Monthly Archives: October 2017

Health Insurance Facts to Know

How can health insurance help you out? Being an investment, it is imperative that people prioritize this expense along with many other financial responsibilities. Health insurance coverage should be there to support you and your family in times when you need immediate health care. Think of it as a nest egg where you can get funds from to pay for the various costs of medical treatment, hospitalization, medication, and more.

There are various types of health insurance plans that you can obtain, and there is an equally innumerable number of firms that offer such services. It can be a little challenging to choose one that is right for your budget, as well as tailor made to suit your health needs. Note that you don’t have to spend a fortune to be able to get insurance coverage. There are ways by which you can earn discounts and save, while at the same time receiving quality and reliable services from your insurance provider. All it takes is the right knowledge to be able to evaluate your health insurance priorities and lock down your choice of provider.

In line with this, this article presents some interesting statistics that you might want to keep in mind regarding health insurance plans in the United States. Knowing these important notes will help you make a wise decision with regards to choosing a plan for you and your family. Mentioned here is also vital news regarding the direction that the health insurance system in the US is headed.

How many people in the United States are without health insurance? Regardless of how important it is to be covered, there is a significant percentage of the population who has no resources to obtain their needed health policies. As the Centers for Disease Control and Prevention (CDC) reports, about 45 million people in the US have no health insurance. And that translates to roughly 15 percent of the population. The Hispanics have the most number of uninsured children and adults, which is about 32 percent of the total Hispanic population. On the other hand, 19 percent of the total African American population does not have health insurance, and around 10 percent of all whites are uninsured as well.

If you are interested to know, there are specific states that contribute the most to the uninsured adult statistics in the country. If nearly 20 percent of Americans aged 19 to 64 have no form of health insurance, which states significantly add to that number? To be more precise, Texas and New Mexico have almost a third of the total aged 19 to 64 population uninsured. On the other end of the spectrum, Massachusetts has the least number of uninsured adults in that age group, with only about 10 percent accounted by the Kaiser Health Foundation statistics.

How many children in the US are without any form of health insurance? This age group is considered as the minor group, comprised of children aged 18 and below. The CDC stated in a 2007 report that about 10 percent of the total minor population does not have health insurance. That means that there are 7 million children out there who may not be able to get afforded medical treatment. Which states have the most number of uninsured children? The Kaiser Health Foundation accounts that Texas ranks at the top of the list, with about 22 percent of the ages 0 to 18 population having no health insurance. Massachusetts is still the state with the least number of uninsured children, with only about 5 percent having no coverage.

In terms of the performance of insurance companies in the country, which are the ones that write the most number of health policies? As of the year 2007, the National Association of Insurance Commissioners reports ten of the largest insurance firms in the US, with respect to their market shares. Topping that list with approximately 12 percent of the market share is the UnitedHealth Group. Second is WellPoint, Inc, having almost 10 percent of the market share. The third largest with 7.7 percent market share is the Kaiser Family Foundation. Blue Cross, which is among the oldest health insurance providers in the country, ranks ninth, with a market share of 1.7 percent.

On a final note, what does the American government intend to do in response to the ever growing health insurance needs of the country? Among the highest priorities of the new Obama administration is to focus on revamping and further developing the health insurance system in the US. About $150 billion is expected to be allotted for provision of more accessible and more affordable health insurance options for the population. In line with the recession which led to the loss of over 7 million jobs, $25 billion will be used to cover for nearly 65 percent of health insurance premiums for these employees.

To be able to answer to the health needs of children, it is expected that 5 million kids will be granted health insurance, as $87 billion will be for funding state health insurance programs, including the SCHIP or State Children’s Health Insurance, which assists minors from low income families as well. The rest of the funding will be for modernization of medical facilities, including access to records, as well as research for diseases such as cancer, Alzheimer’s, diabetes, and heart conditions.

Get Cheap Health Insurance

Cheap health insurance may look like a bargain, but what happens if you have a major medical problem? You don’t want to be caught off-guard if an unexpected major medical problem arises. Cheap health insurance means one thing to one person and something else to another. While the idea of getting cheap health insurance is very appealing, no one wants to deal with the repercussions of bad or inadequate health insurance. Cheap health insurance has become the issue of the moment in South Carolina and across the country. More small businesses are increasingly unable to provide cheap health insurance plans to their employees because of the rising cost and the lack of federal and state legislation that would allow small businesses to purchase cheap medical insurance in pools.

