Are health screenings free once you’re over the age of 50? I have health insurance, I’m 52 and I was billed for my last colonoscopy.
Answer:
All ACA plans have built in benefits including colorectal cancer screening for adults over 50.
If you received your colonoscopy from an in-network physician, it should have been included in your plan.
All health insurance plans regulated by the Affordable Care Act, by law must provide patients with preventive services such as vaccinations and routine screenings—without charging you a copayment or coinsurance. This is true even if you haven’t met your yearly deductible.
Please keep in mind these services must be performed by a doctor or other provider in your plan’s network. If you are unsure if a doctor or hospital you plan to visit in the future is covered in network or not click here.
Complete list of preventative care benefits and services for adults (services vary for women and children):
Abdominal aortic aneurysm one-time screening for men of specified ages who have ever smoked
Alcohol misuse screening and counseling
Aspirin use to prevent cardiovascular disease for men and women of certain ages
Blood pressure screening
Cholesterol screening for adults of certain ages or at higher risk
Colorectal cancer screening for adults over 50
Depression screening
Diabetes (Type 2) screening for adults with high blood pressure
Diet counseling for adults at higher risk for chronic disease
Hepatitis B screening
Hepatitis C screening for adults at increased risk, and one time for everyone born 1945 – 1965
HIV screening for everyone ages 15 to 65, and other ages at increased risk
Immunization vaccines for adults—doses, recommended ages, and recommended populations vary:
Diphtheria
Hepatitis A
Hepatitis B
Herpes Zoster
Human Papillomavirus (HPV)
Influenza (flu shot)
Measles
Meningococcal
Mumps
Pertussis
Pneumococcal
Rubella
Tetanus
Varicella (Chickenpox)
Lung cancer screening
Obesity screening and counseling
Sexually transmitted infection (STI) prevention counseling for adults at higher risk
Syphilis screening for adults at higher risk
Tobacco Use screening for all adults and cessation interventions for tobacco users
I'm switching jobs and will be without health insurance for a month. I can elect COBRA but it's $700 a month.
Question:
I am looking for temporary coverage while I’m switching jobs. I do not want to be without health insurance for an entire month but COBRA is just too expensive. Are there cheaper coverage options?
Answer:
Consider short term health insurance.
It’s a convenient alternative to COBRA—with lower monthly premiums and next day enrollment, you can fill out a form today and have a policy in your name by tomorrow.
On average, short term health insurance is less than half the price of major medical. A family of 6 can elect short term for as little as $400 dollars a month.
Short term it is meant to cover those with a temporary gap in coverage or in times of transition for up to 6 months:
In-between jobs
In need of a low-cost alternative to COBRA
New hire waiting on group coverage to kick in
Not quite eligible for Medicare—almost 65
No longer on parent’s policy—recently turned 26
Waiting for approval of major medical coverage
Uninsured and don’t have a Qualifying Life Event
Keep in mind most short term policies are medically underwritten so unlike qualified health plans you can be denied coverage if you have a pre-existing condition.
For example: If you are asthmatic and you are hospitalized for an asthma attack. This policy will not cover your claim.
Petersen International is the only carrier that is guaranteed issue, meaning they cover pre-existing conditions.
I’m an Illinois resident but I travel to Florida every winter. Is there a health insurance plan that would cover me in multiple states?
Answer:
We typically recommend you purchase a permanent policy in the state you reside in for 6 months or more a year.
In the state of Illinois, the Blue Choice Preferred PPO is the only option that allows you to receive necessary medical care across state lines with the BlueCard.
What’s Not Covered:
Prescription Drugs
Elective surgeries
Hearing/Vision
Dental (non-surgical)
Federal Employee Program (FEP)
What’s Not Covered:
All inpatient, outpatient and professional services
Thinking about Medicare? Chances are, if you’re nearing the age of 65, you know you’ve got to put some effort into learning about and making the right choices when it comes to your Medicare coverage. And if you’re already receiving benefits through an employer, you might want to take a look at Medicare coverage as a viable option.
