Health Insurance


Do you know losing a job will affect your insurance? (image via fairfaxcounty on flickr)

Times are tough and the economic turmoil of recent years continues to claim jobs almost every day.  The loss of a job presents problems on several fronts, first and foremost, the loss of income.  For many people who become unemployed, this problem overwhelms any others and makes it difficult to see how losing a job impacts other areas of your life.  Unfortunately, not dealing with these other areas can lead to more problems down the road.  One of these areas is your insurance coverage.

The last thing you need when you lose your job is to add to your family’s financial burden by purchasing insurance policies.  However, if you are like most people, you have been getting at least some of your insurance coverage through your employer.  Some of this coverage, like health and disability coverage was provided by your employer.  Other types of coverage like life, auto, and even homeowner’s coverage were purchased through your employer.  When your job goes away, in almost all cases, so does this coverage.   You may find yourself without life insurance, auto coverage, or a homeowner’s policy which further endangers the financial future of your family.

Here are things you must consider in terms of your insurance policies when you lose your job.

Health Insurance

Most people will have the option of continuing employer offered health insurance through the COBRA program once their employment ends.  This can be a lifesaver for families where the primary insurance provider suffers a job loss.  However, be prepared to pay significantly more for the same coverage.  Shop around to see if you can find an individual policy that is more cost effective.

Life Insurance

If your life insurance was provided by or through your employer, you will need to find a new individual policy to meet your life insurance needs.  This should be a top priority in order to protect your family’s future.  Temporary loss of your income is challenging enough; don’t take the chance that the worst happens and your family must figure out how to move forward without you while also dealing with the permanent loss of your income.

Disability Insurance

Life insurance is important, but disability coverage is just as important, especially for those in their middle years with families.  People in this age group are actually more likely to become disabled than to die, according to the Social Security Administration. This means that protecting your family’s finances may mean you need to secure a disability insurance policy that is separate and distinct from your employment.

Auto and Home

Many employers offer group insurance coverage for auto and homeowner’s policies that enables their employees to purchase this coverage at a discount.  When your employment ends, these policies may remain in effect but the cost to keep them may increase because you are no longer part of the group.  There is also a chance that this coverage will no longer be available.  Make an appointment with your insurance agent to discuss these policies and make sure you have the coverage you need at the best possible price.

Losing a job is difficult enough; make sure you don’t compound the problem by failing to attend to your family’s insurance needs.

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http://www.iii.org/articles/life-stages/employment-change.html

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What impact does your credit score have on what you pay for insurance? (image via Flickr)

In a nutshell, yes.  Insurance companies use a variety of factors to develop a risk profile for you when they are underwriting your insurance policy and determining your rate.  One of these factors may be your personal credit history and not because they are weighing the likelihood that you will pay for your policy.

Insurance rates are based in part on how much risk the insurance company believes they will be taking on by underwriting your policy.  In order to determine that risk level, they rely on real world statistics and actuarial tables built from those statistics.  By looking at large amounts of data, the insurance industry can make certain assumptions about you based on specific characteristics like your gender, age, marital status, etc.  This is how insurance companies determine that teenage boys are more likely to be in accidents than teenage girls and that married people are less likely to file an insurance claim than single people.

When it comes to your credit, the statistics can tell the insurance company some important things about how much of a risk you are.  The industry has demonstrated that there is a very strong relationship between credit history and risk level meaning that just looking at a person’s credit history can be used as an objective measurement of their insurance risk.  The bottom line is that people who pay their bills on time and are good stewards of their finances are more careful and conscientious with their cars and homes, which makes them a lower risk from an insurance perspective.

This means that the insurance company is using your credit history in a very different way than your bank might.  When your bank looks at your credit, they are assessing your income, assets, debts, and financial history to determine how likely it is that you actually meet the financial obligation of a loan or line of credit.  They are looking at your individual details to make a decision about your ability to pay.  The insurance company is looking at your credit as an objective way to assess how risky you are from an insurance standpoint.  They are looking at your individual details as compared to other people.  The bank cares about where you work, how long you have been there, how much you make, and how much you owe.  The insurance company only cares about how your credit history informs your risk profile based on the actuarial data.

