Health Insurance | Safeguard Assurance

Replace Expensive Small Group Health Plans with Affordable Individual Plans

Dawn Cook — Wed, 08 May 2019 19:47:19 +0000

Are you struggling to pay your group health insurance premiums?

As a small business owner (less than 7 employees), are you struggling to pay the monthly premium for your group health insurance? Sadly many small business owners have to answer “yes” to this question and it is very stressful since they do want to continue to offer health insurance benefits to their employees, but it has to be affordable for the business. Luckily there are some other options that could be more affordable as many small businesses have discovered. If you only have 3 – 7 employees, you may want to consider an alternative to fully funded group plans.

Why are group health insurance premiums high?

Fully insured group health insurance rates through insurance carriers are usually based on all employees as a group, with no ability to consider the cost savings that are there for the healthy employees, the group health premiums are quite high. Said a little differently, with some group health coverage, insurers cannot base their premium prices on the medical history of any one individual in the group, but instead must account for a wide variety of statistical illnesses for the entire population of the group. Group premiums

could be less if insurers could base it on the medical history of each employee and if a larger percentage of the employees are in good health with no pre-existing conditions. So it really comes down to what type of group coverage you have in place. Fully insured can be very expensive because the entire group rates are based on the entire group. Level funded group coverage may be something to consider if your group is younger and healthy. This type of insurance usually requires at least 10 employees or more for the deepest savings.

What this means for you and your business?

If your business has less than 7 employees, you probably have a group plan currently in place, and most of your employees are in good health (the most savings is available when employees have no pre-existing conditions), there may be lower premiums that you are missing out on. An analysis can be done to determine if

individual health insurance plans for each employee would produce a lower total premium over your current group health insurance premium. Individual plans may also offer more flexibility in choice for each employee which employees appreciate. As a small employer (less than 7 employees), by law, you can provide individual health insurance plans to your employees over the group plan.

What your next step should be if you want to know if your business could benefit?

Contact a local insurance agency with experience in this cost savings employee health insurance approach, like Safeguard Assurance LLC. They will need an employee census and your current group plan premium and benefit summary for analysis and comparison. They will then be able to evaluate the options and crunch the numbers for you to determine if significant savings is available and if it makes sense to make a change. We at Safeguard Assurance keep our client’s best interests as our top priority and we’ll tell you if making no change is the best option for you.

Affordable Group Insurance | Cheap Health Insurance | Bradenton FL | Sarasota FL

Better Alternative to Obamacare

Dave Cook — Wed, 03 Apr 2019 22:11:10 +0000

Health insurance is getting more and more expensive. Being involved in the health insurance industry, we have found that people are looking for better alternatives to Obamacare just like ourselves.

Dawn and I (Dave Cook) found a cheaper and better solution for ourselves. Granted neither of us have any pre-existing conditions and we are okay with self-insuring our healthcare up to a certain dollar amount annually to save on those higher monthly premiums

You must realize that the only option that still covers pre-existing conditions for the first 12-24 months is a “Qualified Health Plan” (QHP) offered through the marketplace (Obamacare). All other terms of insurance usually have a 12 month and, in some cases, up to a 5-year pre-existing look back period.

For us, the cheapest Obamacare plan we could find in our area was an HMO for $1,063.25 per month with a individual deductible of $7,900 with a combined Max Out Of Pocket (MOOP) of $15,800.00. A lot of people never heard of this carrier and a lot of doctors and hospitals do not even accept this carrier in our area. Remember that the only benefit for us is that these plans do cover pre-exiting conditions and preventative services such as pap-smears, colonoscopies and other things, but doesn’t cover doctor visits and other things until we reach the $7,900 deductible per person.

All insurance comes down to what “Risk” are you willing to accept. At a monthly premium $1,063.25 ($12,782.76 annually) plus a combined MOOP of $15,800.00, our Risk with the above plan would be $28,582.76 per year. Since we are both healthy with no pre-existing conditions, this annual risk is just too high!

Based on our health insurance needs, we opted for what is called a Short-term Medical (STM) plan that is a PPO and uses the Aetna network. In the past, STM could only run for 3-month periods and you were exposed to the government health insurance mandate (government tax penalty) for not having an Obamacare plan. With the NEW law, STM plans in Florida can offer 364 days of coverage and the insurance mandate is no longer an issue for being penalized.

Now if someone is getting a tax credit (a subsidy based on family makeup and income) to offset their monthly premium or they have health issues, then maybe an Obamacare plan is a good option to lower their overall risk.

Based on our situation, the Short-term Medical Aetna PPO option is better for us with a monthly premium of only $708.17 ($8,498.04 annually) and a deductible of $5,000.00 with a combined Max Out Of Pocket of $10,000.00. With this our overall risk is $18,489.04 vs. the Obamacare HMO alternative of $28,582.76 per year.

