Watch this link for an idea on why healthcare is so expensive and what we can do to control it.
http://www.youtube.com/watch?v=JYC2DJWU41s
Showing posts with label affordable health care. Show all posts
Showing posts with label affordable health care. Show all posts
Monday, February 9, 2009
Monday, February 2, 2009
Rising Cost of Insurance
http://docs.google.com/Presentation?id=dfk9fpgn_5gv7j35dn
This link will take you to a Google document presentation by Partners Insurance out of Arkansas. Please note the focus is on wellness and claims errors.
I believe that a shift to the consumer driven/one deductible plans will encourage the insured to monitor their costs and their bills. Once we take the waste out of the health delivery system we can start to control costs and, therefore, premium.
This link will take you to a Google document presentation by Partners Insurance out of Arkansas. Please note the focus is on wellness and claims errors.
I believe that a shift to the consumer driven/one deductible plans will encourage the insured to monitor their costs and their bills. Once we take the waste out of the health delivery system we can start to control costs and, therefore, premium.
Tuesday, January 6, 2009
Benefits Solutions
Benefits Solutions to Health Insurance Dilemma
by J. Keith Johnson
Benefits Representative- Olathe, KS
Colonial Life
Rapidly rising health care costs and the plight of the uninsured have reached the status of nearly daily mention in most news media. As health care costs continue to increase, many businesses are moving toward high-deductible major medical plans in an effort to better manage benefits program costs. Yet this approach can put employees at greater financial risk, forcing them to pay the expanding difference between what their health insurance covers and what their medical care costs. In addition, premiums for employer-sponsored health insurance have been rising four times faster on average than workers’ earnings since 2000.1
While that’s bad enough news for workers with health insurance, it’s a potential disaster for those who don’t have health coverage to help buffer these costs. A recent Census Bureau report estimated 47 million Americans have no health coverage.2 Still more worrisome is the fact that most uninsureds belong to a family with at least one working member. 3
The good news is employers have access to two solutions to meet this health coverage dilemma:
§ A voluntary supplemental health insurance plan can help fill gaps in coverage under a high-deductible major medical plan, such as increased deductibles and out-of-pocket maximums.
§ A group limited benefit hospital confinement indemnity insurance plan for employees who don’t have access to major medical insurance through their workplace or their spouse’s workplace.
Voluntary Supplemental Health Insurance
With voluntary supplemental health insurance, businesses can offer their employees a solution to help fill coverage gaps and protect employees against increasing out-of-pocket expenses. These products typically pay lump-sum benefits for medical expenses resulting from inpatient hospitalization and rehabilitation unit or outpatient services, diagnostic testing, doctor’s office visits and wellness checkups. For example, an employee who has to go into the hospital may have to pay a $1,500 deductible before health insurance kicks in — money the employee has to pay up front. With voluntary supplemental health insurance, the employee would receive a lump-sum benefit payment for the inpatient confinement and could use it to help pay for the deductible.
Group Limited Benefit Hospital Confinement Indemnity Insurance
This type of insurance is a group product that provides benefits to help insureds pay many routine, noncatastrophic health care expenses. It’s not major medical coverage, and it isn’t a replacement for major medical coverage. Offered through the workplace at group rates, this plan can meet the need for affordable, limited and clearly defined health benefits for full-time and part-time workers who don’t have access to major medical insurance and need some coverage for basic, routine medical expenses. Coverage is available for:
Doctor’s office visits
Outpatient diagnostic and lab tests
Inpatient hospital stays
Surgery
Prescription drugs
With either plan, benefits communication plays a critical role in successful implementation. Consistent, clear communication through group and one-on-one meetings with employees helps ensure they understand what their plan covers and what it doesn’t. This leads to much greater satisfaction with the benefits plan. A quality voluntary benefits provider can deliver this service at no direct charge to the employer.
Rising health care costs and the resulting plight of the working uninsured are not likely to go away anytime soon. But innovative products like voluntary supplemental health insurance and group limited benefit hospital confinement indemnity insurance provide workable solutions for the health care cost issue.
