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Your Guide: Private Health Insurance Exchanges

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Today we’re going to look at “private health insurance exchanges.” This has been one of the biggest “buzz phrases” in the health insurance industry over the past couple of years for a number of different reasons. The biggest reason though, is healthcare reform. With the implementation of new provisions required in the Affordable Care Act, the way that employers offer health insurance to their employees is changing.

We’ll take a look at the structure of private health insurance exchanges. We’ll also describe the different components that make-up a private health insurance exchange, the types of businesses that should be taking the closest look at these exchanges, how private exchanges work, and why they’re growing in importance.

Private health insurance exchanges are exactly what they say they are: they’re exchanges that are set up privately through an employer. Many private health insurance exchanges utilize two important components:

  1. Technology and software: software programs help facilitate administration of private health insurance exchanges. Technology keeps private exchange administration simple for both the employer and the employee. One example is www.liazon.com. Liazon’s platform allows an employer to define a contribution (much like an allowance), and then employees select their own health benefits. Simply, it’s an employee’s money to spend how he/she wants. The software keeps track of funds spent, shows the employee what kind of health insurance options are available in the private exchange, and allows employees to select the plans they want.
  2. Group health insurance plans: in the past, many employers only offered one group health insurance plan. Administration of multiple plans could be a challenge. So to fix that problem, software companies (like Liazon) have arrangements with insurance companies that allow the employer to more easily offer multiple group health insurance plans, from multiple carriers. The important word here is multiple. With the software and technology that’s available, it’s not nearly as difficult to offer a selection of group health insurance plans anymore. This is important because one of the biggest goals of private health insurance exchanges is to provide choice. By utilizing a private exchange, employees now have choice.

There are additional ways to set up private health insurance exchanges, but businesses with +50 full time equivalent employees will almost always be utilizing the two concepts we’ve described above. And that’s who this article is intended for: businesses that are mandated to provide coverage. However, smaller businesses can also utilize this exact same strategy. If you’re a business that is at 20 employees or above, you’ll want to understand this concept.

Question: Why are private health insurance exchanges becoming more important?

Here’s why:

  • Private health insurance exchanges give employees choices. Instead of being “stuck” in one group health insurance plan, they can more efficiently choose which plans fit them best. Having choices is now more important than ever before, because dependents (spouses and children) need to have affordable access to coverage. In the past, sometimes it was flat-out too expensive for an employee to include their dependents. The private exchange concept helps alleviate that issue.
  • Businesses with +50 full time equivalent employees are mandated to provide coverage. A private exchange is a cost-effective and budgetable way for employers in the “large group” category to provide coverage. You decide on the amount (called a “defined contribution”), and then give that amount to each employee. They pick the plan they want. Simple.
  • Efficiency. If employees are making their own decisions and picking their own plans, the whole system becomes more efficient. Instead of you telling them what they get, they instead pick what they want. When consumers are making their own decisions, they’re more conscience about where money is being spent.

That’s the basic break-down of private health insurance exchanges. Unlike public health insurance exchanges (ie: state & federal exchanges), private exchanges are completely administered within the private workplace.

As mentioned, private exchanges can be an exceptionally important concept for those businesses in the +50 employee range. They accomplish three very important things: budgetability, selection, and flexibility. Those qualities will be very significant to businesses that are mandated to provide coverage. However, this same concept can work very well for smaller businesses too (in the 2-100 employee range).

We work with private health insurance exchanges at Policy Advantage Insurance Services. If you are an employer that fits into the “group-sizes” we’ve described, contact us anytime if you have questions.

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: https://policyadvantage.com

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

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

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

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Covered California: SHOP (Small Business Health Options Program)

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Thanks for stopping by today, we’re glad that you here. Today we’re going to talk about the Covered California SHOP program, otherwise known as the Small Business Health Options Program.

As you know, Covered California is the new state health insurance exchange in the state of California. The new exchanges were a major part of healthcare reform, and were designed to help extend health insurance coverage to eligible individuals and businesses. There are two different programs available at Covered California:

  1. Individual & Family Plans (IFP): these are plans that you enroll in outside of an employer (or group) plan. They are available with APTCs (or subsidies) at the exchange. These subsidies make premiums more affordable.
  2. SHOP (Small Business Health Options Program): these are group health insurance plans through Covered California that are available to qualified businesses. Depending on the size and average income of your business, you may be eligible for tax credits that can help reduce the cost of coverage. 

