C is for:

“COINSURANCE”

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Coinsurance (or co-insurance): is the percentage of covered expenses under a major medical plan that will be paid once the deductible is satisfied.

Said another way, it’s the portion of the bill that the policyholder is responsible for, once the deductible has been met. 

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Example:

Plan Type: PPO

Co-Payment: $30 primary care, $50 specialist

Deductible: $3000

Coinsurance: 70%/30%

Annual out of Pocket Maximum: $5000

Based on the example above, once the $3000 deductible has been paid, the policyholder is then responsible for 30% of covered expenses (the coinsurance) up to $5000 (the out of pocket maximum)The insurance company pays the remaining covered expenses.

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In many cases, the use of coinsurance is most common with a hospital stay. However, in some cases (depending on the structure of the insurance contract you have in place), there may be coinsurance for outpatient surgeries, basic physician services, primary care, etc.

Thanks for stopping by, we hope you found our information to be valuable. Check back at our blog to get further information about funding healthcare. Also, please share with your friends, clients, colleagues, and family. Here are a few of our other information outlets:

Home Page: http://www.policyadvantage.com

Twitter: http://www.twitter.com/policyadvantage

Facebook: http://www.facebook.com/policyadvantage

YouTube: http://www.youtube.com/policyadvantage

Pinterest: http://www.pinterest.com/policyadvantage

Word Press (you are here): http://www.policyadvantage.wordpress.com

This is the Policy Advantage Insurance Services comprehensive content guide. We are giving you insight into our various information outlets (much like TV channels), so that you can effectively utilize these resources as valuable tools. You can find us at all of the top social media sites on the web. (username: policyadvantage)

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In this blog post you will discover all of the platforms and services where we distribute our information (ie: Facebook, Twitter, YouTube, etc). Although each location is a little bit different, we try to stay as consistent as possible with the information we share. Our biggest goal is to help empower our clients, when it comes to making decisions about funding their healthcare.

You can click on the icons below to visit each location. There’s a goldmine of information… here you go:

Policy Advantage Insurance Services’ Homepage: 

home

Page URL: www.policyadvantage.com

Purpose: Like any home page, this is where our business resides online. Here you will find standard company information (addresses, phone numbers, email addresses, etc). You will also find things like customer testimonials, links to our social media, online application tools, and other information that is useful for both clients and colleagues.

Our homepage’s goal is to be a very important resource to our clients and policyholders. We are currently in the early stages of our homepage development, with a goal to make it a very interactive and user-friendly location that provides many tools (ie: applying online, user profiles, easy accessibility to information, and many others). We’ll continue to improve our homepage, so make sure to check back.

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Policy Advantage Insurance Services’ Twitter Page:

Twitter

Page URL: www.twitter.com/policyadvantage

Purpose: The purpose of our Twitter page is to distribute short, valuable, up-to-date pieces of information to our Twitter followers. We like to call it a “micro-blog.” At our Twitter page, we will tweet links to articles of interest, important webpages, important blog posts, etc. Our Twitter posts are also sometimes social (ie: non-insurance content that may include current events, pictures, “inside” company info, sports, local events, etc).

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Policy Advantage Insurance Services’ Facebook Page:

facebook f

Page URL: www.facebook.com/policyadvantage

Purpose: The purpose of our Facebook page is to distribute valuable information to the people who “Like” our Facebook page and also to the general public. Everything (all posts) at our Facebook page are public. We encourage our friends, clients, and followers to “like and share” the information that we post in our news feed. There are graphics, links, etc that can come in handy. We share a lot of info at our Facebook page.

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Policy Advantage Insurance Services’ Word Press Page:

word press

Page URL: www.policyadvantage.wordpress.com

Purpose: This is Policy Advantage Insurance Services’ primary blog. This is where you’ll find the most in-depth written information that we share. Our intended audience here is both employers and individuals. You will find valuable information across all subjects when it comes to financing (paying for) healthcare. Many of our posts are categorized, and we try to keep things as simple as possible. Whatever you are looking for, you will find it here… spend some time at this blog. It’s like a health benefits newspaper.