Cheap health insurance is your access to the best options in the market. This is because you no longer have to spend so much time searching for the product that will suit your health care needs. Cheap health insurance rates work so much better when you know what you are supposed to be looking for. Get some tips on what you should look for when dealing with a health insurance plan. Cheap health insurance quotes can help you to find the best and the most inexpensive coverage that is available. You will be covered, and relieved to know that if anything happened to you, you will not have that major financial stress of paying full price for your injuries or illnesses.

Medicare supplemental insurance offers senior coverage for health care costs that are not covered by a traditional Medicare plan. By having Medicare supplemental insurance, seniors can rely on consistent, constant and comprehensive coverage when they need it. Medicare supplemental insurance is designed for people on Medicare, who wish to have more comprehensive coverage. These supplemental plans may include Managed Care HMO plans or Medigap PPO plans that provide you with greater access to participating physicians. Medicare and Medicaid are both excellent programs for those individuals who qualify, but they are no substitute for a system which allows us all to access basic private medical insurance cover at a cost which we can afford.

Medical Insurance also known as health insurance is a protection to individuals and their families against unforeseen expenses. In the process, there are two parties namely the insurer and the insured. Medicaid is for people who come under the low income’s bracket. Every person is eligible for it and having a job does not affect one’s eligibility. Medical terms can be confusing, and before speaking with an insurance agent, you should make sure you understated his or her language. Make sure you read our overview of health insurance companies to get a better idea of each provider’s identity.

Individual companies are free to evaluate the risks to insure you in whatever manner they see fit. Each health insurance company employs people (actuaries) that try to calculate the statistical risks involved in insuring you, and not surprisingly, has a slightly different view of the statistics. Individual health insurance works differently. It generally can’t be terminated just because you use it, but you can be turned down in the first place if you do not pass health underwriting; you can be rated up if you have a history of illness or obesity; and your premiums can be and often are increased if you suddenly have a major illness. Individual health insurance covers different types of injuries as well. An active lifestyle increases the risk of accidental injuries and repairing broken bones can become very expensive.

Individual health insurance is State specific. Each state has slightly different laws and regulations governing the implementation of private individual health insurance.

Hospitalization, medicines, doctor fees can be very high and if the patient cannot get a suitable insurance cover, it is very difficult. Health insurance can be a tough battle for cancer patients. Hospitals have an extraordinary ability to save life and without health insurance you could be medically saved but financially ruined. Hospital cash plans are a form of medical insurance that takes care of everyday medical costs. Many will pay for dental or optical treatment up to a set limit every year; physiotherapy; specialist consultations etc.

Comparison of your options: To be able to find an affordable health insurance you must have an idea of all. What is available in the market? After you have shopped enough get hold of a broker who can help you in comparing the policies. Comparing health insurance is a case of finding the right health insurance provider to cover your particular circumstances as well as comparing the types of policy provided by each health insurer.

Comparing Medical Insurance isn’t just a case of finding a handful of brand names and trusting they have everything covered in their policies. The cover varies wildly, as will your medical insurance quotes. Compare several plans from top rated medical insurance companies and apply online.

COBRA, short of Consolidated Omnibus Budget Reconciliation Act, came into being in 1985, and it is also a low cost health insurance option for short-term coverage up to 18 months. It’s great for transition periods such as school age children, widowed spouses, divorced couples, and other situations where you may have been covered by employee programs previously. COBRA has an 18 month limit, or 36 months if you’re permanently disabled. Most people are under the impression that COBRA is expensive, or that it’s better to stay with a plan they know.

Again, depending on where you live, requirements may be stringent. However, it wouldn’t hurt to see if you or your family qualifies. Ask around to find out about the different agents and their policies. Many agents will work very hard to get you an affordable health insurance plan for your family at a cost you can live with. Ask if the agent will be available for phone calls and if he or she will make phone calls on your behalf if you have questions in the future. Ask your agent to be sure.

Ask for a quote from several sources, and see what kind of a deal, they can get for you. Make sure they are also licensed in your state, because it does no good getting insurance if they can’t operate in your state. Ask about policy rates, terms, services, co-pays, and claim procedures. If the representative has a difficult time answering your questions, or you just don’t think the company is legit, consider visiting your state’s Department of Insurance website to read through reviews and financial information of the company.

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Small Business Health Insurance

Saving on your small business health insurance can be a challenge. But there are ways to overcome the financial obstacles and get the coverage necessary for your business. There are two major benefits of employer-based coverage. First these plans, although expensive, usually carry the best all around protection for you and your employees. Second, providing benefits plays a key role in attracting and retaining quality employees.

Why is coverage for small businesses so much more than for large corporations?

