With the new health care reform, states were to have set up high-risk health insurance pools for individuals with pre-existing conditions that could not get coverage in the private market.
This pool was to be in effect on 6/1/2010, but Illinois has yet to establish.
Individual's eligible for coverage must have gone without health insurance for the past 6 months in order to apply.
Currently, Illinois has always had The Illinois Comprehensive Health Insurance Plan (ICHIP) for high-risk insured's. There were 4 types of coverage available, and depending on coverage there is a 6 month waiting period for coverage on pre-existing conditions. There is no current requirement to how long you have been without health insurance for.
For more information please feel free to contact The Shoppe.
-The Shoppe
Wednesday, June 23, 2010
Friday, June 18, 2010
Make sure you know what Hospitals are covered with your health insurance
Be careful when applying for new health insurance coverage in the private market.
The #1 mistake people can make is going to a hospital or doctor that is not in their health insurance plans network of providers.
Click to see a list of hospitals covered by major health insurance companies in Chicago...http://bit.ly/NetComp
Even though your plan may be a Preferred Provider Organization (PPO), many insurance carriers offer smaller networks of providers for a discounted cost in monthly premium.
Depending on the insurance carrier, plans have separate deductibles and out-of-pocket expense limits for non-participating providers.
When selecting a smaller network of providers, make sure that your hospital of choice is in the network as well as your current doctor if you have been seeking care with him/her for a while.
If you live in the City of Chicago you will not find Northwestern Memorial, Rush, and possibly Advocate.
For any questions, please contact The Shoppe. Hope this was useful information.
Thanks!
-The Shoppe
The #1 mistake people can make is going to a hospital or doctor that is not in their health insurance plans network of providers.
Click to see a list of hospitals covered by major health insurance companies in Chicago...http://bit.ly/NetComp
Even though your plan may be a Preferred Provider Organization (PPO), many insurance carriers offer smaller networks of providers for a discounted cost in monthly premium.
Depending on the insurance carrier, plans have separate deductibles and out-of-pocket expense limits for non-participating providers.
When selecting a smaller network of providers, make sure that your hospital of choice is in the network as well as your current doctor if you have been seeking care with him/her for a while.
If you live in the City of Chicago you will not find Northwestern Memorial, Rush, and possibly Advocate.
For any questions, please contact The Shoppe. Hope this was useful information.
Thanks!
-The Shoppe
Tuesday, June 15, 2010
How to cut your costs with HSAs
Are you looking to cut your health insurance premium cost's. Look no further than moving to an HSA compatible plan.
The below link will take you to a comparison of 3 plans of health insurance coverage from Blue Cross and Blue Shield of Illinois for a 35 year old male living in Chicago.
http://bit.ly/bWHWFo
The comparison will show 2 traditional plans of coverage that have office visit copays with 1 HSA compatible plan that does not provide office visit copays, but will cover annual physicals under a $20 copay.
The comparison will show the costs for someone who has been having issues with their stomach and acid indigestion. The insured first seeks care at their internist who then must refer to a Gastroentologist, a specialist.
In the comparison all 3 plans have the same cost exposure other than for office visits. The HSA compatible plan is the most beneficial in this scenario, since it has the lower deductible and provides 100% coverage after the deductible is met...and did I mention it is the lower cost in premium..??
As for the Rx illustration, none of the plans have a copay. With BCBSIL you must select a $500 or lower deductible in order to receive a $10 copay for generics and cost share for preferred and brand name drugs. The presented plans will all discount the cost when purchased in-network and the final paid will be applied to the plans deductible.
In this scenario, if the insured has an HSA compatible, they are allowed to take up to a $3,050 above-the-line tax deduction for 2010. The insured would have to open a Health Savings Account (HSA) at a local bank for free or for a $2-$3 monthly fee.
In this example, the insured could pay for these expenses out-of their own pocket or via credit card (get miles) and can definitely work out a payment plan with the provider. The insured would then have to make deposits into their HSA for any amount up to the total amount of expenses prior to 4/15 of the following year. A deduction can only be taken for the total amount on the HSA ledger.
Now...when the insured is to contribute monies into the account, he/she can then immediately withdraw the money as a reimbursement to what they had paid out-of-pocket or on credit card. This then allows them to use the HSA strictly as a tax-vehicle for medical expenses, rather than a savings account.
Hope this is all making sense. There is no need to pay the insurance company more in premium to have office visit copays or to have a lower deductible.
Please call the shoppe with any questions!
-The Shoppe
The below link will take you to a comparison of 3 plans of health insurance coverage from Blue Cross and Blue Shield of Illinois for a 35 year old male living in Chicago.
http://bit.ly/bWHWFo
The comparison will show 2 traditional plans of coverage that have office visit copays with 1 HSA compatible plan that does not provide office visit copays, but will cover annual physicals under a $20 copay.
The comparison will show the costs for someone who has been having issues with their stomach and acid indigestion. The insured first seeks care at their internist who then must refer to a Gastroentologist, a specialist.
In the comparison all 3 plans have the same cost exposure other than for office visits. The HSA compatible plan is the most beneficial in this scenario, since it has the lower deductible and provides 100% coverage after the deductible is met...and did I mention it is the lower cost in premium..??
As for the Rx illustration, none of the plans have a copay. With BCBSIL you must select a $500 or lower deductible in order to receive a $10 copay for generics and cost share for preferred and brand name drugs. The presented plans will all discount the cost when purchased in-network and the final paid will be applied to the plans deductible.