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Policy Advantage Insurance Services’ YouTube Page: 

youtube-logo

Page URL: www.youtube.com/policyadvantage

Purpose: Some people would rather watch/listen than read. For those that would rather watch, our YouTube page is for you. If you are interested in hearing presentations on the various topics and subjects, this is where you want to be. We add Power Point presentations on a periodic basis. Some of our most important information is shared through our YouTube channel.

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Policy Advantage Insurance Services’ Pinterest Page:

Pinterest

Page URL: www.pinterest.com/policyadvantage

Purpose: Pinterest is kind of a newbie in the social media world. It is a great website. This is a place where you can learn more about us at a personal level (outside of just insurance/health benefits talk). We have various creative pin boards here, where we pin the things that inspire us. We even have one dedicated to our clients and colleagues: “Heart of a Lion.” Definitely look us up and follow us at Pinterest, we have fun here. Our webpage was also just recently “Pinterest verified.” We now have the official red check mark next to our URL.

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Policy Advantage Insurance Services’ Blogspot Blog:

Blogger

Page URL: www.policyadvantage.blogspot.com

Purpose: Our Blogspot blog is currently our secondary blog (we always recommend our Word Press blog first). We have future plans to develop this blog further. Currently, it is pretty much a “mirror” to the rest of our content.  Check back periodically.

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Policy Advantage Insurance Services’ About.me Page:

about.me

Page URL: www.about.me/policyadvantage

Purpose: Our newest addition to the content family, our About.me page is currently under construction. Check back periodically as we prepare it to distribute more Policy Advantage Insurance Services information in the future.

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This concludes our comprehensive review of our internet content guide. Check any of the various outlets, and you fill find valuable, up-to-date, relevant information about financing (paying for) healthcare. There is some great information at these different Policy Advantage Insurance Services social media locations.

We also stay on top of current trends, and will add additional “channels” when they become popular. Our username at each one is typically “slash policyadvantage.” (www.example.com/policyadvantage)

As always, thanks for stopping by. We hope that you found our information to be valuable. Please share it with friends, clients, colleagues, and family.

B is for:

“BROKER”

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Broker: is one that negotiates insurance contracts on behalf of the insured, therefore representing the client’s interest, not the insurer’s.

Brokers already have established relationships with the companies that they contract with. Because of this, they are able to navigate for the insurance consumer more easily. Areas of advantage:

  • Customer Service (changes, enrollment, administration, etc)
  • Ability to Expedite Processes (saving the consumer time, and making things more convenient)
  • Brokers are “Fluent in Insurance Language” (able to communicate w/ companies efficiently)
  • Product Knowledge (knowing the insurance company’s products inside-and-out)

Give yourself the advantage, and put a medical benefits broker to work for yourself or your company today.

PAIS Twitter: www.twitter.com/policyadvantage

PAIS Facebook: www.facebook.com/policyadvantage

This is our first post in our series called “Benefits Chalk Talk.” Much like an after-practice or halftime chalk session in athletics, our goal is to help empower our clients to put all the many different benefits tools in play.  And, much like you face different opponents in a sports contest (and strategies change over time)… our chalk sessions will provide relevant, up-to-date information that will help give you the advantage.

Today’s topic is “Consumer Directed Healthcare.” We selected this as our first concept for a number of different reasons:

  1. Consumer Directed Healthcare’s foundation rests upon individual choices, planning strategies, and knowledge.
  2. Consumer Directed Healthcare will be a concept of emphasis in the post-healthcare reform (Obamacare) environment.
  3. Consumer Directed Healthcare emphasizes the direct involvement of the consumer, encouraging people (and employers) to make sound, informed purchasing decisions (the idea is to make the whole system more efficient).

HealthBenefitsChalkTalk1So this leads us to our question: What exactly is consumer directed healthcare?

Well… consumer directed healthcare has many different definitions. Sometimes it’s even referred to as consumer driven healthcare.

This is the definition we use at Policy Advantage Insurance Services:

Consumer directed healthcare is the idea that patients will behave as medical consumers. Patients will be the ones deciding how their healthcare dollars will be spent. Not doctors, employers, insurance companies, or the government.

Some definitions claim that consumer directed healthcare must be utilized with a high deductible health insurance plan (HDHP). We reject this definition, because we think that all tools and programs must be considered when someone is directing their own program (whether-or-not their strategy includes the use of a high deductible health insurance plan).

