Archive for the ‘Group insurance’ Category

COBRA – notice requirements

Wednesday, May 2nd, 2012

Good Neighbor Insurance at www.gnazhealth.com continues to update our clients on the new health insurance laws.  There are six major coverage options for those in the US and even though some of the rules and regulations are similar for all many differences are there and it all depends on how old you are and for whom you work.  Many critical details of this new insurance law will be clarified in the months and years to come. 

These six major coverage options are:

(1) Individual or family coverage (private health care plans)

(2) Employee/employer group option for small businesses (typically under 50 employees)

(3) Employee/employer group option for large businesses (typically larger than 50 employees)

(4) Exchange options through the state you are residing in (fully integrated 1-1-2014 and are quasi-government and private insurance coverage combined)

(5) Medicare (which include Parts A, B, C, and D) for those 65 years onwards

(6) Full government health plans like Medicaid, CHIP, TRICARE, VA and other coverage plans as may be designated by the Department of Health and Human Services based mostly on financial criteria and/or military service.

Notice requirements

  Who sends notice? Content required Sent when? DOL Model notice available? Alternate notice available?
General or initial notice Plan administrator to covered employee and spouse Minimum requirements Within 90 days of commencement of coverage Yes SPD
Qualifying event notice-employer Employer to plan administrator Info about plan, qualifying events, and dates of events 30 days after qualifying event Yes None
Qualifying even notice – employee Covered employee to plan administrator Plan must provide a reasonable written procedure 60 days after qualifying events No Depends on plan procedure
Election notice Plan administrator to qualified beneficiary Minimum requirements as listed in final regulations 14 days after notice of QE, or 44 days if employer is plan administrator Yes None
Notice of COBRA unavailability Plan administrator to individuals who provided QE notice Why individual is not entitled to COBRA Same as election notice timeframe No None
Early termination notice Plan administrator to qualified beneficiaries Reason for, date of termination, conversion rights, if any “As soon as practicable” after decision is made to terminate No None

Election period

The Qualified Beneficiary has 60 days from the later of a) the date coverage would be lost as a result of the Qualifying Event, or b) the date the notice was provided to the Qualified Beneficiary. There have been, however, a number of court cases in which the date the  Qualifying Event Notice was actually received marked the beginning of the 60-day election period.

Before rejecting an election form that may be received a few days after the 60-day election period ends, the Plan Administrator should determine whether the Qualified Beneficiary actually made the election within 60 days of the receipt of the Qualifying Event Notice. The maximum COBRA continuation period is generally measured from the date of the Qualifying Event , not the date of election.  As a result, a Qualified Beneficiary who waits until the last day of the election period before choosing to elect will have his/her coverage reinstated retroactively back to the original benefits termination date.

Election without a premium payment

A Qualified Beneficiary has 45 days from the date of the election in order to make the initial premium payment. The Plan Administrator may not make the election of coverage contingent on the Qualified Beneficiary making the first premium payment at the time of election. If the Qualified Beneficiary fails to make the initial premium payment within the 45-day grace period, all COBRA continuation coverage will be terminated.

For a group health plan that provides health services such as an HMO or a walk-in clinic, a Qualified Beneficiary who has not yet elected or paid for coverage may be required to either elect and pay for continuation coverage, or pay a reasonable charge for services (but only if the Qualified Beneficiary will be reimbursed within 30 days of election and payment of continuation coverage).

Doug Gulleson loves to scuba dive overseas and makes sure he has his US health care and overseas health care, http://onlineglobalhealthinsurance.com/my-travel-guard.asp , information with him at all times when he travels   Keep our blog close by you, www.gntravelinsurance.com, for continual updates on the changes with the U.S. health care system.

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Posted in Understanding COBRA |

COBRA – length of coverage for qualifying events

Tuesday, April 3rd, 2012

Good Neighbor Insurance at www.gnazhealth.com continues to update our clients on the new health insurance laws.  There are six major coverage options for those in the US and even though some of the rules and regulations are similar for all many differences are there and it all depends on how old you are and for whom you work.  Many critical details of this new insurance law will be clarified in the months and years to come. 

These six major coverage options are:

(1) Individual or family coverage (private health care plans)

(2) Employee/employer group option for small businesses (typically under 50 employees)

(3) Employee/employer group option for large businesses (typically larger than 50 employees)

(4) Exchange options through the state you are residing in (fully integrated 1-1-2014 and are quasi-government and private insurance coverage combined)

(5) Medicare (which include Parts A, B, C, and D) for those 65 years onwards

(6) Full government health plans like Medicaid, CHIP, TRICARE, VA, and other coverage plans as may be designated by the Department of Health and Human Services based mostly on financial criteria and/or military service.

