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Health Choices

Understanding Cholesterol

This article was originally written by David Saunders

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Whenever the word cholesterol comes up in any conversation, almost always, people are talking about how high levels of cholesterol can be bad for your body and can even be fatal. What one never hears about is the fact that cholesterol is essential for our bodies. Here’s a look at the cholesterol molecule, and how it benefits our bodies.
The cholesterol molecule is a wax like fatty substance, which comes from a family of molecules known as steroids. The cholesterol molecule is present in our blood, as well as all the cells in body tissue. A cholesterol molecule does not enter our bodies through food, but is made by different parts of our body. Body tissues that have highly packed membranes, such as the liver, arethoma, etc are known to produce more cholesterol molecules and have more cholesterol present in their cells.
A form of the cholesterol molecule, if present in large numbers in our bodies, can form deposits known as plaque on the walls of our arteries, which can in turn block the flow of blood supply and cause heart problems. But, the cholesterol molecule also plays an important part in the following:

In the formation of sex hormones (so definitely can’t be all bad).
Cholesterol molecules help the cells to withstand temperature fluctuations and also protect the nerve fibers.
Cholesterol molecules help in digestion of food through production of bile salts.
HDL Cholesterol molecules act as a broom and sweep LDL Cholesterol molecules from the arteries.
The conversion of Vitamin D from sunlight is helped by the cholesterol molecule.

Thus, the cholesterol molecule is essential for bodily functions, but as forms of it can be harmful in increased quantities, people should control the amounts of cholesterol molecules present in their bodies. This can be best done through improved diet, and lifestyle and, when called for, through the short term use of certain medications.
ZZZZZZ

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Health Choices

Understanding California Health Plan Deductibles

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Summary:

First, the official definition:

Deductible

The amount you must pay for medical services each year before your insurance begins paying.

Now what does that mean?

The deductible is an amount you will pay first before you get help from the carrier. Keep in mind that with a PPO plan, you will get discounted PPO rates which can lower the costs by 30%-60% even though you have a deductible to meet. It’s very important to always stay in-network to keep your costs down.

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california,health,insurance,deductible


First, the official definition:

Deductible

The amount you must pay for medical services each year before your insurance begins paying.

Now what does that mean?

The deductible is an amount you will pay first before you get help from the carrier. Keep in mind that with a PPO plan, you will get discounted PPO rates which can lower the costs by 30%-60% even though you have a deductible to meet. It’s very important to always stay in-network to keep your costs down.

Exceptions to deductibles. Most traditional plans on the market allow copays for office visits and prescription before you meet your deductible. For example, if there is a $40 copay for office visit, you will pay the $40 right away rather than having to pay the full doctor visit subject to the deductible.

Prescription coverage is frequently broken out separately from the main deductible. There may be a separate deductible from Brand name drugs. This means that with a $250 brand deductible and $30 brand copays, you would pay the first (resets each Jan 1st) $250 of your drug costs and then you would get $30 copays afterward. The brand RX deductibles on the California individual family market typically run from $250-$750 depending on the plan. On the California Small group market, the deductibles run from $0 to $250 on average.

Some plans, such as the popular HSA (Health Savings Account) plans do not break out office visit and prescription from the main deductible. The deductible are all inclusive. There are a few other plans on the market which include the office and/or rx as part of the deductible so make sure to look at the plan detail when running your California health quote. The trade off with the HSA plans is that they can be much less expensive. If you are saving $500-$1000 annually or more, that pays for a lot of office visits and medication cost.

Deductible are handled in two ways when multiple family members are on one policy. Except for HSA plans, deductible are usually per person when you have more than one family member on a policy. You will typically see a “2 member max” statement around the deductible. This means that if two people in a family hit their deductible, the other family members do not need to. This is to protect against a catastrophic health situation where every family member had large bills in one year and the resulting out of pocket could be 10’s of thousands.

HSA’s or Health Savings Account plans on the other hand are cumulative deductibles. You essentially double the single person deductible and the entire family (2 or more people) is working towards one family deductible. Depending on the situation, this works to your favor or not. If one person in a family has large bills, he or she has a larger deductible to meet than if he/she were on an individual deductible plan. However, if multiple members have bills, it can be work to their advantage. Ultimately, the premium savings on an annual basis should more than compensate for the large deductible and that has been the attraction of HSA plans.