Using information like your credit history to determine your insurance rates is one way that insurance companies guarantee that they are offering their products at fair prices.  The use of statistics and actuarial information in determining risk helps remove any subjective decision making from the process.  Insurance companies can offer better prices to a broader range of consumers by using factors like their credit history.

The score used by the insurance company however, is different than your standard credit score used by banks and other financial institutions.  In order to determine your insurance score, the credit bureaus use a formula that looks at things like the number of accounts you have, how good you have been at paying your bills, how stable your finances are, any negative factors like liens and bankruptcies, and how much you currently owe.  Unlike your regular credit score, occasional late payments have less of an impact on your insurance score than patterns of financial irresponsibility.

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Employees

Good group benefits can help you land a great employee. (Image via Inkyhack on Flickr)

There are many factors that contribute to having a happy, productive workforce.  Human resources experts could give you a list a mile long of why things like company culture, employee appreciation, and providing meaningful work for a living wage would be near the top of that list of factors.  Group benefits, the ones that are optional, not the ones required by law, would also be up near the top of the list.  Group coverage often fulfills more than one need for your employees and can be a powerful way to express the company’s gratitude and appreciation for all the work employees do.  Providing these kinds of benefits can even be the thing that sets your company apart in the eyes of potential employees.

Here are 5 reasons small business owners should consider adding group benefits for their employees.

1.     Providing Peace of Mind

Two of the most common group benefits are life insurance and disability insurance, both of which protect the financial future of the employee and/or their family.  With these kinds of group benefits, employees can feel confident in their ability to support their family in trying times.

2.     Cost Control

The group nature of the benefits helps keep the costs down which means the company can offer things like health insurance or dental coverage because they are affordable.  It is also common practice to require that employees contribute toward the cost of many group benefits so that the costs are shared.  When you add in cost savings you may achieve by reducing turnover, benefits make good financial sense for most businesses.

3.     Tailored Solutions

Most insurance companies that provide this type of coverage will allow you to tailor the type of benefits you offer to meet the specific needs of your employees.  Additionally, there are other things, like subsidized gym memberships, which can be counted under the group benefits umbrella that are not related to or provided by an insurance company.

4.     Benefits Support

Many insurance programs offer support for their group benefits product lines that can provide real benefit to the business owner or manager.  When a group benefits package comes with this kind of support, it alleviates the need for HR staff or business owners to take time away from other things in order to answer questions.

5.     Recruiting and Employee Retention

One of the best reasons to offer group benefits is because benefits make employees happy and happy employees don’t leave for other opportunities.   The cost to the company of finding, hiring, and training a new person is likely much higher than the company’s contribution to the cost of benefits for that role.  If you are looking to attract the best and brightest people, you need to offer a work environment that doesn’t just compare with the completion, but surpasses it.  Group benefits can be the thing that turns your job offer into a candidate’s best offer.

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Marriage

Are you properly insured after a major life-changing event? Image via cheesy42 on Flickr

Many people don’t realize that different life events can have an impact on their insurance needs as well as their insurance premiums.  You might think that turning 25 will bring your auto insurance down or realize that getting married means you need to combine your coverage into a single policy, but there are many other ways that major life events can impact your insurance.   A survey conducted by Trusted Choice and reported in Insurance Journal found that more than 30 million U.S. households have insurance policies and/or coverage that don’t fit their current needs.

Here are 3 of the major life events that can change what kind of insurance you need, how much insurance you need, or how much your insurance costs.

1.     Getting Married

When you tie the knot, your insurance needs and costs can change in a couple different areas.  First, your car insurance rates may go down because you are married and combining policies may qualify you for a multi-car discount.  If you are purchasing a house, you will need a new homeowner’s policy.  If you are moving in together but renting, you will want to combine your renter’s insurance and make sure the coverage limits of the policy are enough to replace both of your possessions.  Regardless of whether you are a renter or a homeowner, you may want to make sure your property replacement coverage will cover your wedding rings.  Finally, now that you are married, your life insurance needs may be drastically different and should be reviewed.  Even if you have enough insurance, you will likely need to make beneficiary changes at a minimum.  Talk to your insurance agent to make sure the coverage you have is the coverage you need and that you aren’t paying more for it than you should be.

