The 1st Step Toward Consumer Driven Health Plans - Why supplemental benefits make the transition easier

Part of the reason that I initially got my insurance license, was that as a business consultant focused on change management, nearly every business owner, CFO and HR director that I spoke to asked me what I could do about the rising cost of their healthcare benefits. Up until recently, with regard to their major medical plan costs rising at double-digit rates every year, there was little I could recommend aside from biting the bullet and accepting that it would be a painful process of micro re-examination of plan costs nearly every year. Many decision makers are being forced to shift costs to their employees or do away with certain benefits altogether. Fortunately, now there is finally a sensible way to reduce costs (and taxes, by the way), give employees more choice, more security and believe it or not, keep them from storming the castle with rakes and torches when you ask them to contribute more out of their own pockets. These plans are aptly called “Consumer Driven Health Plans” (or CDHPs) because the policyholder makes as many choices about their health benefit plans as their employer.

Two key components of CDHPs have been receiving a lot of press. The first is the Health Savings Account (HSA), which must be used in conjunction with the second, a High Deductible Health Plan (HDHP). Without going into great detail about the restrictions, the whole idea is that by enrolling in a major medical health insurance plan with a significantly higher deductible ($1000 or more), the company (and/or the employee) can dramatically reduce the premium cost. In addition, by replacing Flexible Spending Accounts (FSAs require the participants to use the tax free money contributed during the plan year or lose it) with HSAs (that allow the participants to accumulate money in their account tax free BUT the money rolls over from year to year) eventually, the deductible is covered with tax-free dollars.

The only downside to this plan is that FSAs make the elected amount available on day one of the plan, whereas HSAs allow only the amount that has been funded to date to be made available. In other words, for most folks, the first year of such a plan puts them at risk for substantial out of pocket expense related to the deductible.

The way to avoid this risk is to implement a third key component of the plan, Supplemental Benefits. Most often via a new or existing Cafeteria (Section 125) plan.

For several reasons, supplemental benefits should be the first step in any HDHP/HSA plan. First is that they introduce employees to employee funded, 100% voluntary plans so employees come to feel comfortable with contributing to their own financial security. Second is that supplemental plans cover deductibles and co-pays, so employees realize that by participating, they reduce their own out of pocket expense should the unthinkable happen. Thirdly, they learn the value of pre-tax dollars. And last, more choice lends itself to better education in just what those choices are. In other words, employees take more interest in learning how their overall plan fits together and what the best choices are for their family.

When Supplemental plans are introduced first, employees feel empowered by the fact that the company is giving them options to better protect their family without changing anything else. Then when the HDHP/HSA changeover is eventually made, far fewer employees will feel like they’re getting the short end of the stick.

So what makes up a good Supplemental plan?

While many of the plans are similar in benefits and structure, the providers vary widely in how they work and what they actually provide in terms of customer service. Your employees trust you to select high quality benefit providers that give them financial stability and control when they need it most. As more and more players enter the game, every insurance provider will be touting their respective accolades. Just be aware that many small, unproven operations hide beneath the veil of a well-known brand. In some cases, insurance conglomerates are simply an affiliation of unrelated subsidiaries that were acquired for a specific strategic purpose; in this case, to enter the voluntary benefits market. Like the Wizard of Oz, you may find that a parent company’s financial and marketing statistics give a misleading view of the size and capabilities of the business unit that actually does the product design, underwriting, and servicing.

Nobody likes surprises. Especially, related to financial security. And the last thing anyone wants to hear from an employee who has claims issues and thought they signed up for a policy with BIG Insurance Company (whose slick marketing reps touted gazillions in financial backing and years of experience), is that they’ve now found out that the policy they were counting on to protect their family was really underwritten by the National United Smoke and Mirrors Insurance Company of Hoboken, NJ., which did strictly Property and Casualty insurance until last year. So pay attention to the man behind the curtain.

If you ask the right questions of potential providers, you’ll be doing your company and your employees a big favor by picking the best provider for their needs.

