Volume 7 Number 32 August 6, 2010

Dear Floridian:

This week I am urging self-employed Floridians to take advantage of August open enrollment. Through August 31, insurers and HMOs that write small-group policies must offer basic and standard coverage to self-employed Floridians regardless of their health status, and it’s a great opportunity for our state’s small businesses to obtain health insurance or switch plans.

Small businesses are the backbone of our economy, and this open enrollment helps to assure that they have proper coverage and can focus on running a successful company!



Alex Sink
State of Florida

CFO Sink Urges Self-Employed Floridians to Buy, Review Health Insurance during August Open Enrollment

Florida CFO Alex Sink is urging Florida’s self-employed individuals to take advantage of the August open-enrollment period that allows sole proprietors, independent contractors and others to obtain health insurance or switch plans on a guaranteed-issue basis, without regard to health status. .

“Unforeseen medical expenses can be financially devastating, and it’s so important that our state’s self-employed workers and small businesses have adequate coverage,” said CFO Sink. “Our state’s small businesses are the backbone of Florida’s economy, and I encourage Floridians who qualify to take advantage of this open-enrollment period.”

From August 1 through 31, 2010, insurers and Health Maintenance Organizations (HMOs) that write small-group policies must offer basic and standard coverage to self-employed Floridians without regard to health status. Policies written or renewed in August have a plan start date of October 1, 2010.

Applicants must meet all of the conditions and criteria established by law, and provide documentation verifying the operation of an active business, including tax forms, license information and business receipts, per Florida Statute 627.6699(3)(u).

The Small Group Carrier List is available on the Department of Financial Services’ web site at: http://www.myfloridacfo.com/Consumers/Guides/Health/smallGroupMarketCarriers.htm.

For premium comparisons, go to https://apps.fldfs.com/sercs/ on the Office of Insurance Regulation web page. Click on the “One Life Group Factor” button to get rate information for a one-life group.

For plan options, go to: http://www.floir.com/lh_fr/is_LHFR_Small_Emp_Benefit_Plan.aspx.

In addition to basic and standard policies, coverage options for employers include health savings accounts (HSAs) or health reimbursement arrangements (HRAs). HSAs, which operate like Individual Retirement Accounts (IRAs), allow people to save their own money in a tax-free account for use on health-related expenses. If the money is not spent, it rolls over annually and accumulates until the policyholder reaches age 65, at which time the money can be used for any purpose.

A Health Insurance guide and Small Business Owners’ Insurance guide are available on CFO Sink’s web site. Additional information regarding health care plans may be obtained from the Department of Financial Services’ Consumer Helpline at 1-877-My-FL-CFO (1-877-693-5236) or visit www.MyFloridaCFO.com.

My Family CFOTax-free Shopping Days for Back-to-School Bargains

Over three days next weekend, Florida shoppers can save on certain items during the sales tax holiday. From Friday, August 13 through Sunday, August 15 books, clothing, footwear and certain accessories selling for $50 or less along with certain school supplies selling for $10 or less will be exempt from Florida's 6 percent sales tax and any local sales taxes.

The sales tax exemption applies to each eligible book or item of clothing selling for $50 or less and to each eligible school supply item selling for $10 or less. The sales tax break is on each item that qualifies no matter how many items are on one invoice. But it cannot apply to items that cost more than the limits. If you buy $80 shoes, there will be sales tax.

The sales tax holiday is popular with taxpayers and retailers alike. Getting ready for another school year can be costly, and the sales tax break added to store sale prices can help stretch the family budget dollars.

Florida's sales tax holiday is a real break for working families and retailers will get more customers, providing a good boost to the economy. But the tax break isn't just for the kids. It's for anyone who wants to buy a shirt, a skirt, shoes or a raincoat (each item under $50) or any of the dozens of items on the state-approved tax-exempt list.

The three-day sales tax break means a $21.3 million tax saving for Florida consumers, according to the official estimates.

Consumer Corner

Money Received from BP Claims Is Taxable

Many of the Floridians affected by the Deepwater Horizon oil spill have filed claims with BP and some of the claimants have received at least partial payments over the last few months. Florida CFO Alex Sink cautions those who have received claims payouts from BP to keep in mind that the money they’ve received is taxable.

