Make Your Health Benefits Work for You in MOUNT PLEASANT
The Department of Labor´s Employee Benefits Security Administration (EBSA) administers several important health benefit laws covering employer-based health plans. They govern your basic rights to information about how your health plan works, how to qualify for benefits, and how to make claims for benefits.
In addition, there are specific laws protecting your right to health benefits when you lose coverage or change jobs. EBSA also oversees health care laws covering special medical conditions. For more information on the laws that protect your benefits, see EBSA´s Website. Or call the agency toll free at 1-866-444-3272 to reach a regional office near you. These 10 tips can help make your health benefits work better for you.
1. Explore Your Options for Health Coverage
You have options for health coverage. There are many different types of health benefit plans. Find out what your employer offers, then check out the plan (or plans). Your employer´s human resource office, the health plan administrator, or your union can provide information to help you match your needs and preferences with the available plans. Or consider a health plan through the Health Insurance Marketplace. Visit HealthCare.gov to see the health plan options available in your area. Get information about all of your options and review it. The more information you have, the better your health care decisions will be.
2. Review the Benefits Available
Do the plans offered cover the benefits that are important to you, such as mental health services, well-baby care, vision or dental care? Are there deductibles? What are the out-of-pocket expenses you may face? Determine your needs and priorities. Compare all of your options before you decide which coverage to elect. Matching your needs and those of your family members will result in the best possible benefits. Cheapest may not always be best. Your goal is high quality health benefits.
3. Read Your Plan´s Summary Plan Description (SPD) for the Wealth of Information It Provides
Your health plan administrator should provide a copy. It outlines your benefits and your legal rights under the Employee Retirement Income Security Act (ERISA), the Federal law that protects your health benefits. It also should contain information about the coverage of dependents, what services will require a co-payment or coinsurance, and the circumstances under which your employer can change or terminate a health benefits plan. You also can find many of the answers to your questions in the Summary of Benefits and Coverage (SBC), a short, easy-to-understand summary of what a plan covers and what it costs. You should receive a copy with your enrollment materials. Save the SPD, the SBC, and all other health plan brochures and documents, along with memos or correspondence from your employer relating to health benefits.
4. Use Your Health Coverage
Once your health coverage has started, use it to help cover medical costs for services like going to the doctor, filling prescriptions or getting emergency care. Using your benefits will help you and your family stay healthy and reduce your health care costs. The Patient Protection and Affordable Care Act (ACA) provides many valuable protections for people enrolled in employment-based health plans including prohibiting preexisting condition exclusions and annual and lifetime limits on essential health benefits. What’s more, many plans cover certain preventive services for free, including routine vaccinations, regular well-baby and well-child visits, blood pressure, diabetes and cholesterol tests, and many cancer screenings. You also can keep your children on your health plan until age 26. Take advantage of your benefits, especially free preventive care if your plan covers it. If you were required to pay cost-sharing for a preventive service, check your Explanation of Benefits and ensure that the provider billed the service properly.
5. Understand Your Plan’s Mental Health and Substance Use Coverage
Many health plans provide coverage for mental health and substance use disorder benefits. If a plan does offer these benefits, the financial requirements (such as co-payments and deductibles) and the quantitative treatment limits (such as visit limits) for the mental health and substance use disorder benefits cannot be more restrictive than the financial requirements or treatment limits applied to medical/surgical benefits. Plans also cannot impose lifetime and annual limits on the dollar amount of mental health and substance use disorder services, including behavioral health treatment. Some plans cover preventive services like screenings for depression and child behavioral assessments for free. Check your SPD and SBC to find out what your plan covers.
6. Look For Wellness Programs
More employers are establishing wellness programs that encourage employees to work out, stop smoking, and generally adopt healthier lifestyles. The Health Insurance Portability and Accountability Act (HIPAA) and the ACA encourage group health plans to adopt wellness programs but also includes protections for employees and dependents from impermissible discrimination based on a health factor. These programs often provide rewards such as cost savings as well as promoting good health. Check your SPD and SBC to see whether your plan offers a wellness program(s). If your plan does, find out what reward is offered and what you need to do to receive it.