In this scenario, if the insured has an HSA compatible, they are allowed to take up to a $3,050 above-the-line tax deduction for 2010. The insured would have to open a Health Savings Account (HSA) at a local bank for free or for a $2-$3 monthly fee.
In this example, the insured could pay for these expenses out-of their own pocket or via credit card (get miles) and can definitely work out a payment plan with the provider. The insured would then have to make deposits into their HSA for any amount up to the total amount of expenses prior to 4/15 of the following year. A deduction can only be taken for the total amount on the HSA ledger.
Now...when the insured is to contribute monies into the account, he/she can then immediately withdraw the money as a reimbursement to what they had paid out-of-pocket or on credit card. This then allows them to use the HSA strictly as a tax-vehicle for medical expenses, rather than a savings account.
Hope this is all making sense. There is no need to pay the insurance company more in premium to have office visit copays or to have a lower deductible.
Please call the shoppe with any questions!
-The Shoppe
Friday, June 11, 2010
Let's talk about Health Savings Accounts (HSA)
What is an HSA?
- An HSA (Health Savings Account) is a government regulated savings account where you can contribute money, tax-free, to pay for your medical expenditures, such as your deductible, prescriptions drugs, dental, vision and so on... Any unused funds in the account for the year, roll over to the next year. Your money in the account will earn interest that is tax-deferred.
- In order to have an HSA you must apply for a qualifying High Deductible Health Plan (HDHP)
- An HDHP is a health insurance plan with a deductible greater than $1,200 that does not include any pre-paid benefits such as an office visit copayment or prescription drug card.
- In Illinois, there are only two carriers that offer deductibles below $1,000. All other carriers begin at $1,000 or $1,500 for non HSA plans.
- First, when you become a member of an insurance carrier, you are given access to their network of providers, known as a PPO (Preferred Provider Organization). By seeking services at providers within the network, you fully utilize the plans benefits. This allows you to receive a negotiated rate on the services provided.
- An example would be a doctor charging $100 to the public for an office visit in relation to an accident or illness. If the doctor is in your carriers network, you would not be subject to the $100, but a negotiated rate, which could be anywhere from 20-50% lower.
- The final negotiated rate is what the insured would be responsible to pay the provider, which would be applied towards the plans deductible, whereas an office visit copay would not apply to the plan. An insured may be responsible for around $65-$70.
- Second, 90% of insurance carriers cover your annual physcial for males and females along with a females annual OB/GYN visit at 100% or under a copay, even HSA plans.
- If a non-HSA plan has an office visit copay, the copay will only cover the cost of the initial visit, the negotiated rate. Once lab work, diagnostic tests or X-rays are ordered...than they all become a deductible expense and do not fall under the copay.
- Now, keep in mind that doctors all charge different rates, especially a specialist which could run around $300/visit before the negotiated rate.
- You can always call your doctors billing department and ask how much they charge for visits.
- If you currently are in treatment and take prescription medication, carriers may offer a genric presciption drugs card on non-HSA plans than require you to meet a separate $500 or $1,000 deductible for Brand or Preffered Brand name drugs, before a copay would then apply.
- HSA plans will apply the cost of your prescription to your plans deductible, whereas if there was a copay for a Brand or Preferred Brand name drug, it would not be applied to your deductible
- If you were on a Brand Name drug and had a copay of $35-$75/month, the copay would not go towards your deductible. This is an average of $500 in annual copays that would be an out-of-pocket expense. If you had an HSA plan, than you would have lowered your deductible exposure by $500, meaning you would owe less on a larger claim, if there was one.
What does a copay cover?
Office visit copays cover the cost of your visit to either a specialist or non-specialist physician. Usually, a plan will have a copay from $20-$50.
When paid, your copayment does not apply to your plans deductible or out-of-pocket expense limit.
Your copay will only covers the cost of what the physician charges for that particular office visit. If you receive any immunizations or vaccines at the time of visit, they will be covered under the copay. If the doctor requests any additional lab work or diagnostic tests, these will not be covered under the copay, and be an expense subject to your plans deductible and/or out-of-pocket expense.
-The Shoppe
When paid, your copayment does not apply to your plans deductible or out-of-pocket expense limit.
Your copay will only covers the cost of what the physician charges for that particular office visit. If you receive any immunizations or vaccines at the time of visit, they will be covered under the copay. If the doctor requests any additional lab work or diagnostic tests, these will not be covered under the copay, and be an expense subject to your plans deductible and/or out-of-pocket expense.
-The Shoppe
Tuesday, June 8, 2010
Faced with COBRA??
You may not know...but for someone who has been terminated from employment after 6/1/2010 they are not eligible for COBRA subsidy and will be responsible for the whole cost.
If you are now faced with the high cost of COBRA, here are some options:
1. If you have medical conditions that make you ineligible for health insurance in the private market you can pursue ICHIP. The Illinois Comprehensive Health Insurance Plan (ICHIP) is our states high-risk insurance pool. If you have medical conditions that make you ineligible for health insurance in the private market you can pursue ICHIP. The Illinois Comprehensive Health Insurance Plan (ICHIP) is our states high-risk insurance pool.
- Depending on your age and smoking status, COBRA may be lower in cost
- Would need a declination letter from a private carrier to be eligible for coverage if COBRA has not exhausted
2. Depending on medical condition coverage you can pursue coverage in the private market and possibly be offered coverage w/o any exclusions, but with an increase of premium to take on health risk
3. If you are not receiving treatment and have a clean health bill then seeking coverage in the private market is your best alternative to COBRA.