Many of you are probably familiar with the individual plans that are available through the exchange (option #1 above). A lot of you probably even enrolled — over 1.2 million people in California participated during the exchange’s first open enrollment period that just ended.

Even though you might be familiar with individual health plan enrollment at the exchange, this article is about option #2 above. Covered California can also help small businesses. 

SHOP

If you’re a small business owner (especially in a group with less than 25 FTEs), you may want to take a close look at Covered California’s SHOP. This program is specifically designed to help small businesses offer coverage. Here are some important facts about the SHOP:

  • It’s a new marketplace through the Covered California exchange designed specifically for businesses with 1-50 eligible employees.
  • Employers under 50 FTE are not required to provide health insurance, but this program could be a good option.
  • Important: unlike individual enrollment, Covered California SHOP enrollment is open all year in 2014. So, request information and a quote anytime this year.
  • An eligible full-time employee is an employee that works 30hrs per week or more for the month. An eligible part-time employee is an employee that works 20hrs per week or more for the month.
  • To be eligible for SHOP, an employer must provide a minimum 50% contribution to employee plans.

Question #1: What businesses are eligible for a tax credit?

Answer #1: Businesses that 1) have fewer than 25 FTE for the year, 2) have an annual average wage of less than $50,000 per FTE, and 3) who pay at least 50% of their employees’ premium costs.

Question #2: How much is the tax credit?

Answer #2: Starting in 2014, the maximum tax credit for businesses as a percentage of insurance premium expense is 50% (or up to half of your premium). The maximum tax credit for tax-exempt organizations as a percentage of insurance premium expenses is 35%. These premium subsides are available for two consecutive years.

As a small business owner, it’s a great idea to talk with a Covered California “Certified Agent” about this program. They can run a quote for you. You may be eligible for substantial premium savings. Policy Advantage Insurance Services is certified and can help you with your questions. Feel free to contact us anytime. For more information about SHOP, please visit their official FAQ page here.

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: https://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: http://www.policyadvantage.wordpress.com

 

 

Phrases Made Easy: “Advanced Premium Tax Credits” (APTCs)

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Welcome back to another edition of “Phrases Made Easy.” This series at our blog aims to help make all of those long, drawn-out insurance phrases easier to understand. One thing we notice when talking about health insurance (and health benefits in general) is that the concepts can be “wordy” and boring. We emphasize fixing that here.

Today we’re going to talk about “Advanced Premium Tax Credits” (or APTCs). And we’ve got great news for you: this one is really easy.

If you’ve enrolled in a health insurance plan at the new health insurance exchanges, there’s a pretty good chance that you’ve already put “Advanced Premium Tax Credits” to work. We’re going to give you the long version of the definition first. This one comes directly from www.healthcare.gov (*note: skip below the “Easy St” sign if you want to make this easier):

The Affordable Care Act provides a new tax credit to help you afford health coverage purchased through the Marketplace. Advance payments of the tax credit can be used right away to lower your monthly premium costs. If you qualify, you may choose how much advance credit payments to apply to your premiums each month, up to a maximum amount. If the amount of advance credit payments you get for the year is less than the tax credit you’re due, you’ll get the difference as a refundable credit when you file your federal income tax return. If your advance payments for the year are more than the amount of your credit, you must repay the excess advance payments with your tax return. Also called premium tax credit.

Easy

OK. That was pretty wordy. Now let’s make this easy. Here’s what you need to know about “Advanced Premium Tax Credits” (or APTCs):

  • APTCs are the health insurance “subsidies” that you hear so much about.
  • They are credits that make your premiums more affordable if you purchase insurance through the new exchange.
  • The APTCs that you may qualify for are based on FPL or “Federal Poverty Level” (we made that phrase easy one time before, go check it out).
  • The more money that you make, the less of a monthly APTC you will get.
  • The less money that you make, the more of a monthly APTC you will get.
  • If you get too much credit for the year (because you under-stated your income), you’ll have to pay it back at tax time.
  • And (you guessed it), if you don’t get enough credit for the year (because you over-stated your income), you’ll get a credit at tax time.

