Health Savings Accounts – An American Innovation in Health Insurance

INTRODUCTON – The term “health insurance” is commonly used in the United States to describe any program that helps pay for medical expenses, whether through privately purchased insurance, social insurance or a non-insurance social welfare program funded by the government. Synonyms for this usage include “health coverage,” “health care coverage” and “health benefits” and “medical insurance.” In a more technical sense, the term is used to describe any form of insurance that provides protection against injury or illness.

In America, the health insurance industry has changed rapidly during the last few decades. In the 1970’s most people who had health insurance had indemnity insurance. Indemnity insurance is often called fee-forservice. It is the traditional health insurance in which the medical provider (usually a doctor or hospital) is paid a fee for each service provided to the patient covered under the policy. An important category associated with the indemnity plans is that of consumer driven health care (CDHC). Consumer-directed health plans allow individuals and families to have greater control over their health care, including when and how they access care, what types of care they receive and how much they spend on health care services.

These plans are however associated with higher deductibles that the insured have to pay from their pocket before they can claim insurance money. Consumer driven health care plans include Health Reimbursement Plans (HRAs), Flexible Spending Accounts (FSAs), high deductible health plans (HDHps), Archer Medical Savings Accounts (MSAs) and Health Savings Accounts (HSAs). Of these, the Health Savings Accounts are the most recent and they have witnessed rapid growth during the last decade.

WHAT IS A HEALTH SAVINGS ACCOUNT?

A Health Savings Account (HSA) is a tax-advantaged medical savings account available to taxpayers in the United States. The funds contributed to the account are not subject to federal income tax at the time of deposit. These may be used to pay for qualified medical expenses at any time without federal tax liability.

Another feature is that the funds contributed to Health Savings Account roll over and accumulate year over year if not spent. These can be withdrawn by the employees at the time of retirement without any tax liabilities. Withdrawals for qualified expenses and interest earned are also not subject to federal income taxes. According to the U.S. Treasury Office, ‘A Health Savings Account is an alternative to traditional health insurance; it is a savings product that offers a different way for consumers to pay for their health care.

HSA’s enable you to pay for current health expenses and save for future qualified medical and retiree health expenses on a tax-free basis.’ Thus the Health Savings Account is an effort to increase the efficiency of the American health care system and to encourage people to be more responsible and prudent towards their health care needs. It falls in the category of consumer driven health care plans.

Origin of Health Savings Account

The Health Savings Account was established under the Medicare Prescription Drug, Improvement, and Modernization Act passed by the U.S. Congress in June 2003, by the Senate in July 2003 and signed by President Bush on December 8, 2003.

Eligibility –

The following individuals are eligible to open a Health Savings Account –

– Those who are covered by a High Deductible Health Plan (HDHP).
– Those not covered by other health insurance plans.
– Those not enrolled in Medicare4.

Also there are no income limits on who may contribute to an HAS and there is no requirement of having earned income to contribute to an HAS. However HAS’s can’t be set up by those who are dependent on someone else’s tax return. Also HSA’s cannot be set up independently by children.

What is a High Deductible Health plan (HDHP)?

Enrollment in a High Deductible Health Plan (HDHP) is a necessary qualification for anyone wishing to open a Health Savings Account. In fact the HDHPs got a boost by the Medicare Modernization Act which introduced the HSAs. A High Deductible Health Plan is a health insurance plan which has a certain deductible threshold. This limit must be crossed before the insured person can claim insurance money. It does not cover first dollar medical expenses. So an individual has to himself pay the initial expenses that are called out-of-pocket costs.

In a number of HDHPs costs of immunization and preventive health care are excluded from the deductible which means that the individual is reimbursed for them. HDHPs can be taken both by individuals (self employed as well as employed) and employers. In 2008, HDHPs are being offered by insurance companies in America with deductibles ranging from a minimum of $1,100 for Self and $2,200 for Self and Family coverage. The maximum amount out-of-pocket limits for HDHPs is $5,600 for self and $11,200 for Self and Family enrollment. These deductible limits are called IRS limits as they are set by the Internal Revenue Service (IRS). In HDHPs the relation between the deductibles and the premium paid by the insured is inversely propotional i.e. higher the deductible, lower the premium and vice versa. The major purported advantages of HDHPs are that they will a) lower health care costs by causing patients to be more cost-conscious, and b) make insurance premiums more affordable for the uninsured. The logic is that when the patients are fully covered (i.e. have health plans with low deductibles), they tend to be less health conscious and also less cost conscious when going for treatment.

Opening a Health Savings Account

An individual can sign up for HSAs with banks, credit unions, insurance companies and other approved companies. However not all insurance companies offer HSAqualified health insurance plans so it is important to use an insurance company that offers this type of qualified insurance plan. The employer may also set up a plan for the employees. However, the account is always owned by the individual. Direct online enrollment in HSA-qualified health insurance is available in all states except Hawaii, Massachusetts, Minnesota, New Jersey, New York, Rhode Island, Vermont and Washington.