Even though we do not get the preventative screenings offered under a QHP, we are potentially saving over $10,000.00 per year and we receive discounts using a much larger PPO network of doctors and hospitals.

NOTE: You can drop your Obamacare plan throughout the year, but you can only enroll in those plans during Open Enrollment. If Short-term Medical isn’t a good fit, there are other options available as well that may better suit your needs and you can enroll at any time during the year such as; Minimal Essential Coverage (MEC) plans, Healthshare Ministry plans, Hospital Indemnity plans and more…

Short Term Medical | Obamacare Alternative | Bradenton FL | Sarasota FL

Medicare – 4 Main Points When You Turn 65

Dawn Cook — Wed, 20 Mar 2019 15:13:15 +0000

If you are nearing age 65 and are getting ready to enroll in Medicare, you may feel buried and confused by all the mail and phone calls you are receiving. We can help unbury you by improving your understanding and reducing the confusion by separating Medicare into four main points and giving you a brief overview of each.

1. Understand Medicare Parts A, B, and D — Medicare has 3 parts, Parts A, B and D, and here’s the main points of each. Parts A and B, called Original Medicare, are provided by the Centers for Medicare and Medicaid Services (CMS). When you apply for Medicare through Social Security, Parts A and B come together. Part A is for inpatient hospital and skilled nursing care. Part B is for doctor visits, outpatient procedures, tests, lab work, etc. Part D is an insurance plan to decrease the costs of prescription medicines. Eligibility for Part A, B and D start the first day of the month you turn 65, or at a sooner date in the event that you have been receiving Social Security Disability Benefits for 24 months.

2. Understand your Premiums for Each Part — For a great many people, Part A is no cost as long as you or your spouse has 10 years of work history. Part B has a premium and it is based on your income. The lowest premium for 2019 of $135.50 every month and most people pay this amount. Those with higher earnings pay a higher monthly premium. Your earnings used for calculating a higher Part B premium come from your last filed tax return. So, on the off chance that you have experienced an earnings decrease, get in touch with Social Security and request a recalculation. Part B premiums are withheld from your month to month Social Security check, except if you delayed receipt of your Social Security benefits. If you have delayed, then you are billed quarterly for Part B premium. You can setup automatic bank draft if you like. Part D’s prescription medicine insurance is provided by private insurance carriers, and the monthly premium differs by state and carrier. Part D premiums are paid by you to the carrier rather than to CMS, but you can have the premium taken out of your Social Security check. The possible higher premium for Part B, discussed above, also applies to Part D premiums.

3. Understand Your Cost Share When Services are Used — Medicare is quite comprehensive, but it does not cover 100% (except Medicare does cover 100% of certain preventive services) of all medical services. Original Medicare, Parts A & B, have cost share responsibilities for you in deductibles, co-pays, and co-insurance. Part A has a deductible of $1,364 for 2019 and it covers your first 60 days in the hospital. Days 61 and more have daily co-pays as your cost share. Part B pays 80% of your outpatient costs after a one-time deductible every year, $185 for 2019. So for Part B, your cost share is the deductible and the remaining 20% of all medical services. It is very important to know that there is no annual limit to the cost share you are responsible for Parts A and B. This unknown cost exposure can be quite scary (See your Medicare Options next for alternatives to this problem.) Your Part D cost share varies by plan but includes the deductible then co-pays or coinsurance for each medicine you take.

4. Understand your Medicare Options — There are two options to pick from:

Option 1: Add a Medicare Supplement (Medigap) plan to help you pay your cost share within Part A and B. There is a premium for a Medigap plan, but the plan can completely pay your Medicare Part A & B cost share mentioned above or most of it, your choice. A Medigap plan, offered by private insurance companies, lets you see any doctor or hospital that accepts Medicare so there is good flexibility and peace of mind with this option and this is great for snowbirds. You will keep your stand-alone Part D plan with this option.

Option 2: Replace Original Medicare with a Medicare Advantage plan while still paying your Part B premium. Medicare Advantage plans are called Part C plans. The main advantages of a Part C plan over just Original Medicare is the annual limit in the amount of cost share you must pay and there can be no additional premium over the Part B premium you are already paying.

Medicare Advantage plans are offered by private insurance companies and can be either an HMO or PPO; HMO- you must go to doctor or hospital who accepts the plan, PPO- you must go to doctor or hospital that accepts plan to get lower cost. Part C plans can have a deductible and always have co-pays or co-insurance as your cost share as you use the services. Your prescription costs will be part of your Medicare Advantage plan with this

In the event that you need help understanding Medicare and eliminating the confusion, we are here to be YOUR expert from YOUR local insurance agency. This was a brief overview and we can add the required specific details based on YOUR particular needs, so call Safeguard Assurance today. There is no cost to you for our Medicare assistance, and that’s only one of the reasons you will be happy you called Safeguard Assurance.

Dawn Cook Medicare Supplements | Ellenton FL Medicare Advantage | PDP Plans