QetHara.com

Posts Tagged ‘Health Insurance’

When it comes to health coverage these days, we sure have a lot of various options to choose from. One of such options, which has become quite popular lately are Point Of Service (POS) plans that can be viewed as a mix of traditional indemnity and modern managed coverage options. And what such a combination provides you with are money saving potential and flexibility, all in a single package.

Health coverage on two levels at once

People familiar with HMO plans can easily see the similarity between HMOs and PPOs when it comes to organizing the services. Here you are also required to choose a PCP (Primary Care Physician), who will coordinate your services and provide referrals to other specialists within the network when required. But you are also free to choose any facility or physician that doesn’t make a part of the specified network. And a POS plan will pay for such services out of the network, however to a narrower extent than with in-network services. So it will still cost you less to get your services within the POS network. Read the rest of this entry »

When time comes for deciding which type of health insurance coverage is most appropriate for your family there are many options you can choose from. And one of the most influential factors here is whether your employer provides you with a group coverage plan or not. In case your employer offers you family coverage through a group plan, you should think well about whether you want to apply for this group plan or get a separate policy for your family. In case there is no group health insurance coverage offered by your employer, you will have to search for a provider on your own, analyzing all the options in order to determine which plan and insurance company will cover your family insurance needs to the right extent.

In general, family insurance plans are individual health insurance policies that allow the policy-holder’s family to be included in it as well. A great number of employers instead of providing group coverage, offer their workers individual plans with including possibilities if they have any family members they want to add. The federal law also restricts the insurance companies from excluding family members with pre-existing conditions from group plans. And in most cases, the employer will pay a part of the worker’s yearly premium. This of course makes family health insurance less costly for an individual’s family budget. Still, if you lose the job your insurance coverage will also be taken away.

When speaking of individual plans, we speak about the health insurance plans you buy directly from a provider. Such plans provide a high degree of freedom, as you can freely choose the company to buy from or the type of coverage you want in your policy or not. In most cases, however, the coverage provided by individual plans will be somewhat inferior to the extents you get with a group plan, still if there’s no other option you can choose a plan that will meet your exact requirements. Keep in mind that in many cases individual health insurance plans won’t allow you to include family your members with pre-existing conditions. Read the rest of this entry »

Small business owners are constantly looking for ways to cut their costs and when it comes to insuring own employees there are certain alternatives to traditional group plans that may be quite costly for small enterprises. The two most common alternatives are purchasing alliances and association plans. The first are generally nonprofit organizations with private ownership that connect more small enterprises for purchasing group plans as a whole.

The concept behind this is quite obvious: the more the better. Because there are many people involved in insurance purchasing pools they usually have better rates and stronger negotiation abilities. There are pools allowing individuals to join, however in most cases they serve only small enterprises with 2 to 50 workers. Such pools have more attractive rates and premiums for their members if compared to typical group plans because the total number of underwriters can sometimes be of a big international corporation. So yes, size does matter.

Insurance purchasing alliances usually involve three parties:

1. Alliance company. Purchasing alliances are usually private companies by the form of ownership, which acts in the interest of smaller enterprises participating in the pool. The company is responsible for rules and regulations, requirements for new members and their eligibility. It is also the party responsible for negotiation the rates and premiums with the insurance provider. Quite often a local state agency or chamber of commerce works as an alliance company.

2. Health insurance providers. The alliance companies contact insurance companies for providing their members with coverage. Sometimes the company will contact several insurance providers to offer their pool members wider selection of plans and better coverage rates. Quite often you can find HMOs, PPOs, and POSs with the same alliance company but provided by numerous insurers. Read the rest of this entry »

Washington likes acronyms when it comes to lawmaking and this new law is no exception. This is the Genetic Information Nondiscrimination Act (GINA) and this November sees it finally come into force. Because it affects both employers and the insurance industry, this has been a hard-fought change and was only signed into law last year. Now it should prevent you from obvious discrimination. Sadly, it does not rule out discrimination by backdoor means. If an employer overhears you talking at the water cooler or routinely surveys local news including the obituaries, it is legal to use this information. But, overall, you should find some improvement. It covers two different situations with the same type of result. Firstly, it prohibits employers from asking you to go through a genetic test or making genetic information the basis of deciding whether to hire, promote or fire you. Secondly, it prohibits insurers from testing or demanding genetic information about you or your family in deciding whether to offer you coverage, in setting the premium rate and level of the deductible, or continue the cover.

Let’s be completely clear. The law does not care who is asking for the information If it is going to be used for either purpose, the asking is unlawful. If this happens to you in an interview, it may pose a dilemma. If you cite the law and refuse to answer, the interviewer may think you a troublemaker with something to hide and not hire you. That you can complain to the local Department of Labor and take satisfaction in seeing a civil penalty imposed, this does not replace the offer of employment in these difficult economic times. The temptation to answer will be strong. But when it comes to insurance companies, you must stand up and assert your rights. If the insurer persists, report to your state’s Department of Insurance. This will put the insurers at risk of losing their license to sell policies in your state. This is a big stick to wave in defense of your rights. More importantly, the Department can order the insurers to offer you insurance on regular terms which protects you. Once employed, it’s just as important to stay alert. The operators of group health plans are known to offer incentives like lower premiums to employees who answer a questionnaire including questions about their family medical history. Obviously, insurers want to know if there is a risk of serious diseases like cancer. You might be more at risk if there is a history of cancer in your family. Everyone should refuse to answer. Read the rest of this entry »