About the Author
J. Keith Johnson is an agent for Colonial Life. A veteran of more than six years in the insurance and benefits industry, Mr. Johnson is responsible for marketing Colonial Life’s products, programs and services in the Kansas/Missouri area.
Colonial Life & Accident Insurance Company is a market leader in providing insurance benefits for employees and their families through their workplace, along with individual benefits education, advanced yet simple-to-use enrollment technology and quality personal service. Colonial Life offers disability, life and supplemental accident and health insurance policies in 49 states, the District of Columbia and Puerto Rico. Similar policies, if approved, are underwritten in New York by a Colonial Life affiliate, The Paul Revere Life Insurance Company. Colonial Life is based in Columbia, S.C., and is a subsidiary of Unum Group.
For more information about Colonial Life’s products and services or opportunities with the company, call J. Keith Johnson 913-205-6396 or visit www.coloniallife.com.
# # #
1 The Henry J. Kaiser Family Foundation, 2006 Employee Health Benefit Survey, September 26, 2006.
2 U.S. Census Bureau report, Aug. 28, 2007.
3 California Health Care Foundation, 2005.
4 “Growth Potential of Small Business Markets,” LIMRA, 2006.
5 “Statistics of U.S. Business,” U.S. Census Bureau, 2004.
by J. Keith Johnson
Benefits Representative- Olathe, KS
Colonial Life
Rapidly rising health care costs and the plight of the uninsured have reached the status of nearly daily mention in most news media. As health care costs continue to increase, many businesses are moving toward high-deductible major medical plans in an effort to better manage benefits program costs. Yet this approach can put employees at greater financial risk, forcing them to pay the expanding difference between what their health insurance covers and what their medical care costs. In addition, premiums for employer-sponsored health insurance have been rising four times faster on average than workers’ earnings since 2000.1
While that’s bad enough news for workers with health insurance, it’s a potential disaster for those who don’t have health coverage to help buffer these costs. A recent Census Bureau report estimated 47 million Americans have no health coverage.2 Still more worrisome is the fact that most uninsureds belong to a family with at least one working member. 3
The good news is employers have access to two solutions to meet this health coverage dilemma:
§ A voluntary supplemental health insurance plan can help fill gaps in coverage under a high-deductible major medical plan, such as increased deductibles and out-of-pocket maximums.
§ A group limited benefit hospital confinement indemnity insurance plan for employees who don’t have access to major medical insurance through their workplace or their spouse’s workplace.
Voluntary Supplemental Health Insurance
With voluntary supplemental health insurance, businesses can offer their employees a solution to help fill coverage gaps and protect employees against increasing out-of-pocket expenses. These products typically pay lump-sum benefits for medical expenses resulting from inpatient hospitalization and rehabilitation unit or outpatient services, diagnostic testing, doctor’s office visits and wellness checkups. For example, an employee who has to go into the hospital may have to pay a $1,500 deductible before health insurance kicks in — money the employee has to pay up front. With voluntary supplemental health insurance, the employee would receive a lump-sum benefit payment for the inpatient confinement and could use it to help pay for the deductible.
Group Limited Benefit Hospital Confinement Indemnity Insurance
This type of insurance is a group product that provides benefits to help insureds pay many routine, noncatastrophic health care expenses. It’s not major medical coverage, and it isn’t a replacement for major medical coverage. Offered through the workplace at group rates, this plan can meet the need for affordable, limited and clearly defined health benefits for full-time and part-time workers who don’t have access to major medical insurance and need some coverage for basic, routine medical expenses. Coverage is available for:
Doctor’s office visits
Outpatient diagnostic and lab tests
Inpatient hospital stays
Surgery
Prescription drugs
With either plan, benefits communication plays a critical role in successful implementation. Consistent, clear communication through group and one-on-one meetings with employees helps ensure they understand what their plan covers and what it doesn’t. This leads to much greater satisfaction with the benefits plan. A quality voluntary benefits provider can deliver this service at no direct charge to the employer.
Rising health care costs and the resulting plight of the working uninsured are not likely to go away anytime soon. But innovative products like voluntary supplemental health insurance and group limited benefit hospital confinement indemnity insurance provide workable solutions for the health care cost issue.