Out of network providers. Keep in mind that the discounted PPO rate for a given charge is what will be applied to a deductible if you use out of network providers. For example, let’s say you have a $500 deductible. If you have a $200 charge for an out of network provider, and the PPO contracted rate for that procedure is $100, the carrier will typically only apply the $100 to your deductible. Try to stay in-network with PPO plans.

After your deductible is met in a calendar year, with most plans, you then start to share the costs with the carrier for future medical charges in the form of co-insurance or copays according to the benefits of the policy.

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Patios Dublin

PDD1 Robot Vacuums: The Modern Way Of Cleaning

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Contrary to most popular beliefs, the concept of robotics is not exactly a new form of technology. According to history, robots have been on the market for so many years now. In fact, the very first documented construction of a working robot was a masterpiece of Jacques de Vaucanson in 1738. Since then, many have attempted and triumphed in building these remarkable mechanical devices.

At RobotShop, you can find almost every kind of robot that you have long wanted. Along wi…


robots, roomba, irobot, scooba, robot toy, robot parts, robotics,, lego mindstorms,robot lawn mower

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Contrary to most popular beliefs, the concept of robotics is not exactly a new form of technology. According to history, robots have been on the market for so many years now. In fact, the very first documented construction of a working robot was a masterpiece of Jacques de Vaucanson in 1738. Since then, many have attempted and triumphed in building these remarkable mechanical devices.

At RobotShop, you can find almost every kind of robot that you have long wanted. Along with its long line of robotics, the robot vacuums come close to perfection as far as freedom from tedious work is concerned.

Of the many functions of robots, the idea to provide people with machines that facilitates and helps lighten the burden of their daily chores is the most solid reason why robots are created. That’s why manufacturers all over the world know the importance of producing robots to meet the needs of household makers, among other markets. Domestic robots are now gaining their own followers. They have been able to help housekeepers worldwide because of their efficient and speedy way of getting the job done.

Robot vacuums are not necessarily reserved to residential use only. They can also be used in shops, offices, school, etc. Built with unmatched power as far as cleaning is concerned, robot vacuums can absolutely make a huge difference in the way people utilize their time in cleaning.

One of the best things about robot vacuums is that they can absolutely clean places that are hard to reach. They have built-in sensors that can warn the robot of its current position and make sure that the robot will not trip over ledges or stairs.

At RobotShop, consumers can choose from a wide variety of robot vacuums, each design has its own remarkable functions.

On top of the list is the powerful line of iRobot Roomba Robot Vacuums. These robot vacuums are specifically built to deliver utmost productivity when it comes to cleaning. In fact, according to statistical reports, iRobot Robot Vacuums Roomba line are the top selling robot vacuums worlwide. Prices range from CAD $250 to CAD $440.

Next is the Karcher RC 3000 Robocleaner. This particular type can actually operate and do the tasks on its own. For instance, if its battery needs to recharge, or when the dustpan is already full, this robot vacuum will find its own way to the docking station. Here, the robot vacuum will also unload its dirt and dust into a 2.0 L vacuum bag.

You can also check out Metapo CleanMate personal cleaning robot. Like any robot vacuum, CleanMate is specially designed to alleviate people from the difficulties of daily cleaning. It is very versatile and can almost clean any kind of surface, from carpet to hard-to-clean surfaces like tiles and hardwood. Best of all, CleanMate is the only robot vacuum that can simultaneously do the cleaning, deodorizing, and sanitizing of the area.

Given all these facts, it can be clearly stated that the dawn of modern cleaning is at hand. With robot vacuums, people can start living a life free from the bondage of cleaning. With domestic robots, you can have more time with your family and do things that are of greater importance than holding a mop.

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Patios Dublin

PDD1 Retro Furniture Buying Guide

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The Mies van Der Rohe “Barcelona” Day Bed is an ideal addition to your family room. Comfortable contours and stylish design is the benchmark of this Barcelona Day Bed.The bed has a black walnut wood frame which stands tall on strong steel chromed legs.


Modern Classic Furniture, Retro Furniture, Bauhaus Furniture, Retro Modern Classic Furniture, Mid Century Classics.

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Retro furniture not just sounds interesting; it also has a rich history to be proud of. The word retro has its origin from the 1950 s cutting right through the times with current furniture items. The decade produced a diverse range of ideas and innovative furniture. There were many names and designs that revolutionized the furniture era with modern designs like steel tubular furniture, G-plan and other innovative designs that forms the concept of retro .

