What Types Of Florida Health Insurance Are Best?

Packaged Long Term Care Policies

A majority of Long Term Care Insurance policies are sold as comprehensive and stand alone health plans. These plans have options of annual, semi-annual, quarterly or even monthly premiums. There are also other types of payments like an abbreviated payment plan. The comprehensive Long Term Care Insurance plan is similar to the group health plan or individual health plan. This type of plan covers most of the health care alternatives. There are four primary methods to package Long Term Care Insurance.

1. The Long Term Care Insurance may be packaged with life insurance with either or feature which is very beneficial and flexible. In case of policy holder dies, their beneficiary will get the death benefit. While in case of policy holder wants Long term care, prior to his/her death than instead of life insurance predetermined benefits are paid. You can buy this type of policy by either paying the one time premium of $ 50,000 or more or with quarterly, yearly premiums.

2. The Long Term Care Insurance is packaged as rider to life insurance policy’s cash value. This type of policy covers two different types and the premiums are also divided to pay for both.

3. The Long Term Care Insurance may be packaged with disability income policy. It can be used before the age of 65years. This type of packaged policy is mainly for disability income but there are possibilities of long term coverage if premiums are paid after the age of 65.

4. The Long Term Care Insurance may be packaged with deferred annuity that has single premium option. This type of packaged policy is for those people who has around $ 50.000 or more money that is free and don’t mind if it is tied up.
There is pending legislation which if passed will make Long Term Care Insurance premiums exempted form tax.

What is Long term care?

The Long term care may be defined as when some one can not perform their emotional or physical needs without the help of other for extended time period than it is termed as Long term care. The external help required for activities like pain management, bathing, comfort and assurance, walking, toilet usage, meals providing, feeding, money management, phone answering, visiting doctor, shopping, taking medication, transport providing, laundry, grooming, paying bill, letter writings, small home repairs, yard maintaining, snow removing etc. are covered under Long term care. Able people take this type of activities for granted.

There are many reasons that are responsible for Long term care like disability, terminal condition, injury, illness, old age etc. It is found out that around 60 percentage of population require extended help during their life span. For some, the Long term care lasts for few days or weeks or months. But there are some persons for whom the Long term care goes for years. Depending upon the person’s condition they require different periods of care. The care may be divided in to two broad categories.

Ongoing Long term care: This type of care requirement is for extended period, may be for months or years. Ongoing Long term care is required when

1. Disabilities of permanent nature

2. medical conditions which are chronic

3. Daily routine require help

4. chronic pain

Temporary Long term care: This type of care requirement is for short period, may be only weeks or months. Temporary Long term care is required when

1. recovering from illness

2. Recovering from surgery

3. Recovering from injury

4. Terminal medical condition

5. Hospital stay for rehabilitation

The Long term care services may be given in an adult day servicing home, in the house of the patient, even in the house of patient’s friends or any of the family member’s house, in a board and care house or in a nursing home or many other such places.

Understanding Long Term Care Insurance benefits

Out of all insurance products the Long term care insurance is the most complicated health benefit product. The Long term care insurance provides around 16 options of different benefits. Out of this 16 options each option also offer 2 to 5 selections. The story does not end here, daily benefits gives other selections which may be rounded up to 30 in number. So theoretically there are hundreds or thousands of different policies possible in the same plan. With the results there is thousands of premiums combination. For lay man to grasp all this different combination of policy is very difficult.

So to make this thing simple, best way is to limit the choices. For example many employer will pre select only 2 to 4 different combination of benefit, and offer their employees only this with extra riders like inflation protection, shortened pay or non forfeiture. This procedure will leave thousands of options in to only 10 to 20. Many see advantages of this procedure but there are also some disadvantages.

Selecting from very limited options prevents many employees from selecting other batter and richer benefit plans. Some time it is also observed that limited number of benefits which is often proved to be inadequate. The obvious danger of offering limited benefit policy is employees may be under the false impression that they are covered for particular thing when actually they are not covered. For example to increase the employees’ participation rate they are offered incomplete protections which reduce the rate of premiums and superficially look very attractive. Some time initial payment may be lower but it increases as time passes.