Here are some suggestions:

Who is really underwriting the policy and how long have they been doing it?
Experience has its strength, and in the guaranteed renewable (supplemental) market, size does matter. What is the company’s history and track record? You want a company that has the depth to handle any adverse selection, and a track record of satisfied clients across industries.

What is the financial standing of the company?
Regardless of whether you use A.M Best, Moody’s, Fitch, Standard and Poors or some other rating system, make sure you choose one of the highest rated companies. There are several. A is better than B,

Health Plans: an Affordable Health Insurance Plans

All of us have to be familiar with the cost of healthcare has increased faster than inflation? Health checkup costs can be a big drain on finances. A medical crisis can strike anyone, anytime and may even force an individual to dip into savings to meet these sudden and steep costs. Such an eventuality could delay or destroy a cherished financial goal. No wonder, health is wealth. The health of every member of the family is precious and you need to safeguard it as a priority. Use some Health Plans to make sure your family stays fit and fine as suggested by some insurance company.

 

Health Insurance, popularly known as Medicash in India, offers protection in case of unexpected medical emergencies. In case of a sudden illness or accident, the medicash policy takes care of the hospitalization, medical tests and other costs incurred.

 

There are a number of insurance corporations (both public and private) in India offering health insurance and Affordable health insurance plan.
There is a certain criteria for choose best health insurance policy as follows..
I. Wide range of plans:– Varieties of plan is carefully designed keeping individual needs in mind and offers something unique (in addition to the usual Medicash policies) to suit individuals specific needs.
II. Huge network of hospitals: Organizations should have one of the largest networks of hospitals.
III. One policy for the entire family
IV. Access policy anywhere, anytime
V. Instant policy, no paperwork
VI. Track your claims Easily
VII. Renew Easily

One of the most important thing is Always read the policy wordings carefully. Be clear on the coverage’s, exclusions, terms and conditions and clear out any confusion you might have before buying your policy.

http://www.maxnewyorklife.com/individual/health.aspx

 

Will an Hmo be the Best Health Plan for You?

A Health Maintenance Organization (HMO) is a type of managed health care plan. An insurance policy is combined with a network of medical providers like doctor’s, hospitals, and pharmacies. The network providers agree to the network policies for providing care and setting prices. In return, network providers get added to the list which should provide them with a steady stream of patients.
Because of this arrangement, the medical provider can keep attracting patients, and perhaps save some costs associated with that activity. A doctor’s office, for instance, that can count on a steady stream of regular patients, may be able to charge less for an appointment than a doctor’s office without a full schedule.
The network gets to manage costs and care, and that way they can contain costs and improve efficiency for themselves, and for their covered clients.
The health plan participants must use the network providers in order to have their health care covered in most cases. This restriction also allows the health care plan to manage costs. Exceptions are made to the network coverage policy in the case of an emergency. Sometimes, if a particular medically needed service is not provided by the HMO, an exception will be made to the network restriction as well. In any case, if the insured person needs to seek care outside the network, in a non-emergency situation, the service should be pre-approved, in writing, by the health plan’s administrator.
HMO plans work well for many people. Most of us are used to choosing a primary care doctor from a list that our insurance company provides us. We are also used to accepting that professional’s advice when we need to see a specialist. For people that live in an area where an HMO has a large network of medical providers, it is usually no problem to find quality care for a variety of medical needs.
Insured people enjoy lower premiums and copays in return for accepting tighter network restrictions and managed health care. In addition, patients usually do not have to complete much paperwork as all forms are handled by the doctor’s office and insurance company.
However, people who do not live by a large and active network may not be satisfied with their available privders. In particular, people who need to seek specialized medical services may have to travel or have trouble obtaining a referral to a specialist outside of the local medical provider network. If a situation comes up where an HMO participant wants to see a particular doctor who does not work with the network, they may have to pay the full cost of the appointment and associated costs if they cannot get an exception approved.
The health plan that will satisfy you, and your family really depends upon many factors. Your age, gneral health, and the available plans in your area will affect your choice. But for those who live close to a large network of providers, and who usually only need routine or typical medical care, an HMO can be a great choice.

The Truth About US Discount Dental Health Plans

US Discount Dental Health Plans are an inexpensive dental care alternative instead of buying dental insurance. These discount dental plans never make any payments directly to your dentist or specialist.