Contributions to the Health Savings Account

Contributions to HSAs can be made by an individual who owns the account, by an employer or by any other person. When made by the employer, the contribution is not included in the income of the employee. When made by an employee, it is treated as exempted from federal tax. For 2008, the maximum amount that can be contributed (and deducted) to an HSA from all sources is:
$2,900 (self-only coverage)
$5,800 (family coverage)

These limits are set by the U.S. Congress through statutes and they are indexed annually for inflation. For individuals above 55 years of age, there is a special catch up provision that allows them to deposit additional $800 for 2008 and $900 for 2009. The actual maximum amount an individual can contribute also depends on the number of months he is covered by an HDHP (pro-rated basis) as of the first day of a month. For eg If you have family HDHP coverage from January 1,2008 until June 30, 2008, then cease having HDHP coverage, you are allowed an HSA contribution of 6/12 of $5,800, or $2,900 for 2008. If you have family HDHP coverage from January 1,2008 until June 30, 2008, and have self-only HDHP coverage from July 1, 2008 to December 31, 2008, you are allowed an HSA contribution of 6/12 x $5,800 plus 6/12 of $2,900, or $4,350 for 2008. If an individual opens an HDHP on the first day of a month, then he can contribute to HSA on the first day itself. However, if he/she opens an account on any other day than the first, then he can contribute to the HSA from the next month onwards. Contributions can be made as late as April 15 of the following year. Contributions to the HSA in excess of the contribution limits must be withdrawn by the individual or be subject to an excise tax. The individual must pay income tax on the excess withdrawn amount.

Contributions by the Employer

The employer can make contributions to the employee’s HAS account under a salary reduction plan known as Section 125 plan. It is also called a cafeteria plan. The contributions made under the cafeteria plan are made on a pre-tax basis i.e. they are excluded from the employee’s income. The employer must make the contribution on a comparable basis. Comparable contributions are contributions to all HSAs of an employer which are 1) the same amount or 2) the same percentage of the annual deductible. However, part time employees who work for less than 30 hours a week can be treated separately. The employer can also categorize employees into those who opt for self coverage only and those who opt for a family coverage. The employer can automatically make contributions to the HSAs on the behalf of the employee unless the employee specifically chooses not to have such contributions by the employer.

Withdrawals from the HSAs

The HSA is owned by the employee and he/she can make qualified expenses from it whenever required. He/She also decides how much to contribute to it, how much to withdraw for qualified expenses, which company will hold the account and what type of investments will be made to grow the account. Another feature is that the funds remain in the account and role over from year to year. There are no use it or lose it rules. The HSA participants do not have to obtain advance approval from their HSA trustee or their medical insurer to withdraw funds, and the funds are not subject to income taxation if made for ‘qualified medical expenses’. Qualified medical expenses include costs for services and items covered by the health plan but subject to cost sharing such as a deductible and coinsurance, or co-payments, as well as many other expenses not covered under medical plans, such as dental, vision and chiropractic care; durable medical equipment such as eyeglasses and hearing aids; and transportation expenses related to medical care. Nonprescription, over-the-counter medications are also eligible. However, qualified medical expense must be incurred on or after the HSA was established.

Tax free distributions can be taken from the HSA for the qualified medical expenses of the person covered by the HDHP, the spouse (even if not covered) of the individual and any dependent (even if not covered) of the individual.12 The HSA account can also be used to pay previous year’s qualified expenses subject to the condition that those expenses were incurred after the HSA was set up. The individual must preserve the receipts for expenses met from the HSA as they may be needed to prove that the withdrawals from the HSA were made for qualified medical expenses and not otherwise used. Also the individual may have to produce the receipts before the insurance company to prove that the deductible limit was met. If a withdrawal is made for unqualified medical expenses, then the amount withdrawn is considered taxable (it is added to the individuals income) and is also subject to an additional 10 percent penalty. Normally the money also cannot be used for paying medical insurance premiums. However, in certain circumstances, exceptions are allowed.

These are –

1) to pay for any health plan coverage while receiving federal or state unemployment benefits.
2) COBRA continuation coverage after leaving employment with a company that offers health insurance coverage.
3) Qualified long-term care insurance.
4) Medicare premiums and out-of-pocket expenses, including deductibles, co-pays, and coinsurance for: Part A (hospital and inpatient services), Part B (physician and outpatient services), Part C (Medicare HMO and PPO plans) and Part D (prescription drugs).

However, if an individual dies, becomes disabled or reaches the age of 65, then withdrawals from the Health Savings Account are considered exempted from income tax and additional 10 percent penalty irrespective of the purpose for which those withdrawals are made. There are different methods through which funds can be withdrawn from the HSAs. Some HSAs provide account holders with debit cards, some with cheques and some have options for a reimbursement process similar to medical insurance.

Growth of HSAs

Ever since the Health Savings Accounts came into being in January 2004, there has been a phenomenal growth in their numbers. From around 1 million enrollees in March 2005, the number has grown to 6.1 million enrollees in January 2008.14 This represents an increase of 1.6 million since January 2007, 2.9 million since January 2006 and 5.1 million since March 2005. This growth has been visible across all segments. However, the growth in large groups and small groups has been much higher than in the individual category. According to the projections made by the U.S. Treasury Department, the number of HSA policy holders will increase to 14 million by 2010. These 14 million policies will provide cover to 25 to 30 million U.S. citizens.