It is always better to select a Long term care insurance plan that offers the option of additional benefits. These additional options are mostly medically under written, but the coverage is very broad. Contrary to belief that underwriting has very strict rules and it is very difficult to be eligible, around 95 % of employees are qualifies for medically underwritten Long term care insurance plan.

Health Savings Accounts (HSA)

The Health Savings Accounts (HSA) is some what new in to the market of health insurance. Health Savings Accounts is based on entirely new concept and provide people with great option for health care insurance.

You should consider buying Health Savings Accounts insurance when you are seriously thinking health insurance as a form of investment. There are some restriction and regulations regarding Health Savings Accounts insurance plan. Different person find different benefits that is useful for them, for example if you are self employed than Health Savings Accounts insurance plan offer you the benefit like exemption from tax, up to the limit of $ 2,700 for individual plan and up to $ 5,450 for family plan.

For childless couple who does not own any health insurance, Health Savings Accounts insurance is good health plan, since purchasing Health Savings Accounts insurance and paying premiums regularly the amount of premiums will be accumulated in to tax free money. This money will be like lottery when after substantial time policy holder becomes old and their children becomes young. Large sum of money they will receive when they are old is really blessings.

Apart from many benefits, Health Savings Accounts insurance is not as famous as required. There are certain disadvantages which make Health Savings Accounts insurance good for certain types of people. Many people will benefit from Health Savings Accounts insurance but they don’t know about it. Slowly the situation is improving and people stated inquiring about Health Savings Accounts insurance. People become more aware about the savings on their expanses which is medical related. There are many people who opt for high deductible health plan combine with Health Savings Accounts. Now it is generally known that Health Savings Accounts insurance allow people to keep aside before-tax money, which can be utilize for future medical expenditure. This means that if people has Health Savings Accounts insurance and remains healthy than they may accumulate hundreds or thousands of dollar in their Health Savings Accounts at the time of retirement.

Health Insurance Buyer’s Guide

Buying Shopping for health insurance can leave many people confused. Knowing which insurance company to choose or which insurance plan is the best may seem daunting impossible. But once you know the basics of health insurance, choosing the right health insurance plan is simple easy.

This article will provide some of the most basic and helpful tools and explanations for health insurance shoppers. First, it is important to learn about helps to understand the different types of health insurance plans and their benefits and drawbacks. Plans differ in the amount you pay out-of-pocket, which doctors you can visit, and how the your insurance bills are paid. Besides just helping you choose the most efficient and cost-effective plan, we’ll teach you about another way you can save on health insurance: a Health Savings Account. Additionally, it is important to learn about dental insurance as well. Many health insurance plans do not include dental insurance under their benefits, so we’ll go over how to shop for and obtain separate dental coverage. Then it is important to learn about ways you can save on health insurance. There are several ways you can save including Health Savings Accounts and Discount Cards. LastlyAnd finally, don’t forget to compare plans before you make your decisionwe’ll explain why it’s so important to put your new knowledge to good use by comparing health insurance plans.

Types of Health Insurance Plans

Health Maintenance Organization (HMO) Plans

Generally, HMOs have low or even no deductible and the co-payments will be relatively comparatively low as well. You pay a monthly premium that gives you access to coverage for doctor appointments, hospital stays, emergency care, tests, x-rays and therapy. You will have to choose a primary care physician (PCP) within your insurance provider’s network of physicians, and in order to see a specialist you need to receive a referral from your PCP. Under an HMO plan, only visits to doctors and hospitals with the insurance company’s network of providers are covered; you’ll have to pay for visits if you go to an out-of-network doctors or hospitals your insurance will not cover the costs.

Preferred Provider Organization (PPO)

Plans Under a PPO plan, you will use the insurance company’s network of doctors and hospitals for any services or supplies you need. These healthcare providers have been contracted by the insurance company to provide services at a discounted rate. Generally, you will be able to choose doctors and specialists within this network without having to choose a primary care physician or get a referral. Before the insurance company will start paying for your medical bills you will usually need to pay an annual deductible. Also, you may have a co-payment for some services or be required to cover a percentage of the total medical bill.