Please call or stop by the shoppe with any questions.
Thanks,
The Shoppe
Friday, June 4, 2010
Reviews from the shoppes clients..
The Health Insurance Shoppe allows current and past clients to write a review about their experience on YELP.
We currently have a total of 6 reviews but only 3 are being shown on YELP, while the other 3 are being filtered since the reviewers are not active on YELP.
Below are our 6 reviews from our clients...enjoy :-)
Jason B.
Chicago, IL
11/3/2009
Ashley W.
Chicago, IL
1/22/2010
We currently have a total of 6 reviews but only 3 are being shown on YELP, while the other 3 are being filtered since the reviewers are not active on YELP.
Below are our 6 reviews from our clients...enjoy :-)
Jason B.
Chicago, IL
11/3/2009
The Health Insurance Shoppe was a pleasure to work with. Mr. Wishner is extremely knowledgeable on the subject. I quickly understood the underlying aspects of the different policies and made a decision with their guidance and expertise. I plan on referring all of my friends to The Health Insurance Shoppe. It was refreshing to actually sit down and discuss my options with someone in person versus today's automated world.
Ashley W.
Chicago, IL
1/22/2010
For the many of us out there attempting to find the right health insurance plan, I strongly recommend that you consider the Health Insurance Shoppe. Working with the owner Jordan was quite pleasurable. It's refreshing to have an actual individual to talk to about the matter and find a plan that meets each applicants unique needs. Not only can you drop into his office on the fly (big plus!) but he is great about emailing and following up with phone calls.
Overall, if you are over your head trying to sort out health insurance, it is definitely worth your time to stop in. I am a 24 year old female and I did not feel pressured or taken advantage of during the process. Jordan is highly personable and it shows that he has the desire to help individuals become insured.
Like I said earlier, its worth the trip to Roscoe Village if you are contemplating heath insurance issues.
Overall, if you are over your head trying to sort out health insurance, it is definitely worth your time to stop in. I am a 24 year old female and I did not feel pressured or taken advantage of during the process. Jordan is highly personable and it shows that he has the desire to help individuals become insured.
Like I said earlier, its worth the trip to Roscoe Village if you are contemplating heath insurance issues.
Carine M.
Chicago, IL
2/18/2010
We were approved in no time at all (for real, today is 2/18 at 9:47am, we finished our application at 6:15pm on 2/15) . Fast service, too! Thanks Jordan!
We had a great experience shopping for health insurance at the health insurance shoppe. First of all, there is a super cute and friendly dog named Vail there that entertained our dog while we took care of business.
Jordan was great and answered all of our questions. We got on a great plan (once we're approved; cross your fingers everyone), and we are super excited to save $800/month!!
Jordan was great and answered all of our questions. We got on a great plan (once we're approved; cross your fingers everyone), and we are super excited to save $800/month!!
Wylee J.
Chicago, IL
3/1/2010
The Health Insurance Shoppe made it easy to select the right health insurance plan for me. As a freelancer, it's hard to find an affordable plan that still provides the coverage that I need. Jordan was able to help me select the best plan for me as well as go over it with me in person. He was extremely helpful throughout the entire process. I highly recommend stopping by or calling if you need health insurance!
Kay B
Chicago, IL
4/30/2010
If you are looking for Health Insurance, your search is over. Jordan at the Heath Insurance Shoppe is wonderful. He is very good at explaining all of your options so you can make an educated choice in Heath Care. I would highly recommend him. He is very professional and very knowledgeable.
Burt I.
Oak Park, IL
5/22/2010
I found myself with somewhat difficult problem of trying to get short term health coverage for my son who was bumped off my family plan when he turned 19. I was told by several other insurance agents that the best I could do was pay a very high Cobra premium due to several preexisting conditions. I had resigned myself to writing a big check (basically throwing money away) but as a last resort I called some more agents. I was lucky enough to find Jordan Wishner at the Health Insurance Shoppe.
He was the first insurance broker I talked to that had the breadth of knowledge about the ins and outs of getting coverage with preexisting conditions in this complicated market. Within a week we had approval for coverage for my son at about one third the price of Cobra.
Jordan literally saved me thousands of dollars of Cobra payments. I highly recommend you consult Jordan for your health insurance needs. He's extremely competent and patient and knows the market very well. He went out of his way to help solve what seemed like an unsolvable problem before I talked to him.
He was the first insurance broker I talked to that had the breadth of knowledge about the ins and outs of getting coverage with preexisting conditions in this complicated market. Within a week we had approval for coverage for my son at about one third the price of Cobra.
Jordan literally saved me thousands of dollars of Cobra payments. I highly recommend you consult Jordan for your health insurance needs. He's extremely competent and patient and knows the market very well. He went out of his way to help solve what seemed like an unsolvable problem before I talked to him.
Wednesday, June 2, 2010
Health Insurance 101
If you are in the search for a health insurance plan, Health Insurance 101 can be a great tool to help understand the following:
- Difference between insurance carriers
- HSAs
- Glossary of commonly used terms
The link below will direct you to Health Insurance 101
Thanks,
-The Shoppe
#1 benefit to why HSA compatible plans are the plan to choose
Whether you are looking for health insurance coverage or are currently insured, the below link will take you to an illustration that will show how much one is to pay for a $10,000 hospital bill from 5 plans provided by BCBSIL.
HSA Plan Exposure Comparison
All 6 plans presented cover an annual physical and annual OB/GYN visit (mammogram and pap smear) under a $20 or $30 copay, even the HSA plan.
