Should I buy all health benefits from one carrier or use multiple carriers?

This question can apply equally to individuals and groups. A lot depends on specific needs and medical conditions. Each carrier has the right to choose the level of risk they wish to accept. As such depending on the coverage needed and other factors the same carrier may be a great option or it may be that multiple carriers need to be used. It is important to use an independent broker who can shop multiple carriers and understands the differences in coverage as well as underwriting. Here is more about how it gets determined.

First, you have to decide on the types of coverage you want. Discussing your needs and desired protections with a broker will allow you to map out the slate of coverage you want to get. With that initial step done you can then begin to look at what companies offer the coverage and at what price. The broker will also know and should advise if coupling together one or more of the products will help generate related policy discounts for the insured.

It is typically hard to get, at the best rate all of your coverage from the same carrier. To bring this home, your home, auto, life, health, long term care, disability, and umbrella is typically not available from a single carrier. When it is, the carrier is not providing the best coverage and best price for each and every one of the products because there is no carrier leading in each product.  Thus, you could find yourself overpaying quite a bit for less than the best coverage for your specific needs.  Discounts aside, and even just dealing with a single agent are all great but it is probably not the best deal for you.

It may be possible to pair a few of the plan Health-Life related types together with one carrier and secure some discounts.  Similarly family discounts may be available from some carriers. Medicare Supplements are one area where the couple’s discount is prevalent.  Some mutual companies, because the policy owner is also an owner of the mutual company, offer multi-policy discounts as well.   Knowing this and already knowing your slate of needed coverage, a great broker will help you pick the right plans based on your needs while at the same time looking for multi-policy discounts that enhance the cost effectiveness of the coverage you do end up buying.

The next step in the process of determining for you, all from one or best from different carriers approach is best, is assessing your underwriting status. You will need to share medical history with your broker so they can use the information to assess underwriting status with each carrier with a policy that otherwise meets your needs. Then where there are several policies, it moves to the point that the broker is assessing pricing, and cost effectiveness of the coverage.

If by chance the cost effective policies for you are all with the same carrier great. If not then you will want to compare the price of going all with one carrier and decide if the extra cost is worth any additional administrative efforts you incur.  This is where we separate out group from Indivdual policies just a bit. The additional administration for an individual policy holder of several policies at the same carrier vs. administration of several policies by a single carrier is very different.

In most cases with Indivdual policies you will get separate bills, or have separate bank drafts for each of the policies regardless of how many are owned. This all has to do with accounting by the carriers. Thus, if you are not saving by having the policies all with a single carrier there ends up no real benefit to doing so.  When you can have more cost effective coverage spread over different carriers and still pay the same number of bills or have the same number of bank drafts administratively you are pretty much equal.

For groups because of their larger size and economies of scale working in their favor many carriers will consolidate several polices into one or two bills each month.  With this groups may find that the ease in administration is worth a bit of extra cost. This is especially true when you are able to secure several policy elements for employees off of a single application.  When you begin to bog down in the Human Resources realm completing several applications for disability, life, dental, medical, and any other insurance related benefit the efficiencies of a single or two applications becomes evident. 

Typically with the very large carriers using them to administer several lines of business will almost always generate some additional savings. There are several reasons for this, but one of the biggest is administrative ease on their end. They also know that usually when they provide a slate of benefits packaged together they will be able to work the economics to retain the client longer than if there is only one benefit sold.

In the end on the individual side it is usually best to select the most cost effective set of plans based on your needs. Unless it creates a significant administrative burden to have the plans with multiple carriers you should use the best plans for you based on your needs.  For groups more often than not a single or perhaps a couple of carriers typically is the best option.

We can offer you many different solutions when you work with us.  If you need Life Insurance in Houston we are here to help you.

Does one need a Medicare Supplement Policy?

If you have Medicare unlike your old traditional major medical policy there is no limit on how much money you could owe during the course of a calendar year. On traditional Major Medical Policies there are annual spend limits, typically separate for both in and out of network care.  With Medicare you face out of network costs and unlimited cost sharing. A lot of the costs will depend how much you use care but they still exist.

Because the numbers change each year and I am not focused on super specific numbers, I don’t plan to quote the Part A co-payments and Part B deductibles for any given year here, other than to say they exist. Each year the numbers typically increase as well making your stay in the hospital or visit to the doctor or other outpatient provider more expensive as well.   In the event you get really sick during the course of a year you could face rapidly mounting out of pocket costs that can easily be controlled with the appropriate coverage in place.