COBRA Background

Congress passed The Consolidated Omnibus Budget Reconciliation Act (COBRA) in 1986. One of the provisions of COBRA is to provide certain individuals with the right to temporarily continue their health coverage at group rates. The law generally applies to employers who sponsor a group health plan and have 20 or more full or part time employees during 50 percent or more of the business days in the preceding calendar year.  A “group health plan” is defined as a plan that provides medical benefits for the employer’s own employees and dependents through insurance, HMO, or self funded arrangement. Medical benefits may include:

1. Hospital Care

2. Physician Care

3. Prescription Drugs

4. Other types of medical care, such as dental and vision.

Life insurance is not covered under COBRA.

Qualifying Events

Qualifying Events are events that would cause a covered employee to lose group health coverage.  The Plan Administrator will send a Qualifying Event Notice to a Qualified Beneficiary who has a Qualifying Event as listed below.

1. Termination of employment (for reasons other than gross misconduct)

2. Reduction of hours worked by the covered employee.

3. Death of the covered employee.

4. Divorce or legal separation.

5. Dependent child no longer meets the plan’s eligibility requirements.

6. Dependent loses coverage due to the employee becoming entitled to Medicare.

7. Company files for Bankruptcy under Chapter 11 of the U.S Bankruptcy Code.

Length of Coverage for Qualifying Events

The length of COBRA continuation coverage that must be offered depends on the type of Qualifying Event. When a Qualifying Event causes a loss of coverage, the employer must allow COBRA continuation coverage under the group health plan for up to 18 months for Qualifying Events that are the termination of employment or reduction of hours.  This period may be extended to 29 months if the Qualified Beneficiary is or becomes disabled at any time during the first 60 days of continuation coverage. A second Qualifying Event for a dependent occurring during the 18-month continuation coverage period of the first Qualifying event extends the original period to 36 months.

It is important to note, however, that COBRA continuation coverage may terminate prior to the end of the maximum coverage period for any of the following reasons:

1. Non-payment of premiums. Continuation coverage for a Qualified Beneficiary may be terminated if the premiums are not paid in a “timely” manner. A payment is considered “timely” if it is made on the due date, or within the 30-day grace period (45 days for the initial premium payment).

2. Termination of all Group Health Plans.  Continuation coverage for a Qualified Beneficiary may be terminated if the employer ceases to sponsor any group health plan.

3. Other Coverage. Continuation coverage may be terminated if the Qualified Beneficiary first becomes covered under another group health plan, which does not contain any pre-existing exclusion limitation, after the Qualified Beneficiary elects COBRA continuation coverage.

4. Entitlement to Medicare. Continuation coverage may also be terminated if the Qualified Beneficiary first becomes entitled to Medicare after the Qualified Beneficiary elects COBRA continuation coverage.

5. Loss of Social Security Disability Status. Continuation coverage may be terminated if the

Qualified Beneficiary is determined to be no longer disabled by the Social Security Administration.  Coverage can, however, be terminated only during the 11-month disability extension period.

6. Termination for Cause. Continuation coverage may be terminated, for cause, if the Plan would otherwise terminate coverage on that basis for similarly situated covered employees.

18 Months for Qualifying Events:

1. Termination of employment for reasons other than gross misconduct.

2. Reduction in the number of hours of employment. For these Qualifying Events, the maximum continuation coverage period will be 18 months, measured from the date of the Qualifying Event. This maximum coverage period may be extended to 29 months if a Qualified Beneficiary who is, under Title 11 or XVI of the Social Security Act, determined to have been disabled at the time of a Qualifying Event, or, within the first 60 days of COBRA continuation coverage for all Qualified Beneficiaries. COBRA continuation coverage may be expanded to 36 months for a spouse or dependent of an employee who has experienced one of the above listed Qualifying Events if a second Qualifying Event occurs, (such as divorce, legal separation, death of the employee, Medicare entitlement, or loss of dependent child status) during the original 18 month COBRA continuation coverage period. Notification by the Qualified Beneficiary should be made to the Plan Administrator within 60 days of the second Qualifying Event, and within the original 18 month COBRA continuation coverage period.