The moral of the story: APTCs are really what makes individual health insurance “affordable” in the Affordable Care Act. They’re government tax credits that are designed to make health insurance premiums less expensive.

In certain exchanges (like Covered California), when you shop and compare plans (using their “Shop & Compare Tool“), they will apply the APTCs you may eligible for, and give you your total monthly premium estimate. This estimate is based on four factors:

  1. Number of People in the Household
  2. Ages of People in the Household
  3. Yearly Household Income
  4. and Zip Code

Once again, if you want to see an example, look at Covered California’s “Shop & Compare Tool.” Once you input the factors listed above, you’ll be able to see what kind of APTC you may qualify for.

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: https://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: http://www.policyadvantage.wordpress.com

 

#Advantage: Working with a Covered California “Certified Agent”

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“Covered California” is the new public health insurance exchange in the state of California. If you live California, you’ve probably heard quite a bit about it over the past 6 months. These exchanges are a new way to buy health insurance and are a major part of healthcare reform.

The California exchange opened back in October of 2013. Since then, hundreds of thousands of Californians have enrolled in individual insurance plans there. Many of these plans have been subsidized by Advance Premium Tax Credits (or APTCs). These APTCs can substantially reduce the monthly cost of health insurance.

If you’ve taken a look at Covered California, you’ll know that there are various ways in which to enroll. Some of them include:

  • Online. You can set up an online account and enroll via the internet. You can also assign a Certified Insurance Agent to your case through your online portal.
  • Over the phone. You can call Covered California’s phone number and enroll with a service agent.
  • In person. You can enroll in person with A) Certified Enrollment Entities, B) Certified Enrollment Counselors, or C) Certified Insurance Agents. 

The purpose of this blog post is to explain some of the advantages of enrolling with a Certified Insurance Agent. 

Advantage

Here are some really good reasons to work with a Covered California “Certified Insurance Agent”:

  • Certified Agents are Licensed Professionals: Any insurance agent that is certified with Covered California is also licensed with the state department of insurance. Many of these agents also have years of experience and know the industry well.
  • A Single Point of Contact: This is one of the biggest advantages. You’ll have a single point of contact if you enroll with a certified agent. You can pick up the phone or send an email to that person anytime. If you need to make changes or have questions in the future, you’ll have someone familiar to work with.  However, if you enroll with a Covered California customer service rep over the phone, or a Certified Enrollment Counselor, you may speak with different people each time.
  • Certified Agents are Appointed Directly with the Insurance Companies: Insurance agents are appointed and have a direct relationship with the insurance companies. This can help with quick, effective, and efficient customer service.
  • Certified Agents Have Passed Rigorous Certification Requirements: These are people that have gone through extensive training and testing to obtain their certified status.
  • No Cost. You can work with a Covered California “Certified Agent” at no cost to you. Compensation is built into every insurance plan, regardless of whether-or-not you decide to work with an agent.

As you can see, there are a number of good reasons to work with a Covered California “Certified Insurance Agent.” Look for this badge when searching for assistance from an agent or agency:

CCCertified

Policy Advantage Insurance Services is certified. Please contact us if you have questions, or need ongoing help at Covered California.

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: https://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: http://www.policyadvantage.wordpress.com

Policy Advantage Insurance Services: How We Can Help

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Today’s article is about how Policy Advantage Insurance Services can help you with your health benefits planning. As you know, we’ve written a few blog posts about this topic in the past. If you’re new, we’d encourage you to catch up here:

Policy Advantage Insurance Services literally has the ability to help you with your health benefits planning, no matter what your current situation is. This blog post intends to specifically identify where we can help.

