Tag Archive for: health insurance coverage

Offering Health Insurance is Good Way to Attract Millennials as Employees

 

A survey conducted by Anthem Life Insurance Company suggests that one in three millennial workers turned down a prospective job offer either due to insufficient health insurance coverage or none being offered at all.

 

As more millennials are entering marriage and purchasing homes, etc., concerns are shifting. Disability coverage is now part of the conversation and if employers are not offering it, many potential workers will keep walking. In addition, as millennials begin to start families, health insurance coverage, beyond the basics, is also important. Protecting themselves and their families become the forefront. Vision and dental are no longer looked at as optional add-ons, employees want to know they will have the coverage they need, or a loved might need to ensure peace of mind.

 

The Anthem survey also found that millennials are more likely than older workers to have engaged in long-term financial planning over the past year. Twenty-nine percent of millennials responded that they have conducted long-term financial planning, compared to 19% of 35 to 54-year-olds. (Anthem Life Insurance Company, March 2017)

 

Take a look at your providers

Tip #2 from “The Single Mom’s Guide to Health Insurance” – Take a look at your providers

Take a look at your providers
Do you always go to the same pediatrician? Is your nearest hospital your favorite? Make a list of all the providers you have seen over the last year, and add in any others that you plan to see in the next year. Either you, or your agent, will want to run this list through any potential insurance carriers to make sure you can still access your favorite providers.

To get the entire guide for free, click here.

 

If you need any help getting health insurance or if you have any questions, please reach out to us at 801-901-7800.

You may qualify for health insurance assistance

Below is the table that the federal government uses to determine health insurance assistance.

If your income falls between 135% and 400% of the federal poverty level for your family size you may qualify for assistance with your premiums.

Understanding CHIP

The Children’s Health Insurance Program (CHIP) provides low-cost insurance converge to children in families who earn too much money to qualify for state Medicaid. If your child(ren) are eligible for CHIP, you do not have to purchase an insurance plan to cover them. Each state has its own rules and guidelines, but the CHIP program works closely with the state’s Medicaid program.

The funding for the program expired on September 30 and in recent actions by Congress, short-term funding for CHIP will again expire at the end of January. A new budget was proposed last week.

“The Congressional Budget Office says a Senate bill adding five years of financing to the program would cost $800 million. Previously, the analysts estimated it would cost $8.2 billion.” –Associated Press

What CHIP covers.

CHIP benefits are different in each state. But all states provide comprehensive coverage, including:

  • Routine check-ups
  • Immunizations
  • Doctor visits
  • Prescriptions
  • Dental and vision care
  • Inpatient and outpatient hospital care
  • Laboratory and X-ray services
  • Emergency services

There is no cost for routine ‘well-child’ doctor and dental visits under CHIP. However, there may be co-payments for other services. In addition, some states charge a monthly premium for CHIP coverage but you will never pay more than 5% of your families’ yearly income.

 

Common Health Insurance Terms

Common Health Insurance Terms

Common Health Insurance Terms

We understand that navigating the insurance maze can be daunting. Insurance companies use terms like, “Copay” and “Out of Pocket” and sometimes their terms can seem like a foreign language. Here are some of the most common terms you may hear and what they mean.

 

Insurance Premium– This is the cost of your plan, the monthly bill you, or your employer, pays for insurance coverage.

 

Deductible-This is the amount you pay BEFORE your insurance plan kicks and pays for certain services.

 

Copay– This is the upfront fee you pay to your doctor for services and office visits. This also applies to some medications.

 

Coinsurance– This is the amount you pay for services after your deductible has been met.

 

Total Member Responsibility-The amount that you owe for services AFTER your insurance plan has paid their portion. This can include deductibles, copays and coinsurance.

 

Out of Pocket Maximum– This the MOST you will be required to pay towards your deductible, copays and coinsurance. When you meet the Out of Pocket Maximum, all eligible charges for medical services are covered at 100% for the rest of the year.

 

Have questions? Give us a call!

Recent Study Looks At Health Care Pricing

According to a recently published healthcare economics paper, different insurers pay varied prices for the same services and procedures at the same hospital, indicating that bargaining leverage really does impact healthcare prices.

 

Authors took actual data from claims for three national insurers. Studies showed that dominate hospitals can dictate how much they are going to get paid for specific services and procedures. For hospitals that hold an monopoly in their area, that number was 12.5% higher than those who had nearby competitors. For more concentrated markets, providers can shift more risk to insurers, which affects the ability to keep prices at a set standard.

 

“The two main types of contracts use prospectively set prices that pay a fixed dollar amount based on the DRG classification code, or a model that sets payments as a percentage of hospital charges.
Hospitals are likely to prefer the latter because they get paid for every service they provide, and thus bear less risk. This drives prices up and also places less pressure on the hospital to reduce costs.”

 

In simply terms, it’s about negotiation. The hospital may charge $50,000 for a hip replacement, but the negotiated price may be more like $22,000, Medicare reimbursements would be even less.

 

“Researchers also found that prices increased by more than 6% when merging hospitals were less than 5 miles apart. They didn’t find significant price impact when the hospitals were separated by at least 25 miles.”

 

 

 

 

Sources: The Price Ain’t Right? Hospital Prices and Health Spending on the Privately Insured Zack Cooper (Yale University) Stuart V. Craig (University of Pennsylvania) Martin Gaynor (Carnegie Mellon University and NBER) John Van Reenen (Massachusetts Institute of Technology, CEP, and NBER)

Modernhealthcare.com

Health Care Cost Institute

 

 

Understanding Mini-Medical Plans

Many industries or small sized employer groups utilize a mini-medical plan, such as restaurants, hotels, maid services, catering services, etc. These limited benefit plans pay for covered services at an affordable premium for both the employees and the employers. But keep in mind, they cost less, so they cover less, and most likely will not protect you from a bankruptcy situation for any catastrophic medical care.

Mini-medical plans provide a basic level of coverage for people who do not have access to a major medical plan or traditional coverage.

Some large employers have a class of employees who are ineligible for their companies traditional health insurance plan for a variety of reasons. For instance, they may be only seasonal or part-time employees. Being able to offer them a mini-medical plan helps to boast employee moral and increases retention.

Mini-medical plans are not meant to replace major medical plans, but to fill a specific niche and provide some medical coverage for those who may not qualify otherwise.