The benefit to using these types of discount plans is that they offer substantial discounts, in some cases as high as 60% off, on most routine dental care, such as cleaning, dentures, orthodontic braces and much more.

Here are some of the pro’s and con’s of US discount dental health plans.

Pro’s

One of the good things about these types of plans is they don’t have any age limit restrictions. This means that you can see a qualified participating dental provider no matter how old you are.

Another benefit is that pre-existing conditions are included. Dental insurance policies won’t cover any condition that already existed at the time you were issued the plan. That means that if your whole reason for buying insurance was to get your teeth fixed that you’re in for a rude awakening because it won’t happen. You can get a discount at a participating dentist as soon as you have your discount card in hand.

Although the cost of joining a discount dental plan and getting insurance is close to the same, a discount plan does not require you to pay co-pays each time you visit the dentist. Also, there are no annual limits with discounted plans as there are with most types of insurance.

Cons

If you have a major accident, such as falling off a bicycle, falling out of a tree, falling down and breaking your teeth, etc, then dental insurance would cover most of the costs of fixing your teeth, whereas a discount plan would only offer the discount.

Although there are well over 100,000 providers that accept discount plans in the USA, there are still many areas where service is very limited and you may be forced to travel an hour or more to see a participating dentist.

You may not be able to continue seeing your current dentist, if you have one. You could ask that they become a discount plan provider and then see them, but if they refuse then you’ll have no choice but to find a new dentist within the network of the discount plan.

So are us discount dental health plans a better deal than traditional dental insurance? This depends on your personal needs and the immediate care needs of whoever is going to be included in the plan. It would be best for everyone if they could carry both plans, but that’s not feasible for everyone to do since there are costs involved. Your best option is to get as much information as possible about these two plans, evaluate your urgent dental care needs and make an informed decision afterword.

What are Good US Discount Dental Health Plans

Are you looking for a dental plan that you can afford for your family? Many people are and this is why U.S. discount dental health plans are sometimes your best choice.

Did you know that tooth decay is the most common chronic disease that affects children in the United States? There are 20 million kids in the country that don’t have any type of dental health plan, this was reported by Kaiser. There are many people that are unaware of the fact that they can get discount dental plans for their family that even they can afford.

There are many U.S. discount dental health plans that are available such as the state funded Medicaid programs. People who fit into a particular income requirement and their kids may be eligible for dental care that is routine and emergency for a low cost.

This would be a good option for someone that is having problems keeping up on the premium payments that are required by most other discount dental plans in the U.S.

There are many options available when it comes to U.S. discount dental health plans for people who are low income and minority families, as well as for anyone else that wants to use a discount dental plan. You just need to do some research to see how you can match your income level to the best options available for you.

There are a couple of different places that you can find U.S. discount dental health plans. You just have to be willing to search because it will take you some time to do.

One good place where you can find discount dental plans is on the internet. To find out about different plans there are a number of websites you can look at.

Another good place to find these plans is to go to a comparison site where you can see all of the different options that are available for dental plans in your area. You will be able to find out about dental discounts and yearly fees.

Once you find the plan you want to use you can sign up for it online or you can call a toll free number to sign up.

It is important to have dental health care for everyone, especially children. So make sure you look at all of your options before you decide what you are going to use for your dental plan.

That way you can make sure that you are getting the coverage that your family needs and so you can find the right U.S. discount dental health plans that will fit your needs.