WeCanHelp

  • Employers of Any Size: We have the ability to help any size employer, large or small. If you’re a business owner or executive, you probably know that there are some important differences between businesses (especially your number of full time equivalent employees), when it comes to healthcare reform. We can help employers with 2, 20, 80, 500, or even 1000’s of employees. We can help you design an effective, efficient, and budget-conscience health plan that will fit any business.
  • Individual Health Insurance Plans Off of the Exchange: Are you self-employed or not offered a health insurance plan at work? It’s now easier than ever to “shop” and find individual health insurance. If your income is too high to qualify for exchange subsidies, we can help you find a plan off of the exchange. These are plans that are purchased directly through the insurance companies.
  • Individual Health Insurance Plans On the Exchange: If you’d don’t currently have access to an affordable health insurance plan, and your income is between 100% and 400% of FPL, you may qualify for help with your insurance premiums through the new health insurance exchanges in the form of “Advanced Premium Tax Credits” (or APTCs). These credits can significantly reduce the amount of your monthly premiums. Policy Advantage Insurance Services is “Covered California Certified” and can help you select plans on the new exchange.
  • SHOP Plans On the Exchange: The “SHOP” program is the new “Small Business Health Options Program.” This is a new program on the exchange that is specifically designed to help small businesses (under 50 employees) expand health insurance options to their employees. Those businesses that have less than 25 employees may see significant tax-credits to off-set the cost of premiums. The SHOP program is a group health insurance plan.

As you can see, Policy Advantage Insurance Services has the capacity to help you in any circumstance. If you are a business, individual, or self-employed, we can help you find a plan that will fit your situation. One of our biggest goals is to help our clients save money and improve coverage. Contact us today, and we’ll help you sort it all out.

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: https://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: http://www.policyadvantage.wordpress.com

Operation Patience: Exchange Plans Taking Time to Process

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Recently, many who have applied for a January 1st, 2014 plan start at the new state health insurance exchange have learned that it’s taking some time for the insurance companies to process your plan. This is currently a common occurrence, as they continue to sort through 10’s of thousands of new applications (literally). Our advice right now: be patient.

Although you may not have received your plan documents and your member ID card yet, if you sent in your “binding payment” on time, you should be retroactively covered:

  • In California, the “binding payment” is due (in-hand at the insurance company) by January 15th, 2014. This may vary from state-to-state and insurance company to insurance company, so make sure to check.
  • “Retroactively covered” means that if you incur medical charges before your plan is processed (and as long as your “binding payment” was received on-time), you will be retroactively reimbursed for covered charges.

Be assured that the insurance companies are doing everything that they can to take care of your policy as quickly as possible. You’ll see across Twitter that they’re actively communicating with their new members. Here are some Tweet examples of what we’ve seen to customers:

Blue Shield of California, 1/9/2014:

We’ve extended customer service hours to meet the higher demand and tripled online bandwidth to make payments. Thanks for hanging in there.

Health Net, 1/6/2014:

@justex07: You should get your ID card in approx. 5 business days, but you can go to the doctor before then and file a claim after if needed.

Anthem Blue Cross of California, 1/11/2014:

@mobilefilmclass: Also, we hired 100s of new cust service folks for 1/1, cancelled vacays & pulled 100s other people from other jobs to help.

So although you may have waited on hold for hours, or no one is returning your email inquiries, or you’re just frustrated in general because you haven’t received your packet or ID card yet… stay patient. They’re working diligently to take care of your policy.

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: https://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: http://www.policyadvantage.wordpress.com

California Continues Rollout: Won’t Allow Cancelled Policy Reinstatements

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This Fall, hundreds of thousands of non-compliant health insurance plans began to be cancelled throughout the nation. These plans did not comply with the new requirements set forth in the new healthcare reform law, and for that reason, were deemed not “legal.” As a result, these non-compliant plans needed to go. For more information about why, see this blog post.

However… last week, in light of these cancellations, the Obama Administration made the decision to allow insurers to reinstate these cancelled non-compliant plans. This would allow those plans to be continued for at least the remainder of 2014.

During his campaign to promote healthcare reform, President Obama reiterated that “If you like your plan, you can keep your plan.” However, in this example (the cancellation of these non-compliant health plans), this did not hold true. For this reason, the administration felt it was responsible for not “honing up” to the promise that it made. As a result, Obama decided that those plans that were cancelled needed to be reinstated for at least an additional year.

However, California was one state that did not agree with the Obama Administration’s decision to reinstate these cancelled policies. The executive board of Covered California (the new state health insurance exchange) unanimously voted to continue to move on with reform implementation, and not reinstate cancelled health insurance policies. This decision was on-par with many state insurance commissioners, and also with certain insurance company executives within the industry.