36 Months for Qualifying Events:

1. Death of the covered employee.

2. Divorce or legal separation.

3. Dependent child ceases to meet the plan’s eligibility requirements

4. When dependents would lose coverage due to covered employee becoming entitled to Medicare (see next section).  For these Qualifying Events, the maximum coverage period will be 36 months, measured from the date of the Qualifying Event, or, up to 36 months measured from the date of the covered employee’s Medicare entitlement, if the covered employee becomes entitled to Medicare and, within 18 months thereafter, has a Qualifying Event that is either termination of employment, or reduction of hours.

29 Months for Qualifying Events:

A Qualified Beneficiary who is determined under Title II or XVI of the Social Security Act, to have been disabled at the time of a Qualifying Event, or, within the first 60 days of COBRA continuation coverage for all Qualified Beneficiaries, may be eligible to continue coverage for a total of 29 months (11 additional months). The Qualified Beneficiary must provide, to the Plan Administrator, a determination of disability from the Social Security Administration

within 60 days of the date of the determination, and prior to the end of the original 18-month COBRA continuation coverage period. The employer is permitted to charge up to 150% of the applicable premium during the 11 month disability extension. The Qualified Beneficiary is also required to notify the Plan Administrator, in writing, if the Social Security Administration has determined that the Qualified Beneficiary is no longer disabled under Title II or XVI of the Social Security Act. Bankruptcy of the Employer When a retiree, spouse or child of a retiree loses coverage within one year before or after the commencement of proceedings under Chapter 11 of the U.S. Bankruptcy Code

The maximum period of COBRA continuation coverage is as follows:

1. Coverage will continue, until the date of death, for covered employees, who retired on or before the date of the loss of coverage. Lifetime coverage is also available to widows or widowers of retirees.

2. Continuation coverage will be made available for the spouse and dependent children of a retiree for 36 months from the date of death of the retiree.

Other Coverage

The employer may not deny to the Qualified Beneficiary the option of COBRA continuation coverage based on the fact that the Qualified Beneficiary has other health coverage prior to the date COBRA continuation coverage is elected.

Gross Misconduct

The employer, however, is not required to offer COBRA continuation coverage to individuals who have been terminated from employment because of “gross misconduct” (IRC section 4908B (f)(3)(B). Unfortunately, “gross misconduct” is not defined in COBRA law. In the absence of any clear guidance from the IRS or Department of Labor on what constitutes gross misconduct, the employer should consider denying continuation coverage only in cases where the employer has a clear, well-documented case of gross misconduct. There have been numerous court cases in which ex- employees have sued challenging their former employers’ failure to offer continuation coverage. Because of the nature of the alleged behavior, what might be considered gross misconduct in one job or industry may not be considered as such in another, and as a result, there has been no clear standard to follow. It is recommended that before a Plan Administrator denies continuation coverage to a  Qualified Beneficiary because of termination due to gross misconduct, they make certain that they are able to produce sufficient documentation to back the claim. Also, if the employee accused of gross misconduct is allowed to resign, this may be seen as intent on the employer part to waive COBRA.

Doug Gulleson loves to scuba dive overseas and makes sure he has his U.S. health care and travel medical insurance, http://onlineglobalhealthinsurance.com/my-travel-guard.asp , information with him at all times when he travels   Keep our blog close by you, www.gntravelinsurance.com, for continual updates on the changes with the U.S. health care system.

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Posted in Understanding COBRA |

COBRA – 2012 news

Wednesday, March 7th, 2012

COBRA refers to the Consolidated Budget Reconciliation Act of 1985, and specifically to the Title X of the Act.  This benefit allows the member of a group policy, who has lost their coverage due to a “qualifying event” to continue coverage the former employee’s expense for a period of time.  This is the same group policy with the primarily difference of having the former employee paying the total premium.  The COBRA option may be elected after leaving work and if elected the former employee may have this continuation of group coverage for up to 18 months and longer if divorced or if spouse has passed on.

Here are a few answers to commonly asked questions on COBRA for the 2012 year.

Q:        Since the Patient Protection and Affordable Care Act (the PPACA signed into law 2010) is phasing in, are employers still required to administer COBRA?

A:        Yes, in fact, there was no mention of COBRA in the PPACA legislation.  Continuation coverage will likely become more cumbersome for employers and carriers under health reform.  As individual choices increase so too will the requirement to explain cover options and choices to participants.