The first 5 plans will provide the same copay for additional office visits as well. The HSA plan will not provide a copay and require you to pay the discounted amount of the visit towards the plan deductible.
Now onto the illustration....
The highlighted plan, being HSA compatible, is the lowest cost of the plans presented. Not only is it the lowest in premium, but it also provides the least risk to the insured for a hospital expense as illustrated.
Now, if I compare the cost of the HSA plan to the first plan presented with the lowest deductible, the annual savings in premium is $793. Since the HSA plan does not have copays, that amount in savings is more than enough to cover the cost of additional visits other than preventative. Make sense?
Why should I pay an insurance company more premium for a plan that will cost me more at time of a large claim?????
As for the actual Health Savings Account (HSA)...This is a no-brainer. HSAs can be opened at a local bank branch for free or for a $2-$3 monthly fee. With the account, the IRS allows for an individual to deposit up to $3,050 for 2010. The total amount deposited into the account, is taken as a above-the-line tax deduction, reducing your taxable income by up to $3,050.
Remember the account is optional. In the presented illustration, the insured can pay for these expenses on a credit card or another payment other than the HSA. Anytime before 4/15 of the following year, the insured can make deposits into the HSA for the amount spent, and then immediately withdraw as reimbursement. This way, funds hit the ledger in order to take a deduction.
So...to sum it up, the one with the HSA plan will be able to take a 100% tax deduction on the total amount spent for the hospital bill, where as anyone on the other 5 plans would only be able to deduct if the expenses were greater than 7.5% of their total adjusted gross income.
Make Sense?
Please call the shoppe to learn more on HSAs.
Thanks!
-The Shoppe
HSA Plan Exposure Comparison
All 6 plans presented cover an annual physical and annual OB/GYN visit (mammogram and pap smear) under a $20 or $30 copay, even the HSA plan.
The first 5 plans will provide the same copay for additional office visits as well. The HSA plan will not provide a copay and require you to pay the discounted amount of the visit towards the plan deductible.
Now onto the illustration....
The highlighted plan, being HSA compatible, is the lowest cost of the plans presented. Not only is it the lowest in premium, but it also provides the least risk to the insured for a hospital expense as illustrated.
Now, if I compare the cost of the HSA plan to the first plan presented with the lowest deductible, the annual savings in premium is $793. Since the HSA plan does not have copays, that amount in savings is more than enough to cover the cost of additional visits other than preventative. Make sense?
Why should I pay an insurance company more premium for a plan that will cost me more at time of a large claim?????
As for the actual Health Savings Account (HSA)...This is a no-brainer. HSAs can be opened at a local bank branch for free or for a $2-$3 monthly fee. With the account, the IRS allows for an individual to deposit up to $3,050 for 2010. The total amount deposited into the account, is taken as a above-the-line tax deduction, reducing your taxable income by up to $3,050.
Remember the account is optional. In the presented illustration, the insured can pay for these expenses on a credit card or another payment other than the HSA. Anytime before 4/15 of the following year, the insured can make deposits into the HSA for the amount spent, and then immediately withdraw as reimbursement. This way, funds hit the ledger in order to take a deduction.
So...to sum it up, the one with the HSA plan will be able to take a 100% tax deduction on the total amount spent for the hospital bill, where as anyone on the other 5 plans would only be able to deduct if the expenses were greater than 7.5% of their total adjusted gross income.
Make Sense?
Please call the shoppe to learn more on HSAs.
Thanks!
-The Shoppe
Friday, May 28, 2010
For Clients and prospects on Medicare
CMS mailing to Medicare Beneficiaries: "Medicare and the New Health Law - What it Means for You"
Beginning Thursday, May 27, Medicare beneficiaries across the country should begin receiving a copy of the brochure “Medicare and the New Health Law – What it Means for You." The mailing from the Centers of Medicare and Medicaid Services (CMS) outlines key provisions of the Affordable Care Act for people with Medicare as well as members of their families.
Some of the improvements that beneficiaries will see during open enrollment this fall and in the future, include:
- More affordable prescription drugs
- Important new benefits to help beneficiaries stay healthy. Starting next year, free preventive care services like colorectal cancer screening and mammograms, in addition to a free annual wellness visit.
- Better access to care
- Better chronic care
- New tools to help fight fraud and protect Medicare rights
If you receive a call from a member, advise them to contact member services. Please do not refer members to contact 1-800-Medicare for assistance.
FYI - CMS sanctions for Aetna Medicare MAPD/PDP plans
As previously communicated, CMS imposed intermediate sanctions on Aetna suspending the enrollment of and marketing to new members of all Aetna Medicare Advantage and Standalone Prescription Drug Plan Contracts effective April 21, 2010.
Thursday, May 27, 2010
Aetna starting to add dependents before new Health Bill begins on 9/23/2010
If you currently are insured with Aetna or know someone insured with Aetna...please share :-
If you have a dependent child between 19-26 years of age, that is not a full-time college student, Aetna is beginning to add children back on to your coverage prior to the mandate that takes effect on September 23rd, 2010.
Please call the shoppe to learn more about this immediate benefit.
Thanks,
-The Shoppe
If you have a dependent child between 19-26 years of age, that is not a full-time college student, Aetna is beginning to add children back on to your coverage prior to the mandate that takes effect on September 23rd, 2010.
Please call the shoppe to learn more about this immediate benefit.
Thanks,
-The Shoppe
Saturday, May 22, 2010
NEW Cash for Cancer plan from Humana
The Health Insurance Shoppe has a new product to offer to accompany the purchase of a health insurance plan.
