HealthySmallBusiness.org

Archive for the ‘Insurance Health’ Category

I learned something new shortly after I published my last book in 2010 that I have looked forward to sharing. I was filing a complaint with the state insurance commissioner against a healthcare provider that was trying to collect an insurance company underpayment from a patient. In this state it was illegal for medical providers to go after patients for account balances remaining merely because the medical provider was unsuccessful in collecting the amount owed from an insurance company. This law was enforced by the state division of insurance. Recall that insurance companies are state-licensed business and that they are in fact regulated by the state governments. If you ever have an insurance-related issue, there is nearly always a process for filing a complaint with your state?s insurance commissioner.

What I learned in this situation was that because the patient?s health insurance benefits were ?fully funded? by his employer, it was not a true insurance plan and the state division of insurance had no jurisdiction to enforce the law as it applied to traditional health insurance. The idea that employees in self-insured health plans are not protected by the laws that govern traditional health insurance is a new concept to me and I find it fascinating.

?Self-insured? or ?fully funded? health plans are terms for an employer that has enough money to pay for their employees? healthcare costs directly and cut-out any extra money that an insurance company might make on their employees. What is special about self-insured companies is that they still usually hire a health insurance company to administer the health plan. When I say administer, I mean that the insurance company merely credential physicians, processes claims, and takes care of all the paperwork. In this arrangement, the health insurance company is merely a ?third party administrator? that processes employees? benefits. The insurance company is not ?at risk? and will not lose money if patients spend too much on the healthcare. The financial burden falls directly on the self-insured employer.

So employees at Company A and Company B could both think they have United Healthcare for their health insurance, but perhaps Company B is in fact fully funded by the employer which has hired United Healthcare as a third-party administrator. In this case, Company B is paying United a fixed fee to administer the plan. Company B is paying the actual costs of the employees? healthcare bills and United does not get to keep any extra money from premiums if employees are not using their benefits.

Fully-funded, self-insured health plans are very common at big corporations. What is unique about them is that the coverage determinations are ultimately going to be made by your employer, not the insurance company. I have not tried this, but I think it is more likely that you may be able to successfully appeal a medical issue to someone you will see at work every day than a complete stranger you will never meet. I would not expect them to change their policies for individuals, but I think it is realistic that with enough feedback from employees, an employer may be inclined to modify the plan based on employee preferences from year to year.

The downside to self-insurance that I pointed out at the beginning of this section is that the insurance laws regulated by your state?s insurance commission may have no jurisdiction if your employer is paying the bills. This scares me a little because it implies that companies that have enough money can do whatever they want. This is all the more reason to become acquainted with your benefit plan if your employer is self-insured. The contractual aspect of the benefit plan as a written agreement could be all you have to reason with in this situation.

While the purchase of coverage can be expensive, there are some things you can do to save the cheap insurance.

Save on health insurance, you should know a bargain when you see one, but spots a bargain, you should be well versed in the market. health insurance providers tend to operate at the regional level, but you should have several options, depending on where you live.Before you buy, you should look for cheap insurance quotes online from the beginning of the process. First, you must be able to answer some simple questions and provide basic information about your medical history. But remember, when you select a health plan, it is important to compare apples to apples. Next, make sure the deductibles, co-pays and other policy features before looking at the corresponding premiums.The price you pay for cheap insurance health will depend largely on what kind of policy you choose. But politics is not one-size-fits-all, meaning that you want to buy private health insurance that fits your stage of life.
If you are young, single and healthy, chances are that you can choose a plane safely with a lower premium, even if it means a higher deductible. If you buy for a family or if you are elderly, a plan with lower deductibles will probably help you save money on their pocket.
Although they do not like to admit it, our health is often a factor in how to pay for cheap insurance health. One way to reduce health care is to maintain a healthy weight. If you smoke, consider quitting.

The same applies if you use drugs or alcohol. Maintaining a healthy lifestyle to save on premiums, but may also reduce medical costs as they age. So there is a real financial incentive to stay healthy.

