Great News! Two-Man PPO Health Insurance now Back in Texas

Health insurance is something that every American Citizen gets exposed to some time or the other, regardless of what section of society from where they come. However, especially in the recent years, we see that health insurance has become quite a controversial issue, especially after the introduction of Patient Protection and Affordable Care (ACA) also known as Obamacare.

With effect from 2017, Husband and Wife Two-Man PPO Health Insurance policies are being allowed once again in Texas. With this good news, however, we should also examine how it stands against Obamacare. Here, we go into the pros and cons of Obamacare and then proceed to see the benefits of Husband and Wife Two-Man PPO Health Insurance over Obamacare.

Obamacare Pros and Cons

Pros

Rising cost of preventive health care is suppressed.
Mental health, addiction, and chronic diseases are also covered, and the cost of these conditions is passed on to the taxpayer.
Insurance companies cannot deny coverage on the grounds of pre-existing medical conditions or change premiums midway during the term of a policy.
Lifetime and annual coverage limits have been outlawed leading to a lower cost of healthcare in the USA.
Parent’s health insurance plans can cover children up to 26 years of age.
Insurance exchanges will be set up by states which will ensure easier shopping for insurance.
Tax credits will be available to the middle class on their premiums.
“Donut hole” (gap in coverage) will be removed by 2020.
Employees will be eligible for health insurance from their employers if the organization they work for is over 50 employees.
Obamacare projects a reductionof the budget deficit by $143 billion by 2022.

Cons

3 to 5 million citizens had their employment-based insurance stopped.
30 million people who had private plans had their policies canceled by insurance companies as their policies didn’t come under the “ACA 10 Essential Benefits.”
The new health insurance model became more expensive in the short term than before.
Although ACA taxed people without insurance, those people used loopholes in the law to avoid the taxes.
4 million people opted to pay tax in preference to buying health insurance.
The ACA increased income tax rates in the higher income group in 2013 and additionally also increased Medicare tax.
A massive excise tax of 2.3% was levied on manufacturers and importers of medical devices (later suspended).
The deduction of medical expenses for families was reduced from 10% to 7.5%.
Pharmaceutical companies were made to pay a considerable amount of fees totaling to $84.8 billion over a period of ten years from 2013 to 2023. This cost is likely to be passed on to the consumers.
The massive excise tax of 40% is to be levied on Cadillac Plans by 2020. This tax will adversely affect old employees of a company and those with dangerous jobs.

So, where does leave us while comparing Obamacare with Husband and Wife Two-Man PPO Health Insurance? Let’s take a closer look at what Two-Man PPO Health insurance has to offer with relation to Obamacare.

Features of Husband and Wife Two-Man PPO Health Insurance

Overview

If you and your spouse are part of an LLC and are currently on Obamacare, you are probably paying too much for your Obamacare HMP Plan. The good news is that you can have your PPO plan back now. These plans are specially meant for couples which don’t get a subsidy on their health insurance and pay full rates towards their Obamacare plans.

PPO insurance cost is less than Obamacare plans. Furthermore, you can also buy a PPO plan that is not available through the ACA anymore. There are insurance brokers who have been writing these plans in pre-ACAdays for maternity benefits, for couples that wanted to be eligible for maternity and it was not being offered on the individual market before 2014. So, considering the above points, if you would like to reduce your current rate, or reinstate your PPO plan and have access to doctors of your own choice, a competent insurance agent will now be able to get this done for you.

Benefits of Husband and Wife Two-Man PPO Health Insurance

You get to choose the doctors that you would like to see in your network
You can have your original PPO Plan reinstated with all the features.
These plans offer similar features as if the policy owners work for a company.
Husband and Wife Two-man PPO Health Insurance plans are cheaper than ACA plans.

Eligibility Criteria

A company needs to be registered as an LLC with a partner, to form a 2-man group, typically husband and wife.
The husband and wife need to be the registered owners of the LLC.
If not getting a subsidy, the Obamacare policy can be relinquished in favor of the PPO plan.
Small Employer Benefit Program Application (BPA)
Employee applications must be submitted.
Signed BCBS quote to be provided.
Proof of wages (TWC report or other payroll documents) to be furnished.
Texas Supplemental Employee Verification form – needs to list out any employees who are not on the TWC report.
Proof of business – required only in TWC is not available
Employer Group Information form
EFT form or physical check for 1st month’s premium.

Legal Sanction to the Act

The new act has been legally endorsed. Hence any insurer big or small cannot refuse to issue new coverage for a Husband and Wife PPO Health Insurance Policy. According to Texas law, the policy must be granted in line with TIC §1501.151, any employer with two or more employees, even in the case where the two individuals are married to each other.

The rest of the act is all legalese, but the gist of the bill is that insurance carriers are bound to provide a PPO health insurance policy to a couple if they are married to each other and can provide evidence that they are members of the same LLC company. Further provisions supporting this facility can be found in Federal law (42 US Code 300gg-91(e)(1)(B)) which elaborates on the technical and legal definition of “employee.”

A Move in the Right Direction

So, if we look at this new development in retrospect, we see that there are a few clear advantages of the Husband and Wife PPO Health Insurance Policy over Obamacare after studying the Obamacare facts more closely.

The primary and most obvious benefit is that it is cheaper than the former. Otherwise as well, there are several advantages to the two-man PPO policies, which make them the preferred choice out of the two different categories concerning the cost of private health insurance in USA.

If you have a previous PPO Plan and would like to have it reinstated or if you want to take out a new policy in preference to an Obamacare policy, any good insurance agent will help you. In the long run, you will benefit from buying an affordable PPO Insurance Plan.