For most we start the new year with creating resolutions focused on improving ourselves. We hope you have had a productive first month so far! This February is the shortest month but the most important because it is American Heart Month. This issue includes:
- February: American Heart Month
- Quick Guide – Understanding Health Insurance Terms
- Digital Health Insurance ID Cards
- Your Primary Care Physician (PCP)
- Tips for Choosing Employer Group Insurance
- Turning 26 and aren’t on your parents health insurance anymore?
- Dental & Vision Coverage
- You Missed Open Enrollment – Now What?
- Special Enrollment Period for Medicare
- Life Insurance
February: American Heart Month
Heart disease is the leading cause of death for both men and women. To prevent heart disease and increase awareness of its effects, Keystone Advisors is proudly participating in American Heart Month.
Cardiovascular disease is the leading global cause of death, accounting for more than 17.9 million deaths per year in 2015, a number that is expected to grow to more than 23.6 million by 2030. Direct and indirect costs of total cardiovascular diseases and stroke are estimated to total more than $329.7 billion; that includes both health expenditures and lost productivity.
You can make healthy changes to lower your risk of developing heart disease. Controlling and preventing risk factors is also important for people who already have heart disease. To lower your risk:
Watch your weight.
Quit smoking and stay away from secondhand smoke.
Control your cholesterol and blood pressure.
If you drink alcohol, drink only in moderation.
Get active and eat healthy.
Even if you have no symptoms, you may still be at risk for heart disease. Those with a high risk of developing heart disease should speak with their doctor. Call us today at 866-469-4921 to find a doctor in your network.
Quick Guide – Understanding Health Insurance Terms
A recent survey identified four key health insurance terms necessary for a basic knowledge of healthcare: deductible, co-insurance, co-pay, and out-of-pocket maximum. It found that just 4% of Americans are able to correctly define all four terms.
Here are just a few terms that are important for you to comprehend the basics of your policy and navigate your way through health insurance benefits.
- Deductible – This is the amount you pay out-of-pocket for covered health care services before your health insurance provider begins to pay. It may take a few doctor’s visits before you meet your deductible.
- Copayment – A fixed amount you pay for a covered health care service each time you receive it. The amount can vary depending on the type of service. You often may hear this referred to as a co-pay.
- Coinsurance – Sometimes the cost for your medical services is shared between you and the health insurance company. Coinsurance is calculated as a percentage of the total cost you must pay above and beyond your copay. For example, you may be responsible for 20 percent of the cost, while the insurer covers the remaining 80 percent.
- Out-of-pocket maximum – This is the most you have to pay for covered services in a plan year. If your out-of-pocket max is $5,000, once you have spent $5,000 on deductibles, copayments, and coinsurance, your health plan will pay 100% of the remaining costs of covered benefits for the year.
Still have questions?
While these terms will get you started, there’s still a lot more to understand. Give us a call at 866-469-4921 and a licensed insurance agent can evaluate and explain your health insurance policy since they are not associated with one specific insurance carrier.
Digital Health Insurance ID Cards
Why go digital?
- Digital ID cards are accurate and up to date.
- They’re a more secure source of benefits information.
- Producing less plastic helps our environment.
How can I get a new ID card?
If you need a duplicate or additional ID card, you can view and print one within your secure member website. A digital or printed card is identical to a plastic ID card. If you’re having trouble, contact us and we can help.
You can change your PCP through your secure member website. You also can call the toll-free number on your ID card, and follow the menu options.What happens if my PCP leaves the network?
If your doctor leaves the network, you will need to select another participating provider. You can use the online directory of doctors and hospitals to find one.
If I am leaving my job, how do I find information on continuing my health insurance?
Contact your prior employer’s benefits office and tell them you’re interested in purchasing a COBRA policy. According to federal law, companies that employ more than 20 employees must make you aware of your options for purchasing this coverage.
Where can I get a summary of my benefits?
If you have insurance through your job or your spouse’s/partner’s job, the employer’s benefits office will give you a summary of your benefits.
Depending on your plan, you also may find the summary of benefits information on your secure member website. If neither of these options applies to you, please contact Member Services. A representative can send you a summary of benefits.
1. Your employee demographics
There are specific generational differences in preference when it comes to group benefits. Because of this, it’s important for you to take your employee demographics into account when shopping for a group benefits plan. For instance, does your company have a broad mix of age groups? If so, consider a plan that offers a healthy mix of dental, medical and paramedical benefits. Alternatively, if you happen to employ mostly millennials, you should look for a plan that offers more paramedical and lifestyle-related benefits.
The next factor you should consider when shopping around for a benefits plan is your budget. Some bare-bones plans may cost a mere $75 a month per employee, while others may cost upwards of $500 a month per employee. Think about how much you are willing to pay for employee group benefits and how much you can realistically afford.