The tax code considers payments made to individuals in the form of compensation for lost wages or as a substitute for what would have otherwise been taxable income to be taxable income. Unemployment compensation is also considered taxable income. Except last year, when the first $2,400 of the government benefit was tax free. CFO Sink advises Floridians not to spend claims payouts received from BP without setting aside a portion to pay taxes next year.Deepwater Horizon Oil Spill Resources

CFO Sink encourages Floridians who have lost business income due to the oil spill to keep documentation of their losses for the purposes of filing a claim and for tax purposes.

Navigating the Patient Protection and Affordable Care Act Part IX - Women’s Health Issues

ICA Sean Shaw

Sean Shaw, Insurance Consumer AdvocateInsurance Consumer Advocate

As the summer comes to an end, the Navigating the Patient Protection and Affordable Care Act (PPACA) series has also come to a conclusion. Navigating the PPACA can be a daunting task without guidance, and throughout the summer the Office of the Insurance Consumer Advocate has provided consumers with information regarding benefits that will be enacted September 23, 2010, the PPACA timeline, preventative health benefits, advantages for small businesses, how the PPACA affects children and parents, and more. In this final edition, the Office will focus on how PPACA will impact women and women’s healthcare.

Numerous enactments have taken place as a result of the PPACA, and many of them specifically affect women and women’s health. Pregnant women, in particular, will see various changes as well, and they are as follows:

According to the U.S. Department of Health and Human Services, in 2006, 12,000 women in the U.S. were diagnosed with cervical cancer, and approximately 4,000 women died from the disease. More than 16% of women in the U.S. are smokers, which significantly increases their risk of lung cancer and other tobacco-related illness.

The PPACA regulations ensure that new health plans offer coverage to women without cost-sharing for a variety of important cancer prevention tools including:

For more information on the PPACA and women’s healthcare services, consumers should visit http://www.healthcare.gov/.

As more information is available and additional changes become effective, the Office of the Insurance Consumer Advocate will generate advisories regarding healthcare services for women. More information regarding the PPACA can be found on the website of the Insurance Consumer Advocate at, http://www.myfloridacfo.com/ica/federalhealthcare.asp.

Florida Consumer WarningInsurance Company Search

Bogus Health Insurance Being Marketed in Florida

The Florida Department of Financial Services (DFS) and the Office of Insurance Regulation (OIR) are warning Floridians of the solicitation of unauthorized health insurance plans sold by the Association of Independent Managers (AIM). The OIR has issued a Cease and Desist Order to AIM, and preliminary OIR estimates indicate as many as 1,800 consumers have already purchased these bogus health plans.Agent and Agency Search

“Bogus health insurance scams rob consumers of their hard-earned money and also leave them uncovered in the event that medical care is needed,” said CFO Alex Sink, who oversees the Department of Financial Services. “My Department is working together with OIR to actively seek out and hold accountable any agents involved in unauthorized insurance transactions.”

On Tuesday, the OIR issued a Cease and Desist Order to AIM for the unauthorized sale of health insurance products. Preliminary OIR estimates indicate as many as 1,800 consumers have already purchased these illegitimate health plans from AIM.

“This type of illegal and unethical activity will not be tolerated as Floridians must rely on health insurance to pay their claims during these vulnerable economic times,” said Insurance Commissioner Kevin McCarty. “We can assure Floridians that our team will continue to be vigilant to ensure the legitimacy of health insurance products sold in Florida.”

The DFS has received complaints from over 96 consumers involving 49 agents soliciting health benefits through different unauthorized entities. Most notably, AIM recently marketed “AIM Health Plans.” Insurance Resource Group (IRG) is another name associated with AIM Health Plans. Some of the individuals involved with the sale of AIM plans have also participated in the unauthorized sale of health insurance products with other companies including Serve America Assurance and Real Benefits Association.

Other unauthorized plans marketed by AIM are known to include—but are not limited to:

AIM is also known to associate with the names of:

No entity under these names is currently authorized by the OIR to transact health insurance business in Florida.

