Tag Archive for: health insurance coverage

What are the Silicon Slopes Health Plans?

What are Silicon Slopes Health Plans and What Do They Mean For Your Utah Business?

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They could mean great rates on group health insurance, and if the medical loss ratio is low for your company, you might actually get a rebate check from your plan administrator.
What are the Silicon Slopes Health Plans?

If you own a small business, you understand the challenge of finding affordable, quality health insurance coverage for your employees. The Kaiser Family Foundation estimates that businesses with five employees could pay $100,000 in the first year for coverage — not including copays and coinsurance.

Last week, Silicon Slopes, a 501(c)(3) nonprofit organization empowering Utah’s startup and tech community, introduced Silicon Slopes Health Plans. Developed in partnership with University of Utah Health and EMI Health Plans, these plans are partially self-funded, and look to move beyond the transactional approach, where it’s all about paying premiums and claims, to put more focus on the ultimate goal of keeping employees healthy.

So how exactly do these plans work, and how can you know if they’re right for your company?

First, let’s look at a typical “fully insured” health plan. This is the model we’re all familiar with where the employer pays a fixed monthly premium to the health insurance carrier, and in return, the carrier pays all eligible member claims. If the premium collected is greater than the amount of the claims, the carrier gets to keep the excess as profit.

With a partially self-funded health plan, the employer contracts for the assistance of a health insurance carrier or third-party administrator (TPA) to administer all aspects of the health plan. The employer funds the claims payments. Something called “stop loss” insurance pays any catastrophic claims for conditions such as cancer or premature birth. While claims will vary from month to month, the employer reaps the rewards when few claims need to be paid. Any surplus funds can be reserved for future claims.

There are several attractive features of a partially self-funded plan (like the Silicon Slopes plans), including a statistical likelihood that it will cost less.

Other benefits of a Silicon Slopes Health Plan include:

  • As the employer, you can choose whether providers are in IHC network or non-IHC network
  • The plans are administered by University of Utah Health or EMI Health
  • These are “medically-underwritten” plans which means if your staff is very healthy, your company can actually see the benefits through lower rates
  • You’ll be pooled with other like-minded employers
  • You need not be a tech company or a start-up to benefit from this plan
  • You can qualify to participate with as few as two (2) full-time (W2) employees
  • You can sign up your company to participate at any time, with the starting date at the first of the next month

There are some important considerations to take into account when looking at these plans. Ark Insurance Solutions can help. Reach to us today for a no-cost consultation to determine if a Silicon Slopes Health Plan is right for your business.

Navigating the complex world of health insurance can be daunting. The Ark Insurance Solutions team has the skill and experience to guide you. We’ll help you compare health plans to make the best decision based on your unique circumstances and budget. Give us a call at 801-901-7800 or click here to schedule an appointment with us.

Rebecca Yates Talks Health Insurance on the Cre8tivity podcast

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Photo courtesy of Cre8tivity

 

CEO Rebecca Yates recently sat down with the hosts of the Cre8tivity podcast.  They talked about all things health insurance, focusing on freelancers and businesses, as well as family coverage.

Get to know Rebecca and learn how you can get the best health insurance plan to meet your needs.

Listen in here:

http://utahpodcastnetwork.com/2020/09/20/cre8tivity-107/

 

From Cre8tivity:

REBECCA YATES is a superhero! Running over half a dozen businesses, being a single mother of two daughters, and helping everyone she can to get health coverage, in case anything unexpected happens (Illness, COVID, Etc)!

We hope this episode is helpful to freelancers, families,  & businesses!

New Dietary Guidelines for Americans

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The foods and beverages you consume have a significant impact on your health. Diet-related chronic diseases—such as cardiovascular disease, Type 2 diabetes, obesity and some types of cancer—are prevalent among Americans and pose a major public health problem. In fact, 60% of adults have one or more diet-related chronic diseases.

Every five years, the U.S. Department of Health and Human Services and the U.S. Department of Agriculture publish nutrition advice. The newest version of the Dietary Guidelines for Americans (2020-2025) offers science-based nutrition advice to develop healthy eating habits and reduce chronic disease risk. For the first time, this edition provides recommendations by life stage, from birth through older adulthood.

2020-2025 Dietary Guidelines

The latest guidance provides four overarching guidelines that encourage healthy eating patterns while recognizing that individuals will need to make shifts in their food and beverage choices to achieve a healthy pattern.