Humana has introduced there Cash for Cancer plan for a limited time in Chicago. You can click the title of the this blog for a benefit highlight of the plan.
The Cash for Cancer is a plan that will give the insured a cash payout from $10,000 - $50,000 in increments of ten when the insured is diagnosed with a form of cancer.
The cash payout will help the insured to cover the cost of their health insurance plans deductible and out-of-pocket costs, along with expenses that are not covered by your health insurance, such as wigs that can cost on average $7,000.
The insured has the option of paying monthly premiums for 20 years or for life with a Return of Premium (ROP) option available for both methods.
If there is more than one insured, than the benefit becomes available to all members of the insureds family.
Below are a sample of rates for a 20 year premium period:
Male and Female, 30-39 years of age
$18/month for $20,000 lump-sum pay
$45/month for $50,000 lump-sum pay
Male and Female, 40-44 years of age
$24/month for $20,000 lump-sum pay
$60/month for $50,000 lump-sum pay
Family, 30-39 years of age (premium based on youngest spouse)
$32/month for $20,000 lump-sum pay
$79/month for $50,000 lump-sum pay
Family, 40-44 years of age (premium based on youngest spouse)
Humana has introduced there Cash for Cancer plan for a limited time in Chicago. You can click the title of the this blog for a benefit highlight of the plan.
The Cash for Cancer is a plan that will give the insured a cash payout from $10,000 - $50,000 in increments of ten when the insured is diagnosed with a form of cancer.
The cash payout will help the insured to cover the cost of their health insurance plans deductible and out-of-pocket costs, along with expenses that are not covered by your health insurance, such as wigs that can cost on average $7,000.
The insured has the option of paying monthly premiums for 20 years or for life with a Return of Premium (ROP) option available for both methods.
If there is more than one insured, than the benefit becomes available to all members of the insureds family.
Below are a sample of rates for a 20 year premium period:
Male and Female, 30-39 years of age
$18/month for $20,000 lump-sum pay
$45/month for $50,000 lump-sum pay
Male and Female, 40-44 years of age
$24/month for $20,000 lump-sum pay
$60/month for $50,000 lump-sum pay
Family, 30-39 years of age (premium based on youngest spouse)
$32/month for $20,000 lump-sum pay
$79/month for $50,000 lump-sum pay
Family, 40-44 years of age (premium based on youngest spouse)
$42/month for $20,000 lump-sum pay
$105/month for $50,000 lump-sum pay
Please feel free to share this information with anyone you know, who might see this plan as a benefit to their current insurance portfolio.
The Health Insurance Shoppe has had family members effected by cancer and understands the cost that can come with this awful disease, any form. We see plan strictly as insurance against high costs that can accompany the diagnosis of cancer.
Please feel free to call or stop by the shoppe with any questions.
Thanks!
-The Shoppe
Thursday, May 13, 2010
Are you a small business owner
Please share this to any small business owners that you know!
- Effective 1/1/2010 small businesses with 25 or less employees with an average salary of $50,000 or less can receive a dollar-for-dollar 35% tax credit on the employers 50% share of premium currently being paid.
- Effective 1/1/2010 small businesses with 10or less employees with an average salary of $25,000 or less can receive a dollar-for-dollar 35% tax credit on the employers 50% share of premium currently being paid.
This amounts to a large sum of money an employer can receive in a tax credit.
Please call the shoppe for more information.
Thanks,
The Shoppe
Wednesday, May 12, 2010
Our Purpose at The Shoppe
At The Health Insurance Shoppe our goal is to educate the consumer on their current or future health insurance benefits to make sure they are receiving the best possible benefit at the lowest possible price.
What do we mean?
We want to address consumers that currently do not have a HSA (Health Savings Account) qualifying plan.The Health Insurance Shoppe is a large advocate of HSA compatible health insurance plans and believes that these are the best available plans to Americans and cost the least in monthly premium. Before we are to et into HSAs lets go over a traditional plan of health insurance.
Right now in the current private health insurance market it is very difficult to find a low deductible health plan such as a $500 deductible. There are two carriers that offer one, Blue Cross and Assurant. All remaining carriers begin at $1,000 and up. The deductible is the amount of money that you must pay first before your insurance company is to begin paying a percentage of future bills.
The percentage the insurance carrier will pay is referred to as Co-insurance. This is usually presented as 100%, 80%, 70% and 50%. This # represents how much the insurance carrier will begin to pay after your deductible. Your share is the remaining amount out of 100%. The percent that you pay goes towards what is referred to as your out-of-pocket (OOP) expense limit. Once your OOP is met, the insurance carrier will then begin to pay 100% of further calendar year expenditures.
When you add the plan deductible and OOP together, you will get your true exposure in risk on a large claim. If there is more than one person on the plan, than you must multiply the plans deductible and OOP x 2. Each member will have their own separate deductible and OOP to meet before the plan will begin to pay 100%.
Some plans might include pre-paid benefits such as office visit copay's and prescription drug copay's and a possible ER benefit. Blue Cross and Blue Shield of Illinois is the only carrier that offers an ER benefit that will either cover 100% of the charges or waive the deductible and require you to pay your co-insurance of the bill towards your OOP. All other carriers are going to slap a copay of $100 and require you to pay the whole bill as a deductible than OOP expense.