Point of Service (POS) Plans

A POS plan is a combination of the features offered by HMO and PPO plans. You are required to choose a primary care physician, whose services are not usually subject to a deductible, but your PCP can refer you to out-of-network specialists whose services will be partially covered by your insurance company. Additionally, POS plans usually offer coverage for preventive healthcare, which includes regular checkups. Your PCP will be able to give you referrals for any specialists. If these specialists are out-of-network you will need to pay out-of-pocket and then apply for reimbursement from the insurance company. With a POS plan you will benefit from some of the savings of an HMO and will have greater flexibility in choosing healthcare providers, similar to PPO.

Dental Insurance

It is important to get a dental insurance plan along with your health insurance plan. In order to keep your teeth and gums health you need regular visits to the dentist. Without dental insurance, the cost of dentist appointments will be much higher making it difficult to keep up with the payments. Dental insurance is similar to health insurance in that each month you pay a premium, which entitles you to certain dental benefits. Benefits include checkups, cleanings, x-rays, and other dental services. There are plans that may cover dental implants, oral surgery and orthodontia, but they will be more expensive. Like health insurance, plans are categorized into indemnity and managed-care plans. If you choose an indemnity plan you will have a broader choice of dental care providers to choose from. You won’t have to choose one primary dentist and generally, you won’t need to acquire referrals. In order for the insurance company to cover your dental expenses you will need to send them a claim before they reimburse you for covered services. As a result, you will have to pay more out-of-pocket with an indemnity plan, but you will have more flexibility in choosing which dentists you visit. On the other hand, managed-care plans will provide you with a dental provider network and you will need to visit dentists within this network in order to get coverage for these services. With a dental care network, the insurance company has arranged pre-negotiated rates that you will receive when you visit these dentists. With a managed-care plan, the dentists will submit the claim for you, lowering your out-of-pocket expenses.

Save on Health Insurance

Health Savings Account

Health Savings Accounts (HSA) are tax-free savings accounts designed to help consumers pay for healthcare services while limiting premium expenses for unwanted benefits. The plans have lower premiums and higher deductibles than other insurance plans because they offer fewer benefits and require you to use the money in your HSA to pay for certain qualified medical services. However, if you don’t need to visit the doctor frequently and don’t anticipate requiring regular medical attention, HSA plans are a cost-effective method of insuring against the worst without paying for coverage you won’t use. In order to open an HSA, you’ll need to have an HSA-compatible health insurance plan. You may only use the funds in your HSA to pay for qualified medical expenses. Usually, your HSA plan will have a deductible that, once met, requires your insurance company to pay for any additional qualified medical expenses for the rest of the year.

Dental Insurance

Health insurance typically does not cover dental services, but in order to keep your teeth and gums healthy, you need regular visits to the dentist. Without dental insurance, regular dentist appointments can prohibitively expensive. Make sure your mouth is covered by shopping for both health and dental insurance. Dental insurance is similar to health insurance in that each month you pay a premium, which entitles you to certain dental benefits. Benefits include checkups, cleanings, x-rays, and other dental services. There are plans that may cover dental implants, oral surgery and orthodontia, but they will be more expensive. Like health insurance, plans are categorized into indemnity and managed-care plans. If you choose an indemnity plan you will have a broader choice of dental care providers to choose from. You won’t have to choose one primary dentist and generally, you won’t need to acquire referrals for special services. In order for the insurance company to cover your dental expenses you will need to send them a claim for reimbursement. You’ll end up paying more out-of-pocket with an indemnity plan, but you will have more flexibility in choosing which dentists you visit. By contrast, managed-care plans limit you to the doctors and services within a dental services network, and you will need to visit doctors within this network in order to get coverage for their services. Within the dental care network, your insurance company has arranged pre-negotiated rates that you will receive when you visit dentists in the network. Your dentist will submit your insurance claim for you, keeping your out-of-pocket expenses lower than with an indemnity plan.