In the Individual Market, 1.5 million people were covered by HSA/HDHPs purchased as on January 2008. Based on the number of covered lives, 27 percent of newly purchased individual policies (defined as those purchased during the most recent full month or quarter) were enrolled in HSA/HDHP coverage. In the small group market, enrollment stood at 1.8 million as of January 2008. In this group 31 percent of all new enrollments were in the HSA/HDHP category. The large group category had the largest enrollment with 2.8 million enrollees as of January 2008. In this category, six percent of all new enrollments were in the HSA/HDHP category.

Benefits of HSAs

The proponents of HSAs envisage a number of benefits from them. First and foremost it is believed that as they have a high deductible threshold, the insured will be more health conscious. Also they will be more cost conscious. The high deductibles will encourage people to be more careful about their health and health care expenses and will make them shop for bargains and be more vigilant against excesses in the health care industry. This, it is believed, will reduce the growing cost of health care and increase the efficiency of the health care system in the United States. HSA-eligible plans typically provide enrollee decision support tools that include, to some extent, information on the cost of health care services and the quality of health care providers. Experts suggest that reliable information about the cost of particular health care services and the quality of specific health care providers would help enrollees become more actively engaged in making health care purchasing decisions. These tools may be provided by health insurance carriers to all health insurance plan enrollees, but are likely to be more important to enrollees of HSA-eligible plans who have a greater financial incentive to make informed decisions about the quality and costs of health care providers and services.

It is believed that lower premiums associated with HSAs/HDHPs will enable more people to enroll for medical insurance. This will mean that lower income groups who do not have access to medicare will be able to open HSAs. No doubt higher deductibles are associated with HSA eligible HDHPs, but it is estimated that tax savings under HSAs and lower premiums will make them less expensive than other insurance plans. The funds put in the HSA can be rolled over from year to year. There are no use it or lose it rules. This leads to a growth in savings of the account holder. The funds can be accumulated tax free for future medical expenses if the holder so desires. Also the savings in the HSA can be grown through investments.

The nature of such investments is decided by the insured. The earnings on savings in the HSA are also exempt from income tax. The holder can withdraw his savings in the HSA after turning 65 years old without paying any taxes or penalties. The account holder has complete control over his/her account. He/She is the owner of the account right from its inception. A person can withdraw money as and when required without any gatekeeper. Also the owner decides how much to put in his/her account, how much to spend and how much to save for the future. The HSAs are portable in nature. This means that if the holder changes his/her job, becomes unemployed or moves to another location, he/she can still retain the account.

Also if the account holder so desires he can transfer his Health Saving Account from one managing agency to another. Thus portability is an advantage of HSAs. Another advantage is that most HSA plans provide first-dollar coverage for preventive care. This is true of virtually all HSA plans offered by large employers and over 95% of the plans offered by small employers. It was also true of over half (59%) of the plans which were purchased by individuals.

All of the plans offering first-dollar preventive care benefits included annual physicals, immunizations, well-baby and wellchild care, mammograms and Pap tests; 90% included prostate cancer screenings and 80% included colon cancer screenings. Some analysts believe that HSAs are more beneficial for the young and healthy as they do not have to pay frequent out of pocket costs. On the other hand, they have to pay lower premiums for HDHPs which help them meet unforeseen contingencies.

Health Savings Accounts are also advantageous for the employers. The benefits of choosing a health Savings Account over a traditional health insurance plan can directly affect the bottom line of an employer’s benefit budget. For instance Health Savings Accounts are dependent on a high deductible insurance policy, which lowers the premiums of the employee’s plan. Also all contributions to the Health Savings Account are pre-tax, thus lowering the gross payroll and reducing the amount of taxes the employer must pay.

Criticism of HSAs

The opponents of Health Savings Accounts contend that they would do more harm than good to America’s health insurance system. Some consumer organizations, such as Consumers Union, and many medical organizations, such as the American Public Health Association, have rejected HSAs because, in their opinion, they benefit only healthy, younger people and make the health care system more expensive for everyone else. According to Stanford economist Victor Fuchs, “The main effect of putting more of it on the consumer is to reduce the social redistributive element of insurance.

Some others believe that HSAs remove healthy people from the insurance pool and it makes premiums rise for everyone left. HSAs encourage people to look out for themselves more and spread the risk around less. Another concern is that the money people save in HSAs will be inadequate. Some people believe that HSAs do not allow for enough savings to cover costs. Even the person who contributes the maximum and never takes any money out would not be able to cover health care costs in retirement if inflation continues in the health care industry.

Opponents of HSAs, also include distinguished figures like state Insurance Commissioner John Garamendi, who called them a “dangerous prescription” that will destabilize the health insurance marketplace and make things even worse for the uninsured. Another criticism is that they benefit the rich more than the poor. Those who earn more will be able to get bigger tax breaks than those who earn less. Critics point out that higher deductibles along with insurance premiums will take away a large share of the earnings of the low income groups. Also lower income groups will not benefit
substantially from tax breaks as they are already paying little or no taxes. On the other hand tax breaks on savings in HSAs and on further income from those HSA savings will cost billions of dollars of tax money to the exchequer.