Q:        When PPACA goes into effect, will terminating employees have to be offered COBRA?  Won’t they have access to guaranteed issue at the exchanges?

A:        While no clear direction has been published, here’s what we know.  The intent of the exchanges is to offer more choices and drive down costs.  The current requirement in most states for groups subject to mini-COBRA with fewer than 20 employees, and for those subject to federal COBRA with more than 20 employees is as follows:

  • Those who experience a qualifying event (including termination of employment) are entitled to be offered continuation coverage (the ability to continue on the group coverage at the same rate under the same plan).
  • They should also be afforded the opportunity to keep the coverage for a period of time.
  • At the time of the qualifying event, the person might be in the middle of a deductible or in the midst of treatment supported by the current plan.  So if the continuant is in the midst of services or treatment, a continuation option greatly eases the transition.

With these facts in mind, employers should plan to offer COBRA even after PPACA goes into effect.  Employers will likely have to present any/all options to terminating employees.

Q:        What are the most common COBRA mistakes that employers make?

A:        We all know COBRA is complicated, especially during and after open enrollment.  Below are a few of the most common oversights:

  • Failing to give appropriate notices – especially to qualifying beneficiaries.
  • Failing to offer open enrollment to COBRA participants.
  • Providing more coverage than what is required, or for longer than required.
  • Failing to document when notices were sent
  • Forgetting to collect COBRA premiums from participants.
  • Overpaying insurance invoices and/or continuing to pay for participants who have dropped off the plan.

Doug Gulleson loves to scuba dive overseas and makes sure he has his US health care and overseas health care, www.gnazhealth.com, information with him at all times when he travels Keep our blog close by you, www.gntravelinsurance.com, for continual updates on the changes with the US health care system.

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Posted in COBRA, Updates 2012 - 2014 |

Understanding the basics of HRAs – Health Reimbursement Account(s)

Wednesday, May 18th, 2011

HRA, HSA, FSA, group insurance, Arizona insuranceGood Neighbor Insurance (www.gnazhealth.com and www.gninsurance.com) is continuing to update our clients on the new health insurance laws that were signed into law in the spring of 2010.   There are six major coverage options for those in the US and even though some of the rules and regulations are similar for all many differences are there and it all depends on how old you are and for whom you work.  Many critical details of this new insurance law will be clarified in the months and years to come. 

These six major coverage options are:

(1) Individual or family coverage (private health care plans)

(2) Employee/employer group option for small businesses (typically under 50 employees)

(3) Employee/employer group option for large businesses (typically larger than 50 employees)

(4) Exchange options through the state you are residing in (fully integrated 1-1-2014 and are quasi-government and private insurance coverage combined)

(5) Medicare (which include Parts A, B, C, and D) for those 65 years onwards

(6) Full government health plans like Medicaid, CHIP, TRICARE, VA and other coverage plans as may be designated by the Department of Health and Human Services based mostly on financial criteria and/or military service.

FSA – Flexible Spending Account

HRA – Health Reimbursement Account

HSA – Health Saving Account

Please note:  HSA plans are medical insurance plans while FSA and HRA are not medical insurance plans.  Instead, FSA and HRA plans are stand-alone benefits to help pay towards  HSA deductibles and/or high deductible plans that do not include co-pays.

Health Reimbursement Account (HRA) option – one of the tools in the Consumer Driven Health Care (CDHC) movement – is a great benefit for employers and employees alike.  HRAs are used in the corporate group settings and not for individual and family plans. 

HRAs are IRS sanctioned programs that allow an employer to reimburse medical expenses for their employees in the company that allow for tax advantages / tax savings to offset health care costs.

HRAs are created by the employer and serviced by a third-party administrator or plan service provider.  The HRA is not serviced by the insurance company that handles the employer’s group health insurance policy.

The employer is not required to prepay into a fund for reimbursements, instead, the employer reimburses employee claims as they occur.travel insurance, pre-existing medical, trip cancellation

The Benefits

  • Applies to any health plan, regardless of the deductible structure of a related medical insurance plan or carriers.
  • Avoids any need to disrupt the employer’s and employee’s HRA experience when a carrier change occurs. HRAs can be linked with most carriers
  • Allows employers greater control of their benefit dollars. HRA is often a better choice than funding a HSA = which is a cash contribution to employees.
  • Flexible coordination with an existing or new FSA or HSA

Plan Requirements

  • IRS requirements to maintain tax-favored status:
    • Plan document and summary plan description
    • 100% Employer funded (no employee contributions permitted)
    • Claims substantiation required by third party
    • HRA must be non-discriminatory

HRA: Who Pays First?