About the Author
J. Keith Johnson is an agent for Colonial Life. A veteran of more than six years in the insurance and benefits industry, Mr. Johnson is responsible for marketing Colonial Life’s products, programs and services in the Kansas/Missouri area.
Colonial Life & Accident Insurance Company is a market leader in providing insurance benefits for employees and their families through their workplace, along with individual benefits education, advanced yet simple-to-use enrollment technology and quality personal service. Colonial Life offers disability, life and supplemental accident and health insurance policies in 49 states, the District of Columbia and Puerto Rico. Similar policies, if approved, are underwritten in New York by a Colonial Life affiliate, The Paul Revere Life Insurance Company. Colonial Life is based in Columbia, S.C., and is a subsidiary of Unum Group.
For more information about Colonial Life’s products and services or opportunities with the company, call J. Keith Johnson 913-205-6396 or visit www.coloniallife.com.
# # #
1 The Henry J. Kaiser Family Foundation, 2006 Employee Health Benefit Survey, September 26, 2006.
2 U.S. Census Bureau report, Aug. 28, 2007.
3 California Health Care Foundation, 2005.
4 “Growth Potential of Small Business Markets,” LIMRA, 2006.
5 “Statistics of U.S. Business,” U.S. Census Bureau, 2004.
Saturday, December 6, 2008
Communication will solve the health care crisis.
As my wife is fond of saying to me, "communication is key".
One of the main reasons we find ourselves in the state we're in is because people do not understand insurance products, especially health insurance products. If we had automobile insurance built in a similar fashion to health insurance, no one could afford to own a car, much less drive one.
Imagine getting a starter or muffler installed for a $20 copay. Need a transmission or engine overhaul? As long as you were in your automotive repair network, you get 80/20 coinsurance until your deductible is met. Have existing accident damage? As long as you can get in an employer group where the carrier has to accept you, you get your car fixed. No matter that you weren't part of the original underwriting, Everyone helps pay your expenses. After all, isn't that what America is all about?
Now I know this sounds ridiculous, but no more ridiculous than for people to expect healthcare delivered this way for little or no cost.
The American public needs an education. I'm afraid it will come at the expense of the healthcare/insurance industry collapsing. No one knows what procedures cost, where they can get cost effective care, care provider success/mortality rates, what insurance carriers pay claims best, and how money works within the system.
HDHP/HSA's are a great first step because a policyholders self interest requires that they ask these questions. At this time they cannot get all the answers, but more and more light is being shed on the situation.
As agents that have our clients best interests at heart, we must continue to fight the good fight. If we continue to promote, communicate, and educate, we know that understanding will provide a sensible answer.
One of the main reasons we find ourselves in the state we're in is because people do not understand insurance products, especially health insurance products. If we had automobile insurance built in a similar fashion to health insurance, no one could afford to own a car, much less drive one.
Imagine getting a starter or muffler installed for a $20 copay. Need a transmission or engine overhaul? As long as you were in your automotive repair network, you get 80/20 coinsurance until your deductible is met. Have existing accident damage? As long as you can get in an employer group where the carrier has to accept you, you get your car fixed. No matter that you weren't part of the original underwriting, Everyone helps pay your expenses. After all, isn't that what America is all about?
Now I know this sounds ridiculous, but no more ridiculous than for people to expect healthcare delivered this way for little or no cost.
The American public needs an education. I'm afraid it will come at the expense of the healthcare/insurance industry collapsing. No one knows what procedures cost, where they can get cost effective care, care provider success/mortality rates, what insurance carriers pay claims best, and how money works within the system.
HDHP/HSA's are a great first step because a policyholders self interest requires that they ask these questions. At this time they cannot get all the answers, but more and more light is being shed on the situation.
As agents that have our clients best interests at heart, we must continue to fight the good fight. If we continue to promote, communicate, and educate, we know that understanding will provide a sensible answer.
Monday, December 1, 2008
Wall Street Journal article, Beware the pitfalls of early retirement.
Almost everyone fantasizes about swapping the cubicle and BlackBerry for a life of leisure while they're young enough to enjoy it.
Millions work long hours to make the fantasy a reality, and in these rough economic times, others have simply taken buyouts. But America's patchwork health-care system is making those transitions harder.