Here are some of the reasons why some states, insurance commissioners, and insurance executives thought policy reinstatements would be a bad idea:

  • Insurance Companies: Reinstatement of cancelled plans would contribute to the destabilization of an already turbulent insurance market.
  • Covered California (the new state exchange): Covered California was already leading the way with exchange enrollments. Nearly one-third of those enrolled in the first month at both the state & federal exchanges (in other words, nation-wide) were Californians. It made little sense to slow down.
  • Insurance Commissioners: Being this far into the implementation of reform, various insurance commissioners throughout the country also felt that it was inappropriate to reinstate health insurance plans that had been cancelled.

For these reasons (and others), a handful of states made the decision to tell the Obama Administration “thanks, but no thanks” when it came to reinstating policies. Certain states continued to move along with reform implementation as-is, and California was one of those states.

As a result, individuals now have more time to enroll in the state health insurance exchanges. The original open enrollment deadline for a 1/1/2014 plan start was 12/15/2013. This has now been moved back to 12/23/2013. 

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: https://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: http://www.policyadvantage.wordpress.com

Phrases Made Easy: “Cost Sharing Reductions”

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Welcome back to another edition of “Phrases Made Easy.” This series at our blog aims to help make all of those long, drawn-out insurance phrases easier to understand. One thing we notice when talking about health insurance (and health benefits in general) is that the concepts can be “wordy” and boring. We emphasize fixing that here!

Today we’ve selected the phrase “Cost Sharing Reductions.” The primary reason we’ve selected this phrase, is because it can be a very important concept for certain people in the new Covered California state health insurance exchange. Like many other phrases in our “Phrases Made Easy” series, this one sounds difficult, but it’s really not that bad at all.

If you are shopping in the health insurance exchange, you may start to see the phrase Cost Sharing Reduction (or CSR). Here is what a Cost Sharing Reduction is:

Cost sharing reduction plans are offered through Covered California for consumers whose income is between 133% to 250% of the federal poverty level (FPL). These plans offer lower cost-sharing to reduce your clients’ out-of-pocket costs when accessing medical care. These plans are available only through Covered California.

Quite simply: Cost Sharing Reductions reduce your out-of-pocket expenses. If you purchase what is called an “Enhanced Silver Level Plan” through Covered California, and are eligible for Cost Sharing Reductions, you will get help with your co-payments, deductibles, and other out-of-pocket medical expenses.

————————————————————————————————————

Question: What is the criteria for Cost Sharing Reduction eligibility?

Answer: There are two criteria:

  1. You need to purchase an “Enhanced Silver Level Plan” on the Covered California state health insurance exchange.
  2. Your yearly income must be between 100% and 250% of FPL (or approximately $11,490 per year & $28,725 per year for individuals).

————————————————————————————————————

Here are the three tiers of Silver Level Plans that include Cost Sharing Reductions (or CSRs) in the new state health insurance exchange in California. A standard Silver Level Plan without Cost Sharing Reductions has 70% actuarial value:

  • Enhanced Silver 94: 100% FPL to 150% FPL (94% enhanced actuarial value)
  • Enhanced Silver 87: 150% FPL to 200% FPL (87% enhanced actuarial value)
  • Enhanced Silver 73: 200% FPL to 250% FPL (73% enhanced actuarial value)

Essentially, these are additional benefits that help people who make less, reduce their out of pocket costs. If you have additional questions about “Cost Sharing Reductions” (or CSRs), and how they may apply to you, please contact Policy Advantage Insurance Services. We are “Covered California Certified” and can help you with your questions when navigating the exchange.

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: https://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: http://www.policyadvantage.wordpress.com

Benefits Chalk Talk: 10 Essential Health Benefits

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Welcome back to another edition of “Benefits Chalk Talk.” In this series at our blog, we provide you with valuable, up-to-date, relevant information about health benefits planning so that you can put the things in place that make the most sense for yourself or your company. At Policy Advantage Insurance Services, we feel that informed consumers can make a really big difference in our industry.