Making smart choices when it comes to Medicare will provide you with reliable health coverage, but we understand – learning about your options can seem overwhelming. We’ve prepared this guide to help explain how Medicare works and provide you with the information you need in order to make decisions about the coverage options available to you.
What is Medicare?
If you’re like most people, you’ve got a vague idea of what Medicare is, but if pressed, you might not be able to define it.
Put quite simply, Medicare is a national social health insurance program administered by the U.S. government for citizens age 65 or older. If you’ve paid into the system, you’re eligible to participate in the program and receive benefits.
Medicare benefits are also available to peopleunder the age of 65 with certain disabilities.
Medicare doesn’t automatically cover all of your expenses, however, so you need to purchase supplemental insurance to cover medical expenses that are not automatically paid for by Medicare
Medicare is overseen by a governing body called the Centers for Medicare and Medicaid Studies, or CMS. CMS is responsible for making sure that those who are eligible for Medicare have access to the program and its benefits.
How does Medicare Work?
Now that we’ve given a brief overview of the program, let’s take a look at how it works. We’ll look at each Part to get a better idea of what’s covered.
Medicare Part A – Hospital
Medicare Part A covers hospital stays. There are a number of different types of hospital stays
that are covered. For example, you may be an inpatient at a hospital if you need surgery or have an illness. You might also require a stay at a rehabilitation center or skilled nursing facility, and some of those services are covered by Part A. Hospitals also offer extended care services such as home health care, which falls under Medicare Part A, as well as hospice care, which can take place on-site at a hospital or nursing facility, or at home.
Part A covers these services and more, although you are responsible for a large deductible.
The important thing to know is that Part A, while it is good coverage, comes with some substantial out-of-pocket costs.
Medicare Part B – Medical Coverage
Medicare Part B (sometimes called “doctor’s insurance”) covers doctor visits as well as a host of other services you would typically receive as an outpatient. Under Part B, you’ll pay a monthly premium (typically just over $120.00 per month) and you’ll have a deductible that you’ll need to meet before Part B provides any coverage.
t’s important to note that while it provides good coverage, Part B only pays for 80 percent of charges that are approved, and you are responsible for paying the remaining 20 percent of the approved amount.
Original Medicare
There have been some changes to Medicare over the years. Medicare Part A and Part B served as the original foundation for the Medicare program, but since these two programs launched, additional parts and have been added, such as Medicare Part C and Part D, which we’ll review next. Because Part A and Part B serve as the original core for the program, they have come to be known as ‘Original Medicare’. You must have Original Medicare in place as your foundational care before you can consider adding Part C, Part D or, as the next section discusses, a Medicare Supplement Plan. Keep this in mind as you read on.
Medicare Supplement Plan a.k.a. “Medigap Plan”
To provide yourself financial protection, you can choose to enroll in a Medicare Supplement policy, which is also called “Medigap” coverage. Medigap is a health insurance policy that you purchase from a private insurance company to pay the health care costs that are not covered by Original Medicare (remember those deductibles and coinsurance amounts you are responsible for paying under Part A and Part B?).
How Medigap Works
Purchasing a Medicare Supplement plan does not replace your Original Medicare coverage – it simply serves as a supplement to help cover all or some of the costs that Original Medicare doesn’t cover.
If you opt into a Medigap plan, you won’t have to stick to certain networks or get referrals for care as you might with Medicare Part C. All providers who accept Medicare will also accept your Medicare Supplement plan – the good news is that more than 90 percent of physicians nationally accept Medicare.
So, the combination of Original Medicare and Medigap Insurance means that you get help making up for that 20 percent that’s not paid by Original Medicare. Depending on the plan you select (there are many types of Medigap plans available), you may be responsible for no or very little out-of-pocket cost, although each plan comes with a monthly premium that must be paid to retain the coverage.