The Tonik Health Plan Copay and You

Let’s take a look at the office copay for Tonik health insurance plans. Tonik was designed to give people access to coverage for the things they use most and keep cost down. The office copay definitely fits in this category. First, what does the term copay mean.
First, what is a copay? Officially, a copay is the fixed portion of charges you pay to your provider for covered health care services in addition or separate from any deductible. For example, $20 for an office visit or $15 for a prescription drug. It is similar to coinsurance, but it is a dollar amount instead of a percentage of the charges.
The whole point of a copay is to give you a cost for certain health care services that you can count on. No hidden surprises. If an in-network doctor charges $65 and a specialist charges $95, you can the same flat copay amount and this takes some of the guesswork (and fear) out of going to a doctor when you need care. There are a few qualifications on the Tonik health plan office copays we should look at.
More detail on the Tonik office copays
The copay typically applies to the office consultation itself. It’s not uncommon for other services such as labs or simple procedures to be done during an office visit. These servcies outside the consultation would usually go towards your Tonik plan’s deductible. For example, let’s say you feel pretty lousy and go to your general practice doctor. The copay would apply for this visit. If the doctor decides to run a blood test to make sure it’s not a serious issue. You would pay the discounted rate (assuming in-network providers/ covered benefits) for this labwork subject to your deductible. Speaking to the “benefits need and keep cost low”, some Tonik insurance plans cap the number of office visit copays you have in a calendar year. After using these visits, additional visits in the same calendar year would be subject to the deductible. This number was based on what the average member needs in a typical year based on the theory that most people will find this perfectly adequate and the premium can be kept lower.
Tonik deductible and network providers
It’s important to stay within Tonik’s doctor network to get full benefit of the office copays. You will likely pay more out of pocket when using a non-network provider. Luckfully, the PPO network is pretty extensive but it’s always important to verify with your doctor of choice that they are in the Tonik PPO network.
Prescription Copays in Tonik
There is also a separate copay for generic only medications. Brand name medications are not covered with the typical Tonik health insurance plan even if there is not generic available as an alternative. The generic copay usually runs $10 and is for a $30 day supply. There is also an option of $20 copays for 60 day supplies when purchased through mail order.

How To Buy Health Plans In Virginia?

A very important question rings in the ears of residents of Virginia when they set forth to buy health plans. How to buy a health plan in Virginia? What to look for while buying health plans in Virginia? Should I approach a broker or an agent to buy health plans? Should I surf the internet to know more about affordable health plans? Does Virginia’s insurance department help in any way? How I will determine the cost involved in any health plan?

All these questions are general and come quite naturally. For a first time buyer of health plans in Virginia, these questions are normal and you should not be perplexed if you have some more in addition to these. In fact, it is better if you are able to write down questions that are obstructing your decision to buy health plans in Virginia. Why? Because once you got the answers to all of these, you will be able to make the decision with confidence.

The first step in buying health plans in Virginia is to sit with your family members and chalk out the coverage that you would like to avail. This may range from baby care, specialty care, preventive care, senior citizen care, drug prescription coverage, preferred doctors, and so on. Once you have enlisted all these points, you know what you need.

Then approaching a broker or an agent could be the next step. If you feel comfortable otherwise, you can search on internet and try some free health plan quotes and compare them. Checking the credibility of brokers, agents and companies with Virginia’s insurance department is a good exercise. It helps you in making sure that you are not being trapped.

Once you have some affordable health plan quotes to compare, check what they are providing under the coverage. See the budget. Does it fall in the range of your allotted budget? If you have a pre-existing medical condition, do they provide coverage for that? If you have a preferred doctor, does the company have this doctor in their network; if not, will you still get coverage? Do they have doctors or physicians in your area so that they are easily accessible to you?

Once you have checked all these conditions, you can filter down some health plan quotes that you are likely to choose. Once you have 4-5 such health plans, you can sit with your spouse and family members and take their opinion also. It helps in getting the health plans reviewed by multiple eyes. If you have a friend or a colleague who has availed the health plans in Virginia, take his/her advice and compare his/her plan with yours. See if your needs are similar or different.

To buy health plans in Virginia, a lot of effort and home-work should be done from your side. Thought it might appear to be time-consuming or wastage in the beginning but later on, you will realize that you made the right decision in comparing health plans and buying the correct one.

Compare Health Plans In Virginia

Like any other state, there are many health insurance options open to the residents of Virginia. The important question is that if you are not employed or are not covered by your employer, are you in a position to buy a health insurance plan on your own? Or if you an individual and looking for family medical plans in Virginia, are you aware about the type of coverage you need? It is always better to start questioning yourself before you question others about what type of health plans are available in Virginia.