Retro belongs to mid century classics and includes Bauhaus furniture and lavish leather sofas that left its modern impression and are still much adored. The style is back and it s the rage like never before. But before we purchase some classic retro furniture, let us learn a bit about its history. Belonging to the era and before are some names that have steeped the history of retro modern classic furniture. Telling the tale of some unsung and recognized heroes from the times should include,

Eileen Gray: An unsung name, Eileen Gray was a designer and architect who won acclaim quite later in her life. Her designs were modern and had an individualistic mark that inspired both modernists and the Art Deco. Her collaboration with architect and critic Jean Badovici led to introduction of tubular steel furniture, rugs and lighting for her studio and Galerie Jean D sert.

Joseph Hoffman: An Austrian architect and town planner, he was popularly known as “Quadralateral Hoffmann for his passion for geometric forms. His armchairs and sofas in geometric patterns were a rage with modern classic designer and craftsmen. Hoffman`s modern classic work combined the rationalism of Wagner with geometrical, rectilinear style of decoration influenced by Charles R. Mackintosh.

Le Corbusier : Charles-Edouard Jeanneret-Gris, or more popularly known as Le Corbusier (October 6, 1887 August 27, 1965), was a Swiss-born architect, designer, urbanist, writer and painter. Also recognized for his visionary architecture, what now is called Modern Architecture, Le Corbusier started his venture on furniture design in 1928 after inviting the architect, Charlotte Perriand, to join his studio.

Charles Ray Eames: Charles Eames (1907-1978) and his wife started the modern classics trend in the 20th century with their great designs and child-development toys and puzzles. They were a successful couple whose work designs like seating furniture in mesh, metal legged chairs and other revolutionary designs were much admired worldwide.

George Nelson: George Nelson was a visionary architect and designer with rare talent. His work includes Marshmallow sofa, the Nelson platform bench and the first L-shaped desk, a forerunner to the present-day modern workstation. He also designed graphic wall clocks, bubble lamps made of self-webbing plastic and developed forward looking, occasionally futuristic concepts.

Harry Bartoia: A futuristic Italian designer, Harry Bertoia envisioned futuristic designs that inspire people today. His patented Diamond chair for Knoll in 1952 is an unusually beautiful piece of furniture. The unique quality about the chair was its robustness within the light and almost petite frame, making it a huge commercial success. With the success of Diamond chair, the world was introduced to a new material wire mesh and it was a great icon of modern design.

Marcel Breuer: Marcel Breuer is famous even today for his modern classic designs better known as the Breuer Chairs. Well acclaimed for his Simplistic designs combined with neat lines make these chairs exceptionally popular. The range of Breuer chairs includes Marcel Breuer Cesca Arm Chair, Breuer Wassily Chair, and Marcel Breuer Cesca Chair etc. Besides Breuer Chairs, the Breuer label is also known for Marcel Breuer Bookshelves.

Mies Van Der Rohe: A popular architect of his times, Mies Van Der Rohe built one of his most famous buildings, the German Pavilion at the International Exposition in Barcelona, for which he also created a chair called the Barcelona Chair. He was considered a visionary architect whose work was much acclaimed worldwide.

Retro design furniture from the Fifties onwards includes many designers from the USA as well as Europe and Scandinavia. From the US, designers had a huge impact on furniture production throughout the, world. Once you have decided on a retro theme of furniture like mesh, steel or leather or perhaps a merger of themes, check out for details like color and finish the manufacturer has to offer. Retro is backing the big way. And you can be sure that it will be in vogue. How you team it up with your modern furniture is a creative venture by itself.

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Patios Dublin

PDD1 Retro Decor: How to Upgrade with a Touch of Nostalgia

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Styles are sometimes fads. Occasionally, there is something classic in a particular style. What is classic, holds value and remains beautiful, while trends pass by within the year. The savvy homeowner, who wants to improve and decorate with a retro flair, should be able to distinguish a classic retro design from trendy fads. Here are some helpful hints to direct you towards the right way to “retro fit” your home.


home improvement, home decoration, interior design, exterior design, california real estate

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Styles are sometimes fads. Occasionally, there is something classic in a particular style. What is classic, holds value and remains beautiful, while trends pass by within the year. The savvy homeowner, who wants to improve and decorate with a retro flair, should be able to distinguish a classic retro design from trendy fads. Here are some helpful hints to direct you towards the right way to “retro fit” your home.