What you need to know about Original Medicare + Medigap
So, let’s review the main points so far. These are the things you’ll want to consider as you look at the Original Medicare + Medigap option:
Combining Medicare Part A and Part B and supplementing with a Medicare Supplement/ Medigap is a lot like buying insurance in chunks and gives you options to consider when you’re looking at factors such as cost, coverage, a choice of doctors and hospitals, and some additional coverages or services. Now, let’s review Medicare Part C.
Medicare Part C – Medicare Advantage Plans
Medicare Part C plans are also known as Medicare Advantage Plans. You can opt into a Medicare Part C/Medicare Advantage plan instead of the Medigap option described in the previous section.
You get all of the same coverage that is provided with Parts A and B (and in most cases, prescription drug coverage as well) and, in fact, Part C/Medicare Advantage plans typically include additional benefits-dental, vision or hearing benefits, for example.
What’s the difference? Under a Medicare
Part C/Medicare Advantage Plan, private companies are contracted with Medicare to offer the benefits of Part A, Part B, and sometimes Part D and other benefits. It’s important to know that with this option, there is a network of doctors and hospitals that the plan provides for your care.
Medicare Part C/Medicare Advantage plans are often less expensive than a Medicare Supplement/Medigap Plan. In fact, some plans offer a $0 or low monthly premium, although you still need to continue to pay your Medicare Part B premium. Additionally, depending on where you live, you may not have access to this option as Medicare Part C/Medicare Advantage plans are available only in certain geographic areas.
Doctors and hospitals are reimbursed directly from the insurance company that issues the Part C/Medicare Advantage plan. You get all of the same coverage that is provided with Parts A and B (and in most cases, prescription drug coverage as well) and, in fact, Part C/ Medicare Advantage plans typically include additional benefits-dental, vision or hearing benefits, for example.
Medicare Part D – Prescription Drug Coverage
Prescription drug coverage is an important aspect of the Medicare system. While exact coverage and costs are different for each Medicare Part D plan, all plans must offer at least a standard level of coverage that is defined by Medicare.
Note that not all drugs are covered by Part D, so it’s important to confirm that your prescriptions are part of the formulary (list of drugs) for the plan you have chosen prior to enrollment. You can purchase a stand-alone plan, and some Medicare Advantage plans offer built-in prescription drug coverage.
Enrolling in Medicare
Now that you understand your options, you may need to complete some additional research to find out which plan is right for you. Here’s what you need to know about enrollment.
First, there are three types of enrollment periods:
Initial Enrollment Period
The Initial Enrollment Period, or the IEP, is when you first become eligible for Medicare. You qualify for the IEP when you turn 65, or 24 months after being deemed disabled by Social Security.
If you’re enrolling in Medicare for the first time because you’re turning 65, the following chart shows you the enrollment period that surrounds a June birthday. You can enroll in Medicare during a 6-month window of time surrounding your birthday month. For many, this can be a very busy time with lots of decisions to make regarding retirement and a host of other issues, so be prepared and mark deadlines on your calendar so you don’t forget them.
The IEP is your chance to establish your coverage. As your friends and colleagues may tell you, it’s important to make good choices about your coverage, so it really is worth your while to think ahead and explore your options to make sure you can have the type of coverage that’s important to you – and that makes the most sense for your lifestyle and your budget.
Don’t worry, you can update your options annually if you want to, but typically, you’ll have to qualify for a Special Enrollment Period or wait for the next Open Enrollment Period after your IEP.
Special Enrollment Period
There are a number of factors that qualify you for a Special Enrollment Period (SEP).
Annual Enrollment Period
The Annual Enrollment Period (AEP) happens at the end of each calendar year and represents the period of time when you can change or update your coverage. Enrollment dates are October 15 – December 7 of each year. During this time period, all Medicare beneficiaries can enroll in a new plan, switch current plans, or drop their plans.
Making the Best Choice for You
As you can see, there is a lot to consider when selecting your Medicare options. Take some time to review your options by visiting our website where you’ll find additional information and detail about your Medicare options, or call us directly. We have trained staff who can answer your question and assist you with additional details about your coverage options.