To , one should be quite aware about the types of medical plans available. This could vary from individual health plans, family health plans, group or business health plans, etc. The coverage, premium, deductible and other terms of each of these medical plans could vary from company to company. It is always better to check for exact wording that is written in black and white.

While searching to , the most important factor for any individual, family or group would be the type of coverage needed. It can be repeated almost 100 times that till you do not know what type of coverage you require, you can’t get the right kind of health plan. Due to plethora of medical plans available in Virginia, you are bound to be confused by the terms and conditions written and still not able to know whether you are covered for a particular medical need or not.

While almost all medical plans should provide basic coverage of meeting the healthcare requirements, sometimes individuals or families need speciality check-ups. This is where it becomes necessary to compare health plans quite carefully. Baby care, family planning services, emergency services for non-citizens, pharmacy assistance, plans for senior citizens, etc are some of the features you can find in different types of medical plans.

Special features of any medical plan in Virginia can include the following features: adult access to preventive health services, child access to primary are, prenatal and postpartum care, asthma medication management, cardiovascular disease management, common childhood illnesses, diabetes care & management, mental healthcare, etc.

For family health plans in Virginia, one should be very careful while selecting a company. The coverage need should be considered within the family with your spouse and then you should talk to you friends or colleagues who might have availed the insurance earlier. Ask for affordable health plan quotes from insurance agents and compare them. Surfing the internet and asking expert’s advice is also a good option. Though testimonials or customer’s feedback is a good support for company’s credentials, it is better to talk to people in person.

Some medical plans offered in Virginia

Dental Insurance And Individual Health Plans

 

One could rarely find and buy individual health plans that also cover dental care. There is useful information that people should know especially if they consider buying the policies separately.

 

It is estimated that about 45 million Americans currently do not own any dental insurance policy. Most non-elderly citizens who own individual health plans also own dental care policies. However, majority of people who buy health insurance plans on their own do not have dental insurance. This data is according to a report released by Centers for Disease Control and Prevention.

 

While individual health plans cover several added services like basic emergency care as well as costs of prescription drugs, they logically are not required to include coverage for adult oral care. However, for health insurance policies for children, dental services are required.

 

In March 2010, reforms to the healthcare insurance were set. However, despite the push exerted by many advocates, that bill did not include a wider dental component. Supporters and proponents of the reform argued that individual health plans already cover costs for other pressing health conditions like diabetes and heart diseases.

 

About 75% of 172 million Americans under the age of 65 years (who own private health insurance policies) have dental insurance plans as well. Their employers mostly provide the health insurances. Among those with separate dental coverage, more than a quarter of them have comprehensive plans with dental insurance while a quarter have stand-alone plans. Some have both.

 

About 90 million American citizens own individual health plans through Medicaid and Medicare, which both do not offer dental care plans for adults. There is no figure available pertaining to public health insurance plans. Medicaid shoulders dental care for people under 21 years old. The insurer currently serves up to 45 million people belonging to the low-income group. However, such patients complain about troubles in finding accredited dentists.

 

A separate government-sponsored program provides dental care, albeit limited. It is the Children’s Health Insurance Program. As for the older people, they could always opt to purchase separate dental care policies from health insurers.

 

Do you look for health insurers that also offer dental care plans? Data from the Association for Health Insurance Plans reveal that there are only a few insurers that do so. Those include Cigna Corp, Aetna Inc, Assurant Inc, Humana Inc, and UnitedHealth Group Inc. The association represents up to 80 of overall dental insurance plans in the US. There are also health insurance plans that offer dental coverage as part of health policies. They include several and specific plans from MetLife, Principal Financial Group Inc, and Blue Cross Blue Shield Association.

 

Experts advise people to buy dental care insurance policies even if they already own individual healthcare plans. Purchasing separate plans is more advisable especially because it would be very hard, if not impossible, to find and buy health insurance policies that also include dental coverage.