The Treasury Department has estimated HSAs would cost the government $156 billion over a decade. Critics say that this could rise substantially. Several surveys have been conducted regarding the efficacy of the HSAs and some have found that the account holders are not particularly satisfied with the HSA scheme and many are even ignorant about the working of the HSAs. One such survey conducted in 2007 of American employees by the human resources consulting firm Towers Perrin showed satisfaction with account based health plans (ABHPs) was low. People were not happy with them in general compared with people with more traditional health care. Respondants said they were not comfortable with the risk and did not understand how it works.

According to the Commonwealth Fund, early experience with HAS eligible high-deductible health plans reveals low satisfaction, high out of- pocket costs, and cost-related access problems. Another survey conducted with the Employee Benefits Research Institute found that people enrolled in HSA-eligible high-deductible health plans were much less satisfied with many aspects of their health care than adults in more comprehensive plans People in these plans allocate substantial amounts of income to their health care, especially those who have poorer health or lower incomes. The survey also found that adults in high-deductible health plans are far more likely to delay or avoid getting needed care, or to skip medications, because of the cost. Problems are particularly pronounced among those with poorer health or lower incomes.

Political leaders have also been vocal about their criticism of the HSAs. Congressman John Conyers, Jr. issued the following statement criticizing the HSAs “The President’s health care plan is not about covering the uninsured, making health insurance affordable, or even driving down the cost of health care. Its real purpose is to make it easier for businesses to dump their health insurance burden onto workers, give tax breaks to the wealthy, and boost the profits of banks and financial brokers. The health care policies concocted at the behest of special interests do nothing to help the average American. In many cases, they can make health care even more inaccessible.” In fact a report of the U.S. governments Accountability office, published on April 1, 2008 says that the rate of enrollment in the HSAs is greater for higher income individuals than for lower income ones.

A study titled “Health Savings Accounts and High Deductible Health Plans: Are They an Option for Low-Income Families? By Catherine Hoffman and Jennifer Tolbert which was sponsored by the Kaiser Family Foundation reported the following key findings regarding the HSAs:

a) Premiums for HSA-qualified health plans may be lower than for traditional insurance, but these plans shift more of the financial risk to individuals and families through higher deductibles.
b) Premiums and out-of-pocket costs for HSA-qualified health plans would consume a substantial portion of a low-income family’s budget.
c) Most low-income individuals and families do not face high enough tax liability to benefit in a significant way from tax deductions associated with HSAs.
d) People with chronic conditions, disabilities, and others with high cost medical needs may face even greater out-of-pocket costs under HSA-qualified health plans.
e) Cost-sharing reduces the use of health care, especially primary and preventive services, and low-income individuals and those who are sicker are particularly sensitive to cost-sharing increases.
f) Health savings accounts and high deductible plans are unlikely to substantially increase health insurance coverage among the uninsured.

Choosing a Health Plan

Despite the advantages offered by the HSA, it may not be suitable for everyone. While choosing an insurance plan, an individual must consider the following factors:

1. The premiums to be paid.
2. Coverage/benefits available under the scheme.
3. Various exclusions and limitations.
4. Portability.
5. Out-of-pocket costs like coinsurance, co-pays, and deductibles.
6. Access to doctors, hospitals, and other providers.
7. How much and sometimes how one pays for care.
8. Any existing health issue or physical disability.
9. Type of tax savings available.

The plan you choose should according to your requirements and financial ability.

BIBLIOGRAPHY

1 Questions and Answers about Health Insurance- A Consumer Guide’ published jointly by the Agency for Healthcare Research and Quality (AHRQ)and America’s Health Insurance Plans (AHIP)
2 http://www.en.wikipedia.org/wiki/Health_savings_account
3 2002 AHIP Survey of Health Insurance Plans
4 “How High Is Too High? Implications of High-Deductible Health Plans” Davis, Karen; Michelle Doty and Alice Ho. The Commonwealth Fund, April 2005
5 http://www.fdhc.state.fl.us/schs/pdf/hsa_tri-fold_brochure.pdf
6 HSA/HDHP CENSUS 2008 by Hannah Yoo, Center for Policy and Research, America’s Health Insurance Plans
7″HEALTH SAVINGS ACCOUNTS Early Enrollee Experiences with Accounts and Eligible Health Plans” John E. Dicken Director, Health Care.
8 Thomas Wilder and Hannah Yoo, “A Survey of Preventive Benefits in Health Savings Account (HSA)Plans, July 2007,” America’s Health Insurance Plans, November 2007
9 Gladwell, Malcolm, “The Moral Hazard Myth”, The New Yorker (29-08-2005)
10 2008 Benchmark Survey HAS Bank
11. Employer Health Benefits 2007 Annual Survey, Kaiser Family Foundation
12. Health Savings Accounts and High Deductible Health Plans: Are They An Option for Low-Income Families?Catherine Hoffman and Jennifer Tolbert for Kaiser Family Foundation, October 2006
13. Medicare Prescription Drug, Improvement, and Modernization Act of 2003

