How To Keep Your Health Costs Low In 2016: Part II

How To Keep Your Health Costs Low In 2016: Part II

by Shideh Kerman, BS, MBA

How can we save money by choosing the right Health Insurance plan?

Has this question ever crossed your mind? If yes, let me tell you that you are not the only one who had thought about lowering your medical insurance costs every time you see the high insurance premium expense or when you pay copays when visiting a doctor.

Three things you need to know when you are picking your health insurance:

  1. Decide what level of coverage you need that year.
  2. Review the total cost of your health plan.
  3. Check the plan network.
  4. Decide what level of coverage you need: The “metal” categories.

Microsoft Word - HealthArticle-Shideh.rtfThe Affordable Care Act (ACA) has prompted health insurance companies to offer health care plans in four categories. The category you choose determines how you and your plan share the costs of care. This structure helps make it easy to compare health care plans from a range of companies.

The plans are divided into four “metal levels,” plus catastrophic.

 

Plan     Insurance         Patient

Category         Pays     Pays

Platinum          90%     10%

Gold    80%     20%

Silver   70%     30%

Bronze 60%     40%

 

If you are under 30 years of age, you might be eligible to apply for a Catastrophic coverage. For more info go to the CMS website at https://www.cms.gov.

Just like car insurance, you pay for it hoping you never need to use it. Health insurance is for unpredictable and fundamentally serious health problems that occur in people’s lives. Health insurance covers these costs and offers many other important benefits.

In general if you are healthy and don’t need to visit the doctors, a bronze plan might be better choice. But if you need to see the doctor often and or have planned surgeries, having a plan that offers more coverage will save you a lot of money.

  1. Total Cost of your health plan.

You pay for health insurance in two ways:

  1. The monthly premium that you pay to purchase your plan.
  2. The fees you pay when you receive medical care. Those are some combination of
  • Copay
  • Deductible
  • Coinsurance
  • Out-Of-Pocket

COPAY — A copayment or copay is a fixed payment for a covered service, paid when an individual receives certain types of service.

For example, you might pay $50 for a doctor’s visit and the insurance company will pick up the rest. Plans with higher premiums generally have lower copays, and vice versa. And some plans do not have copays at all. They use other methods of cost sharing.

DEDUCTIBLE — The amount you owe for covered health care services before your health insurance plan begins to pay.

For Example, if your deductible is $2,500, then you would pay cash for the first $2,500 in health care you receive each year, after which the insurance company would start paying its share.

COINSURANCE — Is your share of the costs of a service that is covered by your health insurance.

For example if you need a CAT Scan that costs $1,500, you might pay 30 percent ($450). And your insurance company will pay the other 70 percent ($1,050). Plans with higher premiums generally pick up a larger portion of the bill.

OUT-OF-POCKET LIMIT — Out-of-pocket costs include deductibles, coinsurance, and copayments for covered services plus all costs for services that aren’t covered. Once you hit this limit, the insurance company will pick up 100 percent of your costs for the remainder of the year. Most people never pay enough for health care services to hit the out-of-pocket limit but it can happen if you require a lot of costly treatment.

In general, if you pay a higher premium upfront, you will pay less when you receive medical care, and vice versa. Below graph demonstrates how premiums affect out of pocket paid.

  1. Check the plan network.

Every health insurance plan has a network of providers such as doctors, hospitals, laboratories, imaging centers, and pharmacies that have signed contracts with the insurance company agreeing to provide their services to plan members at a specific price.

If a provider is not in your plan’s network, the insurance company may not cover the bill, or may require you to pay a much higher share of the cost. So if you have doctors you want to continue to see, you will want them to be in the plan’s network. Some most common networks are PPO, POS and HMO plans.

Preferred Provider Organizations (PPOs): PPOs give you the choice of getting care from in-network or out-of-network providers. You pay less if you use providers that belong to the plan’s network.

Point-of-Service (POS) Plans: POS plans let you get medical care from both in-network and out-of-network providers. If you have a POS plan, you’ll choose a primary doctor from a list of participating providers. Your primary doctor can refer you to other network providers when needed.

Health Maintenance Organizations (HMOs): HMOs usually limit coverage to care from providers who work for or contract with the HMO. An HMO generally won’t cover or has limited coverage for out-of-network care except in an emergency.

What plan is the right one for you depends on your health, your financial situation and the providers that you prefer to provide care for you.