As far as office visit copay's, these will cover the cost if the initial office visit, not any additional lab work, x-rays or diagnostic tests that may be requested at time of visit. Please note that copay's do not apply to the plans deductible or OOP. When you select a copay, you are automatically asking the insurance company to begin paying on claims. The typical cost of an office visit for an Internist is usually $75-$125. This cost is established for patients w/o health insurance. If the provider accepts your insurance than you will receive a discount on the base cost. Typically 30-40%. So...if we discounted $125 x 40%, we would be looking at a true cost of $75. With a copay, you would be paying anywhere from $20-$35 for this cost, and at the same time, you are paying 30-40% more in premium for this benefit.
Now, with prescription drugs, majority of carriers other than Blue Cross and Blue Shield of Illinois (must select $500 or lower deductible) will provide an upfront generic Rx copay than require you to meet a separate $500 or $1,000 deductible for Brand Name or Preferred Brand Name drugs, before you would begin to pay a copay. Please note that Rx copay's do not apply towards the plans deductible or OOP.
If there is not a copay for prescription drugs on your plan, but with a benefit, the end cost (discounted rate) will be applied towards your plans deductible then OOP.
That pretty much sums up traditional plans of health insurance.
Now...when we talk about HSA qualifying plans, they are referred to as High Deductible Health Plans (HDHP) . These are the only plans are regulated by the U.S. Government, and for 2010, the lowest qualifying deductible is $1,200 for an individual and $2,400 for a family. The government also regulates how much risk you can be exposed to in a calendar year. For 2010 an individual can not be responsible for more than $5,800 in exposure and $11,600 for a family.
HSA plans are usually presented with 100% coverage or 80% coverage. At 80%, it might be more beneficial to look at a plan with copay's that will provide less risk than the deductible and OOP combined when looking at 80% coverage.
When their is more than one member on the plan, the deductible is a family deductible, and all expenditures are applied towards the one deductible, not separate, like traditional plans.
When looking at 100% coverage after the deductible, the premium rates are significantly lower than non-HSA
plans with the same deductible, and are providing 100% coverage after the deductible, rather than 80%.
HSA plans do not include copays for office visits or prescription drugs. You will be responsible to pay for these expenses at the negotiated (discounted) rate towards your plans deductible.
However, HSA plans will cover your Preventative Care at either a copay or 100%. So...their might not be a copay if you are sick and need to see the doctor, but there is one for your annual physical and OB/GYN for females.
Even while saving you money in premium rates and risk exposure, having an HSA qualifying plan, allows you to open up an actual Health Savings Account (HSA) at your local bank (some offer free-checking). With this account, the money that you contribute into it can be used to pay for your deductible expenses and any IRS qualifying expense tax-free. This method will only put more of your hard earned money back into your pocket. The total amount of money that enters the account for the year, becomes an above-the-line tax deduction.
An individual has the opportunity to contribute up to $3,050 into the account, and a family can contribute $6,150 for 2010. Any unused funds, roll over to the next year for additional contributions.
Please call the shoppe today to learn how you can benefit from HSA plans, and begin to start saving $ today!
You can learn more information by visiting my website, www.thehealthinsuranceshoppe.com
thanks,
-The Shoppe
What do we mean?
We want to address consumers that currently do not have a HSA (Health Savings Account) qualifying plan.The Health Insurance Shoppe is a large advocate of HSA compatible health insurance plans and believes that these are the best available plans to Americans and cost the least in monthly premium. Before we are to et into HSAs lets go over a traditional plan of health insurance.
Right now in the current private health insurance market it is very difficult to find a low deductible health plan such as a $500 deductible. There are two carriers that offer one, Blue Cross and Assurant. All remaining carriers begin at $1,000 and up. The deductible is the amount of money that you must pay first before your insurance company is to begin paying a percentage of future bills.
The percentage the insurance carrier will pay is referred to as Co-insurance. This is usually presented as 100%, 80%, 70% and 50%. This # represents how much the insurance carrier will begin to pay after your deductible. Your share is the remaining amount out of 100%. The percent that you pay goes towards what is referred to as your out-of-pocket (OOP) expense limit. Once your OOP is met, the insurance carrier will then begin to pay 100% of further calendar year expenditures.
When you add the plan deductible and OOP together, you will get your true exposure in risk on a large claim. If there is more than one person on the plan, than you must multiply the plans deductible and OOP x 2. Each member will have their own separate deductible and OOP to meet before the plan will begin to pay 100%.
Some plans might include pre-paid benefits such as office visit copay's and prescription drug copay's and a possible ER benefit. Blue Cross and Blue Shield of Illinois is the only carrier that offers an ER benefit that will either cover 100% of the charges or waive the deductible and require you to pay your co-insurance of the bill towards your OOP. All other carriers are going to slap a copay of $100 and require you to pay the whole bill as a deductible than OOP expense.
As far as office visit copay's, these will cover the cost if the initial office visit, not any additional lab work, x-rays or diagnostic tests that may be requested at time of visit. Please note that copay's do not apply to the plans deductible or OOP. When you select a copay, you are automatically asking the insurance company to begin paying on claims. The typical cost of an office visit for an Internist is usually $75-$125. This cost is established for patients w/o health insurance. If the provider accepts your insurance than you will receive a discount on the base cost. Typically 30-40%. So...if we discounted $125 x 40%, we would be looking at a true cost of $75. With a copay, you would be paying anywhere from $20-$35 for this cost, and at the same time, you are paying 30-40% more in premium for this benefit.
Now, with prescription drugs, majority of carriers other than Blue Cross and Blue Shield of Illinois (must select $500 or lower deductible) will provide an upfront generic Rx copay than require you to meet a separate $500 or $1,000 deductible for Brand Name or Preferred Brand Name drugs, before you would begin to pay a copay. Please note that Rx copay's do not apply towards the plans deductible or OOP.