7. Know How to File an Appeal if Your Health Benefits Claim is Denied
Understand your plan’s procedures for filing a claim for benefits and where to make appeals of the plan´s decisions. Pay attention to time limits – make sure you timely file claims and appeals and that the plan makes decisions on time. Keep records and copies of correspondence. Check your health benefits package and your SPD to determine who is responsible for handling problems with benefit claims. Contact EBSA for assistance if you are unable to obtain a response to your complaint.
8. Assess Your Benefits Coverage as Your Family Status Changes
Marriage, Porce, childbirth or adoption, the death of a spouse, and aging out of a parent’s health plan are life events that may signal a need to change your health benefits. You, your spouse, and your dependent children may be eligible for special enrollment into other employer health coverage or through the Health Insurance Marketplace. Even without life-changing events, the information provided by your employer should tell you how you can change benefits or switch plans. If you’re considering special enrollment, act quickly. You have 30 days after the life event to request special enrollment in other employer coverage or 60 days to select a plan in the Marketplace.
9. Be Aware that Changing Jobs and Other Work Events Can Affect Your Health Benefits
If you change employers or lose your job, you may need to find other health coverage. If you have a new job, consider enrolling in your new employer’s plan. Whether starting or losing a job, you may be eligible to special enroll in a spouse’s employer-sponsored plan or through the Health Insurance Marketplace. Under the Consolidated Omnibus Budget Reconciliation Act – better known as COBRA – you, your covered spouse, and your dependent children may be eligible to continue coverage under your former employer-sponsored plan. This coverage is temporary (generally 18 to 36 months) and you may have to pay the entire premium plus a 2 percent administrative charge. Get information on your coverage options and compare. Be aware of the deadlines for deciding on coverage and find out when your new coverage will be effective.
10. Plan For Retirement
Before you retire, find out what health benefits, if any, extend to you and your spouse during your retirement years. Consult with your employer´s human resources office, your union, or the plan administrator. Check your SPD and other plan documents. Make sure there is no conflicting information among these sources about the benefits you will receive or the circumstances under which they can change or be eliminated. With this information in hand, you can make other important choices, like finding out if you are eligible for Medicare and Medigap insurance coverage. If you want to retire before you are eligible for Medicare and your employer does not provide health benefits in retirement, consider what you will do for health coverage. Your options may include enrolling in a spouse’s employer plan or in a Marketplace plan or temporarily continuing your employer coverage by electing COBRA. Planning for retirement includes planning for your health coverage in retirement. To find out more, read Taking the Mystery Out of Retirement Planning.
These Laws Can Help
- The Employee Retirement Income Security Act – Offers protection for inPiduals enrolled in retirement, health, and other benefit plans sponsored by private-sector employers, and provides rights to information and a claims and appeals process for participants to get benefits from their plans.
- The Patient Protection and Affordable Care Act – Creates the Health Insurance Marketplace and provides protections for employment-based health coverage, including extending dependent coverage of children to age 26; prohibiting preexisting condition exclusions and prohibiting lifetime and annual limits on essential health benefits.
- The Consolidated Omnibus Budget Reconciliation Act – Contains provisions giving certain former employees, retirees, spouses, and dependent children the right to purchase temporary continuation of group health plan coverage at group rates in specific instances.
- The Health Insurance Portability and Accountability Act – Allows employees, their spouses and their dependents to enroll in employer-provided health coverage regardless of open enrollment periods if they lose coverage or in the event of marriage, birth, adoption or placement for adoption. Also prohibits discrimination in health care coverage.
- The Women´s Health and Cancer Rights Act – Offers protections for breast cancer patients who elect breast reconstruction in connection with a mastectomy.
- The Newborns´ and Mothers´ Health Protection Act – Provides rules on minimum coverage for hospital lengths of stay following childbirth.
- The Genetic Information Nondiscrimination Act – Prohibits discrimination in group health plan premiums based on genetic information. Also, generally prohibits group health plans from requesting genetic information or requiring genetic tests.