Make every bite count and consider the following four overarching guidelines:

1. Follow a healthy dietary pattern at every life stage. Dietary needs and recommendations vary based on your age, sex and stage of life. Review the guidelines to ensure that you and your loved ones—whether they’re infants, teens, adults or older adults—are following a healthy diet.
2. Customize your foods and beverages to reflect personal preferences, cultural traditions and budgets. A healthy dietary pattern can benefit all people regardless of age, race, ethnicity or current health status.
3. Focus on meeting food group needs with nutrient-dense foods and beverages while staying within calorie limits. Keep in mind that 85% of your daily calories should meet food group recommendations for vegetables, fruits, grains, dairy and protein. Nutrient-dense foods are rich in vitamins and minerals, without too much-added sugars, saturated fats and sodium.
4. Limit foods and beverages high in added sugars, saturated fats and sodium. Be mindful of the nutritional facts of the foods and beverages you consume—including alcohol. For example, men should limit alcohol to two drinks a day and women should consume no more than one drink per day.
Everyone can benefit from a healthy eating pattern, so start simple with modest changes each day.

 

For healthy recipes or to learn more about the current guidelines, visit MyPlate.gov.

Benefits Breakdown

Benefits Breakdown

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Benefits Breakdown

Understanding Prescription Drug Pricing Trends

In 2019, the United States spent nearly $370 billion on prescription drugs, keeping trend with significant increases year over year. Although prescription drug spending has historically been a small proportion of national health care costs compared to hospital and physician services, it has grown rapidly in recent years—comprising about 10% of national health care spending. Below are the two major factors contributing to the rise of prescription drug costs:

  • Influx of specialty drugs—Specialty medications account for a smaller portion of U.S. prescriptions than non-specialty drugs, yet they command nearly half of the pharmaceutical market. In 2021, experts predict an 11.5% increase in specialty drug prices, compared to a 2.8% rise in non-specialty drug prices. These manufacturer price increases are often cited by insurers as reasons for rising insurance premiums.
  • Price inflation—According to a Segal report, 40% of new products recently launched by drug manufacturers were specialty medications. These drugs are now being pushed at a higher rate than non-specialty drugs, contributing to price inflation. Specialty drug utilization increased by nearly 6% in 2020, whereas non-specialty drug usage remained relatively the same. And there is little recourse for anyone seeking an alternative to these specialty drugs.

Yet, despite these trends, there are cost-cutting strategies available to employers. These include managing drug usage, utilizing rebates, and educating employees. Reach out to learn more about these and other budgetary tactics.

3 Voluntary Benefits Trends to Watch in 2021

Voluntary benefits have always been great tools for rounding off employee benefits offerings. And that value isn’t lost on employers—at least 50% offer some sort of voluntary benefits, according to an Alera Group report. Employers can expect to see voluntary benefits grow in these three key areas in 2021:

  1. Expanded offerings such as eldercare and critical illness insurance
  2. A focus on financial wellness, including budget counseling and financial planning
  3. Greater customization, allowing employees to pick and choose what’s best for them

Voluntary benefits include dental, vision, critical illness, pet insurance, and similar offerings that are paid for partially by employees. During the COVID-19 pandemic, having additional benefits options like these could be exactly what employees need. Specifically, these trends indicate employees want more control over the benefits that are important to them.

Reach out to learn how to help employees maximize their voluntary benefits.

Single Mom's Guide to Health Insurance

Open Enrollment Begins November 1–Five Factors to Consider.

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Health Insurance

 

Did you know there are five factors that can affect how much your health plan’s monthly premium is under the health care law?

However, individual states can limit how much these factors come into play.

These five factors are:

  • Age: Premiums can be up to 3 times higher for older people than for younger people.
  • Location: Where you live has a big effect on your premiums. Differences in competition, state and local rules and cost of living are the reasons why.
  • Tobacco use: Insurers can charge tobacco users up to 50% more than those who don’t use tobacco.
  • Individual vs. family enrollment: Insurers can charge more for a plan that also covers a spouse and/or dependents.
  • Plan category: Bronze, Silver, Gold, Platinum, and Catastrophic. The categories are based on how you and the plan share costs. Bronze plans usually have lower monthly premiums and higher out-of-pocket costs when you get care. Platinum plans usually have the highest premiums and lowest out-of-pocket costs.

In addition, insurance companies may offer more benefits, which could also affect costs. Furthermore, insurance companies can not charge women and men different prices for the same plan, nor can they take your current medical history or health into account when otherwise known as pre-existing conditions.