  • Employee pays first
    • Rewards low and moderate user
    • Employer risk (<20%) of dollars
    • Employer pays first
      • High user still pays dollar gap before insurance covers expenses
      • Employer risk (25-40%) of dollars

 Employer’s Choice: Important Carryover Provision

  • Any dollars left at the end of the year (if employer sets it up that way) can be carried over to the next year.  This provides an incentive for the employee not to spend it.  It is a win-win situation for employees and the company.  Employees spending their own money will make better medical and financial choices, thereby reducing over-utilization by as much as 30%.

FSA, HRA, HSA, Arizona health insurance, Arizona medical insurance 

 Advantages

  • For the employer
    • Reimbursements of qualified claims are tax-deductible for the employer
    • Employers know their maximum expense related to their health care benefit
    • For the employee
      • Contributions that employers make can be excluded from employees’ gross income
      • Reimbursements may be tax free if the employee pays qualified medical expenses
      • Unused funds in the HRA may be rolled into future years for reimbursement (if the employer sets it up this way)
      • HRAs may be offered in conjunction with other employer-provided health benefits including Flexible Spending Accounts (FSAs)
      • Employees do not have to be covered under any other health care plan to participate unlike a HSA which requires a HDHP (High Deductible Health Plan)
      • Employees can be reimbursed for a health care plan that meets their or their families’ specific needs, as opposed to a standard company plan.

 Disadvantages

  • A frequent complaint is that HRA extremely opaque in regards to their requirements; basically a lot of rules and provisions must be followed by the letter for this to work.  Employers and employees must keep in the rules and with changes in laws each year this can be quite a challenge.  Tax forms will be a challenge and one should use a CPA who is well versed on medical tax rules and laws to get the most out of HRA tax advantages.
  • Self-employed persons are ineligible (However, a sole proprietor can employ their spouse and as long as their employable interest, the spouse, does in fact help with the business. Then the employer would need to establish a W-2 to make the spouse’s employment legitimate.
  • “Highly compensated” participants may be subject to “certain limitations.”
  • Medicare age:  HRA plans are considered “primary payers” subject to Medicare Secondary Payer (MSP) reporting requirements. There are significant penalties for failure to comply with the MSP reporting requirements.  Although the MSP reporting requirements began to apply to certain group health plans on 1-1-2009, CMS has delayed mandatory reporting for HRAs.
  • Rules pertaining to their reimbursements are perceived by member participants to be somewhat contradictory and/or even incoherent- leading some to lose contributions which are intended for health care but are learned (after the procedure or laboratory  test) to be disallowed.

Doug Gulleson loves to scuba dive overseas and makes sure he has his US health care and overseas health care, http://onlineglobalhealthinsurance.com/my-travel-guard.asp , information with him at all times when he travels   Keep our blog close by you, www.gntravelinsurance.com, for continual updates on the changes with the US health care system.

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Posted in HRA |

Understanding the basics of FSA, HRA, and HSA plans for US group insurance

Wednesday, March 16th, 2011

property and casualty insurance, dental insurance, group insuranceGood Neighbor Insurance (www.gnazhealth.com and www.gninsurance.com) is continuing to update our clients on the new health insurance laws that were signed into law in the spring of 2010.   There are six major coverage options for those in the US and even though some of the rules and regulations are similar for all many differences are there and it all depends on how old you are and for whom you work.  Many critical details of this new insurance law will be clarified in the months and years to come. 

These six major coverage options are:

(1) Individual or family coverage (private health care plans)

(2) Employee/employer group option for small businesses (typically under 50 employees)

(3) Employee/employer group option for large businesses (typically larger than 50 employees)

(4) Exchange options through the state you are residing in (fully integrated 1-1-2014 and are quasi-government and private insurance coverage combined)

(5) Medicare (which include Parts A, B, C, and D) for those 65 years onwards

(6) Full government health plans like Medicaid, CHIP, TRICARE, VA and other coverage plans as may be designated by the Department of Health and Human Services based mostly on financial criteria and/or military service.

FSA – Flexible Spending Account

HRA – Health Reimbursement Account

HSA – Health Saving Account

Please note: HSA plans are medical insurance plans while FSA and HRA are not medical insurance plans.  Instead, FSA and HRA plans are stand-alone benefits to help pay towards HSA deductibles and/or high deductible plans that do not include co-pays.

