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Merlo represents Rotary Club


Sixty-three clubs are in the district that covers Central and South Texas stretching from Killeen to Yoakum,Corsicana to the north, Teague to the east and Marble Falls to the west. Representing Rotary, Merlo made an appearance at the July 23 Heights club ...

Alvarez says Gophers-Badgers rivalry 'healthy'


Gophers athletics director Norwood Teague said he doesn't yet know where the Axe will ...
POLLS: Two Gophers opponents this season, Ohio State and Texas Christian, debuted at No. 1 and 2 respectively in the the first Amway Coaches Poll released Thursday.

Velma’s Clues


Books may be checked out for advance reading at the Teague service desk. Albert is a prolific writer ...
buy an herb shop in a small town halfway between Austin and San Antonio, Texas. China wants the things that many contemporary women seek: a quieter ...

Memorial service held for Teague baseball coach Kilman


A memorial service was held Wednesday to honor Teague baseball coach Kyle Kilman, who passed away Sunday after a battle with cancer at the age of 51. Kilman won more than 300 games in his career, during which he also coached at Malakoff Cross Roads ...

New Texas law: is it enough to ease concern over franchise liability for employment-related claims?


the Advice Memo may be instructive in determining what constitutes "necessary" control under the new Texas law while we await further guidance from the courts. If you are interested in submitting an article to Lexology, please contact Andrew Teague at ...

Spring grass growth makes for potential fire hazard


PARKER COUNTY – When you look out at browning fields across North Texas, see them through the eyes of a firefighter. "I see potential for some good fires," said George Teague, the emergency management coordinator for Parker County. His crews help battle ...

Betty Jean Madden


Timothy Madden and wife Michelle of Washington and Kendall Madden and wife Amanda of Teague, Texas; 21 grandchildren; 25 great-grandchildren; her best friend, Florence Green of Washington; five sisters, Fay Grisham of Delhi, Calif., Ena Finley of ...

Yoe football garners more top preseason rankings


The Texas High School Coaches Association (THSCA ...
Kirbyville is in the number two slot, with Malakoff, Teague, and Rockdale rounding out the top five. Glen Rose (6), East Chambers (8), and Whitney (10), all of which the Yoemen played in 2014, are ...

Athens, Malakoff ranked in THSCA football poll


In the Malakoff region, the top 10 were Cameron Yoe, Kirbyville, Malakoff, Teague, Rockdale, Glen Rose ...
The panel is chosen from a pool of coaches who have indicated to the Texas High School Coaches Association their willingness to participate.

Florida, Texas governors order states’ National Guard to be armed while on base


Texas Gov. Greg Abbott announced Saturday that he will authorize ...
Matt Jaworowski of the Media General National Desk and KXAN’s Rachael Teague contributed to this report.

Girl wounded in attack on Jerusalem gay pride parade dies


JERUSALEM (AP) — A teenage girl seriously wounded after an anti-gay extremist stabbed her and several others in last week’s attack on Jerusalem’s gay pride parade died Sunday, a hospital official. Sh…

State of Texas In-Depth: Texas’ role in 2016 election


AUSTIN (KXAN) — While it may be the middle of the summer, Texas lawmakers were hard at work, with hearings on Planned Parenthood as well as concerns about Sandra Bland’s death in jail. Early next Mar…
Jobs from Indeed




SPECIAL INFORMATION FOR TEAGUE

The situation of health coverage in in TEAGUE TEXAS

1. After five years of the Affordable Care Act, more than 16 million people have health coverage.

That's more people than the populations of New York City, Los Angeles, and Chicago combined. This number includes parents who can finally afford to take their kids to the doctor, families who no longer risk losing their homes or savings because someone becomes ill, and young people who are now free to pursue their dreams without worrying about losing access to health care. 

With millions of people getting covered, the uninsured rate for non-elderly adults has dropped by 35% since October 2013. “The Affordable Care Act is working,” President Obama said after hearing the news that millions of Americans had signed up and gotten covered. “And I'll tell you, everywhere I go around the country, I'm meeting inpiduals who come up and thank me. How passionate they are about the difference it's made in their lives, it really reminds me why we do all of this." 


2. Medicaid is helping millions.

The Affordable Care Act allows states to expand eligibility for Medicaid, and 28 states and the District of Columbia have done so. Across all 50 states, there are 11.2 million additional Americans enrolled in Medicaid compared to a baseline period in the fall of 2013.