  • If you already know you have an expensive medical condition, consider a plan with a higher premium that covers more of your costs.
  • If you are generally healthy you might come out ahead paying a lower premium and a bigger share of your health costs, because those costs are most likely not going to be that high. Of course, you need to be prepared to pay more if you do unexpectedly become sick or injured.
  • If you have a primary care physician and specialists you like, be sure they’re in the network of any plan you consider buying.
Welcome To The Hotel Confusion

Welcome To The Hotel Confusion

Hollenback - Frey 2-16“You can check out any time you like, but you can never leave.” With the passing of rock legend Glenn Frey I couldn’t help but revisit the Eagles playlist on my podcast. The lyric I opened my article with always rings in my head for various reasons but mostly it’s a lyric I interpret as someone who checks out in their mind because they are stuck in a situation.

Related to dating and relationships I submit there are many of you out there who feel checked out in your relationship and feel like there is no way out. I know ultimately it is up to us as individuals to make decisions that are best for our own personal well-being and mental and physical health but we all know that’s not easy. It’s especially not easy when emotion and guilt are woven in to your decision making process. I rarely see an emotion based decision work out. Again, easier said than done, we are human after all.

But who wants to be “checked out” in life and feel like they can “never leave?” Not me! Let’s talk for a minute about what makes a person stuck in a relationship…

The following are signs that you may be checked out and stuck in a bad relationshit.

  • You’re finding you care less and less about things that were very important to you and now you give up fighting for them because no matter how much you express yourself they just don’t care about what you find important.
  • You find yourself angry at that person all the time even when there isn’t an immediate issue at hand. This comes from built up animosity that has not been addressed which, in turn, leaves you feeling empty, bitter and angry.
  • You begin to start plotting exit strategies in your mind that you never follow through with because of some kind of guilt attachment you have with the other person, i.e., they helped you with something important at one point and it’s held over your head.
  • You have positioned yourself to rely on your current partner and without them your lifestyle or creature comforts would be disrupted.
  • You now avoid any kind of intimate contact with your partner because it seems forced and not genuine.
  • You begin sabotaging your future with that person unconsciously by continually complaining to your friends and family about how miserable you are. Once you do this, of course your friends and family will side with you making it impossible for you and your partner to build a healthy future. Unless, of course, you don’t care about having friends and family in your life.
  • Just like the lyrics say, you checked out and you find yourself not communicating even if you want or need to.

All of these signs are very dangerous. If you are experiencing any or all of the symptoms of a diminishing and dysfunctional relationship you need to push the pause button. You need to pause and ask yourself if you are living in a manner that is true to you. True to your expectations, values, goals and communication level needs to make you a growing, thriving and healthy person. Remember, disease causes disease.

It is very easy to get caught up moving in the wrong direction in life and if there is anything to take away from the Eagles great Glenn Frey, it’s this… Live your life to the fullest, be kind to people, do what you love and be true to what you want because being around tomorrow is no guarantee. Make today your day and lead with your heart, but follow with your fury.

Here’s to happiness and cutting the cancer out of your life once you identify it. Good luck!

Your pal, Sheik

Glendale Raptors Look To Maintain Post At America’s Rugby Pinnacle

Glendale Raptors Look To Maintain Post At America’s Rugby Pinnacle

by Marco Cummings

An old mountaineer’s proverb says: “Even though you have reached the summit, you haven’t reached your final destination.”

It’s an adage that can be applied to the Glendale Raptors men as they enter the 2016 Pacific Rugby Premiership (PRP) campaign.

League titleholders following their 25-11 home Raptors 2-16win over San Francisco Golden Gate in the PRP Final, the Raptors still have work ahead, with this year’s goal set on pushing for a second-straight league crown.

“Our main goal is to retain the title and just play a brand that’s good enough to see us back at the top,” said Raptors head coach Andre Snyman. “Our second goal is to keep developing the depth of the club and the quality of the players.”

The task of bolstering the club’s depth will be a challenge for Snyman with the team losing several key contributors from last season’s championship run.

Among the key losses are lock Austin Welch and prop Nick Wallace. Welch, a former Santa Rosa Junior College standout will be returning to his home state of California. Wallace will also mak

GLENDALE, CO - MARCH 7: Glendale Raptors vs Denver Barbarians at Infinity Park in Glendale, Colorado on March 7, 2015. (Photo by Seth McConnell)

GLENDALE, CO – MARCH 7: Glendale Raptors vs Denver Barbarians at Infinity Park in Glendale, Colorado on March 7, 2015. (Photo by Seth McConnell)

e the trip west. The bay area native and graduate of St. Mary’s college is rumored to have his sights set on playing club rugby in Australia.