If there is not a copay for prescription drugs on your plan, but with a benefit, the end cost (discounted rate) will be applied towards your plans deductible then OOP.
That pretty much sums up traditional plans of health insurance.
Now...when we talk about HSA qualifying plans, they are referred to as High Deductible Health Plans (HDHP) . These are the only plans are regulated by the U.S. Government, and for 2010, the lowest qualifying deductible is $1,200 for an individual and $2,400 for a family. The government also regulates how much risk you can be exposed to in a calendar year. For 2010 an individual can not be responsible for more than $5,800 in exposure and $11,600 for a family.
HSA plans are usually presented with 100% coverage or 80% coverage. At 80%, it might be more beneficial to look at a plan with copay's that will provide less risk than the deductible and OOP combined when looking at 80% coverage.
When their is more than one member on the plan, the deductible is a family deductible, and all expenditures are applied towards the one deductible, not separate, like traditional plans.
When looking at 100% coverage after the deductible, the premium rates are significantly lower than non-HSA
plans with the same deductible, and are providing 100% coverage after the deductible, rather than 80%.
HSA plans do not include copays for office visits or prescription drugs. You will be responsible to pay for these expenses at the negotiated (discounted) rate towards your plans deductible.
However, HSA plans will cover your Preventative Care at either a copay or 100%. So...their might not be a copay if you are sick and need to see the doctor, but there is one for your annual physical and OB/GYN for females.
Even while saving you money in premium rates and risk exposure, having an HSA qualifying plan, allows you to open up an actual Health Savings Account (HSA) at your local bank (some offer free-checking). With this account, the money that you contribute into it can be used to pay for your deductible expenses and any IRS qualifying expense tax-free. This method will only put more of your hard earned money back into your pocket. The total amount of money that enters the account for the year, becomes an above-the-line tax deduction.
An individual has the opportunity to contribute up to $3,050 into the account, and a family can contribute $6,150 for 2010. Any unused funds, roll over to the next year for additional contributions.
Please call the shoppe today to learn how you can benefit from HSA plans, and begin to start saving $ today!
You can learn more information by visiting my website, www.thehealthinsuranceshoppe.com
thanks,
-The Shoppe
Tuesday, May 11, 2010
Why HSAs plans are the way to go...w/o the actual HSA
What is an HSA compatible plan and why do I need one?
First, when The Health Insurance Shoppe recommends an HSA compatible plan, we are recommending the actual health plan design more so than the actual Health Savings Account (HSA) that you have an option of opening.
Traditional plan designs have 5 common elements:

First, when The Health Insurance Shoppe recommends an HSA compatible plan, we are recommending the actual health plan design more so than the actual Health Savings Account (HSA) that you have an option of opening.
Traditional plan designs have 5 common elements:
- Plan Deductible
- The amount of money the insured must spend before the insurance carrier is to begin paying any portion of future medical expenses covered under the plan.
- Out-of-Pocket (OOP) Expense Limit
- This is the amount the insured must meet after their deductible before the insurance carrier is to begin paying 100% of remaining calendar year medical expenses covered under the plan.
- The OOP is paid by a percentage, your plan's coinsurance. You either will pay 20%,30% or 50% after the deductible has been met, which is applied towards the plan's OOP.
- Office Visit Copay's
- Fixed dollar amount the insured must pay the provider at time of visit.
- Copay does not apply to the plan and will always be applied even if the plan is satisfied.
- Copay will only cover consultation and any vaccine or flu-shot that is given. The copay will not cover any additional lab work, diagnostic tests or X-rays. These are all deductible expenditures.
- Preventative Care
- This is a male and females annual physical (includes all diagnostic tests and lab)
- Females annual OB/GYN that includes an annual mammogram and papsmear
- Covered under a copay
- Prescription Drugs
- Depending on insurance carrier, plans may have copay's for prescriptions drugs
- If the plan has a copay, it will usually be for generic drugs and the plan will then subject the insured to a separate $500 or $1,000 Rx deductible for Brand Name and Preferred Brand Name drugs before a copay will begin to apply
- The copay will not be applied to the plan
- If the plan does not have a copay, the discounted cost of the prescription will be applied towards the plans deductible
HSA plan designs have only 3 of the above elements, Deductible, Prescription Drugs and Preventative Care. There is no OOP because these plans are offered with 100% coverage after the deductible is satisfied. Your preventative care will be covered at either 100% by the insurance carrier or under a copay, just like the traditional plans.
As for physician services (office visits) these will be applied towards your deductible at the discounted rate.
Prescription Drugs will be applied towards the plans deductible and then covered at 100% after.
Second, HSA plans are 30-40% lower in cost than traditional plans. You can take the savings in premium and place 50% in your sock drawer, and you would have more than enough money to cover to office visits, when not having a copay.
Not to mention that if you decide to open the HSA you can pay for your medical expenses tax-free!!!
Please take a look at the attached link to view a comparison of an HSA plan and a traditional plan in an hospitalization scenario.

Hope this info helps in making a decision on what plan to choose when applying for health insurance coverage.
-The Shoppe
Monday, May 10, 2010
If you have recently applied for health insurance...beware
If you have applied for health insurance coverage with an effective date after 3/23/2010 and before 9/23/2010 than this blog may be important to how your plan is effected with the new health care bill.
Right now, as everyone knows from media, a child less than 19 years of age can not be declined coverage or have any exclusions on pre-existing medical conditions.