Medicare Supplement plans will cover (depending on the plan design you take) some portion or as much as all of the cost sharing the Medicare leaves for the member to pay. Also, select Medicare Supplement plans also pay the portion above Medicare allowable (which is a 15% surcharge) that out of network providers, (those providers who do not accept Medicare assignment) are allowed under the laws to charge you. This provision helps quite a bit for those who get an illness and need care in an area where the available doctors who treat Medicare enrollees are somewhat limited.  

With a Medicare Supplement you can eliminate the need to worry about going out of pocket for your care. The Supplement, when you pick a Plan F will pick up where Medicare leaves off, for Medicare covered care.  That is one key thing to remember that if you are seeking care that Medicare doesn’t cover neither Medicare nor the supplement coverage will kick in to pay.  Those rare situations aside, your Medicare Supplement policy will provide you with a predictable monthly/quarterly/semi-annually/or annual premium that you pay and avoid the surprise out of pocket costs. 

When you get a plan F which is the most popular plan sold you will pay your premium and avoid paying out of pocket for your care as you go. This plan is so popular because it allows in particular those on fixed incomes to better control their monthly expenses. It is also extremely popular because it allows the plan member to get whatever care is recommended without thinking about can I afford the care or test right now, or do I just need to defer it a while. 

On select Medicare Supplement plans you can even seek limited emergency care outside the United States of America and have some coverage, typically up to $50,000 lifetime coverage with a $250 deductible and 20% co-insurance paid by you. This however is a great benefit for those who travel because Medicare does not otherwise provide any coverage for your medical care outside of the United States.

Because Medicare Supplements work super well with those who have both Part A and Part B Medicare and help control budgets for the insured, Medicare Supplements are very popular with those 65 and over who are on Medicare.  They are best procured when you are first eligible for Medicare, but can be secured at any time once you are on Medicare. Just know that if you are not in a guaranteed eligibility time frame you are subject to full medical underwriting which could prove difficult if you have medical conditions. For expert advise picking the Medicare Supplement Plan in Texas right for you check with us.

We are always helping our clients select the most appropriate plan for their Medicare needs, so give us a call to assist you with the right choice.

Should I buy all my insurance from one agency or use agencies that provide specialized support for each product I need?

Generally, like with Healthcare it’s best to get your insurance from specialized agencies or at least specialized groups within a larger agency.  It is hard for one agent to know enough about all kinds of insurance commercial, individual, property, and health related to cover all bases well. 

I have different agents myself to help with various kinds of insurance needs. These folks have expertise in the specific kind of insurance and as such can offer the best advice about those different coverage types. Specialists are also generally able to better monitor the condition of carriers and have a better grasp on what makes one carrier different from the others within the same market.  Tapping the more in depth knowledge should really help you end up with a better plan.

Our agency focuses on health and life insurance and related products. Because of this we know these products well and can help you pick the policy that is best suited to your specific needs. We also understand the nuances of underwriting and are able to guide clients based in part on who will provide better underwriting for clients specific situations.  By knowing this information we can help clients obtain coverage more quickly and more cost effective coverage is usually easier to come by.

There are many agencies out there trying to sell every imaginable kind of insurance, often representing only a single carrier for each type of coverage. While some of the plans they offer may be great, it’s usually hard for them to represent the best in each class of coverage. Many of these big name big box agencies have agents who seldom work a particular line but instead of losing a sale will make it as an agent anyhow. That can be bad for the customer as they may be missing critical elements of the necessary coverage or they may pay too much for the coverage by selecting the one company represented instead of the best in the class.

We and other specialized agents review pricing from several carriers and often discuss more than one carrier with clients as we get to the one plan that best fits client needs.  We also help our clients identify top brokers for other insurance products we do not represent. This allows us to comfortably refer clients to other specialists who can help the clients with their home, auto, and other similar coverage needs.  These other agents take the same approach as we do and specialize in a handful of related insurance products so they can best serve their clients.

On the extreme opposite end of the spectrum from the big box agencies selling every product they can are the agents who are captive under a single company and represent one or maybe two products. These agents typically know their product well but depending on the market and consumer need their product may not be a best bet for most clients. To that end these agents while well intentioned may end up pushing their product on folks where a broker who can represent multiple carriers would have presented a more cost effective solution to the client.

Ultimately a broker who represents multiple carriers and specializes in a few related lines of business is typically your best source of information for purchasing a policy. They will likely also do a better job of watching for changes in the plans and depending on the kind of coverage you have set up help you change carriers as is appropriate to keep you on the most cost effective coverage. This same broker will usually know a good expert in other areas of insurance to help you as those needs come up to be addressed.

Get with us for your health, Medicare Supplement, Life, Long Term Care, and Disability insurance needs.

How small group health plan designs differ from individual health plans.