2.     Getting Divorced or Becoming Widowed

A change in marital status can mean that you need to make changes to your insurance coverage.  Going from two cars to one, moving to a smaller house, selling valuables, and splitting assets can all result in the need for less coverage and lower limits.  This can be a big cost savings for you that you may not think of during such a difficult time.  You will also want to change any beneficiaries on life insurance or other policy payouts.

3.     Having Children

Becoming a parent for the first time or the last time is a big change and it can mean you need to make changes to your insurance coverage.  According to a life insurance fact sheet put out by LIMRA, almost 70% of U.S. Households with children under 18 would be in jeopardy and destabilized financially if the primary bread winner died.    If you have added a new family member by birth or adoption, it is a good idea to sit down with your insurance agent and make sure you have enough life insurance coverage to meet the needs of your family and that beneficiaries are designated properly.  You may also want to review your auto and home insurance policies to ensure that coverage limits are adequate for your larger family.

While these are 3 of the major life events that can affect your insurance costs and needs, there are several other events that should trigger a review of your policies with your agent.  If you have a new teenage driver, buy a vacation home, have a significant change in income, buy or inherit valuable property, or as you get ready to retire, sitting down with your agent can make sure you and the ones you love are protected.
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Health Insurance

Which type of health insurance is right for you? Image via combusean on Flickr

With the cost of health insurance on the rise, many employers are shopping around for new coverage every year and entertaining plans they would never have considered before.  If you are like many Americans who have had health insurance over the years, you have had an HMO or Health Maintenance Organization, at one point or another.  You may also have had a PPO or Preferred Provider Plan.  But as companies continue to search for health care options that are affordable, you may begin to hear about alternative plans, if you haven’t already.

To aid in your understanding of what the different types of plans are and how they differ, here is a basic overview of each of the main types of health insurance plans.

HMO – Health Maintenance Organization

HMO’s are often the lowest cost plans from both a premium and an out-of-pocket perspective.  Insurance companies lower costs by limiting which providers plan participants can visit.   The insurance company creates a network of doctors and hospitals that agree to accept lower fees in exchange for membership in the HMO.  Plan participants must go to an in-network provider or facility in order for it to be covered.  Participants choose a Primary Care Physician (PCP) that must refer them out to all other doctors and specialists.

Most HMO plans require participants to pay a premium and a co-pay with each service.  However, HMOs do not have a deductible and co-pays are always the same amount.

Bottomline on HMOs – Lowest out of pocket cost, lowest premium, least amount of choice

PPO – Preferred Provider Organization

PPO plans are similar to HMOs in that the insurance company negotiates lower rates with a network of providers and facilities.   Rather than having a set co-pay amount, a PPO will require a certain percentage of co-insurance, which means you pay a certain percentage of every bill.  Another difference with a PPO is that you have the option of going to a provider outside the company’s network that is covered, although, your percentage of the cost will be higher if you go out of network.

Bottomline on PPOs – Out of pocket depends on services received, slightly more expensive premium, more freedom of choice.

POS – Point of Service

Point of Service or POS plans take the freedom of choice provided in the PPO and the cost savings enabled by HMO coverage and melds them together.  Plan participants can go through their PCP and have services covered like in an HMO.  They can also choose a provider from the PPO network and coverage will be covered per the PPO rules, or they can go outside both networks and choose any provider they want.  If they decide to go outside the networks, they are subject to out-of-network rules.

Bottomline on POS – Out of pocket depends on services received, more expensive premium than HMO, and more freedom of choice.

Fee-For-Service Plan

In a Fee-For Service Plan, also called an indemnity plan, the insurance company pays for each service you receive.  Most FFS plans have a deductible that must be met before coverage kicks in which can be significant depending on the plan.