I’m having surgery and my doctor says it will take me over a month to recover. I currently have health insurance through my employer and only 6 sick days remaining for the year. I can’t afford to lose a month’s worth of paychecks. How do other people afford to take off work when they have a serious injury?
Answer:
Does your employer offer short term disability insurance?
Short-term disability is basically protection for your paycheck. It’s designed for situations exactly like yours.
People hear disability and they think permanent, but a disability can be anything that leaves you unable to work for longer than your allotted sick days allow. So in the event something happens that leaves you unable to work, you continue to get paid until you are healthy enough to return to work.
Short-term disability protects your paycheck and allows you to maintain your standard of living when you become disabled for up to six months. The benefits will replace a portion of your salary if you’re out of work due to a qualified illness or injury such as your surgery.
You’ve already elected a plan for 2017—but you’re not covered yet. Understanding the cost of visiting a doctor out-of-network will save you thousands of dollars this year. Avoid the unnecessary stress of filing claims and know what doctors are participating in your network.
Start with the Network
Most health insurance plans are going to have a group of physicians and hospitals that they are contracted with. Typically doctors are affiliated with a specific hospital. For those of us who have a hospital preference, pin pointing these hospital affiliations is a good way to narrow down your search. The best way to prevent having unexpected health care costs is to check which doctors are covered in your plan’s network. Carriers will cover a larger percentage of the costs when visiting a physician or hospital that is in-network, and will cover much less (sometimes nothing) if the doctor is out-of-network.
Note: Visiting an in-network hospital or other medical facility does not guarantee every practicing physician within that facility is contracted with your plan. It’s always good to get a second opinion in medicine, and it’s always good to double check who is in-network and who is not.
Contact your Doctor’s Office
It’s always good to get a second opinion. Call your doctor and ask for the office manager—they have access to the updated list of insurance plans your doctor is accepting this year. When looking for a new doctor they are also the ones who can tell you if that doctor is accepting new patients. Deciding on a doctor can seem like a daunting decision. Remember, you’re never locked in. Patients change doctors every day and that’s okay.
Many people go out of network by accident.
For example: Your Primary Care Physician might refer you to an out-of-network specialist. Unless this is the only specialist who can treat you, kindly ask your PCP to refer you to in-network specialist only.
Rather than relying on a broad search engine or crossing your fingers. Allow us to point you in the right direction.
Step by Step Guide to help you search for In-Network Doctors and Specialists
Under “Links and Tools” (top right of page) select “Find Physician, Laboratory or Facility”
Choose a type of plan—select “All UnitedHealthcare Plans”
To find the plan you are looking for, check the bottom right corner of your member ID card
Enter your zip code for closest proximity or city and state of your choice (you can search as close as 1 mile and as far as 100 miles away from your zip code—depending how far you are willing to travel)
If you know the name of the doctor you’re looking for—great. If not start by selecting a category: Primary Care Physician, Generalist, Internist
Filter further by ranking, alphabetical order or price range
“Select from the list below” and choose your desired network
To locate hospitals close to home—first enter you zip code then select Provider Type to “Hospital or other Facility” and Provider Specialty as “General Acute Care Hospital”
To locate a specific doctor—enter your doctors name, zip and “Results Within”. If you do not have a specific doctor, leave that section blank and search doctors within the designated city or zip
Change is inevitable—and with health insurance it’s become predictable.
For the first few years after the Affordable Care Act was implemented, it was more cost effective to give your employees dollars to shop individual health insurance exchanges instead of offering employer sponsored health insurance. There were multiple carrier options to choose from, plans were lower in cost and individuals were potentially eligible for a subsidy meaning the government would pay a portion of their plan so their employer didn’t have to. There was an ease of employer administration. Employers would hand their employees money and the weight was off their shoulders. The benefit of these individual health insurance exchanges was unbeatable—until the insurance carriers no longer benefited.
Many carriers weren’t able to sustain a consistent cash flow this way and quickly went out of business. This year in the state of Illinois, Land of Lincoln Health was forced to close its doors for this very reason. Other carriers like United Healthcare simply did not have a product offering for individuals but are still successful in the group health insurance market (i.e. employer sponsored health plans).