Too young to qualify for Medicare and rarely covered by employers, early retirees can face premiums they never dreamed of -- triple or more what they paid while working.
And that's for the healthy ones. Others, who suffer from middle-age ailments like arthritis or back pain, wind up paying far more -- if they aren't simply rejected. Researchers at the Commonwealth Fund found that in 2007 about 35% of people between the ages of 50 and 64 were uninsured or underinsured, up from 26% five years ago.
Bought Out, Left Out
In the decades after World War II, most retirees could count on generous health perks. But over the past two decades, the situation has changed. Today, just 29% of large private companies provide insurance to younger retirees, according to the Kaiser Family Foundation. This spring, the Society for Human Resource Management found that less than half of workers laid off or bought out were offered health benefits.
That leaves many younger retirees with only one place to go: the individual-insurance market, which is hardly friendly terrain for fiftysomethings.
Unlike in employer plans, where all members pay similar premiums, here each consumer gets examined for risk. Insurers often react to minor pre-existing health conditions the way an auto insurer reacts to accidents -- by charging steep rates or rejecting the applicant.
Health-care advocates have documented instances of older people being denied coverage because of high blood pressure or mild depression after the death of a spouse. "I used to joke that just living past 45 was a pre-existing condition," says Anthony Wright, executive director of the advocacy group Health Access California.
Higher Age, Higher Risk
Insurance executives defend underwriting practices as necessary to keep up with the costs of care, pointing out that age makes customers riskier to insure. "It's not like we're running a pirate ship," says Richard Collins, president of UnitedHealthcare's individual-insurance unit.
Although states prohibit insurers from dropping consumers who develop health problems after enrollment, they do let insurers purge those who allegedly commit fraud on applications -- leading some companies to comb patients' medical records for signs they should have known a problem was looming.
Fortunately, some younger retirees tame the frontier. Holding on to group coverage helps: Retirees willing to work self-employed can get group rates in 13 states.
For those with health issues who must use the individual market, Carolyn McClanahan, a financial planner in Jacksonville, Fla., recommends applying for a special insurance pool that each state holds open to consumers for the 36 days after they exhaust their COBRA coverage -- while benefits there can be spotty, the pools can't reject anyone.
Early retirees also can boost their underwriting odds by losing belly fat and going over their medical records with physicians for errors.
Email: letters@smartmoney.com
Copyright 2008 Dow Jones & Company, Inc. All Rights Reserved
This copy is for your personal, non-commercial use only. Distribution and use of this material are governed by our Subscriber Agreement and by copyright law. For non-personal use or to order multiple copies, please contact Dow Jones Reprints at 1-800-843-0008 or visit
www.djreprints.com
Millions work long hours to make the fantasy a reality, and in these rough economic times, others have simply taken buyouts. But America's patchwork health-care system is making those transitions harder.
Too young to qualify for Medicare and rarely covered by employers, early retirees can face premiums they never dreamed of -- triple or more what they paid while working.
And that's for the healthy ones. Others, who suffer from middle-age ailments like arthritis or back pain, wind up paying far more -- if they aren't simply rejected. Researchers at the Commonwealth Fund found that in 2007 about 35% of people between the ages of 50 and 64 were uninsured or underinsured, up from 26% five years ago.
Bought Out, Left Out
In the decades after World War II, most retirees could count on generous health perks. But over the past two decades, the situation has changed. Today, just 29% of large private companies provide insurance to younger retirees, according to the Kaiser Family Foundation. This spring, the Society for Human Resource Management found that less than half of workers laid off or bought out were offered health benefits.
That leaves many younger retirees with only one place to go: the individual-insurance market, which is hardly friendly terrain for fiftysomethings.
Unlike in employer plans, where all members pay similar premiums, here each consumer gets examined for risk. Insurers often react to minor pre-existing health conditions the way an auto insurer reacts to accidents -- by charging steep rates or rejecting the applicant.
Health-care advocates have documented instances of older people being denied coverage because of high blood pressure or mild depression after the death of a spouse. "I used to joke that just living past 45 was a pre-existing condition," says Anthony Wright, executive director of the advocacy group Health Access California.