 

FSA

HRA

HSA

Who Can Use

Any size group (Excludes Partners, more than 2% Stockholders in Sub S Corp, and LLC Members)

Any size group (Excludes Partners, more than 2% Stockholders in Sub S Corp. and LLC Members)

Individuals and any size group

Maximum Dollar Contribution

Employer sets maximum Medical Reimbursement limit. IRS sets Dependent Care limit.

Determined by Employer

Limit set by federal guidelines for single/family (CPI rated annually)

Who Can Contribute

Employee primarily, but Employer can also fund

Employer only

Individuals, Employers & Employees (or both)

Tax Deductible / Tax Free

Yes: Employer/Employee

Yes: Employer/Employee

Yes: Employer/Employee

Who Owns the Account

Employer

Employer

Employee

Portability

No

No

Yes

Rollover

No, Optional Grace Period

Yes.  However, not required

Yes

 

 

FSA

HRA

HSA

Funding

Per pay period by employee

Funded when claim is paid

Funded dollars

Health Plan Styles Required

No restrictions

No restrictions

Aggregated high deductible / No co-pays on office visits or RX (HSA plans are no-co-pay plans)

Section 125 FSA (funds may be used for dictated by the IRS under this section)

N/A

No restriction

Insurance premium(s) (only for age 65 onwards), medical, vision, and dental expenses

Minimum Deductibles

N/A

No restrictions

Set by federal guidelines annually

Maximum Out of Pocket

N/A

No restrictions

Set by federal guidelines annually (out of network not included)

Claims Substantiation

Required

Required

No, Employee’s Responsibility

Non-Qualified Withdraws

Each claim is adjudicated to meet IRC Section 213(d)

Qualified expense only. Employer determines past age 65 payments

Taxable plus 20% penalty to age 65

 

FSA

HRA

HSA

Eligible Expenses

All IRC Section 213(d) expenses. Employer can not restrict

All IRC Section 213(d) expenses. Employer can not restrict

All IRC Section 213(d) expenses. Employer can not restrict

COBRA Required

Yes, MRA only

Yes

No

Doug Gulleson loves to scuba dive overseas and makes sure he has his US health care and overseas health care, www.overseashealthinsurance.com/trip-protection.asp , information with him at all times when he travels   Keep our blog close by you, www.gntravelinsurance.com, for continual updates on the changes with the US health care system.

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Posted in HDHP - High Deductible Health Plan |

US group insurance: “How do you decide who and what to cover?”

Friday, December 10th, 2010

Good Neighbor Insurance (www.gnazhealth.com and www.gninsurance.com) is continuing to update our clients on the new health insurance laws.   There are six major coverage options for those in the US and even though some of the rules and regulations are similar for all many differences are there and it all depends on how old you are and for whom you work.  Many critical details of this new insurance law will be clarified in the months and years to come. 

These six major coverage options are:

(1) Individual or family coverage (private health care plans)

(2) Employee/employer group option for small businesses (typically under 50 employees)

(3) Employee/employer group option for large businesses (typically larger than 50 employees)

(4) Exchange options through the state you are residing in (fully integrated 1-1-2014 and are quasi-government and private insurance coverage combined)

(5) Medicare (which include Parts A, B, C, and D) for those 65 years onwards

(6) Full government health plans like Medicaid, CHIP, TRICARE, VA and other coverage plans as may be designated by the Department of Health and Human Services based mostly on financial criteria and/or military service.

Please Note:  Good Neighbor Insurance agency provides US individual, family, group health insurance, and property & casualty insurance in the US as well as for those traveling and residing outside the US. 

*          US health insurance and US property and casualty insurance:  www.gnazhealth.com

*          International travel and medical insurance:  www.gninsurance.com

*          International property and casualty insurance:  www.gninternationalpropertyinsurance.com

How do you decide who and what to cover?

Before we can help you decide what types of insurance to offer, you’ll need to know who and what you want it to cover.

Ask yourself these five questions and then talk with one of our agents at Good Neighbor Insurance to help determine which insurance plans and coverage are the right fit for yourself, your family, your business, and its employees.

1.   Are there any government mandated insurance plans you need to offer?

Of the many types of insurance plans available to business owners, only a few Property and Casualty policies are required by federal or state law. These include Workers’ Compensation, personal or commercial auto, and homeowners’ insurance

Property and Casualty Insurance – Unlike health insurance, which protects people, property and casualty insurance covers the physical assets that are vital to your success and that of your business.

