The Supreme Court of the United States will soon be making a decision on a case that could affect millions of people. The case of King vs. Burwell will decide whether those who use the federal marketplace to buy their health insurance will be allowed to receive a subsidy.
The Background of King vs. Burwell
On March 4, 2015 the Supreme Court of the United States heard King vs. Burwell, a case challenging the availability of Affordable Care Act premium subsidies in states with a federally run marketplace. The law provides for advanced payment of premium tax credits for people with incomes between 100 to 400 percent of the federal poverty level, and cost sharing reductions for people with incomes 100 to 250 percent of the federal poverty level.
In implementing its regulations, the Internal Revenue Service interpreted the ACA to authorize premium subsidies for individuals who purchase coverage on all marketplaces. The King vs. Burwell petitioners are challenging the legality of the IRS regulation allowing premium subsidies in states with a federally run marketplace.
The Two Sides
The controversy of this case lies in the wording of the ACA provision that amends 36B of the Internal Revenue Code “the premium subsidy amount is based on the cost of the qualified health plan…enrolled in through a Marketplace established by the State under 311 of the [ACA].”
The petitioners (King) want the Supreme Court to strike down the IRS regulation making subsidies available to individuals who purchase health plans in a state with a federally run marketplace. Their argument is that the IRS lacks the authority to issue this rule because they contend the ACA’s language is clear that these subsidies only are available in state-based marketplaces.
The respondents (Burwell) of this case are federal agencies charged with implementing the ACA. The federal government wants the court to uphold the IRS’s regulations making subsidies available in states with a federally run marketplace. The federal government argues that the IRS’s rule is consistent with the language of the ACA because a marketplace “established by the state” also means one established by the Department of Health and Human Services standing in as a surrogate for the state.
What the Future Could Hold
The Supreme Court’s decision could affect the number of people who ultimately have access to affordable coverage under the ACA.
- If King wins: If the IRS rule is overturned by the Supreme Court, people in 34 states would lose access to subsidies. Overturning the IRS rule also would essentially nullify the requirement that large employers offer coverage to full time employees in these states. The applicability of the employer mandate is dependent upon the premium subsidies because the associated tax is triggered when one of an employer’s full time workers receives a subsidy. If there are no subsidies, then an employer would never be subject to the tax for failure to comply with the employer mandate.
- If Burwell wins: If the Supreme Court upholds the IRS rule, subsidies will continue to be administered through all marketplaces.
The Supreme Court will be making a decision near the end of June, 2015.
What IAA has to Say
Health coverage is not only important to those who have a chronic illness, but it is also vital to maintaining a healthy workforce. Insurance Administrator of America wants you to have healthy and active employees.
For businesses who do not have health coverage for their workers, IAA has introduced many companies to self-funded healthcare plans. IAA works with you to design a program, pay and manage claims, establish a provider network, and obtain stop-loss coverage. Remember, with IAA one call does it all.
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Summer is just around the corner and you may feel yourself becoming distracted thinking about summer plans. For people with adult attention deficit hyperactivity disorder (ADHD), becoming distracted occurs on a daily basis.
Symptoms of Adult ADHD
ADHD is thought to be an imbalance in neurotransmitters, the chemical messengers that relay signals in the brain, particularly in the frontal cortex that governs planning and impulse control. In adults attention deficit disorder often looks quite different than it does in children. Signs and symptoms of adult ADHD are:
- Angry outbursts: ADHD often leads to problems with controlling emotions. Adults with ADHD may become easily flustered and have hypersensitivity to criticism.
- Extremely distractible: People with adult ADHD may “zone out” without realizing it, even in the middle of a conversation.
- Hyperfocusing: Adults with ADHD have a tendency to become absorbed in tasks that are stimulating and rewarding. This paradoxical symptom is called hyperfocus. It is actually a coping mechanism for distraction. It can be so strong that you become oblivious to everything around you.
- Impulsivity: Those with adult ADHD may frequently interrupt others or talk over them. They may also have addictive tendencies. They can act recklessly or spontaneously, without regard for consequences.
- Lateness: People with ADHD tend to underestimate how much time it takes to finish a task, whether it’s going to an event or simple home repairs.
- Poor listening skills: Problems with attention result in poor listening skills in many adults with ADHD, leading to a lot of missed appointments and misunderstandings.
- Prioritizing issues: Often people with ADHD mis-prioritize, failing to meet big deadlines, while spending countless hours on something insignificant.
- Restlessness: While many children with ADHD are hyperactive, this ADHD symptom appears differently in adults. Rather than bouncing off the walls, adults with ADHD are more likely to be restless or find they can’t relax.
- Trouble getting organized: The responsibilities of adulthood (bills, jobs, etc.) can make problems with organization more obvious and more problematic.
- Trouble starting a task: Adults with ADHD often drag their feet when starting tasks that require a lot of attention.
About 4.4 percent of adults in the United States, some 10 million people, have ADHD and less than one quarter are aware of it. This is because while ADHD always starts in childhood, many adults with the disorder went undiagnosed when they were young.