Today’s contemporary look involves a carefully chosen display of classic pieces from the past. Often homeowners are so excited to go retro that they jump into changes that may be too drastic. Think touches, rather than a complete overhaul. Start with a cohesive, overall vision of how you want your home to look, then slowly build on this plan. You will then be able to see where you can push the edges and where you need to exercise restraint. This approach may also save you money in the long run. Touches are not as expensive as overhaul items: retro gas range, retro appliances, etc.

Retro, is a vague term for anything from a relatively distant past. Specify what era you are getting at- perhaps what decade. From here, think of what palette you are adding these touches onto. You might have a home that is Asian inspired. Imagine and visualize an era that suits this style, like certain aspects of the mid century modern period. (1945-1965) From here, you can begin to blend the two dominant styles harmoniously. Your retro additions should serve as complimentary accents that won’t run the risk of looking garish or just plain old.

Another approach to your plan is to concentrate on one room. A new, clean paint job, alongside some colorful vintage glass pieces, could be just the right touch. Speaking of paint, wall color is a simple way to retro-grade a space. Try painting one stand-out wall in a bold nostalgic color. You can then accent the room with pieces that compliment that color. The great things about paint is that is satisfies the urge to go big, or go home. You can make a strong statement with wall color, but if you end up detesting you color choice, re-painting is not the end of the world.

Personalization is important. Pick retro pieces that inspire you, and that you love. Don’t choose something simply because it belongs in the era you are decorating with.

If you are looking for retro touches, the mid century modern era is easy to start with. You can hunt for unique pieces that are funky, yet classic in design. What came out of the mid century modern design movement, was the production of pieces that were all about economy; economy in terms of price, but also in relation to space and design. The dominant style of this era focused on function, simplicity and natural shapes. Many furniture designers of this era had backgrounds in sculpture. Pieces of the mid century modern era worked with classic lines based on logic and elegance. It is hard to go wrong with classic lines.

Here are some ideas for retro or retro inspired mid century pieces to accent your home. It is great if you can find originals that you love. In this day and age, there are also multitudes of great knock-offs out there.

– Teak furniture, new or used (1950’s)

– Blenko Glass, new or used (1060’s)

– Modern wall clocks (1950-1960’s)

– Sussex Credenza (1950-60’s)

– Eames plywood chair (1950-60’s)

– Noguchi Table (1950-60’s)

Remember, however you go about adding retro flair, a home that is put together with a careful, artistic eye, is a beautiful home. Enjoy the process and the hunt, as you bring together the past and present for a classic home d cor, with a new retro look.

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Patios Dublin

PDD1 Retractable Sunsetter Awning Add It To Your Home Or Camper

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Awnings are a great way to improve your home, especially sunsetter awnings


sunsetter awning, sunsetter awnings, sunsetter retractable awnings

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A Sunsetter awning is the Mercedes Benz of awnings. When you are looking for the top of the line retractable awnings, Sunsetter is the brand name you need to look for. This company offers three different models of awnings as well as the Sunsetter EasyShade to help you block out the heat of the sun. One of the features you can enjoy with the top rated Sunsetter awning is that you can operate the motor with a remote control.

The top selling and most expensive Sunsetter awning is the Pro Motorized awning. This model of Sunsetter awnings has a weather breaker panel integrated with the front bar. This is a screen that you can roll down in front of these Sunsetter retractable awnings to protect you from the breeze blowing the napkins off the patio table. Although it will block about 60% of the sun s rays, this feature of the awning will still allow light to filter through. It unrolls in seconds, but it is not motorized like the retractable awning. A few cranks of the hand mechanism are all it will take to have it in place.

When you use the Pro Motorized Sunsetter awning, you have to use a remote control for opening and closing. The motor used in these Sunsetter awnings is the best you can get the Somfy RTS. When you install the Sunsetter retractable awnings you have to purchase the roof brackets separately and you can set the pitch you want for the awning at this time. The pitch of the awning is preset at the factory at a 29 – inch drop, but you can lower it to 45 inches.

The same motor as in the Pro Motorized Sunsetter awning also powers the regular models of Sunsetter awnings. They also opens easily with one touch of the remote control. The only difference with these Sunsetter retractable awnings is that you don t get the weather breaker addition. You can mount in heights as low as 7.5 feet and install it over siding, vinyl, wood or brick. The fabric of the awning is made from 5 layers giving you a rugged material that will withstand the elements of weather.