The OIR only authorizes insurers that have met Florida’s stringent statutory requirements. The Florida Life and Health Guaranty Association Act protects policyholders with authorized insurance products should the insurer become insolvent. Unauthorized insurance, particularly unauthorized health insurance, can lead to significant unpaid claims and out-of-pocket costs for victims; the Guaranty Fund will not pay these claims. Agents and individuals who sell unauthorized insurance can be required to pay all unpaid claims, and can face felony charges. Agents can lose their licenses and are Consumer Help Onlineurged to verify the company is licensed in Florida before they sell.

Consumers who believe they have bought coverage from an unlicensed insurance operation should take the following steps:

Consumers should also:

To verify the authorization of an insurance company visit http://www.floir.com or for the licensure of an agent, visit www.MyFloridaCFO.com or call the CFO’s Consumer Helpline at 1-877-MY-FL-CFO (1-877-693-5236).

Hurricane Season: Are you prepared?Hurricane Checklist: Make Sure You Have the Right Health Insurance Coverage

If you needed to evacuate because of a storm and needed medical treatment outside of your area, do you know what your plan would cover and how much your deductible may be? Floridians need to review their health plans now to make sure their coverage needs would be met.

Consumers should know the answers to the following questions:

Get prepared:

If you do not currently have health coverage for your children, visit the Florida Kid Care Web site at www.floridakidcare.org or contact the Department of Consumer Services Helpline at 1-877-MY-FL-CFO (1-877-693-5236) for information about health insurance coverage for the entire family.

Uninsured Floridians can also obtain health coverage through Cover Florida by visiting www.coverfloridahealthcare.com. For more information on health insurance in Florida, read our Health Insurance Guide.

Find out when a Hurricane Preparedness Event will be in your area on our calendar. Check back with us next week for more ideas.

Florida Office of Financial Regulation Identifies Top Investor Traps and Tips to Help You Avoid Investment Fraud

In the tough economy, consumers can’t afford to take unnecessary risks with their hard-earned money

The Florida Office of Financial Regulation (OFR) on Wednesday released the 2010 list of most commonly used cons or traps investors should avoid. Regulators found as the impact of the financial crisis continues along Main Street, investors seeking to jump-start their investment portfolios are most vulnerable and need to be wary of these popular scams.

“Investors should remember the speculative investments promising high returns are most often the ones that turn their hard-earned money into thin air,” said OFR Commissioner J. Thomas Cardwell. “We need to warn consumers not to be lured into get-rich-quick schemes. If it sounds too good to be true, or promises large returns in a short period of time, thoroughly investigate the investment and the person and firm selling them before investing.”

Commissioner Cardwell strongly encourages investors to familiarize themselves with the warning signs of investment fraud and independently verify any investment opportunity, as well as the background of the person and company offering the investment. OFR’s Division of Securities can provide detailed information about a firm’s, broker’s or investment adviser’s employment and disciplinary history. Investors should call OFR at 1-800-848-3792 for additional information. In addition, investors should learn as much as possible about the firm, individuals and investment so that they can be comfortable with and fully understand the deal and its risks.

“Knowledge, attention to detail and a healthy sense of skepticism are a triple threat to fight investment fraud,” said Franklin L. Widmann, OFR’s Director of the Division of Securities. “The Division and other state securities regulators can provide the public with detailed background information about those who sell securities or give investment advice, as well as about the products being offered. The more you are prepared, the better your chance of sidestepping a trap that can leave you in a financial hole for many years.”

Read more about OFR's Top 10 Investor Traps.

Florida Housing HelpFlorida Housing Help Website and Workshops

The Florida Housing Help website can help connect struggling Floridians who may be at risk of losing their homes to foreclosure or may be facing mortgage fraud issues with assistance. For a schedule of workshops that include community partners and resources and offer great information for citizens, read the Florida Housing Help Calendar.

Safeguard Our SeniorsSafeguard Our Seniors Helps Protect Floridians

Every day, hundreds of Floridians fall victim to financial fraud. Many of these victims are trusting seniors who were misled into making risky or inappropriate financial investments including annuities and reverse mortgages by unscrupulous agents and scam artists. In response, CFO Sink created the Safeguard Our Seniors Task Force to develop solutions to better protect Florida seniors from falling victim to financial fraud.

Over the last two years, CFO Sink’s Department of Financial Services has held more than 400 Safeguard Our Seniors events throughout the state to teach how to guard against fraud and scams targeting seniors. Calendar of Events