The last installment in our 5 part series, this post runs through your Annual out of Pocket Maximum. What is it? While the Annual Out of Pocket maximum has always been part of medical coverage policy limits, it’s been pretty well ignored. Up until recently, most plans didn’t involve extensive cost sharing – things like [...]
Coinsurance. Often misunderstood. Common in today’s plans.
August 10, 2011 By Leave a Comment
Part 4 in our 5 part series, this post takes you through the ins and outs of coinsurance. What is Coinsurance? Coinsurance is that percentage often illustrated as 90/10, 80/20, 70/30, etc. The first number is what the insurance company pays. The second is the insured’s responsibility. Services that are subject to the deductible will [...]
Deductible. Well, technically it’s called first dollar coverage.
August 4, 2011 By Leave a Comment
Part 3 in our 5 part series, this presents everything you ever wanted to know about deductibles but were afraid to ask. How Deductibles Work A medical insurance deductible operates much like your auto insurance deductible. In each, the insured pays up to the deductible before the insurance benefit commences. That’s why it’s called “first [...]
Evidence of Benefit. The most important document in the claims process.
July 12, 2011 By Leave a Comment
The second post in this 5-part series, this covers the ins and outs of an Evidence of Benefit (EOB). Today’s progressive plan designs are steep in per occurrence copays, deductibles, coinsurance, and a host of other cost sharing arrangements. All this put together makes the EOB is an insured’s best friend. In short, an EOB [...]
What You Must Know About Medical Claims
July 5, 2011 By Leave a Comment
First off, don’t fear the claim. It’s a lot easier than you think. This 5-part series will walk you through the claims process and explain, in simple terms, the key ingredients and how to protect yourself. If you only understand one thing about a claim, know that it’s time sensitive. As long as you file [...]
Improve employee benefits. Attract better candidates.
June 29, 2011 By Leave a Comment
When’s the last time you said something like this? I just have to figure out how to make our benefits package more attractive. I’m sick and tired of hearing that my competitors benefits are so much better. I can’t believe I lost a potential employee because of our benefits plan. You’re not alone. And, you [...]
Raise deductibles. Add dental. Keep employees happy.
June 9, 2011 By Leave a Comment
To control costs these days, you’re almost forced raise the deductible on your medical plan. But it’s a tough choice. Many employers feel that increasing the deductible undermines years of goodwill built up by offering plans with low copays and deductibles. You have to maintain your bottom line without sacrificing employee loyalty. So what’s the [...]
Free Free Free!
May 27, 2011 By Leave a Comment
We have hit a new era in Healthcare costs this past week. In case you have not seen it, Anthem recently released a special for new clients of a free month of healthcare premium. In all my years of doing insurance I have never seen such a promotion from an insurance company. What does this [...]
How to Capitalize on Stabilizing Rates
May 24, 2011 By Leave a Comment
Here’s some good news. Health insurance rates appear to be stabilizing as 2011 progresses. The first quarter brought the typical trend we’ve seen for years – 10% to 15% increases. As the second quarter winds down, most of our clients are seeing low single-digit increases. We think it’s due in large part to the loss [...]
How to Lower Your Premiums
April 28, 2011 By 1 Comment
The easy answer is to eliminate programs altogether. While effective from a dollars and cents perspective, it’s a bit drastic. More importantly, it certainly doesn’t engender any good will from your staff. The current trend is to lessen benefits before eliminating them. This is what the industry refers to as cost sharing. How does cost [...]