The topic today is about the “10 essential health benefits” that must be included in all insurance plans starting on January 1st, 2014. The Affordable Care Act (or ACA/Obamacare), required that certain new “essential benefits” be included in all health insurance plans.

Additionally, you may have heard recently in the news that many people across the country are going to be unable to continue their current health insurance plans. The “10 Essential Health Benefits” provision is one of the reasons why. Many of today’s plans on the individual market do not conform to these minimum standards set forth in the law.

As such, any plans that were not “grandfathered in” (ie: in place before March 23rd, 2010, with certain exceptions) can no longer be offered. As a result, people in these plans will need to find a new one starting on January 1st. In many cases, because of the additional added benefits, premiums will also be more expensive.

Here is an overview of the “10 Essential Health Benefits (source: www.healthcare.gov):

  1. Ambulatory Patient Services: “Outpatient care” – the kind you get without being admitted to a hospital
  2. Emergency Care: Trips to the emergency room
  3. Hospitalization: Treatment in the hospital for inpatient care
  4. Maternity & Newborn Care: Care before and after your baby is born
  5. Mental Health Services: Mental health and substance use disorder services: This includes behavioral health treatment, counseling, and psychotherapy
  6. Prescription Drugs: Your prescription drugs
  7. Rehabilitative & Habilitative Services: Services and devices to help you recover if you are injured or have a disability or chronic condition. This includes physical and occupational therapy, speech language pathology, psychiatric rehabilitation, and more
  8. Laboratory Services: Your lab tests
  9. Preventive & Wellness Services: Preventive services including counseling, screening, and vaccines to keep you healthy and care for managing a chronic disease
  10. Pediatric Care: Pediatric services – this includes dental care and vision care for kids

The above listed are the “10 Essential Health Benefits” that must be included in all insurance plans starting on January 1st, 2014. Keep in mind that there may be minor benefits differences between states, but for the most part, all of the above must be included in new insurance policies.

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: https://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: http://www.policyadvantage.wordpress.com

Insurance Brokerage Explained: An “Insurance Store”

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Hi, and welcome back to another blog post here at Policy Advantage Insurance Services. Today we’re explaining the concept of the insurance broker, and how a broker can benefit you as an individual or business.

As explained in one of our past blog posts: “5 Reasons to Give Yourself the Advantage,” we described the different ways that our clients can really benefit from the services of a health benefits broker. Your broker can be a very valuable asset.

So, instead of repeating what we went over in that blog post, we’re going to conceptualize the broker concept in this one. When we say conceptualize, we mean we’ll put it into everyday terms for you.

The first important thing to understand is the actual definition of “broker.” Here it is:

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

With that definition on-hand, you now understand that brokers are working in the interest of the client, and not the insurance companies. Two of the biggest goals of an insurance broker:

  1. Help the client save money.
  2. Help the client improve coverage.

If we can achieve both in a single case (whether at the individual or group level), we’ve hit a home run. It’s what we try to do for our clients every single time.

Now, we’ll move on to the conceptualization of the term “broker.” Our goal is to make it familiar to you, by comparing it to everyday things.

So, let’s keep it simple: a broker is really an “insurance store.” It’s just like any other store where you purchase goods or services.

For example, a sporting goods store will carry items from Nike, Adidas, Under Armour, Louisville Slugger, Rawlings, and others for their customers to choose from. Or, a grocery store will carry items from Quaker Oats, Chiquita Bananas, Kellogg’s, Frito-Lay, and many other food brands. A customer goes to these stores, and shops for the items that they want.

An insurance broker is no different. Effectively, a brokerage is a place where customers can shop the different insurance brands like: Anthem Blue Cross, Kaiser Permanente, Cigna, Aflac, HealthNet, and many others. There can also be accessibility to the new state health insurance exchanges (ie: Covered California) through brokers.

A brokerage is a place where selections can be made based on preferences like:

  1. Type of coverage.
  2. Cost of coverage.
  3. Network access.
  4. Coverage and costs that fit your business’ (or family’s) specific needs.

You’re able to “one-stop-shop” for the coverage that fits you best. An insurance brokerage customer also gets the added value of licensed professionals that can assist with specific questions when selecting coverage (persons with the RHU® or REBC® designations can also be very valuable to you).

Thanks for stopping by today, 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:

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