Help Control Your Symptoms
There is a lot you can do yourself to help control your symptoms:
- Exercise and eat right: Exercise vigorously and regularly. It helps to work off any excess energy and aggression in a positive way and soothes the body. Eat a variety of healthy foods and limit sugary foods in order to even out mood swings.
- Get plenty of sleep: When you’re tired, it is even more difficult to focus, manage stress, stay productive, and keep on top of your responsibilities. Support yourself by getting at least seven to eight hours of sleep every night.
- Practice better time management: Set deadlines for everything, even seemingly small tasks.
If you are an employer who has an employee with ADHD here are a few tips on how to work alongside them:
- Office configurations: Because of the ease of distractibility, open office arrangements with few walls or dividers to filter out conversations and other noises, may lead to problems.
- Team dynamics: These types of employees tend to be more effective in an individual contributor role, rather than team leader roles.
- Time management: More frequent check-ins from managers or computer-based reminders can help keep a project moving at the desired pace.
Employees who have ADHD can have the most innovative ideas; they just need an environment that can work with their unique needs.
What IAA has to Say
Insurance Administrator of America understands that living with adult ADHD can be difficult. Today’s world is full of distractions, but it is possible to succeed. IAA knows that adults with ADHD can be successful! Remember, with IAA one call does it all.
Interested in reading more on this topic? Click here.
Everyone knows that feeling, when your head is throbbing and there is nothing you can do to stop the pain. While many people experience headaches and migraines, not many know what causes them. As June is Headache and Migraine Awareness Month, take the time to learn what is going on behind your head.
What is a Migraine?
A migraine is an inherited neurological disorder that is characterized by hyper-excitable brain networks that may be triggered by a variety of stimuli or become active spontaneously, leading to attacks. Migraines may be caused by changes in the brain stem and its interactions with the trigeminal nerve, a major pain pathway.
A migraine headache typically lasts about 24 hours, however, an attack that includes all phases from beginning to end can last several days or more. Migraines may progress through four stages:
1. Prodrome: One or two days before a migraine, you may notice subtle changes that may signify an oncoming migraine including:
- Food cravings
- Neck stiffness
- Uncontrollable yawning
2. Aura: Aura may occur before or during migraine headaches. Auras are nervous system symptoms that are usually visual disturbances, such as flashes of light. Sometimes auras can also be touching sensations, movement or speech disturbances.
3. Attack: During a migraine you may experience the following symptoms:
- Blurred vision
- Nausea and vomiting
- Pain on one side or both sides of your head
- Pain that has a pulsating, throbbing quality
- Sensitivity to light, sounds and sometimes smells
4. Postdrome: The final phase occurs after a migraine attack. During this time you may feel drained or washed out.
36 million Americans suffer from migraine headaches.
Types of Headaches
There is a difference between a headache and a migraine headache. Headaches are not usually accompanied by other symptoms associated with a migraine. However, it is quite likely that if you have had a migraine you will also experience other headaches.
The most common types of recurring headaches as classified by the International Headache Society are:
- Chronic daily headache: This term is given to headaches that occur 15 or more days a month. This type of headache pain can vary and can change depending on the individual’s situation.
- Eye strain: Headaches can be caused by weak eye muscles. This type of headache gets worse when the individual reads, uses a computer screen, or any activity which requires their eyes to work in a focused intense way.
- Medication overuse/rebound headache: Caused by the overuse of over –the- counter medication or prescribed headache medications. As the medication wears off, the withdrawal from the medication triggers the next headache.
- Sinus headache: Sinusitis tends to be over diagnosed as a cause of headache in adults based on the belief that pain over the sinus area must be related to the sinus itself. In fact, pain over the sinus area is often caused by migraine and tension -type headache.
- Tension-type headache: The most common type of headache, usually caused by stress, worry, depression, lack of sleep, and tiredness. Common symptoms are a feeling of tightness and pressure around the head with pain occurring on both sides of the head.
Migraines and headaches cost the United States more than $20 billion each year. Costs are attributed to direct medical expenses (e.g. doctor’s visits and medications) and indirect expenses (e.g. missed work and lost productivity).
What IAA has to Say
Insurance Administrator of America knows that migraines and headaches can knock you off your feet. That is why IAA is encouraging you to share this blog post with friends, family and colleagues. Make this the month you spread awareness on migraines and headaches, so that one day we can be headache free.
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One of the best parts about summer is the ability to cook outdoors. However, grilling can become dangerous if not done properly. Each year an average of 8,800 home fires are caused by grilling and close to half of all injuries involving grills are due to thermal burns.
Stop Grill Injuries Before They Start
Roughly, a third of gas grill injuries come from burns incurred while lighting the grill. Problems may be caused by:
- Forgetting to make sure that the hoses that connect the propane tank are in good shape and attached securely
- Leaving grills greasy
- Leaving grills unattended
- Neglecting basic maintenance
According to the National Fire Protection Association, gasoline or lighter fluid is a factor in about a quarter of burn injuries from charcoal grills. These injuries usually happen when cooks get inpatient with charcoal that seems to be taking too long to light, and decide to add fumes to the flame.