Higher Age, Higher Risk
Insurance executives defend underwriting practices as necessary to keep up with the costs of care, pointing out that age makes customers riskier to insure. "It's not like we're running a pirate ship," says Richard Collins, president of UnitedHealthcare's individual-insurance unit.
Although states prohibit insurers from dropping consumers who develop health problems after enrollment, they do let insurers purge those who allegedly commit fraud on applications -- leading some companies to comb patients' medical records for signs they should have known a problem was looming.
Fortunately, some younger retirees tame the frontier. Holding on to group coverage helps: Retirees willing to work self-employed can get group rates in 13 states.
For those with health issues who must use the individual market, Carolyn McClanahan, a financial planner in Jacksonville, Fla., recommends applying for a special insurance pool that each state holds open to consumers for the 36 days after they exhaust their COBRA coverage -- while benefits there can be spotty, the pools can't reject anyone.
Early retirees also can boost their underwriting odds by losing belly fat and going over their medical records with physicians for errors.
Email: letters@smartmoney.com
Copyright 2008 Dow Jones & Company, Inc. All Rights Reserved
This copy is for your personal, non-commercial use only. Distribution and use of this material are governed by our Subscriber Agreement and by copyright law. For non-personal use or to order multiple copies, please contact Dow Jones Reprints at 1-800-843-0008 or visit
www.djreprints.com
Thursday, October 30, 2008
Can you afford a $50 Co-pay?
Can You Afford A $50 Co-pay?
By J. Keith Johnson
With health insurance rates increasing at double digit rates, more and more employers are searching for a way to stem the tide. Employers are forced to ask employees to shoulder more of the cost as premiums increase. If you have health coverage, whether group or individual, ever increasing premiums, deductibles, co-pays, and co-insurance are a fact of life.
To complicate matters, most employees do not understand their health insurance. Ask them about their coverage, they’ll tell you about their co-pay. Few know their individual or family deductible and virtually none of them know their co-insurance amount or maximum out of pocket. If you increase the deductible and co-insurance, hardly anyone will notice. If you increase the co-pay, everyone screams. Therefore, employers take the path of least resistance.
I have a couple of questions. First, do you think most employees could afford a $50 co-pay for doctor’s office visits? Probably. Emergency room co-pays are $50-$100 right now and many use the emergency room rather than a doctor’s office visit for routine illnesses, so it’s possible.
Second question, would most Americans be happy if they could get the insurance company to pay that whole $50? You bet!
So if you would like the insurance company to pay your $50 co-pay, welcome to the HSA plan.
HSA qualified plans use premium savings from the health coverage to help fund medical expenses. Rather than send a large premium for a co-pay plan to an insurance company, you send less premium by purchasing a lower cost, one deductible plan and placing the premium savings up to the amount of the deductible, in a tax-free fund for use as needed.
So how does that equal a $50 co-pay? Easy. An in-network doctor’s office visit is approximately $50. Under a standard co-pay plan, you pay $20 and the insurance company pays $30. Under the one deductible HSA plan, you pay the medical expenses up to the deductible. Voila, $50 co-pay! And, the employee did not have to pay tax on the $50.
But, you may ask, how do I get the insurance company to pay that $50? Once again, it’s easy. Here is an example of a small group with some health issues that recently switched to an HSA qualified plan:
Small group (7 employees)
Last year’s co-pay plan monthly premium: $3,738.00
(This does not include this year’s increase)
This year’s HSA plan monthly premium: $2,604.00
Monthly savings: $1,134.00 (30% savings)
Monthly savings per employee: $ 162.00
Monthly per Employee Contributions:
Contribution to HSA: $ 50.00
Employer paid Dental premium: $ 88.00
(New benefit)
Employer paid voluntary benefit premium: $ 9.00
(new benefit)
Savings to employer’s bottom line: $ 15.00
(per employee)
Total annual employer savings: $1,260.00
As you can see, the employer used part of the monthly savings (insurance company’s money) to help fund the employee’s HSA. This is the money used to pay the doctor’s office visit. Nothing came out of the employee’s pocket. The money literally came out of the insurance company’s pocket.