- The Mental Health Parity and Addiction Equity Act and the Mental Health Parity Act – Requires parity in financial requirements and treatment limitations for mental health and substance use benefits with those for medical and surgical benefits.
- The Children´s Health Insurance Program Reauthorization Act – Allows special enrollment in a group health plan if an employee or dependents lose coverage under CHIP or Medicaid or are eligible for premium assistance under those programs.
For More Information
Visit the Employee Benefits Security Administration’s Website to view the following publications. To order copies or to request assistance from a benefits advisor, contact EBSA electronically or call toll free 1-866-444-3272.
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MOUNT PLEASANT SOUTH CAROLINA
This is Real: The World Climate is Changing
Our Earth is warming. The average temperature of the Earth has risen about 1.4 ° F (0.7 ° C over) over the last century. It is projected that the average temperature rise of approximately 2 to 11.5 ° F (1.1 ° C to 6.4 ° C) over the next hundred years. Small changes in average global temperature could lead to large and potentially dangerous changes in climate and weather.
The evidence is clear. Rising temperatures have been accompanied by changes in the weather and climate. Many sites have seen changes in rainfall, which resulted in more flooding, drought or heavy rain and waves more frequent and severe heat.The oceans and glaciers on the planet have also undergone some big changes: the oceans are warming and acidifying, the ice caps are melting and sea levels are rising. As these and other changes are more pronounced in the coming decades, they will have to present challenges to our society and our environment.
Learn about the signs of climate change in the United States.
Humans are largely responsible for recent climate change
Over the past century, human activity has downloaded large amounts of carbon dioxide and other greenhouse gases into the atmosphere. Most greenhouse gases come from the burning of fossil fuels that produce energy, but deforestation, industrial processes and some agricultural practices also emit gases into the atmosphere.
The greenhouse gases act like a blanket around the Earth, which traps energy in the atmosphere and causes it to heat.This phenomenon is called the greenhouse effect is natural and necessary to sustain life on Earth. However, the accumulation of greenhouse gases can change the Earth´s climate and dangerous effects to human health and welfare and ecosystems.
The choices we make today will affect the amount of greenhouse gases in the atmosphere will in the near future and for years to come.
Learn about the causes of climate change .
Climate change affects all
Our lives are linked to climate. Human societies have adapted to relatively stable climate which have enjoyed since the last Ice Age ended several millennia ago. A warming climate will result in process changes that could affect our water supplies, agriculture, energy and transport systems, the natural environment and to our own health and safety.
Some of the climate changes are inevitable. carbon dioxide can remain in the atmosphere for about a century so the Earth will continue to warm over the coming decades. The hotter it gets, the greater the risk of more severe changes in climate and Earth system. Although it is difficult to predict the exact impacts of climate change, it is clear that the climate to which we are accustomed to is no longer a guide to which we can trust what we can expect in the future.
We can reduce the risks we face from climate change. Choosing options that reduce pollution from greenhouse gases and prepare for the changes that are already underway, we can reduce the risks of climate change. Our decisions will shape the world in which our children and grandchildren will live.
Learn about the impacts of climate change and adaptation to change .
We can make a difference
You can take action. You can take steps at home, on the road, in your office to reduce emissions of greenhouse gases and the risks associated with climate change. Many of these steps can save you money; some, such as walking or cycling to work could improve your health! You may also participate in activities to support local or state level energy efficiency, clean energy programs and other climate programs.
Learn about what you can do .
Calculate your carbon footprint and find ways to reduce their emissions through simple actions you take daily.
EPA and other federal agencies are taking action. EPA is working to protect the health and welfare of the people in this country through common sense measures to reduce pollution and greenhouse gases to help communities prepare for change climate.
Something that you may to know about Saudi Arabia
"The Kingdom ... strongly condemns and denounces this cowardly terrorist act that is rejected by true Islamic religion as well as the rest of the religions and beliefs."
So reads the statement issued by Saudi Arabia, where I grew up, the day the offices of "Charlie Hebdo" came under attack, with the loss of 12 lives.
Last Sunday, to show further solidarity with the victims, the Saudi ambassador to France joined other world leaders in Paris for a unity rally to celebrate free speech.