Before lighting up the grill, do a safety check:
- Check for propane gas leaks. Open the gas supply valve fully and apply a soapy solution with a brush at the connection point. If bubbles appear, there is a leak.
- Has your grill been recalled? If the grill has been recalled, contact the manufacturer and stop using it until you get it repaired or replaced.
- Is the grill clean? Regularly cleaning the grill and grease trap will reduce the risk of flare-ups and grease fires.
- Visually inspect the hoses on a gas grill for cracking, brittleness, holes, and leaks.
According to the U.S. Fire Administration, grill fires cause more injuries when compared to all other fires.
Grilling can cause very serious burns if not handled properly. Knowing how to deal with burns is important, especially if grilling is going to be a big part of your summer. There are three types of burns:
- First degree burns
- Hold skin under cool (not cold) running water or immerse in cool water until pain subsides
- Cover with sterile, non-adhesive bandage or clean cloth
2. Second degree burns
- Immerse in cool water for 10 to 15 minutes
- Don’t apply ice. It can lower body temperature and cause further damage.
- Cover loosely with a sterile, nonstick bandage and secure in place with gauze or tape
- Unless the person has a head, neck or leg injury, or it would cause discomfort: Lay the person flat, elevate feet 12 inches, elevate burn area above heart level if possible, and cover the person with a coat or a blanket.
3. Third degree burns
- Call 911
- Cover loosely with a sterile, nonstick bandage or, for large areas, a sheet or other material that won’t leave lint in the wound
- Separate burnt toes and fingers with dry, sterile dressings
- Do not soak burn in water, which could cause an infection
- Unless the person has a head, neck or leg injury, or it would cause discomfort: Lay the person flat, elevate feet about 12 inches, elevate burn area above heart level if possible, and cover the person with a coat or a blanket. For an airway burn, do not place a pillow under the person’s head when the person is lying down. This can close the airway.
- Have a person with facial burns sit up
- Check pulse and breathing to monitor for shock until emergency help arrives
Burns need to be taken seriously, so if you are unsure of what type of burn it is, seek the help of a medical professional.
What IAA has to Say
Insurance Administrator of America loves a good barbecue, just not the burns that can come with it. Make sure when cooking on the grill that you have all your safety bases covered. No one wants a fun night grilling to end up in flames! IAA wants you to have a fun (and burn free) summer.
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A Memorial Day weekend barbecue is a great way to start off the summer. All that great grilled food plus fresh veggies, who could resist? But have you been feeling sick since that weekend? If so, it might be due to food poisoning.
Signs and Symptoms of Food Poisoning
Food poisoning is a common, yet distressing and sometimes life threatening, problem for millions of people. Food poisoning symptoms vary with the source of the contaminant. Most types of food poisoning cause one or more of the following symptoms:
- Abdominal pain and cramps
People infected with food borne organisms may be symptom free or may have symptoms ranging from mild intestinal discomfort to severe dehydration. Signs and symptoms may start within a few hours after eating the contaminated food or they may begin days or even weeks later. Sickness caused by food poisoning generally lasts a few hours to several days.
More than 250 diseases can cause food poisoning, some examples are:
- Campylobacter: Transmission occurs through ingesting contaminated food.
- E.coli: This is a growing cause of food borne illness. An estimated 73,000 cases of E.coli infections occur in the United States every year, according to the Centers for Disease Control.
- Listeria: The CDC estimates that there are 1,600 illnesses and 260 deaths from listeria infection each year.
- Salmonella: This is a bacterial infection. It is most often caused by eating undercooked poultry.
Food poisoning can become serious, so be safe about how you cook your food!
Don’t let Food Poisoning Ruin Your Barbecue
You don’t want people’s memories of your barbecue to be about how they got food poisoning! You can keep your food clean and safe from the moment you buy it:
- From the store to home: When shopping, buy meat and poultry last, right before checkout. To guard against cross contamination, put packages of raw meat and poultry into separate plastic bags.
- Keep cold food cold: Keep meat and poultry refrigerated until ready to use. When using a cooler, keep it out of the direct sun by placing it in a shelter or shade.
- Keep everything clean: Be sure that there are plenty of clean utensils and platters. To prevent food borne illnesses, don’t use the same platter and utensils for raw and cooked meat and poultry.
- Don’t let perishable food sit out: Food sitting out more than two hours is not safe. The time frame is reduced to one hour if the outside temperature is more than 90°F.
Remember that most bacteria do not grow rapidly at temperatures below 40°F or above 140°. The temperature range in between is known as the danger zone. Bacteria multiply rapidly at these temperatures and can reach dangerous levels after two hours.
What IAA has to Say
Insurance Administrator of America knows that summer is the time for eating outdoors. Summer barbecues can be fun, but if food is not cooked properly, it could mean a bad ending to a good party. IAA wants you to practice food safety this summer. Just think of IAA as your third party grill master, cooking up what’s best for you and your business!