Better To Choose Electric Cigarette(elektronines cigaretes)

Since they were launched, also to learn, you will find the reactions on the shared electronic cigarettes(sigaretta elettronica). You can find a number of people who believe that they are not strong, but much remains to be convinced that they can meet the requirements that can be made until the end. One of the reasons individuals are normally act to facilitate the use of tobacco end. Other than traditional cigarettes(cigarro), tobacco does not work with non-smokers of cigarette. As a result, they are able to produce the positive aspects of welfare services. They are the welfare gains that the persons specifically referred to them are less dangerous than smoking cigarettes(cigarette electronique) that produce and relieve any type of cancer when used. In addition, these residents to help the environment, which in turn reduces pollution.

These electronic cigarette (sigaretta elettronica) contains no tobacco, and then burn the cancer usually does not develop products. They can, therefore, without risk of smoke and indoor smoking was not to think about long ostracized accurate anti-smoking laws. You can pretty much smoking near the mall, and not smoking, as the byproduct of the electronic cigarette is a drinking water vapor. How does it work? It ‘really a brilliant concept, which uses a battery atomizer and the cartridge is composed of water vapor, flavor and varied amounts of nicotine. Inhalation is the electronic cigarette(sigarette elettroniche) activates the rechargeable lithium battery, and this activates the nebulizer, which releases water vapor filled with varying degrees of nicotine.

You will be able to get just a starter kit, consisting of the sprayer, rechargeable battery, battery charger and cartridges of nicotine. For those looking to reduce their nicotine intake or trying to quit smoking, a number of strengths of the cartridges to wean her car out of regular cartridges more powerful. On the other hand, there is however an advantage over the welfare of the new devices mentioned can make use of snuff attract smokers. And who is willing to help users successfully quit using snuff. As the welfare of other positive aspects, is feasible because of the lack of snuff.

Due to the fact that handle more than the number of nicotine was sent to the user, produces a significant help to stop smoking. On the other hand, to obtain the electronic cigarette is not enough to really be able to quit smoking cigarettes. You have to find the best way to prove it, and would need to act, you should take.

* Identify and-fluid, which is necessary to exploit. What it is, and know the taste of nicotine, the amount you’re comfortable with. Nicotine through the place that you have identified, is gradually reduced until you can bear with smokeless cigarettes, nicotine, to zero.

* Knowing the best way to fill the device. If you are unable to fill their non-smoking cigarettes, you may be able to use it anytime and anywhere. It takes away from the temptation to take advantage of real cigarettes when you have the desire to smoke cigarettes.

* It would have been punished. Keep your eyes on your destination stop tobacco use. Stick to the program, gradually lowering down the seat around the nicotine-liquid, which can be used and the temptation to resume

What New Drivers Need to Know About Car Insurance

If you are a new driver, there are several things that you will need to know about car insurance. The most basic rule though, is that if you are going to drive a car, you must carry some form of coverage. This is just one fact you need to know pertaining to auto insurance. Listed below are several more things you will need to know as well.

Locating a Provider

First of all, in the past, you would have to sort through page upon page of ads in your local yellow pages to locate insurance providers in your area. Then, you had to phone them one by one to get quotes. However, this is no longer the case. The Internet has made locating insurance companies extremely easy.

You simply need to choose one of the many car insurance comparison websites available and type in some basic information pertaining to you and your car. The site will then match you with several providers in your area. At this point, you can choose to have these companies phone you, email you or both.

Comparing Coverage and Rates

The next thing you must know about auto insurance is how important it is to compare the coverage and rates of several providers before you choose one. Different companies offer varying rates, coverage and even discounts. With that said, you should always contact the providers in your area and find out more about them before you choose to purchase a policy.

When it comes to discounts, if you search long enough, you are sure to find some valuable ones that will help reduce your insurance premiums. Many insurance providers offer attractive discounts in an effort to gain clients. Some of the discounts that are commonly offered include new drivers, senior citizens, excellent students, safe-driving courses, air bags, safety equipment and good driving histories.

Raising Your Deductible

In addition to discounts, there are many other ways you can reduce your insurance premiums. One way is to opt for a higher deductible. This is a matter of choice, and you should think this through carefully before making a decision. While a high deductible will lower your monthly premiums, you may have to pay more should you become involved in an accident.

Liability or Full Coverage?

Another thing you need to know about car insurance is the difference between liability and full coverage. Liability is the minimum coverage that you can purchase, and it will provide compensation to other drivers in the case of accidents if you are at fault. However, it will not pay for any damage to your car or injuries to you or your passengers.

Full coverage is much more expensive than liability but there are many benefits to this type of coverage. The best thing about full coverage though, is that it not only will pay for the other driver’s damages and injuries, but it will pay for yours as well. In many cases, it will also cover such things as theft and damage to your car due to weather conditions or falling objects.