Compare the Plans

Comparing insurance plans is an important step in buying health insurance. It will save you money in the long run if you take the time to compare premium prices, out-of-pocket costs, plan benefits, the network of physicians available with different plans, and the quality of insurance providers. If you have a favorite physician, make sure your health insurance covers visits to him or her. If you don’t need to see the doctor very often, don’t pay a high premium for low office visit copayments. Health insurance plans are designed to address specific healthcare needs, and you’ll save money and get the most effective coverage by comparing plans to find the health insurance plan that best fits your budget and lifestyle.

Small Business Health Insurance – An Employer’s Guide to Getting 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.

The sad truth is that, no matter how many cost-cutting methods you apply, your insurance premiums are expected to continually rise. In addition to this, you can’t prevent every health problem with exercise and higher co-pays.

Health Insurance Help to Lower Your Premium

Illness for non-work related injuries can be financially devastating. Insurance keeps you protected against disastrous health care expenses and lost wages. There are enormous health insurance plans available day-to-day, the insurance cost and its benefits vary from one plans to another. Before enrolling for a policy, an individual should consult with the insurance agencies, read the policy to get the complete information about the benefits and costs and also the way the plan works.

Today, there are many more kinds of health insurance to choose from than were available just a few years ago. Traditional differences between and among plans do not longer any more. Also, there is been an increased emphasis on the role of consumers in managing their own health care and health care finances. There is a focus on providing information on the cost of care and health care quality-at the level of the physician, physician group, and hospital-to help consumers and employers choose among the many options available to them. The things have changed a lot, when most people in the United States had health insurance has indemnity insurance (also called as fee-for-service or traditional insurance). This type of insurance coverage assumed that the medical provider i.e. doctor or physicians will be paid a fee for each service provided to the patient.

When we talk about health insurance, we usually mean the kind of insurance that pays medical bills, hospital bills, and typically, prescription drug costs. Nowadays, the insurance also covers Medicare and Mediaid that provides health insurance coverage for certain people, senior citizens, people with disabilities and also an individual and families with low income. Today, the online information helps an individual to compare two best insurance policies and choose best among it. The insurance help an individual for financial planning and accordingly choose the best suitable for the family. The policy helps to avoid the burden of expensive medical bills and ensure the penny paid in health plan is paid for your care. It protects you and your family financially in the event of an unexpected serious illness or injury that could be very expensive.

In spite of available health insurance help online, unfortunately many Americans are still uninsured or underinsured. Some may be eligible for private or government but may have difficulty in finding the maze of complex rules and insurance jargons. Many more may not even have chosen the plans due to non-affordability coverage or may not be eligible for any. To help you choose right plan, we give you an overview of programs and strategies for seeking free or reduced-cost health care and managing medical debts.

Why does an individual require health insurance?

As the science and medical care advances, the ways of treatment are also increasing simultaneously. The main purpose of health insurance is to help in paying for care. It protects you and your family members in an unexpected serious illness and injury that may be high in cost. Additionally, you are more likely to get regular and routine checkups, if you have an insurance policy. Every individual requires insurance policy because you cannot predict your illness, injury and your high paying medical bills. One must seriously consider the need for health insurance for own and family. We also know that there is interlinking between having health insurance and getting protective health care. The research states that people having health insurance are more likely to have a regular doctor and get care when it is needed.

How should one get health insurance?

Most of the people get health insurance through their employers or company which they belong to. This is formerly known as group insurance. Some individuals don’t have access to group insurance. In this case, one may choose to purchase their own individual health insurance directly from public or privately owned insurance company. Most of the Americans in North America get health insurance through government programs that operate at National, State & Local Levels. Insurance- whether provided by your employer or purchased by you – can be both expensive and complex. To understand better option, you must take health insurance help from the experts and advisors.

Group Insurance:
Group Insurance is basically offered by the employers or else by an organization of which you are a member of union, professional association wherein you may get group coverage. The employee has to choose between several plans been offered by an employer’s including both indemnity insurance and managed care. Some employer may only offer one single plan. Some group plans may also include dental care with the health and medical benefits. Hence, it is a very important decision to be taken by and employee before choosing any insurance benefits offered by employer or an organization. It is also essential to compare plans to find the one that offers the benefits as per your need. Once you choose an insurance plan, you usually cannot switch over to another plan until next open season, usually set once a year.