One way to help narrow down which benefits you want to offer your employees is to consider the industry you operate in and think about what employees in that industry might find most useful. For instance, if you work in manual labor, such construction, you should offer long-term disability (LTD) coverage and short-term disability coverage (STD), as employees in this industry are more at an elevated risk of injuring themselves.
There are a number of areas you can offer coverage for in terms of group benefits for your employees. Typically, the types of insurance coverage you’ll find in any comprehensive benefits package will include life, AD&D, health, dental, short and long term disability, critical illness, and plenty of other optional benefits.
Now that you know the factors to consider when building or updating your company’s employee health benefits plan, you’re in a far better position to create a sustainable plan your employees will love and job candidates will vie for. If you have any questions about benefits plans or would like more information about the employer group plans we offer, give us a call at 972-441-7130.
What to do when you turn 26 and aren’t on your parents health insurance anymore?
Under the Affordable Care Act, young adults can choose to stay on their parents’ health insurance plan until they turn 26 — no ifs, ands or buts. That means you can stay on your parents’ plan whether or not you:
- Live with your parents
- Are claimed as a dependent on your parents’ taxes
- Have a full-time job
- Are eligible to enroll in your employer’s health plan
- Attend school
- Are married
Young adults who will age out of their parents’ healthcare plans can enroll in their own plans within the 60-day window before they turn 26 or the 60-day window after their birthday. When you’re ready to purchase your own health insurance, you have several options.
You can speak to someone in the human resources department about enrolling in a healthcare plan provided by your employer.
Your own individual plan in your state’s ACA marketplace or in the individual market. If you qualify for subsidies, then you should shop through the marketplace to obtain coverage.
Enroll on a health plan off the marketplace.
If you are married, to be placed on your spouse’s health plan. You must ask your spouse’s employer to add you to the plan within 30 days of your loss of coverage under your parent’s plan.
A final choice is buying a catastrophic plan, which is available to those under the age of 30.
Give us a call at 866-469-4921 to understand all of your options. Our enrollment specialists are here to assist you with plan and cost reviews.
- There are health insurance plans that include vision and/or dental benefits. These can be offered by an employer or purchased on your own.
- There are separate, standalone plans for vision or dental benefits that can be used on top of a health insurance plan as a form of supplemental insurance. There are even dental and vision insurance “packages” that offer benefits for both.
- Medicaid provides vision and dental benefits for children in all states. In some states, Medicaid also provides coverage for adults.
- Many Medicare Advantage plans include vision and dental benefits for seniors.
The most recent ACA Open Enrollment Period ended on December 15, 2018. A Special Enrollment Period (SEP) is a time outside of open enrollment in which your client can sign up for health coverage or apply for a different plan due to a qualifying life event. An SEP is available year-round for individuals who meet the criteria and apply within the event’s window.
Aliera Healthcare created the best of two medical care programs to provide healthcare solutions designed to reduce out-of-pocket expenses and improve individuals’ and families’ healthcare experiences.
3. Short-term Health Insurance Plans
Short Term Insurance is a fast, flexible and affordable coverage that allows a smooth transition to a longer-term insurance. With short term options, you can get coverage as soon as you fill your application. It is the most flexible way to get immediate coverage in situations where long term options are momentarily not available.
4. Find out if you qualify for small group coverage
Many people are surprised to learn that they qualify to enroll in a small business health plan. If you run your own business, work as a consultant or independent contractor, and have one or more employees who aren’t an immediate family member, you may be eligible for small group coverage.
Call us today 866-469-4921, a licensed agent can assist you with more information on your plan options.
Telemed allows you to receive care anytime from anywhere
Telehealth and telemedicine covered services depend on your health plan
Special Enrollment Period for Medicare
You can make changes to your Medicare Advantage and Medicare prescription drug coverage when certain events happen in your life, like if you move or you lose other insurance coverage. These chances to make changes are called Special Enrollment Periods (SEPs). Rules about when you can make changes and the type of changes you can make are different for each SEP.
- You change where you live
- You lose your current coverage
- You have a chance to get other coverage
- Your plan changes its contract with Medicare
- If you’d like to review all your Medicare options or would like to know if you’re eligible for Medicare coverage, give us a call at 866-469-4921.
Facing the subject of life insurance is difficult, which is why most people put it off or avoid it entirely. But the reality is that someone close to you will suffer financially when you pass away. Whether it is a member of your close family – spouse, children, and aging parents – or people closely related to you, like business partners or employees. Forgoing the opportunity to prevent those closest to you the suffering of dealing with the hardships that come with such difficult situation is not a mistake you can fix once you are gone. The only chance you have to make sure they are well taken care of is to act while you still can do something about it.
There are several considerations that come into play when choosing, and we make sure you are aware of them. The two primary considerations to have here are the length of the coverage and the budget you have available to cover it. Knowing how long you need the insurance helps you decide if you need term insurance, which lasts for a specified period; or permanent insurance – which is a lifelong coverage. Both have their advantages and disadvantages.
Call us today 866-469-4921, and agent can assist you with more information on life insurance plans.