Sunsetter awnings fit most homes and offers about 182 square feet of protection. In case of a power outage, there is a manual override on the Sunsetter awning so that you can close it manually. Not only are these awnings economical and easy to use, but the Sunsetter brand leads the way in the awning industry with products unmatched by other manufacturers. The fabric is 100% waterproof and is guaranteed never to leak. When you purchase a Sunsetter awning, you have an awning that will last for years.

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Patios Dublin

PDD1 Retractable Awnings Several Different Shade Positions

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Retractable awnings are the best awnings you can get. There is nothing else as convenient.


retractable awnings, retractable awning, retractible awning

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Retractable awnings add the perfect ambiance to the deck on your home. With an awning that you can roll up when necessary, you don t have to worry about the material ripping in the wind or tearing under the weight of the snow. With the motorized retractable models of awnings, you have the convenience of being able to roll up the retractible awning with just the touch of a button. You install the switch for the retractable awnings outside the home, but these are completely weatherproof. You won t have any worries about it not functioning in heavy rain or wind.

Even if you lose the power during a storm, you can still roll up a retractible awning. Retractable awning manufacturers are very careful to install a manual override so that you can winch in the awning by hand if you need to. Most retractable awnings do not have any poles, which might cause you to wonder what holds them in place. These awnings are designed to be self-supporting. Each retractible awning has a secure mounting with heavy-duty arms for support. There are internal springs that create the arm tension and large radius elbows help to keep the awning fabric taut at all times.

When you have a retractable awning over your patio, rolling it up will help to store it for winter. Therefore, you don t have to disassemble the awning in the fall and reinstall it in the spring. You can remove the loose hangings from the retractable awnings during the winter, but many homeowners don t do anything. It really depends on where you live. In some climates, it is possible to leave the retractible awnings up all year long.

The main purpose of retractable awnings is to provide shade from the sun. There will be times when you don t need to use the retractible awning when you are sitting outside, so you can leave it in the rolled up position. However, awnings are not designed to handle a high wind velocity. For this reason, you can get a retractable awning that contains a wind sensor. When the wind speed picks up, the sensor automatically activates the switch, retracting the awning for you. Experts on retractible models of awnings recommend that if you can comfortably read the newspaper outdoors, then it is safe to have the awning extended.

There is nothing as convenient as retractable awnings, whether you have the manual or automatic models. Even the manual models only take a few cranks of the hand mechanism to have the awning rolled back out of the way. The lightweight fabrics used in retractible awnings are guaranteed against rot and mildew and the warranty covers all defects for up to five years. When you take care of the retractable awnings according to the manufacturer s instructions, you should be able to have an awning that lasts for 8 to 12 years.

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Patios Dublin

PDD1 Retractable Awnings – Top 10 Reasons to Invest in Retractable Awnings

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Retractable awnings provide sun and heat protection, while reducing energy bills and improving the value of your home.


awnings, awning, retractable awnings, patio covers

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Looking for a way to reduce your electric bills or just improve the exterior appearance of your house? Investing in retractable awnings can do all that and much, much more. The top ten reasons to invest in retractable awnings starts and ends with sun and heat protection.

Whether you live in the Northeast or the Southwest, the summer sun can be merciless as it beats down on your patio, your windows or your business. The solution is to install a retractable awning developed from the strictest engineering standards and made from the highest quality materials.

Before the summer sun peaks in the sky, it s time to make your ideal patio dreams come true. Imagine sitting beneath the cool shade afforded by the retractable awning with no worry about fading, cleaning or wear and tear. The wind is not going to rip it away, the rain is not going to rust it and you can program it to retract to meet different conditions. Businesspersons and homeowners alike can appreciate the convenience; the quality and the atmosphere a retractable awning can deliver.

So just what is that makes retractable awnings so impressive? Check this list out:

10. European engineering and design makes even the largest retractable awnings not only possible, but also desirable for commercial & residential use. For states where outdoor seating areas are growing in popularity at restaurants, the large options are the best options.

9. Set the controls to your preferences, whether you want the switch to be indoors, outdoors or available on a remote control.

8. Fading isn t an issue. Your colorful umbrellas will fade. Your permanent addition can rust. Your aluminum frame retractable awning with solution dyed acrylic fabric will not rust nor will it fade within the manufacturer s warranty.

