, with references to alphabetical letters of clauses, in parenthesis, etc etc to boggle the average human's mind, so that they will just give up, i am convinced!

 

[Care4all]

More governmental control of health care....
Sec.115
(a) IN GENERAL.—A qualified health benefits plan
6 that uses a provider network for items and services shall
7 meet such standards respecting provider networks as the
8 Commissioner may establish to assure the adequacy of
9 such networks in ensuring enrollee access to such items
10 and services and transparency in the cost-sharing differen11
tials between in-network coverage and out-of-network cov12
erage.

is the commissioner a federal czar or each state's Insurance Commissioner, do ya know?

 

[jreeves]

More governmental control of health care....
Sec.115
(a) IN GENERAL.—A qualified health benefits plan
6 that uses a provider network for items and services shall
7 meet such standards respecting provider networks as the
8 Commissioner may establish to assure the adequacy of
9 such networks in ensuring enrollee access to such items
10 and services and transparency in the cost-sharing differen11
tials between in-network coverage and out-of-network cov12
erage.

is the commissioner a federal czar or each state's Insurance Commissioner, do ya know?

a federal czar

Sec.201 (b)

outlines the commissioner's duties and responsibilities

 

[jreeves]

ok.

this says they have to cover you....with preexisting conditions.

but the other is saying, you can't charge relatives a HIGHER rate than the negotiated discounted group rate of the individual spouse, no matter their category (high risk category, medium high risk category?) which could legitimately call for a higher premium...

the family is locked in to the individual's discount rate, no matter what, is how i read it, STILL Jr!

this was speaking about price

Why use this verbiage?
(such as variations within categories and
17 compositions of families)
Why not say pre-existing conditions then?

If this was in relation to pre-existing conditions, why not list it under Sec.111?

i don't know jr?

other than maybe, because not all people with preexisting conditions would be trying to get a policy on a spouse's, discounted employee plan?

and preexisting conditions of an illness is not always the only high risk categories....age is one, profession can be another....so a high risk category may not even be a preexisting condition? i dunno???

they purposefully put this crappola in obscure language, with references to alphabetical letters of clauses, in parenthesis, etc etc to boggle the average human's mind, so that they will just give up, i am convinced!

I don't see it referring to pre-existing conditions, otherwise, it would state it explicitly. The phrase is not in Sec.111 nor does Sec.111 refer to this Sec.113 (3). I believe in fact its stating that each member of the family(composition) must have the same premiums of an individual. Although, if you have Committee minutes or any other such information referring to Sec.113(3) stating to the contrary, I could be persuaded.

 

[Care4all]

ok...i concede that preexisting conditions probably would have been singled out, though as i explained, variations in categories of the family could be variations of risk categories....?

crap

it'd be nice to be able to read a law or reg and actually understand it without these acrobatic exercises!

what do you think 'variations in categories' means JR?

 

[Care4all]

ILLEGAL ALIEN: An "illegal alien" is a foreigner who (1) does not owe allegiance to our country; and (2) who has violated our laws and customs in establishing residence in our country. He or she is therefore a criminal under applicable U.S. laws.

The term "illegal alien" is used by U.S. citizens who believe that non-citizens entering our country must comply with our immigration laws.

The term "illegal alien" is predicated upon U.S. immigration law which requires foreigners entering the U.S. to comply with our country's rules and laws regarding entry into, and residence within, our country.

FYI

YOU should know, that if you or reeves took the position I am holding on these regs that we have been arguing about, I would have taken the OPPOSITE position.

Not only do I enjoy playing devil's advocate, I find taking the position much more useful in helping me find out more information regarding the topic being argued, so that I can eventually make a decision based off of my own researched arguments or the arguments of those I chose to oppose... for the sake of opposing :, because their arguments or positions ended up better!

So please don't take any of this debating or arguing as some may see it, personally!!!



care

 

[dilloduck]

ILLEGAL ALIEN: An "illegal alien" is a foreigner who (1) does not owe allegiance to our country; and (2) who has violated our laws and customs in establishing residence in our country. He or she is therefore a criminal under applicable U.S. laws.

The term "illegal alien" is used by U.S. citizens who believe that non-citizens entering our country must comply with our immigration laws.

The term "illegal alien" is predicated upon U.S. immigration law which requires foreigners entering the U.S. to comply with our country's rules and laws regarding entry into, and residence within, our country.

FYI

YOU should know, that if you or reeves took the position I am holding on these regs that we have been arguing about, I would have taken the OPPOSITE position.

Not only do I enjoy playing devil's advocate, I find taking the position much more useful in helping me find out more information regarding the topic being argued, so that I can eventually make a decision based off of my own researched arguments or the arguments of those I chose to oppose... for the sake of opposing :, because their arguments or positions ended up better!

So please don't take any of this debating or arguing as some may see it, personally!!!



care

If taking a position on universal health care mattered I may be more intersted in taking one but I've learned a long time ago. The party in power does what they want and has little concern about what we want. They are of the opinion that they know what is best for me.

 

[Care4all]

ILLEGAL ALIEN: An "illegal alien" is a foreigner who (1) does not owe allegiance to our country; and (2) who has violated our laws and customs in establishing residence in our country. He or she is therefore a criminal under applicable U.S. laws.

The term "illegal alien" is used by U.S. citizens who believe that non-citizens entering our country must comply with our immigration laws.

The term "illegal alien" is predicated upon U.S. immigration law which requires foreigners entering the U.S. to comply with our country's rules and laws regarding entry into, and residence within, our country.

FYI

YOU should know, that if you or reeves took the position I am holding on these regs that we have been arguing about, I would have taken the OPPOSITE position.

Not only do I enjoy playing devil's advocate, I find taking the position much more useful in helping me find out more information regarding the topic being argued, so that I can eventually make a decision based off of my own researched arguments or the arguments of those I chose to oppose... for the sake of opposing :, because their arguments or positions ended up better!

So please don't take any of this debating or arguing as some may see it, personally!!!



care

If taking a position on universal health care mattered I may be more intersted in taking one but I've learned a long time ago. The party in power does what they want and has little concern about what we want. They are of the opinion that they know what is best for me.

I don't disagree Duckydil!

I still enjoy informing myself, the Lord only knows why, since it is as you say, congress will do what THEY think is best, regardless of what the people want and know is best...

Good morning, as well!

Care