If you are looking into private health insurance, you should first do a health insurance compare to make sure that you get the best rates when it comes to your health insurance. There are several companies that offer this type of coverage and many people in Australia are choosing to get private health insurance as a way to get better medical choices as well as save money on their taxes. Before you choose insurance of this nature, however, you need to do a comparison between different companies and the products that they offer you.
Many companies that offer private health insurance also offer different types of other insurance as well. You can get a health insurance compare that not only compares the premiums of the health insurance coverage but also that of other types of insurance such as travel and life insurance. In some cases, you might be able to get several types of insurance that can save you money as well as offer you protection for various purposes. You should take a look at the coverage that is offered when it comes to obtaining private health insurance and then do a health insurance compare to see which is the best company for you to choose.
There are a great deal of people who are choosing to get private health insurance that gives them better choices when it comes to their medical care. There is also a tax incentive for some people who carry a private health insurance policy. Before you purchase any type of insurance, however, you should make sure that you know which type of coverage you are getting, for how much and also do a health insurance compare for the different companies. This gives you a good idea of what you can expect to pay and also what you can expect to get covered should you need to use this insurance. This can end up saving you money in the long run and also enable you to have more choices when it comes to medical care. When you are looking for private health insurance, you want to go with a company that will offer you the most choices as well as offer you the best premiums that you have to use to pay. You naturally want to get the best coverage for the least amount of cost, which is why it pays to check out the companies that you can find right online so that you can easily do a health insurance compare. This can give you a good overall picture as to what you can expect if you have health insurance and also how much it will cost you. You can also discover the savings to your taxes if you use certain types of private health insurance. You should compare the coverage with one another instead of just looking at the rates that they are charging so that you know that you are getting the best type of health care choices for your money and one that will afford you the best coverage as well for all your needs.

The Consolidated Omnibus Budget Reconciliation Act of 1985, more commonly know as COBRA, is a federal law that guarantees your heath insurance coverage will remain in effect for up to 18 months should you be terminated from your job. Most companies that provide groups insurance to their employees are mandated to abide COBRA. In some circumstances, the coverage period can be extended from 18 months to 29 months or even up to 36 months.

COBRA Insurance: Who Benefits from It?

If you have lost your job and you stand a chance of losing your health insurance benefits as a result, you are protected by COBRA. As a stand-by facility, COBRA can help you get through a tough time. However, COBRA insurance does not apply to every terminated employee. Employers need to know if the COBRA exclusion applies to their companies and employees.

If you have been recently terminated, the law allows you to get a health insurance for yourself (and your family, if you had family coverage while you were employed) at the group rate even though you are not employed anymore. Coverage is not cheap and you will have to pay the total cost each month along with a 2% surcharge.

If you are terminated, laid off or experience some kind of change in your employment status, such as reduced working hours, divorce from or death of the eligible employee), and you are qualified for COBRA, COBRA will continue to cover you for at least 18 months or until you get a new health insurance plan or a group health insurance plan.

The law mandates that employers notify eligible former employees of the available option to obtain health insurance through COBRA. Employees would also have to specify the price for this coverage. Employees who are notified of this option have up to 60 days to agree to COBRA coverage.

As COBRA essentially increases a terminated employee’s health insurance coverage by 18 months, you don’t have to be concerned about any changes in your benefits, should you choose COBRA coverage. Under COBRA, your health insurance coverage will not change; the only change is that you will be responsible for paying the monthly premium. If you have your family covered by your company’s group insurance, they will still be covered by COBRA. The only way that any changes will occur on your coverage is if your former employer makes modifications on the health insurance plan it is offering to employees.

COBRA Insurance: It’s only Temporary

COBRA is meant only as a temporary, but a very important, measure. COBRA ensures that you would have health insurance for 18 months. However, you will no longer have health insurance once the 18 months are up, unless you have not gotten an individual health insurance plan or a group insurance plan from your new employer.

And, hopefully you would never find yourself in a position where you discover for the first time that you have a severe medical condition, such as cancer, while you are under COBRA coverage. Should this happen, you would then become “uninsurable” because of a pre-existing condition.