Bottomline of FFS – Out of pocket depends on services received, most expensive premium of the four main types of coverage, and complete freedom of choice.

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Medicare Coverage

Which Medicare coverage is right for you? Image via Old Shoe Woman on Flickr

There is no way to sugar coat it; Medicare can be mindboggling.  For people moving to Medicare from private insurance, switching over can be a frustrating time because you have a lot of questions and aren’t sure where to get the answers.  If you are used to the relatively straightforward private insurance company plans offered through employers, navigating the many parts of Medicare is often the first obstacle you have to overcome.  With so many parts and a late enrollment penalty hanging over your head, it’s hard to know what you need, which parts to choose, and who you need to work with to get all the parts and pieces in place before you run out of time.

To ease the adjustment, here is a basic breakdown of the different parts of Medicare, what each part covers, and how they work in conjunction with each other to provide the health insurance coverage you need.  For more information, you can visit the Medicare website or talk to your insurance agent.

1.     First Things First

Let’s review what Medicare is and who is eligible for it.  The Medicare program provides health insurance for people in specific situations and is funded by the Federal Government.  In order to qualify for Medicare, you must be either 65 years old or older, under 65 with a specific disability, or any age with end-stage renal disease.

2.     Medicare Part A: When You Need to Go to the Hospital

Medicare Part A is part of your base Medicare coverage.  It pays for your medical expenses when you are admitted to a hospital and receive inpatient care.  Additionally, it may provide some coverage or assistance in paying for a skilled nursing facility, hospice care, and some of your home health care needs.  If you qualify for Medicare, Part A is automatically part of your coverage unless you opt for Part C below.

3.     Medicare Part B: When You Need Medical Care Outside the Hospital

Medicare Part B is also part of your base Medicare coverage and it pays for your medical expenses outside of the circumstances covered by Part A.  If you need to see a doctor, have an outpatient procedure at the hospital, or other eligible expenses, Part B pays for 80% of the cost after you meet your Part B deductible.  Preventative care and care associated with managing long term illnesses are also covered by Part B but are generally covered at 100%.  Unlike Medicare Part A, there is a monthly premium that must be paid for Part B coverage.

4.     Medicare Part C: aka Medicare Advantage Plans

Medicare Part C encompasses both Part A and Part B and offers Medicare recipients another option for health insurance.  A Medicare Advantage Plan is run by a private insurance company and functions like the HMO or PPO you likely had through your employer prior to switching to Medicare.   If you choose Medicare Part C, any hospital stays, medical treatments, preventative care, hospice, skilled nursing, or home health care would be covered under the Medicare Advantage Plan you select.  In addition to those Part A and B services, a Medicare Advantage Plan may also cover other costs including prescription drugs.  Medicare Advantage plans have a monthly premium that you must pay.  If you choose Medicare Part C, you do not need Part A or Part B and depending on the plan you choose, you may not need Part D either.

5.     Medicare Part D: Prescription Drug Coverage

Medicare Part D is an optional coverage offered by private insurance companies that have been approved by Medicare to offer coverage for prescription medication.  If you have Medicare Parts A and B, you will more than likely want to purchase a Medicare Part D plan to help cover the cost of any medication.  If you have a Medicare Advantage Plan that doesn’t offer the prescription drug coverage you need, you may want to find out if a Medicare Part D plan could help save money on your prescription drugs.  Part D requires you to pay a monthly premium and has an annual limit.

6.     Medicare Supplemental Insurance: Medigap

This is an extra policy you can purchase to help cover your out of pocket expenses and things that are not covered by Medicare.  If you purchase a Medicare Advantage program, you are not eligible for Medigap coverage as it only applies to those with traditional (Parts A, B, and maybe D) Medicare coverage.  Although there are 12 different types of Medigap coverage offered, each type provides the same coverage regardless of which insurance company you purchase it from.  You will need to pay an additional premium each month if you decide to purchase Medigap coverage.

The complexities of Medicare may seem overwhelming, but once you understand what each part covers and how the different combinations work together to cover your health care costs, you can make the right decision for you.
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