Health insurance for small businesses cost so much because of the high quality coverage concentrated among a small group of people. Every individual within the group represents a different level of financial risk to an insurance company, and this risk is added up and spread out among the group. Large corporations pay considerably less because the risk is spread to such a large group, where small business owners can see unreasonably high increases in premiums due to one or two members. Small businesses also have to insure their employees under state mandates, which can require the policies to cover some specific health conditions and treatments. Large corporations’ policies are under federal law, usually self-insured, and with fewer mandated benefits. The Erisa Act of 1974 officially exempted self-funded insurance policies from state mandates, lessening the financial burdens of larger firms.

Isn’t the Health Care Reform Bill going to fix this?

This remains to be seen. There will be benefits for small business owners in the form of insurance exchanges, pools, tax credits, subsidies etc. But you can’t rely on a bill that is still in the works, and you can’t wait for a bill where the policies set forth won’t take effect until about 2013. Additionally, the bill will help you with costs, but still won’t prevent those costs from continually rising. You, as a business owner, will need to be fully aware of what you can do to maintain your bottom line.

What can I do?

First you need to understand the plan options out there. So here they are.

PPO

A preferred provider option (PPO) is a plan where your insurance provider uses a network of doctors and specialists. Whoever provides your care will file the claim with your insurance provider, and you pay the co-pay.

Who am I allowed to visit?

Your provider will cover any visit to a doctor or specialist within their network. Any care you seek outside the network will not be covered. Unlike an HMO, you don’t have to get your chosen doctor registered or approved by your PPO provider. To find out which doctors are in your network, simply ask your doctor’s office or visit your insurance company’s website.

Where Can I Get it?

Most providers offer it as an option in your plan. Your employees will have the option to get it when they sign their employment paperwork. They generally decide on their elections during the open enrollment period, because altering the plan after this time period won’t be easy.

And Finally, What Does It Cover?

Any basic office visit, within the network that is, will be covered under the PPO insurance. There will be the standard co-pay, and dependent upon your particular plan, other types of care may be covered. The reimbursement for emergency room visits generally range from sixty to seventy percent of the total costs. And if it is necessary for you to be hospitalized, there could be a change in the reimbursement. Visits to specialists will be covered, but you will need a referral from your doctor, and the specialist must be within the network.

A PPO is an expensive, yet flexible option for your small business health insurance. It provides great coverage though, and you should inquire with your provider to find out how you can reduce the costs.

HMO (Health Maintenance Organization)

Health Maintenance Organizations (HMOs) are the most popular small business health insurance plans. Under an HMO plan you will have to register your primary care physician, as well as any referred specialists and physicians. Plan participants are free to choose specialists and medical groups as long as they are covered under the plan. And because HMOs are geographically driven, the options may be limited outside of a specific area.

Health maintenance organizations help to contain employer’s costs by using a wide variety of prevention methods like wellness programs, nurse hotlines, physicals, and baby-care to name a few. Placing a heavy emphasis on prevention cuts costs by stopping unnecessary visits and medical procedures.

When someone does fall ill, however, the insurance provider manages care by working with health care providers to figure out what procedures are necessary. Usually a patient will be required to have pre-certification for surgical procedures that aren’t considered essential, or that may be harmful.

HMOs are less expensive than PPOs, and this preventative approach to health care theoretically does keep costs down. The downside, however, is that employees may not pursue help when it is needed for fear of denial. That aside, it is a popular and affordable plan for your small business health insurance.

POS (Point of Service)

A Point of Service plan is a managed care insurance similar to both an HMO and a PPO. POS plans require members to pick a primary health care provider. In order to get reimbursed for out-of-network visits, you will need to have a referral from the primary provider. If you don’t, however, your reimbursement for the visit could be substantially less. Out-of-network visits will also require you to handle the paperwork, meaning submit the claim to the insurance provider.

POSs provide more freedom and flexibility than HMOs. But this increased freedom results in higher premiums. Also, this type of plan can put a strain on employee finances when non-network visits start to pile up. Assess your needs and weigh all your options before making a decision.

EPO

An Exclusive Provider Organization Plan is another network-based managed care plan. Members of this plan must choose from a health care provider within the network, but exceptions can be made due to medical emergencies. Like HMOs, EPOs focus on preventative care and healthy living. And price wise, they fall between HMOs and PPOs.

The differences between an EPO and the other two organization plans are small, but important. While certain HMO and PPO plans offer reimbursement for out-of-network usage, an EPO does not allow its members to file a claim for doctor visits out its network. EPO plans are more restrictive in this respect, but are also able to negotiate lower fees by guaranteeing health care providers that it’s members will use in-network doctors. These plans are also negotiated on a fee-for-services basis, whereas HMOs are on a per-person basis.