 

Five Insurance Tips for Millennials

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Millennials find themselves in the stage of life that may require them to purchase their own insurance. After having aged out of their parent’s insurance coverage and buying or renting a place to live, coverage needs may not be as black and white as one might think.

Knowing these five tips will help navigate through the sometimes-complicated policies out there.

  1. Shop smart for adequate coverage- Although cost is an important factor, having the coverage you need is equally important. You may be tempted to choose the least expensive plan but when it comes time to make a claim, you will see less of a financial benefit. In fact, a high deductible could cause a unexpected financial burden.
  2. Look for discounts- Often insurance carriers will offer discounts for bundling services, such as your home or rental insurance and your car insurance. In addition, there are discounts for being in school and getting good grades. Be sure to ask your agent about these and other possibilities.
  3. Fill in the gaps- An average policy will provide basic coverage but that may not be enough for all your coverage needs. For instance, a rental or homeowner’s policy may not cover personal items such as jewelry over a certain dollar amount.  Be sure to ask if you have collectables or higher value items. 
  4. Purchase life insurance- Life insurance is important, no matter how old you are. For a millennial, it may also save you money on a policy in the long run. It is especially important if you have children. Life insurance can help your family cover unexpected costs in your absence. If you have children, a life insurance policy can support their education or child care expenses.
  5. Consult an independent broker or agent- Talking with an independent insurance agent is the first step in finding the coverage you need and can afford. An independent broker works with multiple providers and can help you navigate the different policies and coverage. They can also help explain some of the terms and conditions that may be difficult to understand.

 

Health Insurance Guide For The Self-Employed

Tip 5, The Singles Mom’s Guide to Health Insurance

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Beware anything that looks too good to be true!

 

Yes, your parents were actually right on this one.

Insurance is just math. If it’s cheaper, there is a reason. I have found that most of the time those reasons look like limits on care.

For example, many “cheaper” policies limit cancer coverage to $500,000. Sorry, but many
forms of cancer can eat that up in a month or less. In those types of plans, you would be
left holding the bag on the remaining cost of treatment, or WORSE, having the hospital or
physician refuse to treat you.

If you are looking at insurance options and one is much cheaper than the others, find out
why before you sign up! They often have clauses that lock you in for a year or may not be
qualified coverage so you can’t get in through the marketplace. It may be cheaper because
it excludes something you don’t care about (like maternity when you are done having kids),
but you need to read the fine print. And I mean the 130+ page document that outlines
everything.

Or ask a knowledgeable local agent who has probably read the contract for fun,
like the insurance nerds we often are.

 

To download the entire guide, click here. 

Improve Your Employees’ Health

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We are excited to offer  Engage Wellness to enhance health insurance plans you are already offering.

 

Engage Wellness is a great way for businesses with group health plans to save money through tax savings while gaining healthier employees through benefits like:

 

 

If you already offer health insurance, there will be no out of pocket expense and will actually lower your benefit costs without changing your plan.

Contact us at 801-901-7800 to learn more!

Don't lose your health insurance.

Did you lose your job? Don’t lose your health insurance.

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Don't lose your health insurance.

If you lose your job you need to act fast to get the insurance figured out.

There are multiple options for people who have recently lost insurance, but you only have 60 days to enroll through the federal exchange.

COBRA may not be the only option and you may even qualify for Medicaid.

Let us help you navigate the options.

If you’ve recently lost your health insurance (or are in danger of losing your insurance) due to a layoff or job loss, we can help.

Please give us a call or complete the form below and we’ll get back to you within 4 hours (Mon.-Fri. 9am-5pm) for a phone consultation.

Tip # 3 From the Single Mom’s Guide to Health Insurance- Look at your income and cash flow situation.

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There are two basic types of plans.

Traditional plans, which often have low copayments for regular visits, and High Deductible health plans.

Traditional plans are what many people used before healthcare reform. They had copayments
(a small amount due at the time of service) for regular Dr. visits and medications. They have
a deductible and coinsurance for unusual things like MRI’s, CT Scans, and hospital visits.

These plans tend to be more expensive every month, but generally require a smaller portion
to be paid by you when a claim happens.

High Deductible health plans are paired with a tax-protected savings account called a Health
Savings Account or HSA. These plans require that your deductible come first unless it is a
preventive service.

 

To download the complete guide, click here.