The Shift Back to Group
The shift has gone back in favor of group health insurance for the following reasons:
Limited carriers in the individual market,
Of the participating carriers, very limited plan options,
In Illinois, Blue Cross Blue Shield is only one carrier in the individual market that is offering access to a PPO and it is a narrowed network,
Of plan options available, extremely restricted access.
Certain hospitals and doctors will not be available to you,
For example, Blue Cross Blue Shield of Illinois does not offer coverage at major teaching hospitals in the Chicagoland area such as Rush University
By law, individual premiums must be paid for with post tax dollars, making individual monthly premiums more expensive.
Carriers filed for up to a 50% rate increase in 2017.
On the other hand, Group Health insurance allows employees to pay for premiums with pre-tax dollars, direct from their paychecks before they are taxed.
Overall, individual plans versus plans that are run through a business are just not as accessible today. Our advice is to get onto group coverage or (if you are in a position to) offer an employer sponsored health plan to your employees.
Large Group vs Small Group
A large group is defined as greater than 50 employees. For small groups made up of less than 50 employees—rates are based on age similar to individuals. Groups 50+ use a tiered rating system with 4 tiers:
Single rate
Family rate
Employee spouse rate
21-65 rate
Numbers are factored into blended rates based on medical history of the company. If you have someone on staff who is very ill—they will drive up everyone else’s rates. 50 + is also not guaranteed issue as it is in the small group market. Carriers can rate up more than in small groups or even decline the whole company. Pre Affordable Care Act even 2 life groups were medically underwritten—they wouldn’t decline you but they would max rate you at extremely high premiums.
There are lots of buzz words and terminology associated with the Affordable Care Act (ACA). One of the most common questions asked when shopping for health insurance is “where do I shop for plans?”, “should I shop on-exchange or off-exchange?”, and really, “what’s the difference?”
Here we will uncover the common misconceptions about on-exchange and off-exchange plans and guide you on how to make the best decision when shopping for health insurance.
Before shopping for health insurance, first ask yourself: do I qualify for financial assistance? The answer to this question will direct you to the appropriate insurance plans — on-exchange or off-exchange.
Exploring On-Exchange and Off-Exchange Health Insurance
When you’re shopping for health insurance, you’ll often come across the terms “on-exchange” and “off-exchange.” Understanding the difference between on and off exchange is crucial for making an informed decision. On-exchange plans are available through government-sponsored platforms and may offer financial assistance. Off-exchange plans, on the other hand, provide more flexibility but don’t come with subsidy options. Your choice will depend on your financial situation, healthcare needs, and eligibility for subsidies.
What is a Health Insurance Exchange?
A health insurance exchange is an online portal containing information, plan choices and enrollment capability for health insurance. There are two main types of exchanges — public and private. A public exchange is sponsored and run by a government entity, such as healthcare.gov. A private exchange is sponsored and run by a private entity or business, such as IXSolutions.
No matter which exchange you choose, the prices of health insurance will always be the same. The main difference is accessing financial assistance.
On-Exchange vs Off-Exchange
Understanding the nuances between on-exchange and off-exchange health insurance plans is essential for making an informed decision. Here, we break down the key differences:
Financial Assistance
On-Exchange: One of the most significant advantages of on-exchange plans is the availability of financial assistance or subsidies. These subsidies are designed to make healthcare more affordable and are based on your annual household income and family size. If you qualify, these financial aids can substantially reduce your monthly premiums and out-of-pocket expenses.
Off-Exchange: Off-exchange plans do not offer the option for financial assistance or subsidies. Therefore, these plans may be more expensive in terms of monthly premiums, especially if you don’t qualify for any form of financial aid.
Plan Choices
On-Exchange: The range of plan choices on public exchanges is generally limited to those that meet ACA standards. While this ensures a certain level of quality and coverage, it may not offer the specialized plans some individuals might need.