In addition, the employer was able to improve benefits by adding dental and a medical bridge plan to help pay medical costs in the event of a hospitalization. All this and he reduced his costs. Find that in a co-pay plan!
Oh, and the best part? Whatever the employee doesn’t use each year, he gets to keep!
Congratulations. You just started a de facto retirement plan with no IRS reporting requirements.
I’ve heard all the arguments against HSA’s. They are all baloney. The only reason an HSA qualified plan will not work is if you don’t save enough premium. Period.
J. Keith Johnson is an independent insurance broker, specializing in HSA qualified plans. For more information you may reach him at:
Free State Business, LLC
15954 Mur-Len, #305
Olathe, KS 66062
(913) 787-0152
Email: jkjohnson@freestatebusiness.com
By J. Keith Johnson
With health insurance rates increasing at double digit rates, more and more employers are searching for a way to stem the tide. Employers are forced to ask employees to shoulder more of the cost as premiums increase. If you have health coverage, whether group or individual, ever increasing premiums, deductibles, co-pays, and co-insurance are a fact of life.
To complicate matters, most employees do not understand their health insurance. Ask them about their coverage, they’ll tell you about their co-pay. Few know their individual or family deductible and virtually none of them know their co-insurance amount or maximum out of pocket. If you increase the deductible and co-insurance, hardly anyone will notice. If you increase the co-pay, everyone screams. Therefore, employers take the path of least resistance.
I have a couple of questions. First, do you think most employees could afford a $50 co-pay for doctor’s office visits? Probably. Emergency room co-pays are $50-$100 right now and many use the emergency room rather than a doctor’s office visit for routine illnesses, so it’s possible.
Second question, would most Americans be happy if they could get the insurance company to pay that whole $50? You bet!
So if you would like the insurance company to pay your $50 co-pay, welcome to the HSA plan.
HSA qualified plans use premium savings from the health coverage to help fund medical expenses. Rather than send a large premium for a co-pay plan to an insurance company, you send less premium by purchasing a lower cost, one deductible plan and placing the premium savings up to the amount of the deductible, in a tax-free fund for use as needed.
So how does that equal a $50 co-pay? Easy. An in-network doctor’s office visit is approximately $50. Under a standard co-pay plan, you pay $20 and the insurance company pays $30. Under the one deductible HSA plan, you pay the medical expenses up to the deductible. Voila, $50 co-pay! And, the employee did not have to pay tax on the $50.
But, you may ask, how do I get the insurance company to pay that $50? Once again, it’s easy. Here is an example of a small group with some health issues that recently switched to an HSA qualified plan:
Small group (7 employees)
Last year’s co-pay plan monthly premium: $3,738.00
(This does not include this year’s increase)
This year’s HSA plan monthly premium: $2,604.00
Monthly savings: $1,134.00 (30% savings)
Monthly savings per employee: $ 162.00
Monthly per Employee Contributions:
Contribution to HSA: $ 50.00
Employer paid Dental premium: $ 88.00
(New benefit)
Employer paid voluntary benefit premium: $ 9.00
(new benefit)
Savings to employer’s bottom line: $ 15.00
(per employee)
Total annual employer savings: $1,260.00
As you can see, the employer used part of the monthly savings (insurance company’s money) to help fund the employee’s HSA. This is the money used to pay the doctor’s office visit. Nothing came out of the employee’s pocket. The money literally came out of the insurance company’s pocket.
In addition, the employer was able to improve benefits by adding dental and a medical bridge plan to help pay medical costs in the event of a hospitalization. All this and he reduced his costs. Find that in a co-pay plan!
Oh, and the best part? Whatever the employee doesn’t use each year, he gets to keep!
Congratulations. You just started a de facto retirement plan with no IRS reporting requirements.
I’ve heard all the arguments against HSA’s. They are all baloney. The only reason an HSA qualified plan will not work is if you don’t save enough premium. Period.
J. Keith Johnson is an independent insurance broker, specializing in HSA qualified plans. For more information you may reach him at:
Free State Business, LLC
15954 Mur-Len, #305
Olathe, KS 66062
(913) 787-0152
Email: jkjohnson@freestatebusiness.com
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