There are many things that go into consumer directing:

  • Am I an individual or employer?
  • What is my personal situation (family, hobbies, lifestyle, etc)?
  • Should I utilize private or public options (or a combination of the two)?
  • What type of heath insurance plan should I put in place?
  • What are HSAs and HRAs?
  • What do I need to know about dental, vision, and ancillary programs?
  • What kinds of tax incentives are available to me?
  • Plus others…

We’ll answer these kinds of questions in future blog posts. “Benefits Chalk Talk” will identify the different areas of healthcare benefits planning, and then inform the consumer on how to put them into play.

Thanks for stopping by, we hope you found our information valuable. Please feel free to follow us at our other outlets:

Twitter: www.twitter.com/policyadvantage

Facebook: PAIS Facebook Page

Google+: PAIS Google+ Page

Blog: www.policyadvantage.wordpress.com

Blog2: www.policyadvantage.blogspot.com

Note: **this is the second (2) of a series of four (4) blog posts that require some knowledge of previous posts to be understood. We recommend that you read them in order. Here is the suggested order of reading:

  1. Healthcare Reform: The Major Players
  2. Phrases Made Easy: “Defined Benefit” and “Defined Contribution”
  3. The Great Transition: Healthcare Benefits & Defined Contribution
  4. Health Reimbursement Arrangements (HRAs): The Employee Benefits Home Run

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Defined benefit and defined contribution are long, “scary” phrases. We’ve got news for you though: at Policy Advantage Insurance Services, we work hard to explain all this jargon in simpler terms. And even better news: these two are really easy.

That’s right, they’re actually quite simple to understand. Once you “get” them… you’ve got them (there are only two of them, and they won’t change). Understanding their concept will be a valuable tool for you… especially in the post healthcare reform environment.

In the past, these two phrases were most commonly associated with retirement planning. Now (as a result of healthcare reform), you’ll also want to understand them when it comes to health benefits planning. Here we go.

Phrase #1 — “Defined Benefit” made easy:

  • “Defined Benefit” Example in Retirement Planning: You’re a teacher, you retire, and the school district sends you a monthly retirement check! Simple. That’s a “defined benefit.”
  • Simpler Terms: The benefit (cash/check), has been defined (the dollar amount paid to you each month)
  • Examples of “Defined Benefits” in Retirement and Healthcare Planning: a) pension plans (our example), b) cash-balance pension plans, and c) any group health insurance plan (large or small).

Phrase #2 — “Defined Contribution” made easy:

  • “Defined Contribution” Example in Retirement Planning: You work at a software company. That software company matches your contribution to your 401k each month. That is a “defined contribution.”
  • Simpler Terms: The contribution (match to your 401k account), has been defined (usually as a percentage).
  • Examples of “Defined Contributions” in Retirement and Healthcare Planning: a) 401k’s (our example), b) ESOPs, c) stock bonus plans, d) profit-sharing plans, e) target-benefit pension plans, f) money-purchase plans, and g) health reimbursement arrangements (or HRAs).

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As mentioned, health benefits planning will begin to transition from “defined benefit” plans (ie: group insurance plans) to “defined contribution” plans (ie: HRAs). The reason: healthcare reform has created planning conditions that are suitable for this transition. Retirement plans evolved in similar fashion from pensions (defined benefit) to 401k’s (defined contribution).

If you followed along last week (“Healthcare Reform: The Major Players”), you would have read that HRAs were one of the “major players” we described. This is why: health reimbursement arrangements (or HRAs) will be the “vehicle” that will facilitate this change to defined contribution healthcare plans. We’ll begin to explain in our next blog post… so come back and read up!

Important Editor’s Note 11/22/2013: Since these original blog posts, federal guidance regarding “Stand-Alone HRAs” (which are addressed in-depth throughout these articles) has undergone significant changes. In order to stay in full compliance, please be advised that there are now many additional considerations when adopting this type of benefits planning strategy. Consult with a proper broker or insurance professional before utilizing employer dollars to purchase individual health insurance policies. 