This law is to take effect on 9/23/2010.
If you have applied as a family between the dates mentioned and have had a child declined coverage, you will not be able to add your child back onto your policy until 1/1/2011.
The reason is that any health insurance plans issued with an effective date between 3/23-9/23/2010 are grandfathered into the plans previous provisions after the law was passed on 3/23 and prior to the enactment on 9/23.
Please call the shoppe with any questions on the new health care bill.
Thanks,
-The Shoppe
Right now, as everyone knows from media, a child less than 19 years of age can not be declined coverage or have any exclusions on pre-existing medical conditions.
This law is to take effect on 9/23/2010.
If you have applied as a family between the dates mentioned and have had a child declined coverage, you will not be able to add your child back onto your policy until 1/1/2011.
The reason is that any health insurance plans issued with an effective date between 3/23-9/23/2010 are grandfathered into the plans previous provisions after the law was passed on 3/23 and prior to the enactment on 9/23.
Please call the shoppe with any questions on the new health care bill.
Thanks,
-The Shoppe
Sunday, April 25, 2010
A special thanks to our client's!
The Health Insurance Shoppe would like to say "Thank You" to our current clients.
I hope that we have met your health insurance needs and at the same time, provided great service.
Without you, It would not be possible for the shoppe to continue it's efforts in educating consumers on their health care choices, and in how to go about choosing a plan.
If you would like to help us out further, a review of The Health Insurance Shoppe would be greatly appreciated.
You can find us on Yelp at http://www.yelp.com/biz/the-health-insurance-shoppe-chicago
Thanks again for the opportunity to be of help!
-The Shoppe
I hope that we have met your health insurance needs and at the same time, provided great service.
Without you, It would not be possible for the shoppe to continue it's efforts in educating consumers on their health care choices, and in how to go about choosing a plan.
If you would like to help us out further, a review of The Health Insurance Shoppe would be greatly appreciated.
You can find us on Yelp at http://www.yelp.com/biz/the-health-insurance-shoppe-chicago
Thanks again for the opportunity to be of help!
-The Shoppe
Monday, April 19, 2010
Currently on COBRA?
Are you currently paying COBRA premiums?
Were you laid off, and are currently receiving subsidy?
Did you leave your past employment voluntary and have elected COBRA?
If you answered yes, than you should definitely call or stop by the shoppe and learn about your options.
There are cheaper options available for coverage than your current COBRA costs, even when you are receiving 65% subsidy.
Well what about your pre-existing condition? What about it?
Depending on your medical history, it is possible that you can be declined coverage and would then have to seek guaranteed coverage through ICHIP, the risk pool.
What is a pre-existing condition?
-A pre-existing condition is any condition that was diagnosed, consulted, or have been receiving treatment during the 12 months prior to application.
How do health insurance carriers treat pre-existing conditions?
If you currently have not had a break in coverage in health insurance greater than 63 days:
BCBSIL:
Were you laid off, and are currently receiving subsidy?
Did you leave your past employment voluntary and have elected COBRA?
If you answered yes, than you should definitely call or stop by the shoppe and learn about your options.
There are cheaper options available for coverage than your current COBRA costs, even when you are receiving 65% subsidy.
Well what about your pre-existing condition? What about it?
Depending on your medical history, it is possible that you can be declined coverage and would then have to seek guaranteed coverage through ICHIP, the risk pool.
What is a pre-existing condition?
-A pre-existing condition is any condition that was diagnosed, consulted, or have been receiving treatment during the 12 months prior to application.
How do health insurance carriers treat pre-existing conditions?
If you currently have not had a break in coverage in health insurance greater than 63 days:
BCBSIL:
- Will not cover for the first 12 months of the plan
- Depending on medical condition, can place a permanent exclusion rider on condition
- If prior coverage was with Blue Cross (no state preference) than you must provide a Certificate of Credible Coverage (CCC) to he waiting period removed. BCBSIL can still decline coverage as well as place a exclusion rider
Aetna:
- Waives the waiting period and coverage can begin on day one for a pre-existing condition
- Aetna does not place exclusion riders on medical conditions, but can decline coverage as well as increase a members premium as much as 100%
Humana
- Will waive the waiting period as condition is disclosed on application
- Can place an exclusion rider on a medical condition or will increase premium up to 100%
Assurant Health
- Will not cover for the first 12 months of the plan
- Depending on medical condition, can place a permanent exclusion rider on condition as well as increase premium
- Can place a separate condition specific deductible for medical condition
Celtic
- Will not cover for the first 12 months of the plan
- Depending on medical condition, can place a permanent exclusion rider on condition
United Health Care
- Will not cover for the first 12 months of the plan
- Depending on medical condition, can place a permanent exclusion rider on condition as well as increase premium
Please stop by or call the shoppe with any questions.
Thanks,
-The Shoppe
Monday, April 12, 2010
FAQ's on small business tax-credit
Please click on the below link for information regarding the small employer tax-credit that is effective back dating to 1/1/2010.
http://www.irs.gov/newsroom/article/0,,id=220839,00.html
Call the shoppe with any questions!
-The Shoppe
http://www.irs.gov/newsroom/article/0,,id=220839,00.html
Call the shoppe with any questions!
-The Shoppe
How the small business tax-credit works
Do you own a small business? Are you currently offering health insurance benefits? Do you not offer health insurance benefits and are considering?
Well...the below link will help you determine how much of a tax-credit you will begin receiving immediately.
Call the shoppe with questions!
-the Shoppe
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