HSA (Health Savings Account)

An HSA is a tax-advantaged account used to pay existing and future medical expenses. HSAs are used in conjunction with high-deductible health plans (HDHP), which will make some with pre-existing conditions ineligible. Also, HSAs must be funded with cash. Communicating the terms of this account to your employees is important, as a large number of HSAs are underfunded or improperly funded. The health savings accounts were signed into the law by George Bush in 2003, and have become an affordable alternative to a group health plan.

When inquiring about an HSA, there will be a few things you will want to clarify. While HSAs generally cover routine medical expenses and copays, some can provide dental and vision care as well. And since HSAs can be combined with certain compatible plans, it is important to understand how money from the account will be allocated. And finally, you will want to know about cashing out your HSA balance. The amount is taxable and could be subject to a ten percent excise tax.

HRA (Health Reimbursement Arrangement)

An HRA is exactly what it sounds like. The employer reimburses the employee for health care. As an employer, you will usually have the option to contribute to a reimbursement fund, or to pay fees as they are incurred. These reimbursements can be deducted from your taxes, and are tax-free for your employees, saving you both money.

Some providers empower employers by giving them more options. HRAs, unlike HSAs, don’t have to be funded with cash money, placing a book keeping entry on your balance sheet is enough. You can usually control aspects of your arrangement such as reimbursement limits, whether you or your employee pays first, and if the previous year’s funds roll over.

HRAs are becoming a more popular option because of the control it has given small businesses. Combined with a high deductible health plan (HDHP), an HRA could be the most cost-effective solution to your small business health insurance problems. It’s always best to compare these plans to PPOs, HMOs, and EPOs to know what works best.

Fee for Service (FFS) or Traditional Indemnity

A fee for service plan is the most flexible small business health insurance option. You choose your doctor, and your hospital. You can see a specialist without a referral. This flexibility, however, comes with more out-of-pocket expenses and higher insurance premiums.

The typical FFS plan has a deductible ranging anywhere from five to fifteen hundred dollars. After this amount is reached, the provider will pick up eighty percent of your medical bills, and require you to pay the remaining twenty percent. Because of the rising costs of health care, and the potential for a small number of doctor’s visits to cost thousands, these plans can become incredibly expensive.

Flexible Spending Account (FSA)

A flexible spending account is a savings account to be used for medical expenses, and is funded by pre-tax dollars. Using pre-tax dollars means that your employees will actually show that they have less income, and will therefore have less taxes withheld. As an employer, you set the limit on contributions to the account per year. In addition to the employee contribution, you can also credit the account, or fund it completely from your general assets.

An FSA, especially if combined with an HDHP, can significantly reduce the costs of small business health insurance.

You should be forewarned, money from FSA accounts cannot be rolled over. They are, however, available to use for two years and two and half months after the benefit year. A terminated employee won’t be able to use leftover funds, unless there is a positive remaining balance and COBRA is elected.

Small business health insurance providers have made significant improvements in their services to simplify the administration of your plan. With HRAs, FSAs, and HSAs, your employees can use debit cards for medical transactions. Be sure to research this thoroughly. You will want to be sure your debit card plan is IRS compliant, and that you can use a large number of pharmacies. You should also pick a plan that can verify eligibility on the spot. Talk with your agent about linking transit, parking fees, and prescriptions to the same card. When picking the debit card options, please be sure to clarify the details of the substantion process. This is IMPORTANT! With other plans, the provider may assign someone to manage your plan. Or you may have to hire someone. Still, you should be able to login to your account and print insurance cards, important papers etc.

The next thing you can do is thoroughly assess your needs. Being that every member of your small business plays a key role in its success, it is vital that their needs are met. And understanding these needs is crucial to finding the right plan. Find out about chronic illnesses, and additional information related to past health issues. Know what your employees think about health insurance, and get them involved in the process.

Hiring an agent or a broker

Finding and understanding small business health insurance can be a daunting task. While some choose to go it alone, others need some professional assistance. You need to understand the difference between an agent and a broker, and how you can get the most from either of them.

A broker

Brokers function independently and usually work for several different companies. Since they have a variety of resources, they can usually provide more options and a better overall view of the marketplace. Brokers will assist you by evaluating the costs and designs of plans from your local major carriers. The cost isn’t everything, you want to get the coverage that you need.