These are just a few things that new drivers need to know about car insurance. If you are a new driver, the above information can help steer you in the right direction when choosing a policy to suit your needs. However, always remember that you should compare the rates and coverage of several providers before choosing one.

7 Habits of an Addict About to Relapse

Many addicts in recovery that are nearing a relapse episode exhibit predictable and identifiable habits and behaviors before the actual relapse occurs. Recognition of these habits is critical in order for people in recovery and their loved ones to take decisive and immediate action to prevent the relapse. This is especially important considering the potential consequences of each new relapse episode: prison, violence, bankruptcy, death. Relapse prevention isn’t just about stopping someone from using again; it’s about saving a life.

The following are 7 behaviors that many addicts exhibit prior to and/or during the early stages of a relapse:

1.) Withdrawal/Isolation

A person in recovery who is on the verge of relapse will likely become withdrawn and purposefully isolate other people around them. This is particularly true of people that will not support or condone a return to drug use or drinking. This could be evidenced by spending less time with family members, staying out later at night than normal or not coming home, and by seeming withdrawn and quiet when others are present.

2.) Decline in Hygiene/Productivity

There is often a lack of care and concern when a relapse is imminent. Meaning, less attention is paid to personal hygiene details, exercise programs are abandoned, employment or educational inefficiencies or neglect occurs, and regular household upkeep suffers. These are all common signs of an addict who is beginning to care less and less about trying to maintain a legitimate lifestyle.

3.) Glorification of Substance Abuse

An addict that is unhappy with or neglectful of their recovery will often yearn for the days when they used drugs or drank. They may talk about using and relive their past drug use in the form of stories, anecdotes and comments that make it clear that they miss those times, despite the severe consequences they suffered as a result. (Levels of Relapse Warning Signs, T. Gorski)

4.) Reconnecting

An early warning of relapse is when a person in recovery begins to reconnect with friends or acquaintances they used drugs or drank with. This refers mainly to individuals who are potentially still using drugs or those who do not support recovery/sobriety. These reconnections are especially troubling when the person in question has withdrawn from people that DO support their recovery.

5.) Engaging in Risky Behavior

An addict in recovery that is about to relapse will often exhibit abnormally risky behavior. This could include extreme sports or other athletic activities, promiscuity, excessive speeding and other dangerous activities. Engaging in behaviors such as these fills a certain need for excitement and euphoria, but for most addicts in recovery the only euphoria that will satiate them is a return to their drug of choice.

6.) Secretive

As people in recovery get closer to relapse, they sometimes become secretive; carefully guarding their phone or computer, remaining tight-lipped concerning where they go, who they’re with, etc. Often at this stage the relapse has already begun and secrecy is required in order to conceal it.

7.) Abandoning Treatment

Addicts in recovery usually engage in some type of ongoing treatment as part of a relapse prevention program. This can take many forms, but when people in recovery are nearing a relapse episode, they often abandon these types of treatment with little explanation. When combined with any or all of the behaviors outlined above, it’s likely that for these people, relapse is imminent. (Carole Bennett, M.A. 6 Common Relapse Triggers PsychologyToday.com)

If you recognize these signs in yourself or someone you love who is in recovery, taking swift action is critical. This should begin by addressing the issue directly with the individual, and escalate to involve the person’s support network, treatment specialists and if needed, an interventionist.

No More Cash Problems With Fast Loans Online

There are still two weeks to go for payday and you are in need of cash. Instead of panicking or asking friends and family, you can now get loans easily. With fast loans available like payday loans, why worry about cash? Fast loans online are available to help people meet their emergency cash requirements on a temporary basis and then repay the loan together with interest on their next payday. However, there are certain things that you must take into consideration when you are in need of urgent cash.

How Payday Loans Work?
As suggested by the name, payday loans are supposed to be returned together with the amount of interest as soon as you have your next pay check in hand. This is why this loan is considered a very short-term loan. The loan period does not exceed more than 31 days is most cases. To repay the amount in such a short span, the amount granted to individuals does not exceed more than $1000 or $1500 in some cases.

While there is no credit check conducted before granting the loan, some lenders require that you deposit a postdate check with the principle amount plus interest. This is so that they automatically get the loan settled on the agreed date.

In situations where an individual fails to pay back the loan, the company extends the duration as well as the fees. At this point, positivity of these fast loans changes into negativity. Failure in paying back the money to the lender often leads to trouble because the increased fee keeps on accumulating and people repeatedly require more payday loans to get rid of their growing debts.

However, risks are associated with every business and proper money management can help an individual avoid all such risks. Moreover, such short-term cash lenders are also important for our society because people often need urgent cash and they may have no other option. However, at the same time, it is very important to plan your repayment accordingly and pay off the loan as soon as possible.

Taking a wise decision is recommended. It is always good to research for the right lenders and give enough time to go through the loan rules thoroughly. You will be required to give in some basic details about you and your current employment. The procedure is short and simple and in no time, the fast loans will be in your hand. Consider all your options before applying for payday loans.