In group health insurance, employer usually pays portion or all of the premiums. This means your costs for health insurance premiums will be lower than they would be if you paid the entire premium alone.

If you are a member of group insurance offered by an organization, you are benefited from being a member of a large group. You will have to pay lesser premium than an individual would be paying. However, the organization often does not pay a share of premium, meaning you are responsible to pay complete premium by yourself.

Individual Insurance:
In an individual Insurance, you get the coverage directly from the Insurance Company. You don’t have any access to the group insurance offered by an employer or an organization. When you buy you own insurance, you have to pay entire premium rather than sharing with an employer according to Group Insurance. In individual insurance, you do not share any cost of premium with your employer. You should analyze and choose an individual insurance plan that fits your needs at a price that you are willing to pay; you should also consult a tax advisor to find out whether you are eligible for any tax deduction as per the insurance plan.

Insurance variably differs from one company to another within an insurance industry, from one plan to another and one product to another. Hence, choosing right company, right product, right plan are the important criteria before choosing any plans.

Which type of health insurance is right for you?

Whether you choose group insurance or an individual insurance plan, you must carefully compare coverage and costs. You should compare the following important aspects like coverage and benefits, premiums, exclusions and limitations, access to hospitals, doctors, and other providers etc…

One must consider what kinds of services are covered by the plan? How are benefits being availed of health insurance plan; do you have to submit a claim? When do you need pre-approval to ensure coverage for care? What steps do you need to get the care of you and your family members need? You must ensure how does your insurance plan works. Don’t wait until you need emergency care to ask questions.

What to Do If You Were Turned Down For Health Insurance

If you’ve been living without health insurance, you’re not alone. 15.9 percent of all Americans are uninsured as reported by the UHF (United Health Foundation). Sadly, sometimes even when people are trying to be financially and socially responsible they’ll find that they’re unable to qualify for a health insurance policy.

According to survey by U.S. Census Bureau, nearly 60 percent of the population gets health insurance in the form of group policies through their employer. There are other people who get covered by government-sponsored health care, such as children, the elderly, and those with low incomes. Until recently, however, those outside of these groups were largely at the mercy of the policies of for-profit insurance companies when it came to whether they could get coverage.

If initially turned down, ask again or apply with another insurance provider

If you find that you’re in this group that has difficulty getting coverage, the first thing you should do is to try to find out what happened. In some cases, you may be rejected due to an error on the part of the company. If the reasons for your rejection were minor, you may also still be able to get individual insurance through another company. However, if you have a major pre-existing condition such as Cancer or Diabetes, it’s unlikely that any insurance company will consider you a good risk and you’ll have to seek out other options.

State high risk health insurance pools as an option

It is for this reason that a national high-risk insurance pool will be created within 90 days following the passage of the March 2010 Health Care Reform Act for people with existing medical conditions. The pool is backed by $5 billion in federal subsidies, and will offer subsidized premiums to people who have been uninsured for at least six months and have medical problems that have resulted in their being rejected from other insurance options. In some cases these risk pools will be run through the state governments. Either way, the law says that these pools will remain available until the new health care reforms have fully taken effect in 2014.

Prior to this legislation, high risk pools were already available in 34 states and covered 183,000 citizens. From the perspective of someone who wants a policy, the important thing to note is that the quality of coverage offered can vary widely depending on the attitude and policies of the state offering them. Some states are just more generous than others in programs like this, and if you believe that you’re likely to need to use your health care policy regularly, it’ll be worth your while to get a sense of the kind of coverage that your state offers. You should also remember that even though you’ll already be paying higher premiums than a typical insurance plan, you’ll still have to make sure you have enough money in reserve to cover deductibles and co-payments or health care will be as unattainable to you as ever.

In extreme cases, if you find your state’s high risk pool to be a completely unacceptable option, you still have choices but none of them are easy. If you’ve been working at running your own business or at a small business, you may be able to get into a group plan if you can find employment at a large company. In an extreme case, if you know that another state offers a high risk pool option that would work for you, and you have the means to do it (such as family in that area), you could even consider relocating.