This is consistent with the face Saudi Arabia presents to the outside world. Visitors to the website of the Saudi embassy in Washington are invited to "learn ... how the Kingdom´s political system is rooted in Islam´s traditions which call for peace, justice, equality, consultation and respect for the rights of the individual."
Just two days before the Paris rally, my friend Raif Badawi was removed, in shackles, from a mini-bus outside the Al-Jafali mosque in Jeddah as a large crowd gathered around him after Friday prayers. According to eyewitnesses, he closed his eyes and raised his head skyward as a security officer approached him from behind with a large cane and started to beat him. Witnesses say Raif was lashed 50 times. Afterwards, he was taken back to prison where he is serving a 10-year sentencefor blogging.
Raif´s next flogging was set to take place today, but Saudi authorities postponed it due to medical advice, his wife said. She expects he will be flogged again next weekand every following weekuntil his sentence of 1,000 lashes is complete.
Raif is officially charged with "adopting liberal thought," "founding a liberal website," and "insulting Islam." He has become the latest symbol of the two-faced policy his country takes towards human rights.
Saudi Arabia is a strong American ally that has enjoyed virtually unconditional support from the United States for decades. President Bush famously held hands with its monarch, King Abdullah, as the two strolled through his Crawford, Texas ranch during the King´s 2005 state visit. President Obama was widely criticized for appearing to bow to Abdullah at a G-20 summit in London.
In the same month that ISIS horrified the world with its brutal beheading of journalist James Foley, Saudi Arabia publicly beheaded 19 people, for crimes ranging from smuggling cannabis to sorcery. Limb amputations for theft are sanctioned by the state religion.
In addition to oil, Saudi Arabia is the world´s leading exporter of Salafism, an ultra-conservative strain of Islam. The country touts itself as the birthplace of the religion of peaceyet underlines the Islamic declaration of "Shahadah" on its flag with a sword. Osama bin Laden was a Saudi citizen, as were 15 of the 19 hijackers on 9/11.
Why does a world outraged by the horrific actions of ISIS and the Taliban turn a blind eye to the way this country treats its own citizens?
The first reason is obvious. It isn´t just our governments. Every time we fill our cars with gas, we all bow to the Saudi king.
The second is more complex.
Online videos of Raif´s flogging show worshipers from the mosque, including young children, running excitedly towards the square to watch the beating. Afterwards, the crowd erupts into cheers and applause, chanting "Allahu Akbar!" (God is Great!) in unison.
This isn´t surprising. The public likely considers Raif guilty of blasphemy and apostasy. A 2013 Pew Research poll found that large numbers in Muslim countries favor the death penalty for leaving Islamincluding 88% of Egyptian and 62% of Pakistani Muslims, as well as majorities in Jordan, Malaysia, Palestine, and Afghanistan.
Of course, these views don´t represent all Muslims. But contrary to what we´re usually told, they aren´t just held by a fringe minority either. Many of these countries don´t have populations willing to rally en masse to support free speech and pluralism the way France did. The change has to first come from within.
Raif has sacrificed a great deal to make this change happen. The world must support him and call Saudi Arabia out on its hypocrisy.
Some time ago, just 50 miles east of where Raif is being held today, another dissident once spoke of change, of challenging the status quo, of radical new ideas that would ultimately transform his society. He was ostracized, persecuted, and eventually driven from his city by those wanting to kill him. He was Mohammed, the Prophet of Islam; his persecutors, the Quraysh tribe of Mecca.
Muslims endeavor to emulate the life of Mohammed. Saudi Arabia has instead chosen to emulate the Quraysh.
This week, Raif spent his 31st birthday imprisoned and wounded. With enough awareness, we can put enough international pressure on the Saudi government to ensure that he spends his next one with his wife and their three beautiful children.
Ali A. Rizvi is a Pakistani-Canadian writer and friend of Raif Badawi. He grew up in Libya, Saudi Arabia, and Pakistan, and is an advocate for secularism and reform in the Muslim world. He is currently writing his first book, "The Atheist Muslim."