7. Energy efficiency is at a premium with deregulation of power companies and rising gas prices. Retractable awnings can reduce heat on the interior of a home or a business by as much as 77 percent according to a study by the American Society of Heating and Air Conditioning Engineers (ASHRAE). Factor the effects of those savings on your utility bills.

6. Adding room without construction costs. Your retractable awning can add a great patio area for a restaurant or an outside lounging area to your home. A retractable awning is a great deal less expensive than a permanent structure.

5. The are numerous sensor options available for making the retractable awning exactly what you would like it to be whether you live in a hurricane prone area or a hot, dry desert. Wind, sun and rain are no problem.

4. Little to no maintenance is required. Retractable awning manufacturers back their product with up to a 25 year warranty.

3. Improving the exterior appearance of your home while enjoying the benefits of shade. Retractable awnings come in a variety of styles and colors. Whether decorating for an Italian villa, a beach house or a country farmhouse, retractable awnings can match any facade.

2. Rain protection makes up a smaller percentage of retractable awnings sales. Whether the awning provides a place for customers to get out of a gentle shower or just allows you to sit out on the patio during a warm, spring rain (with sufficient pitch); the retractable awning offers a great look and protection rolled into one.

1. First rate sun and heat protection that can make late afternoons and evenings on the porch or deck a pleasurable experience. The majority of customers looking into retractable awnings are doing so for sun protection. Why sit under the sun or ducking your head under an umbrella, when a retractable awning provides full area coverage and all the shade you could desire?

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Patios Dublin

PDD1 Replacing wood sash windows with vinyl windows

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Learn how to replace your old woodf sash windows with energy efficient vinyl replacement windows


Vinyl windows, replacement windows, how to install windows, installing vinyl windows

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When we left off last week, we had removed the old wood sash windows and prepared the opening for the vinyl replacement windows. Now it’s time to install your new windows. You should have someone there to help you when doing the installation. First, Remove all shipping materials from the window. Now, if you are installing several different sizes, make sure you are putting the correct window in the correct opening. You need to put the window into the opening to make sure it’s going to fit, then remove it and run a bead of caulk on the face of the outside blind stop where the window will rest. You don’t want to caulk, only to discover the windows are too big. It’s worth the extra few minutes to make sure it’s going to fit. Lift the window and set the bottom in first. Then raise the top until it rests against the outside blind stops. Sometimes, when raising the top into position, the window frame will hit the top of the wood frame. You need to tPDD1 down on the top of the vinyl frame while keeping pressure towards the outside.

Once you determine that it’s going to fit, remove the new window and set it aside. Run a bead of caulk on the face of the outside blind stops. White latex painters caulk works fine. Raise the window into position again. Now have your helper hold the window in position while you raise and lower the sashes, making certain that the window is square in the opening. Remember how you ordered the windows 3/16″- 1/4″ shorter than the tightest measurement? This is where you use this space to adjust the frame to be the most plumb and level. Get a box of popsicle sticks and wood coffee stirrers at the grocery store. The coffee stirrers are about 1/16″ thick, and the popsicle sticks are approximately twice as thick. You want to put the shims in the four corners. Then caulk the gPDD1 on both sides and along the top before installing the inside stops. I don’t recommend putting any screws in the sides, but you can put one screw in the top center and one in the bottom center. You really dont have to use any screws in this kind of installation, since the shims will eliminate any side play, and the caulk on the blind stops will hold the frame in place as well. Remember, we still need to re-install the inside stops.

Before installing the inside stops, remove all the old nails and replace them with new nails. A 1″- 1 1/4″ finish nail is fine. Before installing the inside stops, scrape all old caulk off the stops. Then, while your helper holds the window in place, nail your stops back on. If the window has 4 stops, install the shortest ones first. That way you can bend the longer stops into place between the two short ones. Use a nail punch to sink the head past the surface of the stop. If you have several windows to do, i suggest doing the first window to this point before going to the next. How frustrating would it be to have a helper removing the old sashes, only to discover that the windows aren’t going to fit!? If the first one goes in fine, then you can send your helper ahead of you to start removing old sashes. The best way to avoid the nightmare of having a bunch of new windows that won’t fit is to make sure you measure CORRECTLY. Remember, tight minus 1/4″ on the width and height should be fine.