Workers’ Compensation Insurance – If you or your employees become disabled due on an on-the-job injury or illness, workers’ compensation insurance protects your business from lawsuits while covering the necessary medical care.

Business Insurance – These plans include several policies that protect your business from circumstances that could negatively affect your operations. Policies include property, casualty, liability, commercial auto, and more.

Individual Property and Casualty Insurance – Individual property and casualty insurance helps protect policyholders and their families with policies that include personal auto, liability, and homeowners’ insurance.

Good Neighbor Insurance provides Property and Casualty insurance in many states.  Please go to our Property and Casualty site at www.gnazhealth.com and fill out the quote so we can look at the best options for you. 

Good Neighbor Insurance also provides international property and casualty insurance for those traveling and living outside the US and you may view our plans at our web site at www.gninternationalpropertyinsurance.com .

2.   Are you concerned about your business operations if you were ever unable to work?

As a business owner, you have the most impact on your company’s direction, day-to-day operation, and customer perception. That’s why it’s so important to prepare in case there’s ever a time that you and other key employees. A key employee is an owner or a highly ranked employee whose work has a direct effect on business profitability, aren’t able to work.

Key Employee Insurance – By insuring yourself and other important employees, your business can use the funds to help find a qualified successor, and protect itself from any potential economic setbacks.

Owner Life and Disability Insurance – You plan for retirement; it makes sense to prepare for unexpected contingencies that could have an even greater effect on your business. We’ll work with you to assess your long-term needs, and help you choose life and disability coverage that provides peace of mind — about your business and your budget.

3.   Do you see offering insurance as a way to attract and retain employees?

Group Health Insurance – Good Neighbor Insurance agency takes a simple, logical approach to group health insurance. We start by offering a wide selection of plans, then we help you understand your options — so you can confidently select a plan that meets the needs of your business, budget, and employees.

The ease and convenience of group plans is a major reason why health insurance is a popular employee benefit, with nearly 178 million Americans covered by health insurance where they work.

Employee Voluntary Benefits – Fill the gaps in your standard insurance plans. Qualified medical expenses not covered by existing insurance — your out-of-pocket expenses., and receive special benefits beyond traditional policies, such as payment for pre-existing medical conditions.

4.   Would you rather cover only yourself and your family?

Individual Insurance - Individual insurance provides business owners with unique benefits, starting with one that may not immediately come to mind — affordability.   Good Neighbor Insurance agency believes you should not have to sacrifice a plan that fits because of your finances.  Our licensed agents will help assess your needs and discuss your options in plain language. Because premiums can easily range from $100 to $1,500 per month, they will help tailor a plan to your needs and budget. Call us at 480-633-9500 for quotes and you may also go to our web site at www.gnazhealth.com for live quotes, up-to-date information, and even apply online.

Health, Life, and Disability Insurance – Protect yourself and your dependants from skyrocketing medical costs with plans providing health, vision, dental, disability, life and other vital coverage.

Property and Casualty Insurance – We partner with highly ranked carriers to provide a wide variety of essential policies from homeowner’s insurance, to auto, and personal liability.

Free Insurance Quotes – For individual and family quotes: View general quotes, look at plan comparisons, and even apply online through our web site quoting engine at www.gnhealthplan.com  or call all us at 866-636-9100 outside of Arizona or in Arizona at 480-633-9500 to go over any questions or concerns you may have.

5.   Would you allow employees to choose your offerings if they pay for their own benefits?

Employee Voluntary Benefits – A comprehensive employee benefits package is a powerful magnet for attracting and retaining the best employees. Whether or not you offer a group health plan, you can work with our agents at Good Neighbor Insurance agency to select voluntary benefits that will:

  • Greatly expand your benefits offerings at little or no cost to you.
  • Allow employees to choose the benefits that meet their needs.
  • Often help employees secure individual life and disability coverage regardless of medical histories, due to simplified underwriting requirements Voluntary benefits tend to attract fewer employees than group insurance as a whole, and those people are more likely to have a pre-existing medical condition that makes them riskier to cover. So to encourage more low-risk individuals to join the plan, insurance companies loosen the underwriting requirements for voluntary benefits policies..

Short-Term Disability Insurance – This replaces partial income if an employee becomes disabled, due to a covered accident or sickness, for a period ranging from three to twenty-four months.