Max Statler retired during the offseason, but the 29-year-old’s status remains up in the air as the rugby bug has begun itching.

“He says he misses the game too much,” Snyman said of Statler.

The club will also be without prop Ben Tarr, who suffered a season ending knee injury last March.

Despite the turnover, the Raptors coach is confident in his roster: “Those are the main guys that we’ve lost but I’m confident we have enough depth to replace them.”

In their place, the Raptors have brought in reinforcements. The team’s most promising new recruit is up and coming USA Eagle scrum-half Niku Kruger. The 24-year-old joins the club after unexpectedly seeing playing time for the Eagles in the 2015 Rugby World Cup.

“Being new to the team, I have a lot to prove to my new teammates,” Kruger said of the Raptors experience. “My goal is to make the No. 9 jersey mine and not only be a great teammate on the field but off the field, too. I would like to bring all that I have experienced through the World Cup and playing for the Eagles to Glendale and help us improve as a team.”

Snyman has also brought in several other players, but training and grading performances in a pre-season “Battle of Champions” between Glendale and the Seattle Saracens, champions of British Columbia Rugby Union (BCRU) will determine whether those recruits are of PRP quality.

Explained Snyman, “We’ve got a few new faces but we’re not sure what their qualities are like. They’ve trained well but haven’t played for us yet so it’s hard to say whether they’re going to have an impact or not.”

However, the coach will receive something more established with the return of veterans like Luke White, Chad London and team captain Zach Fenoglio.

Like Kruger, Fenoglio experienced rugby on the world’s biggest stage with a trip to the World Cup in London, England last fall. He too hopes to translate that experience and bring it back to the club level back at Infinity Park.

“I am very blessed to have had some amazing experiences in my rugby career and my goal has always been to pass my knowledge on to as many people as possible,” Fenoglio said of his World Cup experience. “I look forward to starting another year with Glendale and helping all of us to continue to become the best players we can be.”

Strategies, knowledge of structures and live game experience have been boosted for the pair with exposure to world class competition, but Snyman is focusing on one crucial quality that Kruger, Fenoglio and others bring to the squad.

“They’ve been taking leadership of the training sessions and that’s exactly what I would like to see,” he emphasized. “Guys like Chad London have also been a part of that [USA Eagles] group. Although he didn’t go to the World Cup, [London] is also a leader. We have a good group of senior players with good players around them. I’ve seen some good signs and I’m happy with how the team is training.”

Even with solid leadership in place, winning a second championship and back-to-back titles will be no easy feat, with the opposition locked onto Glendale as its target.

All of the teams provide us with a big game. I think the other coaches will definitely look at our errors from last season and try to analyze us and see how they can beat us,” Snyman said.

“I think it’s going to be tough. There’s no easy game in the PRP anymore. All of the teams are conditioned now and they know what’s at stake.”

Denver’s Latest And Greatest Apt. Project

Denver’s Latest And Greatest Apt. Project

56 Units And ‘ZERO PARKING’

by Glen Richardson

The City and County of Denver has become nationally known for approving apartment projects with extremely low parking requirements under the apparent theory that it will force its residents to walk, ride a bike, take public transportation or utilize taxi cabs/Uber vehicles. Families with kids are apparently not deemed likely to want to move to Denver anytime in the immediate future, just young single members of the millennium generation.

Denver is also believed to be the only major city planning department in the United States that as a matter of public policy refuses to consider the impact of increased traffic because of a development. Real estate developers are said to control both the office of the mayor of Denver, Michael Hancock, and the majority of the 13 member Denver City Council which must approve real estate projects according to the City Charter. Most developers want as little required parking as possible since it significantly increases the price of a project. Often the lack of parking becomes a major problem in the future for such projects, but the developer is usually long gone from the scene.

One of the newest projects in one of Denver’s oldest neighborhoods, Curtis Park, is slated to have 56 micro-units of 300 square feet each and no parking to the outrage of Curtis Park residents. The on-street parking in the area, according to neighborhood residents, is already extremely tight.