Finish the inside by caulking the area of the inside stop where it meets the casing, and the point where the stop meets the new frame. Fill the nail holes in the inside stops with caulk to hide the nail heads. Now it’s time to finish the outside. A quality replacement window will either have a sloped frame to match the slope sill, or it will come with an insert that fits under the new frame to fill the gPDD1 created by the sloping wood sill. If you buy a lower grade window that doesn’t come with anything to fill the gPDD1 underneath, you can buy some wood trim to fill the space, or you can get a flat vinyl trim that attaches to the face of the bottom of the new frame. The flat trim is available on my website under the “shop” tab. Once you cover the bottom gap, it’s time to caulk where the outside blind stops meet the vinyl frame, and where the bottom gPDD1 filler meets the wood sill.

That’s it! You’re done! You can buy accessories to cover your old wood sills with a vinyl wrPDD1 extrusion. That can also be found on the website under the “purchase trim” tab. Next week we are going to start on replacing old aluminum windows.

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Health Choices

Understanding California Health Plan Co-Insurance

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Summary:

First, what is the official definition of co-insurance?

Coinsurance

Once you have met your deductible, you pay coinsurance for additional medical care. It is a percentage of the billed charge. For example, your insurance company might pay 80%, and then you would pay 20%. It is similar to a co-pay, but is a percentage instead of a dollar amount.

Now, let’s dig a little deeper. With California health insurance, it is common to speak of their plan as an 80/20 plan or a …

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This article deals with
coinsurance,co-insurance,california,health,insurance


First, what is the official definition of co-insurance?

Coinsurance

Once you have met your deductible, you pay coinsurance for additional medical care. It is a percentage of the billed charge. For example, your insurance company might pay 80%, and then you would pay 20%. It is similar to a co-pay, but is a percentage instead of a dollar amount.

Now, let’s dig a little deeper. With California health insurance, it is common to speak of their plan as an 80/20 plan or a 70/30 plan. They are essentially referring to the co-insurance part of it. With the 80/20 example, the health carrier is picking up 80% of the charges and you are picking up the remaining 20%. If there is any kind of deductible, you must pay that first at 100% until met.

Let’s take an example and see how California health insurance plans essentially break down into three main stages.

Stage 1 – The deductible YOU PAY 100%

Let’s say you have a $500 deductible. Except for services that are separate from the deductible (usually office visits and prescriptions…see COPAYS), you will pay the discounted charges at 100% until you meet your deductible. You can find more information on deductibles.

Stage 2 – The co-insurance YOU SHARE A PERCENTAGE

Once the deductible is met, you then start sharing the cost with the carrier. Let’s say our plan is 70/30 and the charge is $1000. You pay the first $500 (deductible) and then you pay 30% of the remaining $500…or $150. Of the first $1000 charge, you would pay $650 out of it. If you have another $1000 charge in that same calendar year, you would pay 30% of the 1000 (or $300) since your deductible was already met. When do you stop paying the 30%??

Stage 3 – The Max Out of Pocket THE CARRIER PAYS 100%

Once you have met your Max out of Pocket (sometimes called the Copay Maximum), the carrier will then pay 100% of covered benefits, in-network. For our plan example, let’s say we have a $500 deductible, 70/30 co-insurance, and $5000 max out of pocket. If we get a $50,000 bill in a calendar year, you pay the first $500, then 30% until you reached another $5000 out of pocket. For that $50K, you would pay $5500 and the carrier would pay $45,500. Co-insurance is nice but the real reason to have health insurance is the max out of pocket.

Co-insurance usually applies to services outside of the office visit and prescriptions. You will typically see the same co-insurance percentage for hospital, lab, surgery, emergency (sometimes has separate additional copay) and physician services.

It’s important to stay in network for PPO plans. Let’s say you have 70/30 plan and you see a doctor out of the PPO network on a non-emergency basis for $1000 of services and your deductible is already met (you’re in Stage 2). Two things will probably happen. The health insurance plan will probably have a separate percentage for out of network…let’s say 50/50 instead of 70/30. Also, the carrier will apply this lesser percentage to what they would pay an in-network provider. For example with the $1000 charge, perhaps the contracted PPO rate is $600 (discount is usually 30-60%). The carrier would then pay 50% of the $600 or $300 of the total $1000. You pay $700. Compare this with the 30% of 600 you would pay for an in-network provider. $700 versus $180 out of your pocket. Use in-network providers!