Why Choose Events Calendar Software

You have an exciting event planned to be able to capture many prospective clients, all things are organized, and the only thing you are waiting for is the date for the event. However, do you know how to get more people attend your event? Do you have plans on how to entice people to actually appear in the day of your event? Some businesses try and do the traditional way of advertising their big event by using television and radio as their means to broadcast their plans, while some do it the hard way by printing leaflets and posters to be given away and displayed. On the other hand, some actually see that blasting mass SMS to consumers are truly effective since many nowadays indulge themselves in the high end technological era and mainly utilize cell phones as means of computing.

Since the use of technology has been proven to be very effective nowadays, events calendar software can undoubtedly bring you more reward with less effort and cost than the traditional ways. As some businesses needs a particular marketing plan that is plotted out in the marketing calendar, with the events calendar software, you don’t need to generate a marketing plan because this software includes calendar templates that are easy and convenient to use. Its customizable, sophisticated and it can bring multiple benefits to you and your company.

To be sure that you have the best, the software must obtain the following:

• Integration – the software you should get needs to be integrated with the major calendar programs like iCal, MS Outlook, or Google Calendar so as to communicate your scheduled activity to your specific market segment. Plus, these major programs would undoubtedly have plenty of users that can be your target.

• Controllability – you need to make sure that the consumers would still get the ability to control their own calendar and still own their calendar space to be sure to not spam them or flood them with notifications and updates. Moreover, they should have the power of choice. So that they can either turn on or off the notifications so if ever they do not want to see the notifications or updates, they can easily hide it from their calendar.

• Tracking – as most of the businesses today, analytics are some of the main feature of their software to be able to track or determine the changes that have been made to their market progress, this calendar software also include behavior and activity-based analytics. With pooled data regarding your customer’s profile, you can be able to easily construct a very effective, very suitable event for your prospects.

Fixing Solutions for Automotive Industry

Automotive industry demands high strength fasteners and precision components such as nuts, bolts, studs, screws, rivets, tie rods, shims etc. that are applied to various parts and components to hold and connect two or more surfaces or objects together in a structure.

Automotive industry uses fixing components coming in a huge variety of materials ranging from common steel to aluminum, brass, copper, titanium and plastic to other exotic materials. Choosing the material to manufacture these fixing components is essential due to difference between each material’s strength, corrosion resistance, brittleness, galvanic corrosion properties, and of course cost. Materials are basically selected on considerations of environment, corrosive or thermal extremes, magnetic properties, weight, re usability, stresses, and expected life time.

Depending on these specifications materials are classified into grades & quality standards to produce specific quality alloy mixtures that are then used to produce the fixing components. In addition to this, materials are further processed through a variety of coating, plating and hardening processes to form different specified grades of the alloy mixtures.

The various stages to enhance the metal corrosion resistance and appearance increase the cost of production that leads to expensive parts and fixing components. To keep costs within control, it is always advisable to use standardized materials. As specifying the material with specific chemical analysis adds time & cost to the whole process of manufacturing of fixing components. In a common practice, using standard materials only needs heat treating, cold working and coating to manufacture ready to use fixing components.

Quality is the primary concern for every manufacturing process and hence in order to manufacture high quality fixing tools and apply best industry practices that ensure timely deliverables, companies apply quality control methods such as computerized statistical process control archival documentation and various other approaches.

Inspection process involves utilizing tri-roll gages, hardness testers and optical comparators to ensure optimum performance. Automated sorting technologies are applied for assurance of contaminant free product for use in automated feeding equipment. Other than this, third party inspection, verification and certifications testify quality process on the go.

Used in a variety of application areas, replacing fasteners is quite tedious. It is generally best to match them while replacing. Replacing a bolt or screw with a stronger one is always now a good practice as harder bolts tends to be more brittle and may not work for specific applications. In some environments, applying galvanic corrosion methodology may result better.

Three SEO Strategies That High Ranking Websites Always Follow

Great people do not do different things. They do the same things differently. Well, this phrase is equally applicable to create websites as well. The basics of search engine optimization and social media integration are the same for everybody. The attitude and approach adopted by the webmasters makes all the difference. Let us look at some important differences between popular websites and those websites that fail to make an impression on search engines.

Always Changing, Improving And Evolving

Search engine optimization is a frustrating task primarily because it is always changing. In the beginning, stuffing the webpage with keywords was enough to improve your rankings. Then, Google started penalizing keyword spam and created the distinction between White Hat and other SEO techniques. The latest update by Google penalizes poor quality content. Judging the quality of content of your site through an algorithm may sound impossible. However, Google is making use of algorithms to weed out those websites that offer rehashed content without offering anything new.

Great sites never relax as far as search engine opposition is concerned. They never conclude that they have identified the golden formula and that they need not bother about SEO ever again. They are eager to identify newer solutions and want to find out how such solutions can help them improve rankings. If you want a one-time ticket to online popularity, then you will have to face many disappointing failures. Remaining popular on the Internet requires constant adaptation.

Search Engines Are Secondary. People Come First

This may sound sacrilegious to some SEO experts. To cater to people without bothering about search engines can lead to disastrous consequences. What is the point of setting up a website with high quality content if surfers cannot find it? Well, great websites believe that it is impossible to suppress good content online. If your content is good, then you will automatically become popular even if you are not focusing on search engine optimization.