State risk pools and where to contact them

Alabama Insurance Plan

Toll-free 1-800-513-1384 or (334) 353-8924

Alaska Comprehensive Insurance Association

Toll-free 1-888-290-0616

Arkansas Comprehensive Insurance Plan

Toll-free 1-800-285-6477

California Major Risk Medical Insurance Program

Toll-free 1-800-289-6574 or (916) 324-4695

CoverColorado

(303) 863-1960 or toll-free 1-866-787-9129 (M-F 8am-5pm)

Connecticut Health Reinsurance Association

Toll-free 1-800-842-0004 (M-F 9am-4pm EST)

Florida Comprehensive Health Association (closed to new enrollees since 1991)

(850) 309-1200

Idaho Individual High Risk Reinsurance Pool

(link is to a PDF on program)

Toll-free 1-800-721-3272 (In-state only)

Illinois Comprehensive Insurance Plan

Toll-free 1-866-851-2751 (in-state only) or (217) 782-6333

Indiana Comprehensive Health Association (click “guest” for access, then choose “ICHIA”)

Toll-free 1-800-552-7921 or (317) 614-2000

Health Insurance Plan of Iowa

Toll-free 1-877-793-6880 (M-F 8am-5pm CST)

Kansas Insurance Association

Toll-free 1-800-362-9290 (M-F 8am-5pm)

Kentucky Access

Toll-free 1-866-405-6145

Louisiana Health Plan

Toll-free 1-800-736-0947 or (504) 926-6245

Maryland Insurance Plan

Toll-free 1-888-444-9016 (M-F 8am-5pm)

Minnesota Comprehensive Health Association

Toll-free 1-866-894-8053

Mississippi Comprehensive Health Risk Pool

Toll-free 1-888-820-9400

Montana Comprehensive Health Association

Toll-free 1-800-447-7828

Nebraska Comprehensive Insurance Pool

(402) 343-3574 or toll-free 1-877-348-4304 (M-F 8am-4:30pm)

New Hampshire Health Plan

Toll-free 1-877-888-6447

New Mexico Medical Insurance Pool

(505) 622-4711

North Carolina Health Insurance Risk Pool (NCHIRP)

Toll-free 1-866-665-2117

Comprehensive Health Association of North Dakota (North Dakota health insurance risk pool)

Toll-free 1-800-737-0016 or (701) 277-2271

Oklahoma Health Insurance High Risk Pool

Toll-free 1-800-255-6065 or (913) 362-0040

Oregon Medical Insurance Pool

Toll-free 1-800-848-7280 or (503) 225-6620 (M-F 8am-5pm)

South Carolina Insurance Pool

Toll-free Phone 1-800-868-2500, ext. 42757, or 1-803-788-0500, ext. 42757

South Dakota Risk Pool

605-773-3148 (ask for a Risk Pool representative)

Tennessee’s Tenncare Program

1-888-486-9355

Texas Health Insurance Risk Pool

1-888-398-3927

Utah Comprehensive Health Insurance Pool

Toll-free 1-800-705-9173 or (801) 442-6660

Washington State Health Insurance Pool

Toll-free 1-800-877-5187

West Virginia Health Insurance Plan

1-866-445-8491

Wisconsin Health Insurance Risk Sharing Plan

Toll-free 1-800-828-4777

Wyoming Health Insurance Pool

(307) 634-1393

Mark Anderson is a serial entrepreneur and a self-studied expert in buying individual health insurance [http://www.buyingindividualhealthinsuranceblog.com] and small business health insurance plans. Mark has started, operated and sold several businesses ranging from being a solo-entrepreneur to building a small businesses into a 35 person organization. Through this process Mark has become an expert in the field of medical health insurance for individuals and small business.

The Pros and Cons of Group Health Insurance

The health insurance marketplace is certainly challenging, but count your lucky stars that at least you have choices. To that end, this article is going to explore the pros and cons of group health insurance.