That’s all for now. We hope this information was beneficial, as these can be important concepts for anyone.  Thanks for stopping by, and feel free to follow along at our other outlets:

Twitter: www.twitter.com/policyadvantage

Facebook: PAIS Facebook Page

Google+: PAIS Google+ Page

Blog: www.policyadvantage.wordpress.com

Blog2: www.policyadvantage.blogspot.com

At Policy Advantage Insurance Services… we’re all set to keep-up with the political climate.

Begin to check our various outlets over the next few weeks after tomorrow’s election. We’ll share some great information that’s relevant to the results.

Thanks for stopping by, we hope our information was valuable to you. Check back at our blog to get further information about funding healthcare. Also, please share with your friends, clients, colleagues, and family. Here are a few of our other information outlets:

Home Page: http://www.policyadvantage.com

Twitter: http://www.twitter.com/policyadvantage

Facebook: http://www.facebook.com/policyadvantage

YouTube: http://www.youtube.com/policyadvantage

Pinterest: http://www.pinterest.com/policyadvantage

Word Press (you are here): http://www.policyadvantage.wordpress.com

There’s an election coming up soon, and regardless of results… we’ll have some valuable information to share with you.

So for now… we have some simple IF/THEN election advice:

IF: Obama wins the election, THEN: Start to understand state health insurance exchanges and the Affordable Care Act.

IF: Romney wins the election, THEN: Stay tuned for possible Affordable Care Act changes/repeal.

That’s all for now… pretty simple.

Thanks for stopping by, we hope our information was valuable to you. Check back at our blog to get further information about funding healthcare. Also, please share with your friends, clients, colleagues, and family. Here are a few of our other information outlets:

Home Page: http://www.policyadvantage.com

Twitter: http://www.twitter.com/policyadvantage

Facebook: http://www.facebook.com/policyadvantage

YouTube: http://www.youtube.com/policyadvantage

Pinterest: http://www.pinterest.com/policyadvantage

Word Press (you are here): http://www.policyadvantage.wordpress.com

You probably received a flyer, or heard from us online.  We’re glad that you’re here!

Also… hello to all of our current colleagues…

Every once in a while, we’ll run a short info “campaign.” We’ll get valuable, up-to-date, and relevant content out to our friends, clients, and potential clients.  If you’re familiar with us, as you already know… we like sharing good information.

Basic goals of a Policy Advantage Insurance Services “Information Campaign”:

  1. AWARENESS.  Be aware that we share valuable and relevant information.
  2. FAMILIARITY.  We want people to know where they can access information: (ie: www.policyadvantage.com, YouTube, Facebook, Twitter, WordPress, etc).
  3. SUBSCRIBE & SHARE. We encourage people to follow, subscribe, and stay “in the know” about financing (paying for) healthcare. We’d also like you to share our information w/ friends & colleagues.

Thanks for stopping by, we hope our information was valuable to you. Check back at our blog to get further information about funding healthcare. Also, please share with your friends, clients, colleagues, and family. Here are a few of our other information outlets:

Home Page: http://www.policyadvantage.com

Twitter: http://www.twitter.com/policyadvantage

Facebook: http://www.facebook.com/policyadvantage

YouTube: http://www.youtube.com/policyadvantage

Pinterest: http://www.pinterest.com/policyadvantage

Word Press (you are here): http://www.policyadvantage.wordpress.com

A is for:

“ADVERSE SELECTION”

GreyAAdverse selection is the tendency for higher risks to seek more insurance coverage than lower risks.

Example: A 57 year old female with diabetes and a history of chronic illness would have a tendency to seek more health insurance coverage than a healthy 23 year old male.

Interesting Point: As it stands (starting in 2014) adverse selection will no longer be an underwriting consideration in the health insurance industry. Why? Because those who apply for coverage, must be accepted. This is known as guaranteed issue.

Thanks for stopping by, we hope our information was valuable to you. Check back at our blog to get further information about funding healthcare. Also, please share with your friends, clients, colleagues, and family. Here are a few of our other information outlets:

Home Page: http://www.policyadvantage.com

Twitter: http://www.twitter.com/policyadvantage

Facebook: http://www.facebook.com/policyadvantage

YouTube: http://www.youtube.com/policyadvantage

Pinterest: http://www.pinterest.com/policyadvantage

Word Press (you are here): http://www.policyadvantage.wordpress.com