Of course, this does not mean you should completely ignore optimization. However, your readers and viewers should be preferred over stats about your traffic. Keep your readers happy and they will spread word about your website without being asked to do so. Getting 100,000 web surfers to talk about your website is a lot simpler if you simply provide high-quality content.

Instead of spending a lot of money on expensive SEO strategists, you can adopt this simple approach and extract more value out of your investment.

Never Be In A Hurry For Results

Despite the release of panda and penguin updates by Google, it is possible to manipulate search engines and improve your rankings. However, such a short-term approach is only going to lead to complications. For starters, you can never be certain that your popularity is sustainable. If you focus on the long-term, then you will automatically make use of White Hat SEO techniques that focus on adding value at all times.

Make sure you follow these strategies. The best option is to employ an SEO expert who understands the importance of such an approach. This will help you focus on offering better quality products and services to your customers without worrying about the popularity of your website.

ZNZ Review

So what exactly is ZNZ? ZNZ, also known as ZipNada Zilch, works with Fortune 500 companies to help them acquire people to sign up for their free or low cost trial offers. These companies are willing to pay big money for this service with the hopes that many of these people will stay on as paying customers.

You’re probably wondering how you can make money with ZNZ? It’s very simple! You can sign up for a free account with them through one of their websites such as ZNZ One. Once you are signed up, you must then complete one of the trial offers yourself in order to be eligible to start making money online with them. Once completed you can then start advertising the link that they provide you with.

If you are promoting ZNZ One, you will get paid $20 (directly to your PayPal account or by check) every time a person signs up through your link and completes a trial offer. If you want to make money with ZNZ on a consistent basis, you will need some type of system that will do the work for you. What I mean by work is the selling, telling and showing. There are many systems out there but I would recommend finding a free system for ZNZ.

Using a free system for ZNZ makes it a lot easier to make money with ZNZ. If someone has to pay a monthly fee, they will be less likely to join. When searching for one, it must meet the following criteria: It should have an attractive capture page that entices people to want to submit their contact information to learn more about the system and ZNZ. It should then have an auto responder that automatically sends out follow-up emails. The system should also contain step by step instructional videos that cover everything.

Another thing to look for is whether or not the system provides any type of training and support. A good system will help you with your advertising by providing proper training and teaching you all of the various marketing techniques and strategies. Many systems will provide you with sample ads as well, that you can just copy and paste.

So hopefully this should answer the question, “What is ZNZ?” It is a legitimate company that is helping many people make money online. They have been around since 2007 and have paid out a total of five million dollars in commissions to date! Anyone can make money with ZNZ regardless of your experience level.

Anatomic Gel – Shoes Built for Wear

Anatomic Gel footwear is a range of beautifully styled and manufactured men’s shoes and boots which are made in Brazil and designed in the UK. The key feature of this range is the Anatomic Gel Technology which is created using only the finest softest 100% leather available. The beauty of this leather, used in the uppers, gives a unique and pleasing appearance to each pair of Anatomic Gel shoes. The hinged leather insole allows the shoe to be flexed without breaking and is constructed using four layers. The double layer of foam and latex makes it supremely comfortable for walking throughout the day and there is also a layer or patented antibacterial fabric and a layer of sheepskin. The rubber sole allows for plenty of flexibility and is non-slip. The thread used in the stitching is waxed to help prevent water penetration and it is 100% stitched through using the McKay method.

Jose Rosa Jacomete originally founded Brazilian Anatomic and Co some 20 years ago after working for 20 years from the age of 13 in the footwear industry. Jose Rosa Jacomete (affectionately known as Zuza to his family) left home to earn money for his family and found he had a passion and Uncategorized talent for footwear design. He learnt the trade inside out over the next 20 years and after gaining experience pattern cutting, designing and shoemaking as well as practising and learning at the technology centres that were specific to the shoe trade, he decided to open his own small factory. Since those days Anatomic and Co’s reputation for human rights and fair trade has gained recognition worldwide along with its Anatomic Gel Technology.

Anatomic Gel footwear’s first venture into the overseas market was launched in the UK about 2005 but has now spread to over 60 countries worldwide with customers in Europe, Asia, USA, Japan, South Africa, The Middle East, South America, Australia, New Zealand and also a high quality niche market in China. The company’s attention to detail and use of high quality materials has made them a major force in the world footwear market. Not only mature age customers are attracted to their product but also the younger generation find their shoes appealing with the high level of comfort and trendy stylish good looks.

The range of Anatomic Gel shoes and boots covers a wide variety of styles and colours. There are beautifully crafted dress boots, made of soft sheep leather, that are suitable for the office but that look just as good with a comfortable pair of jeans for that laid back casual weekend outing. There are also wonderfully comfortable elastic sided pull on Chelsea style boots that incorporate the fabulous soft layered insole and like all Anatomic Gel boots have the padded ankle support. In addition there are dress shoes in lace-up or pull on styles in a large range of fantastic colours.

Try a pair of Anatomic Gel shoes or boots for yourself and find out why they are such a favourite with people from all over the world.