While not every state expanded Medicaid, those that did are seeing especially strong coverage gains. In Medicaid expansion states, the uninsured rate among families with incomes below 138 percent of the federal poverty line declined by 13 percentage points, nearly double the decline in non-expansion states.


3. Those with pre-existing conditions can no longer be denied health insurance.

Prior to the Affordable Care Act, health insurance companies could deny you coverage or charge you more because of a health problem that you had prior to applying for insurance. Thanks to the Affordable Care Act, health insurance companies can’t refuse to cover you just because you have a pre-existing condition and they can’t close you out of coverage by charging you more than someone who doesn’t have a pre-existing condition.

This key provision means that up to 129 million Americans with pre-existing conditions are no longer at risk of being denied coverage. This includes the parents of over 17.6 million children with pre-existing conditions who no longer have to live with that worry. 


4. The uninsured rate for young Americans is at its lowest point since at least 1997.

Thanks to the Affordable Care Act, the uninsured rate for young Americans has declined by more than 40 percent over the past five years. Since 2010, more than 5 million young adults have gained coverage.  This includes 2.3 million young adults who have gained coverage by being able to stay on their parent's health plan. Under the Affordable Care Act, young adults can stay on their parent’s coverage until age 26. With all that can happens in a young person's life, this provision helps ensure that those who are just starting out in college and work careers can plan with the assurance that they have access to quality and affordable coverage. 


5. Americans no longer have lifetime and annual limits on their coverage.

The Affordable Care Act has lifted the lifetime health benefit caps for 105 million Americans. Previously, many plans set a lifetime limit on how much they would spend for your covered benefits during the entire time you were enrolled in their plan. If you went over, you’d be paying out of pocket. Annual limits also constrained families and inpiduals by restricting how much they could receive per year. That's not how it should be. That’s why the Affordable Care Act prohibits health plans from putting annual or lifetime dollar limits on most benefits. 


These are just five of the core ways in which the Affordable Care Act has helped Americans get quality, affordable health care. See for yourself: Click here to meet inpiduals who have benefited from health care, read their stories, and then pass them on so others can see what getting covered -- and staying covered -- means. 

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Make Your Health Benefits Work for You in TEAGUE TEXAS

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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People help people. Gods do not help people

HealthDay news image Organ transplants have saved more than two million years of life in the United States over a period of 25 years, new research shows.But fewer than half the people who needed a transplant in this period they received, according to a report in the online edition of the January 28 issue of the journalSurgery JAMA ."The critical shortage of donors continues to affect this field. Just 47.9 percent of patients on the waiting list during the 25 years of the study underwent a transplant. The need is increasing, and therefore the Organ donation should increase, "wrote Dr. Abbas Rana, Baylor College of Medicine in Houston, and colleagues. The researchers analyzed the medical records of more than 530,000 people receiving organ transplants between 1987 and 2012, and nearly 580,000 people who signed up for the waiting list but never received a transplant. In that period, transplants saved 2.2 million life years, with an average of just over four years saved for each person who received a transplant from a living body, the study authors noted in a news release from the journal . The number of years saved by type of organ transplant life were: kidney, 1.3 million years; liver, more than 460,000; heart, almost 270,000; lung, about 65,000: pancreas and kidney, nearly 80,000; pancreas, just under 15,000, and intestines, around 4,500. One expert noted the relevance of the findings. "This study highlights the importance of organ donation, and shows that solid organ transplants save lives. One organ donor can have an impact on up to 50 lives," said Dr. Kareem Abu-Elmagd, director of the Center for transplant at the Cleveland Clinic in Ohio. "The field of transplantation continues to seek ways to save more lives," said Abu-Elmagd. "For example, the program of ex vivo perfusion of organs of the Cleveland Clinic has been studying perfusion technology to better preserve organs donated." Powered by infusion, a machine pumps oxygen and nutrients to the donated enriched to prevent damage or deterioration of the body prior to transplant into a patient waiting, according to the Cleveland Clinic organ solution. Baylor researchers suggested a direct solution. "We call for greater support of transplantation and solid organ donation, valuable efforts have an impressive record of achievements and tremendous potential to do even more good for humanity in the future," concluded the authors. HealthDay, translated by HispaniCare

SOURCES: Kareem Abu-Elmagd, MD, Ph.D., director, Cleveland Clinic´s Transplant Center, Ohio; JAMA Surgery , news release, Jan. 28, 2015

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