Off-Exchange: One of the primary benefits of off-exchange plans is the broader range of options available. These plans can include specialized coverage options that are not typically available on public exchanges, giving you more flexibility to choose a plan that fits your specific needs.
Regulations
On-Exchange: All plans available on public exchanges are required to be ACA-compliant. This means they must offer a set of essential health benefits, including preventive services, emergency services, and prescription drug coverage, among others.
Off-Exchange: While many off-exchange plans are ACA-compliant, some may not meet these standards. It’s crucial to carefully review any off-exchange plan to ensure it provides the level of coverage you need.
Benefits of Shopping On-Exchange
Opting for an on-exchange health insurance plan comes with several advantages that can make it an appealing choice for many individuals. Here are some key benefits:
Financial Assistance
Subsidies: One of the most compelling reasons to shop on-exchange is the availability of financial subsidies. These are income-based and can significantly reduce your monthly premiums.
Cost-Sharing Reductions: In addition to subsidies, some individuals may qualify for cost-sharing reductions, which lower the amount you have to pay for out-of-pocket expenses like copayments and deductibles.
ACA-Compliant Plans
Standardized Coverage: All on-exchange plans are required to meet the standards set by the Affordable Care Act (ACA). This ensures that you receive a comprehensive set of essential health benefits, including preventive care, emergency services, and more.
Quality Assurance: The ACA compliance also means that the plans have passed stringent quality checks, ensuring that you’re not just buying insurance but investing in your health.
Simplified Shopping Experience
One-Stop-Shop: Public exchanges offer a centralized platform where you can compare different plans, making it easier to find one that suits your needs and budget.
Transparency: On-exchange platforms are designed to be user-friendly, offering transparent information on plan features, costs, and provider networks.
By understanding these benefits, you can make a more informed decision when shopping for health insurance, ensuring that you choose a plan that aligns with your financial and healthcare needs.
Choosing an off-exchange health insurance plan also comes with its own set of benefits that can make it an attractive option for certain individuals.
Here are some of the key advantages:
Greater Plan Variety
Specialized Coverage: Off-exchange plans often offer specialized coverage options that you may not find on public exchanges. This allows you to tailor your insurance to meet specific healthcare needs.
Wider Network: Off-exchange plans may offer a broader range of healthcare providers, giving you more choices when it comes to selecting doctors and specialists.
Flexibility
Enrollment Periods: Unlike on-exchange plans, which have strict enrollment windows, some off-exchange plans allow you to enroll at any time of the year.
Customization: Many off-exchange plans offer the flexibility to customize your coverage, including the types of services covered and the level of cost-sharing.
No Income Restrictions
No Subsidy Limits: Since off-exchange plans don’t offer financial assistance, there are no income restrictions. This can be advantageous for individuals who don’t qualify for subsidies but still want comprehensive coverage.
Premium Choices: Without the constraints of subsidies and income checks, you may find premium plans that offer extensive benefits and services not available on-exchange.
Understanding the advantages of getting off-exchange insurance can help you make a well-informed decision that best suits your healthcare needs and financial situation.
Whether you know it as Obamacare or the Affordable Care Act (ACA)—these names refer to the same thing. And contrary to what many people believe, the ACA does not mean free health care or government-provided health insurance. The ACA is a law that impacts everyone who utilizes healthcare today.
No one can be denied basic coverage.
Before the ACA, health insurance carriers could easily refuse coverage if they felt you were “at risk”. Either too old, too sick, overweight; or you suffer from what’s called a “pre-existing condition.” Not anymore. Carriers can no longer refuse to cover the sick or increase rates based on medical history.
You are legally required to have it.
Another big change brought on by the ACA is what’s called the Individual Mandate. This means that practically everyone is now legally required to have health insurance unless you’re one of the few who qualify for an exemption. Just like we need car insurance to be on the road, we now need to insure our health or pay a penalty to the Internal Revenue Service (IRS).
And there’s a timeline for getting it.
In order to get insured, we all need to purchase health insurance during the Open Enrollment Period. This year’s open enrollment period runs from November 1, 2018 – December 15, 2018.