Life Insurance – We will discuss Term life plans, universal life insurance, and whole life insurance plans (3 primary main types of life insurance) as well as level or annual premium payment periods, and is guaranteed renewable. an opportunity to build cash value, coverage can last a lifetime, and help you select the type of plan that fits your needs best.

Dental and Vision Insurance – Beyond medical insurance, dental and vision insurance are popular coverage options for employees — helping insure them against some of America’s most common health problems.

Accident Insurance – Provides indemnity benefits that the carrier will pay a cash benefit in the case of a qualified accident that leaves you or an employee unable to work, for on-and off-the-job, or off-job-only accidents.

Hospital Indemnity and Critical Illness – Beyond your company’s health insurance plan, you can offer employees specific coverage for cancer treatments, out-of-pocket expenses associated with home health care, and other supplemental health insurance An indemnity-based plan with benefits payable as a lump-sum or flat benefits amount for a covered hospital stay or covered outpatient surgery..

 Doug Gulleson loves to scuba dive overseas and makes sure he has his US health care and overseas health care, www.gninsurance.com , information with him at all times when he travels   Keep our blog close by you, www.gntravelinsurance.com, for continual updates on the changes with the US health care system.

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Are you a small business employer with your company in the US needing health insurance options for your employees?

Wednesday, November 24th, 2010

Good Neighbor Insurance (www.gnazhealth.com and www.gninsurance.com) is continuing to update our clients on the new health insurance laws.   There are six major coverage options for those in the US and even though some of the rules and regulations are similar for all many differences are there and it all depends on how old you are and for whom you work.  Many critical details of this new insurance law will be clarified in the months and years to come. 

These six major coverage options are:

(1) Individual or family coverage (private health care plans)

(2) Employee/employer group option for small businesses (typically under 50 employees)

(3) Employee/employer group option for large businesses (typically larger than 50 employees)

(4) Exchange options through the state you are residing in (fully integrated 1-1-2014 and are quasi-government and private insurance coverage combined)

(5) Medicare (which include Parts A, B, C, and D) for those 65 years onwards

(6) Full government health plans like Medicaid, CHIP, TRICARE, VA and other coverage plans as may be designated by the Department of Health and Human Services based mostly on financial criteria and/or military service.

Here are options if you are (1) a small business employer, (2) with your company in the US, (3) and needing health insurance options for your employees?

Note:  Starting on 1-1-2014 individual and family insurance plans may not decline a US citizen due to any medical issue(s).

Small employer plan:  Insurance companies that sell small employer plans can’t turn your business down based on your employees’ health.

Below are some other ideas and options that may or may not be applicable for you and your employees.  However we want to provide these options to you in case they may meet your needs.

Exchanges:  These programs will not be ready until 1-1-2014.  An exchange is where private health insurance and the state come together to make quasi-state government health plans open to individuals, families, and small businesses with certain criteria to meet which will be spelled out more in the months to come.  For more information on exchanges please go to our blog page at http://www.gntravelinsurance.com/category/us-health-insurance-2/insurance-lingo-us-health-insurance-2/exchanges-insurance-lingo-us-health-insurance-2/

Medicaid:  Medicaid provides coverage for low income children, families, the elderly, and people with disabilities. Pregnant women may qualify with higher incomes.

Coverage for young adults under age 26:  If your parent’s insurance offers dependent coverage, you may be eligible to be covered on their policy until age 26.

Pre-existing condition insurance plan (PCIP) / High Risk Pool:  You may qualify for a pre-existing condition insurance plan or a high risk pool, which helps people who have a hard time getting insurance find coverage.  Most states have this option and you may call the department of insurance in the state you are residing for that information. However, if  your state does not have their own high risk program than they are using the US federal government high risk pool which you may find at www.pciplan.com/forms/pdfs/BenefitsSummary.pdf .

Health insurance plans for individuals and families:  If you do not have job-based or other coverage, you may want to buy a policy from a private insurer.

Finding care you can afford:  There may be local facilities that provide free or reduced-cost care, whether you’re insured or not. What you pay depends on your income.

Doug Gulleson loves to scuba dive overseas and makes sure he has his US health care and overseas health care, http://onlineglobalhealthinsurance.com/my-travel-guard.asp , information with him at all times when he travels   Keep our blog close by you, www.gntravelinsurance.com, for continual updates on the changes with the US health care system.

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