Apparently there is not a plan filed with the Denver City Planning and Development Department for the project. However, there have been numerous meetings between the developer, Gaddis Properties, and Councilman Albus Brooks who, according to insiders, has all but given a green light to the project.

The small property is located at 32nd and Stout Street and the residents indicate that a purported exemption for parking was intended for a small commercial business and not a 56 unit apartment house. City records indicate that the property was once used for an auto service garage. In fact residents also indicate that six more square feet and the exemption would not even apply to a small commercial business.

At a heated and angry meeting between Doug Gaddis and resident Andrew Kowalyshyn, reports are that Gaddis stated the residents were lucky he didn’t build a 70 unit building and that no parking was needed anyway as none of the future tenants or their visiting friends or family would ever use a car, a proposition met with incredulity with the people at the meeting. Summing up the feelings of the neighborhood Kowalyshyn stated of Gaddis, “This guy is just a complete bullshit artist.”

Councilman Albus Brooks told local television stations that neither he nor the city could force Gaddis to provide parking. City insiders indicate that virtually any development in Denver requires some variances and waivers by a city and the city could refuse to grant the same without Mr. Gaddis providing some parking, but is simply unlikely to do so.

Neighborhood activist David Johnson noted, “The fix is in, as always. The Planning Department does not plan and Denver councilmen like Albus Brooks don’t represent the residents. There is no part of the city that the epidemic of overdevelopment corruption is not affecting and destroying our neighborhoods. With Gaddis we are evolving from the ‘limited parking’ stage to the ‘absolutely no parking’ stage. How to change a beautiful city with wonderful neighborhoods to an overcrowded dump.”

Rocket Rattles Lowry Residents

Rocket Rattles Lowry Residents

Thrust From 40-foot High Rocket Ship Expected To Ignite Huge Crowds, Create Carnival Atmosphere But That Doesn’t Thrill Some Residents

by Glen Richardson

Rocket At NASA Ames 2-16 A rocket originally built in California and first tested on Nevada’s Black Rock Desert is taking aim at Denver. Target is the Lowry neighborhood, site of the nation’s first Titan Missile Base. Ground zero is Hangar 2 on the corner of East Academy Blvd and Rampart Way.

Holy Moses! Luckily this isn’t a High Velocity Aircraft Rocket — such as those the armed forces nicknamed Holy Moses — but instead is a sculpture identified by the moniker of Raygun Gothic Rocketship. It was built by a group of artists, geeks and inventors in the San Francisco Bay area, not rocket scientists.

Rocket - Allen Lowry 2-16Jim Hartman of Boulder-based Hartman Ely Investments — partner with Larimer Associates in Lowry’s Hangar 2 development — is behind the orbital maneuver to land the spacecraft here with expectations of hooking a lucrative payload of sightseers. A circular kiosk is proposed on the corner of E. Academy Blvd and Rampart Way, with the rocket ship sculpture installed on top. Height of the kiosk would be 10 feet, 10 inches and measure 10 feet in diameter. Overall height of the kiosk and rocket ship combined would be about 50 feet. The kiosk and sculpture together would be shorter than the highest point of the hangar building and comparable in height to the tailfin of the airplane at the adjacent Wings Over the Rockies Museum.

Space Disaster?

The rocket ship, according to Hangar 2 Partners, has a realistic cockpit and other “theatrical” features. The cockpit would be accessed on a custom ladder during periodic supervised events. The retail kiosk would serve as the site’s visual launch pad. Sales of ice cream, rocket models, t-shirts and other items would help to repay the cost of acquiring, shipping and installing the rocket ship. “Like the existing B-52 Airplane at Wings, the rocket ship will be an iconic image of space and flight that will not only be a significant public amenity, but will bolster the Wing’s educational programs,” the partners suggest.

Some residents in Lowry, however, say Rocket - San Francisco 2-16the location and environment at Hangar 2 just isn’t right and believe the ship would create a space disaster. “Of course, beauty is in the eye of the beholder, but to us the sight of this rocket ship has as much appeal as the Blue Monster at DIA,” say Michael and Irina Merson. “By no means do we imply the same karma as befell the creator of the Blue Monster. But it simply does not fit visually and aesthetically with the surroundings that already include four restaurants. It just doesn’t belong here, it belongs somewhere else.” Local homeowner Yvonne Olson adds, “The concept of an outdoor sculpture is a good idea, but only if the size fits with the area.”