 

 

Kentucky Health Insurance: Tips On Choosing The Right Health Plan

Today, there are more Kentucky health insurance plans to choose from than ever before both all across the United States and in Kentucky.  Whether you are interested in a Kentucky individual health insurance plan or a Kentucky family health insurance plan, residents of Kentucky will want to choose their health plan based on the quality of that plan and the quality of the health insurance companies.  Of course, one will also need to choose their health plan based on whether or not they can afford a certain policy.  While the insurance rates have been set by the state insurance department, different types of Kentucky health plans can cost different amounts.  However, quality Kentucky health plans should be of utmost importance to the citizens of Kentucky who are looking for family health insurance or individual health insurance coverage.

Kentucky has some great health insurance providers to choose from such as Anthem and Humana, both recognized as very reputable health insurance companies, and both offer quality Kentucky health plans.  However, all insurance providers for Kentucky will offer different benefits with their health plans and some insurance companies may not offer the benefits that you need in a health plan.  Therefore, you will need to compare different Kentucky health insurance providers’ health plans so that you can choose the right health plan and insurance provider for you.  A Kentucky health plan will likely need to meet various requirements to be fitting for your personal situation.  When choosing a health plan, you will want to look for a plan that meets your budget, provides services when and where you need them, provides the benefits that you are looking for, provides the options that interest and aid you, provides quality care and much more.  When choosing the right Kentucky health plan, you will also need to take into account whether it is an individual health plan, family health plan or a group health plan.  Each of these health plans will need to meet specific needs that you have to be the best health plan option.

Working with an experienced independent insurance agent can make finding the best Kentucky health plans a simple and quick process.  When you work with a professional agent, you can explain to them all of your specific needs, current medical problems and other important information so that they can begin obtaining policies for you from different Kentucky insurance providers..  Once they have obtained the health plan information you need from different insurers, they can help you compare the information you have received and even give you valuable advice to help you make your choice.

Health Plan Versus Health Insurance

Historically in the US, Health Maintenance Organizations preferred using the name “Health Plan,” whilst insurance firms preferred the name “Health Insurance”. A health plan is a medical care arrangement offered by Health Maintenance Organizations through the payment of a fixed subscription. Preferred Provider Organizations and/or Point of Service Plans are also similar to pre-paid legal services and pre-paid dental plans. In a pre-paid health plan, you pay for a certain plan at a fixed rate for a fixed number of services. Say for example $200 for preventive care, care given from skilled nurses, and a certain number of days in hospital care.

Comprehensive Versus Scheduled

With Comprehensive Insurance, the insurer pays a certain percentage for the cost of a physician and the hospital after deductibles and this mainly applies to hospital and physician charges. There are however certain conditions to be met for the insurer to pay that percentage which is usually 80% of the total cost or depending to the policy agreement. This plan is generally expensive, but it comes along with high payouts. Payouts can be up to as much as between $1,000,000 and $5,000,000.

Scheduled plans are more of basic policy plans that offer coverage for daily health care needs such as visiting the doctor and or getting prescribed drugs. Of late scheduled plans are known more as “Association Plans” because they require being members of an association that does not deal only in insurance, but also in other entities.  An example of such an organisation is the Health Care Credit Union Association and these Comprehensive plans offer coverage for instances such as hospitalisation and or surgery. Scheduled plans are however limited to some extent and they do not offer coverage to catastrophic events that may happen to the policy holder. These plans cost a lot cheaper than Comprehensive plans and in the event of payouts, they pay directly to the health provider. Payment benefits are based on the plan’s program and benefits may range between $1,000 and $25,000 yearly.

Factors affecting Health Insurance prices

In a recently conducted study by an independent source, it was revealed that the ever increasing cost of Health Insurance is because of the increase in utilisation and demand. More and more consumers are in need of Health Insurance and factors such as newer medical technologies and more diagnostic testing have caused an increase in demand. In developed countries people tend to live longer and that has contributed to an increase in the aging population and therefore a need in medical care. Increased medical research and technology generally causes the cost of medical treatment to increase significantly. Lifestyle habits also do contribute to an increase in the cost of medical treatment, obesity is on the increase, so are cases of cancer and all these give a rise to medical treatment and in turn gives rise to Health Insurance. Other factors noted by this independent study were that an increase in drug and alcohol abuse has led to the need of medical treatment.