So you own a business and are considering the small group benefits route versus going with individual medical coverage. There is a fairly big difference in some aspects of the coverage but at the same time they are generally very similar. Knowing the difference between the two kinds of coverage is important if you want to make the most appropriate decision, because an assumption that the coverage is the same can cost a lot of money when you realize those things not covered by one or the other policy can add up quickly.

The biggest difference is that group insurance plans (unless specifically excepted out) cover normal maternity services.  Indivdual coverage only covers complications to pregnancy, which generally means there will be no coverage for the actual delivery which can run several thousand dollars. So if you are a young business owner looking to expand your family that is probably all you need to hear to know that group coverage will be the better option for your family.

Individual policies historically have had greater restrictions about the amount of coverage for certain kinds of care as compared with what is found in many small group policies. The group policies tend to be more generous in the amount of care you can get for specific provider types such as therapists. Of course with healthcare reform we will see,  less differential between the plans, but that does not kick in for nearly 2 years still, if it is not overturned in the Supreme Court.

The small group policies comparing the same deductible and PPO to PPO or H.S.A. to H.S.A. based plans we find most often that the small group will be more costly than individual. However when comparing the actual coverage and realizing you have expanded coverage on the group coverage it becomes apparent that for most the small group coverage is better.  Then there is the entire issue of underwriting and getting a policy issued in the first place.

With a small group plan you have a guaranteed issue policy. With individual coverage you are at the mercy of the carrier’s underwriting guidelines to get coverage or be presented with a decline.  In Texas if you are declined for an individual policy you do get the option to secure a policy thru the Texas High Risk Pool, which is quite a bit more expensive.  By contrast any legitimate group is able to get group coverage. A group is 2 or more people working for the same employer, a relationship which must be documented thru specific records.  

Small groups are medically underwritten, but instead of accept (maybe with a rate up) or decline as happens with individual plans small group must accept, but can rate up the group up to 67% above the base rates for the group.   The group will have base rates issued based on age/sex of the employees along with the industry in which the group works. Some groups get a bit of rate relief based on industry while others pay a surcharge.  Then during medical underwriting the underwriter reviews based on information on the application for the group if there is a likely expensive chronic condition which warrants additional premium being charged for the group.

In the end small group is best for those wanting to have kids on the insurance plan, and who have medical issues that would likely cause a decline for an individual insurance application.  Individual may be better for a very healthy young male who has no plans to get married and have kids in the near term.

Call us for more help evaluating what is best for your specific situation. 

As a small business owner should I provide group insurance benefits?

There are no laws requiring the provision of health insurance or other benefits to employees. Even with Healthcare Reform you don’t necessarily as an employer have to provide the benefits instead you can opt to pay fines and let the employees get their benefits on the open market.  Of course the healthcare reform act is subject to what is decided by the Supreme Court this year.

Regardless of the laws involved, generally it is a good idea to offer your full time employees benefits in addition to cash compensation for their work. The key reason for this is the competitive market for good employees. In some industries there are actually shortages of employees period, let alone those who are good hard workers.  Not only do you want to attract employees in a competitive environment you want to retain them when they are producing results for your company.

Aside from direct cash compensation employee benefits are one of the recruiting and retention tools.  Many employees who have benefits in their current job would not consider leaving for a new job that does not include benefits, more specifically health insurance for the employees.  Because of this and likely the need to cover the owner’s own family health benefits offered as a group health plan benefit for the employees is one of the best benefits to employ.

From a health insurance perspective you can obtain better coverage as a group than as an individual. You can also secure guaranteed issue major medical coverage which short of going to the high cost risk pool is not an option in Texas. The cost of the risk pool makes coverage unaffordable for many with medical conditions.  Because in Texas a group is defined as 2+ who get paid by a common entity, yes you have to be able to provide evidence of employment for those being added to the group, even the smallest group can receive guaranteed issue coverage.

Just because coverage is guaranteed it does not mean rates can’t be adjusted based on age/sex/medical conditions suffered by the group. There are however limits about how much of an increase from the base rates (which are filed with the state department of insurance) can be adjusted for medical issues. Age and sex and work industry are standard rate modifications. 

You can add on dental, life, and even disability coverage to these groups. Depending on the size of the group you will have more options for additional add on specialty insurance products as well as more options for the dental coverage, life coverage, and disability coverage. Among the specialty products are cash benefit products for occurrences of cancer and other dreaded diseases. These help the employees both with and without disability benefits cope with the non-medical costs as well as deductibles etc., associated with seeking treatment for such a horrible disease.

We specialize in helping small business owners implement market competitive benefits packages to attract and retain good employees. Again, if you want to attract the best employees you should offer benefits in addition to just offering competitive wages.