Ask the broker how he or she is getting paid for their services. They should readily divulge that information. Some brokers may charge you a flat free. Some receive a fee from an employer, while others receive a commission from the insurance provider. Any commissions could be reflected in your premiums, but not to the point that you should worry.

An agent

Agents typically provide services for one company. They have a closer relationship to the insurance company than a broker would, giving them more leverage to make alterations to your plan. In some cases they can offer a particular plan for less than a broker, and may have access to additional services like worker’s compensation. To find out what different providers have to offer, talk to more than one agent. It may be time-consuming, but it could bring you closer to the most cost-effective solution for your small business health insurance.

One of the common options presented by agents is the employee-elect option. This is an arrangement where employees pick the plan they prefer. Those who don’t need as much coverage won’t be forced to pay so much, and those who do need it can get it without increasing the financial burden of the company as a whole.

How to Save On Your Small Business Health Insurance Plan

What’s important to remember is that there really is no inexpensive solution to health care. Even if your initial premiums are reasonably low, they could rise significantly at your next renewal. So saving money on small business health insurance is about doing a combination of things simultaneously to get good rates, and to then maintain those rates.. And it will require a consistent effort from you, your employees, and your insurance provider.

First, you can save yourself money by reading the fine print. You need to know exactly what your plan does and DOESN’T cover. There are also state mandated coverages. For example, in states like Illinois, your insurance must cover mammograms. Also, understanding the ins and outs of your plan will give you and your employees a better idea of how to deal with your insurance.

Next, you should shave unnecessary benefits. After reading all about your plan, you will find coverage for things you may not need. Eliminating these benefits can significantly drop monthly small business health insurance premiums. For example, eliminating coverage for brand name medications can reduce costs by more than 25 percent.

Wellness program have worked wonders for small businesses. A wellness program is any program designed to promote healthy living within the organization. Weight loss competitions benefit every participant. Add a financial incentive for further motivation. Stock the work fridge with water, and leave literature about healthy living lying around. Search the internet for calorie counting charts. Raising awareness entice workers to make positive changes. Active, exercising, diet-conscious employees have stronger immune systems, more vitality, and more productive workplaces. They also don’t deal with as many health issues. Fewer doctor visits and hospitilizations will help maintain lower annual premiums, because it will prove to your insurance provider that your business is a low financial risk.

Increasing your co-pay and deductible can go a long way towards cutting costs. For instance, raising co-pays by just ten dollars has saved companies as much as thirteen percent on their premiums. A higher deductible will significantly reduce your monthly premium. To lessen the financial burden of high-deductible health plans (HDHPs), combine them with an HSA. Combinations like these have saved both business owners and employees bundles of cash.

Check into getting a nurse hotline. A nurse hotline is a toll free, 24-hour-a-day, seven-day-a-week service. Employees can get medical advice from qualified, registered nurses. This method has deterred a large number of people from emergency visits, and it can also be used for preventative care as well. Insurers like Nationwide have them, or you may have to purchase from a third-party provider.

Increase the size of your group to reduce your monthly small business health insurance premiums. In a survey by America’s Health Insurance Plans, small businesses who employed ten people or less paid forty three more dollars on average than businesses with twenty six to fifty employees. Check around with other businesses owners, or fellow members of business organizations. Some states also have small business groups and pools for this purpose. Check with your state Chamber of Commerce and Department of Insurance.

Beware of heavily discounted plans. First, there are numerous scammers trying to get your money. They promise low rates, and usually cover little to nothing at all. The internet is notorious for swindlers trying to hustle you out of a buck. If you are going with a company you aren’t familiar with, please do your research. On another note, even reputable companies present problems. In an attempt to gain market share, Blue Cross offered small businesses discounted rates in 2008. For 2009, some of these same businesses were set to see increases of as much as 47% in their premiums. As the costs of medical care increases, the costs are shifted from the insurer to the insured, and discount plans become overpriced plans quickly.

Shop around. As mentioned before, talking to different agents will expose you to the best that insurance providers have to offer. Ask other small business owners about their providers. You can use trusted online resources like Netquote and Ehealthinsurance to shop around instantly. These services also let you compare plans side by side, and allow you to purchase your plan online. Even after you get your initial plan, it’s good to annually reevaluate your coverage. This will keep you on the up-and-up about what the market is offering. Keeping costs down is an ongoing effort, especially with rates and plans changing all the time from company to company.

Share some of the costs with your employees. Raising employee contributions isn’t a popular option, but it may be one of the only ways to absorb costs and maintain small business health insurance coverage. Communicate with your employees about how to keep costs down, and remind them that their increase is your increase as well.