Group Health Insurance Pros

Group health premiums are subsidized by the employer. Generally, an employer must contribute at least 50% of the “employee only” premium. As such, if you are the employee, you can likely get a richer health plan for less premium than you would pay in the individual health marketplace. However, the cost to add your dependents to the employer’s plan, may be cost prohibitive. In this case, and assuming that your dependents can qualify, then you may want to put them on an individual health plan.
Group health premiums for large families are the same as for small families; whereas in the individual market, you pay a separate premium for every family member. So, if you have a large family, you may be able to get a better deal by adding them to your employer’s plan. As with any insurance change though, don’t make any changes without consulting with an experienced insurance advisor in your state.
Group health insurance in most states is guaranteed issue – meaning that you can’t be turned down because of pre-existing health conditions. This is a real blessing if you or a family member has a medical condition that prevents you from qualifying for a individual plan. But, this is a double-edged sword. While being guaranteed issue is a huge benefit for those with pre-existing medical conditions, it does come at a price. This one feature alone accounts for most of the disparity between group and individual insurance premiums. Yes, that is right – in most states, individual health premiums are almost always less expensive than group health premiums.
Most group plans cover maternity. So, if you are planning on having more children, you should definitely consider hopping on to a group plan. While you can add a “maternity rider” to individual plans, these riders tend to be expensive, restrictive, and otherwise provide less value than the coverage you can get in a group health plan. That being said, if you are considering having more children, we recommend that you contact a health insurance advisor in your state for advice about what is best for your family. The right answer is different for each unique family.
Economies of scale can benefit employees of large employers. It is true that the larger the group, the larger the risk pool is in which to share the risk which CAN result in lower premiums than are available in the individual health market. However, the guaranteed issue “issue” CAN wreak havoc on this type of plan. For example, a large employer with good benefits tends to retain employees for long periods of time. Eventually, the average age of the group starts to creep up and so do premiums. In addition, people with large medical needs (expensive medical conditions) tend to be attracted to large plans because they are guaranteed issue with good coverage. And so, over time, not only is the group’s average age increasing, but the group is also attracting employees with large expected health costs. This is the dilemma that we see with large health plans like the U.S. auto-makers and even government plans. Eventually, those with lots of medical needs begin to outnumber those with little or no needs and so premiums are driven higher and higher.

Group Health Insurance Cons

Group health insurance can be more expensive than individual health insurance. ln fact, if you don’t factor in the employer’s contribution towards premiums, then individual plans are almost always more affordable than group plans. However, as we discussed earlier, not every one can qualify for an individual plan.
What happens if your employment is terminated (by you or your employer)? Yes, you will likely have some benefit continuation rights (through COBRA or state continuation programs), but these benefits can be very expensive and the term limited. So, eventually, you either have to secure another job with benefits, an individual health plan (assuming you are insurable), or possibly join a government health insurance program for the uninsured (if you are not insurable). Let me emphasize, that you should NEVER be without some form of major medical health insurance. Being without this insurance puts you and your family in serious financial jeopardy. In fact, a recent Harvard University study found that 50 percent of all bankruptcy filings were partly the result of medical expenses.¹ To the same point, every 30 seconds in the United States, someone files for bankruptcy in the aftermath of a serious health problem. Don’t let this happen to you.
Group health insurance premiums are rising faster than individual health insurance premiums. Why? Because most group plans are guaranteed issue and since they accept “all comers”, they tend to attract those with high medical costs. On the other hand, most individual health insurance plans are medically underwritten. This means that the insurance company can say “no thanks” to any application that it deems to not be in its interest. Put yourself in their shoes – would sign a contract to provide $30,000 in annual benefits to someone that was only going to pay $3,000 in premiums (for a net loss of $27,000) if you didn’t have to? Hmm…let me me think about that one. The answer is a resounding “NO!”. Because of this underwriting process for individual health insurance, insurance companies can control their risk and more effectively manage their profitability, resulting in more stable prices.

As you can see, there is no clear cut answer as to which type of insurance is the best. The answer depends on a number of factors and is different for every unique situation. The best advice I can give you as you consider your health insurance options — get good advice from an experienced health insurance advisor.