Once open enrollment ends, we won’t be able to sign up for coverage for the rest of the year unless we experience a life changing event that effects our health care needs. The government refers to these as qualifying life events and include having a baby, getting married or a death in the family.
You may be eligible for government assistance.
To help make health insurance more affordable, the government now offers a way to get lower health care costs for those who qualify.
Depending on what you qualify for, you could receive special discounts on your monthly health insurance premium or the amount you pay when you visit your doctor’s office.
Insurance must cover basic health care needs.
The government has determined 10 basic categories that all insurance plans must now cover. They call these, the essential health benefits, and include things like doctor visits, hospitalizations and pediatric care. When we have health insurance, we’re now guaranteed care to treat and prevent illness or injury.
Essential benefits covered by every plan.
Obamacare requires every health plan sold in the insurance marketplaces to provide coverage for ten essential health benefits.
So, no matter what plan we choose, it’s guaranteed to cover:
Outpatient Care
Emergency Room Services
Hospitalization
Maternity & Newborn Care
Mental Health Services & Addiction Treatment
Prescription Medication
Laboratory Services
Preventive Care
Pediatric Care
It’s important to note that not this does not mean all of these services will now be completely free. Health insurance carriers aren’t required to take on the entire cost for these benefits. Rather, the carrier will pay a percentage of these costs. The percentage that is covered can vary from plan to plan.
As a small business owner, you may think group health insurance plans are only for large corporations. Or maybe you think they are more expensive and harder to administer than individual health insurance plans.
With current market conditions this is no longer the case. One benefit of the Affordable Care Act or Obamacare is the ability for small businesses to now offer coverage to their employees at an affordable cost.
Here are reasons to switch your business to a group plan today:
1. Greater Access to Doctors and Hospitals
Your employees are not limited by individual network coverage. Group means more carrier choices and more health plans available to your employees.
For example, national carrier United HealthCare is no longer participating in the individual market in Illinois, which means it is no longer an option to your employees unless you offer group coverage. The large PPO network that people love from Blue Cross Blue Shield of Illinois is not available in the individual market either, eliminating yet another option to your employees.
But in the Illinois group market, there are over 25 large PPO plans available from Blue Cross Blue Shield alone.
2. Pre-Taxed Dollars
When your employees shop individual health insurance they are spending more money by paying their premiums with post tax dollars.
When shopping group, your employees can pay their monthly premium with pre-tax dollars, meaning money is taken directly from their paycheck before tax deductions. That averages to about 22 percent savings.
3. Get Group Health Coverage In Less Than 48 Hours
In the small group space, medical underwriting is no longer necessary. So running a census is based off age not pre-existing medical conditions so the process is quicker for us and easier for you.
4. Lower Employee Turnover Rate
The highest sought out employee benefit is health insurance. Keep your valued employees satisfied and make health insurance available to them.
5. Cost Control
Control your contribution. The amount you give your employees toward their health insurance can be a set dollar amount. They pay up if they want a richer plan. You don’t budge.
6. Freedom of Choice
You no longer have to choose only one health plan for every employee. You decide what you’re willing to pay and your employees decide what health plan is best for their family’s needs. And yes, you can be enrolled in a different plan than your employees.
7. Smaller Annual Rate Increases
Due to the recent changes in the market, carriers submitted rate increases over 35 percent for individual health plans. Group health plans haven’t broke 11 percent in the past five years, making them more stable than individual health plans.
8. Year-Round Enrollment
You may enroll into a group health plan at any time during the year unlike individual health plans, which only allow you to make purchases during open enrollment period (OEP).
Remember, OEP only comes once a year. This year, OEP ran from November 1, 2016 to January 31, 2017. So if you are reading this now, OEP is already over.
9. Group Plans are Less Expensive
2017 will be the first year individual health plans cost more than group. The time to switch is now.
Setup a Group Health Plan
Getting a group plan can be affordable and simple to administer. One of our licensed agent can walk you through the steps and provide health insurance options for the leading carriers. Our service is available to you at no cost. Get started today.