Johanna Hermanson labels the piece an “ice cream rocket” and says she is amazed the developers would consider installing it at Hangar 2.” It looks as if it belongs at a carnival. Even more disturbing,” she worries, “is the amount of traffic it will produce.” She isn’t sure input from residents will have much influence on the outcome, “but I hope that Lowry rethinks the repercussions.” Betsy Herrick admits that the rocket ship is fascinating. She cautions, however, “that the proposed location

would be a distraction to drivers at the busy intersection, given its size and surprising look. Add kids climbing on it and the staff supervising them, and the distraction is even greater. Insert buyers at the ice cream shop, and there’s more congestion. All in a small space.” She is also dismayed that the developer looked outside Colorado for artists.

Science Fiction

Intended to invoke the romantic notion of space travel before it became reality, the ornate and futuristic ship is a highly stylized vision of space travel circa 1930s-1940s science fiction, according to the organization behind the piece. Using colloquial language, the Raygun Gothic Rocketship website declares, “It is between yesterday’s tomorrow and the future that never was.” To everyone elsRocket - Lift Off SF 2-16e, it’s a 40-foot tall metallic silver rocket ship.

Artists claim the piece was once launched off the ground. That claim, however, is doubtful considering the sculpture doesn’t have an engine.

It initially landed at Burning Man 2009, a festival for academics, geeks and suburban parents that gather on the Nevada Desert each year. It was then installed at Pier 14 in San Francisco where it was a huge success and remained on exhibit for more than two years. Subsequently it was displayed at NASA’s Ames Research Center, Moffett Field, Calif. Most recently it landed at a five-day Arts, Science & Engineering event in Calgary, Alberta, Canada. It would become a permanent art piece should it land in Lowry.

Flight Gone Awry

Anthony Romeo — a former WWII NaRocket - Burning Man 2-16vy and United Airlines pilot who retired from United after 31 years — tells the Chronicle, “I am concerned about the Dining District property.” He admits that installation of the aRocket - Close-up 2-16musement park quality rocket ship will not directly affect him since he and his wife live in the west building at Luce Condominiums that is out of the line of sight. Still, he says, “To my way of thinking, it is totally out of character with the existing ambience of that complex.”

A volunteer at the Wings Museum for more than 10 years, he remembers the site as originally being a bleak looking property. “Over the years I have seen the museum property survive a number of ill advised redevelopment proposals. Then, fortunately, Mr. Hartman saved it and created the very desirable complex that we all presently enjoy. Why he would now change course and destroy his well done project puzzles me,” he wraps up.

Resident Marge Mahoney agrees. Also from an aviation family — her husband and son are Captains for American Airlines — she believes Hangar 2 is a bad place for the cold looking rocket ship. “Why not a beautiful tree in that location? It would warm up the area and be much less expensive.” She says she is also appalled Lowry voted for the extensive building now underway at Quebec, First Ave. and Monaco Parkway.

Hovering At Hangar

A rocket flying toward the ground is usuRocket - Wings 2-16ally a bad precursor, especially for those living at ground zero. That’s the situation faced by the 66 residents living in the Luce Condominiums, a mid-rise condo development adjacent to Hangar 2. “Depiction of this corner as quiet and spacious is far from accurate. Many times it’s not,” clarifies Luce HOA President David Allen.

He understands that the perception of the aesthetic and historical value of the Raygun Gothic Rocketship will differ. However he contends that the negative impact of drawing children and others to the site is undeniable, especially considering they already border on chaotic in good weather months.

“Opening of the fifth dining district restaurant, increasing participation at the fitness center, and a housing complex just across the street will serve to exacerbate an already safety-challenged, pedestrian-dense location,” he warns. The ice cream/t-shirt retail outlet at the base of the rocket ship with cars parked everywhere plus a line of children and others is a formula for accidents. “All neighbors are asking for is an opportunity to have a voice at an early juncture in the process of selecting a more benign art piece for our corner,” Allen concludes.

Hartman Ponders Response To Luce Condo Owner Concerns

As the February issue of the Chronicle was going to press, David Allen, HOA President at the Luce Condominiums adjacent to Hangar 2, received the following reply from Jim Hartman of Boulder-based Hartman Ely Investments:

“Our team wants Luce to know that we have definitely heard your concerns and are looking at a couple of potential ideas that you might like better. Those ideas will take at least a few weeks to analyze completely but I will be back in touch when we know more.” — Jim Hartman