Monday, September 29, 2014

Initial planning stages: business insurance

When starting a business, you may think about putting together an investment plan, creating a marketing strategy, and developing the right products and services. These are all very important to success, but so is one thing that you may overlook in the initial planning stages: business insurance. The type of coverage that you have can help protect against serious losses that could threaten the future of your operations. By choosing the right policies, you can protect your investment, your products, and your employees.
Here are a few popular types of coverage to consider:
Worker's Compensation
Most states require that your company carries worker's compensation insurance, but it depends on how many employees you have, what type of business you are in, as well as other factors. You must check with your state's governing body to learn about the exact requirements as they apply to your company. However, even if you are exempt from carrying this coverage, you should consider getting it anyway. Even in so-called "safe" environments like corporate offices, employees can still be hurt from slips and other accidents. Having this policy can ensure that you protect your employees and your bottom line.
Professional Liability
Professional liability coverage is an important type of business insurance to have. This covers against loss or damage if you make an error in providing services that results in injury, property damage, or some other type of loss for your customers. For example, it may cover you if you are fixing an air conditioning unit and a piece of equipment is broken off. It may also cover bad advice given during a consultation that results in loss for the customer. The specifics depend on the type of policy and company you own.
Property coverage is a basic type of business insurance that every company should have. This policy may cover you if your property is damaged, including both the physical building and the equipment inside. It can also prevent lawsuits if your actions cause damage to another person's property. As with all policies, the exact protection received will depend upon specific details of the plan. Make sure to read through the full list of what is covered to ensure that the plan will provide adequate protection.
There are many more types of business insurance plans available, but these are some of the most popular and the most necessary. Of course, many companies also buy several types of policies to provide them with the most comprehensive coverage. After spending time and money building up your company, you don't want to lose it all as a result of accident or negligence. Get the right insurance to make sure that your investment is protected.

Saturday, September 27, 2014

Problems Associated Individual Insurance

A single visit to the dentist is bound to leave our pockets substantially lighter. In several cases, dental insurance is over lapped with normal health insurance. However, there are also times where one can also get a totally independent policy for the same. Choosing a cheap dental insurance plan is quite difficult as the independent plan is mighty expensive, and the one that acts as an extension to health insurance plans often tends to be inadequate in terms of coverage.

The problem with standard dental insurance is that it tends to have a rather high premium. The average annual premium, ranges from $1,000 to $3,000. The rule of thumb is, more the premium or cost of insurance, more is the coverage going to be. On the whole, the logic says that cheap dental insurance plans and policies are not going to have a very broad coverage, thereby putting your dental health at a substantial risk.

Alternatively, even if you get an independent and individual, full coverage insurance policy, then the coverage would be broad, quite unused and expensive. Apart from that, irrespective of being an expensive policy, some conditions are never covered. Hence the difficulty in choosing an affordable dental insurance plan. But there are a couple of things that can be done. Some of them have been discussed in the following paragraphs, let's take a look...

How to Choose an Affordable and Cheap Dental Insurance?

Having only single, cheap dental insurance plan, without any other backing plan is dangerous, as it covers very few things and tends to have deductibles. However, you can use more than one coverage or insurance policy to make things even, and get a really good coverage.

Employer Facilitated Plans
Several employers often provide a separate plan, which is collectively provided for all the employees and is managed and financed by the employer. The plans that are included in such a spectrum include, Dental Health Maintenance Organization Insurance Plans (DHMO) and Dental Preferred Provider Organization Plans (PPO).

The best thing about such a plan is that it provides for periodic dental care facilities, and smaller non surgical and non cosmetic procedures, and often it does not also have a deductible. Another plan is the Direct Reimbursement Plan (DRP), wherein a reimbursement is provided for certain dental care treatments.

Another similar one is the Least Expensive Alternative Treatment (LEAT), where compensation is provided for dental care costs. Now the problem with both these policies is that they tend to have deductibles, and only cover the cost of treatment. This would include eradication of infection, periodic cleanup, and other first aid procedures. However, orthodontic procedures, correction and procedures that tend to have an element of complexity, are not covered.

Hence if you have the aforementioned coverage, you can get a sort of add-on for complex procedures, now again these coverage tend to have a certain deductible, which is of course quite high. However, the plus point is that you get a remarkably good coverage, within a small and affordable dental plan.

Individual Plans at a Low Cost
There are some individually oriented plans which you can consider. Health insurance often covers some parts of dental insurance, such as first aid or some minor emergency procedures. However, dental care or complicated procedures such as tooth removal or orthodontic procedures are not included in the process. Hence, to cover up the dental care aspect of the coverage you can either avail a Dental Discount Plan and a AARP Dental Insurance.

Monday, August 4, 2014

Health insurance for kids

Medical related expenses have risen dramatically in the past few decades. Children are more vulnerable to diseases than adults and suffer a lot if proper medication is not provided in time. Health insurance for kids ensures that parents can afford the medical care their children require, no matter what the cost maybe. Whenever a person tends to spend money, he tries to look for the immediate benefits. This is not the case with insurance plans, as they take monthly installments, but cover the medical expenses at the time of need and are beneficial in the long term.

At times, when the child falls sick or gets injured, parents are able to deal with it quickly, based on their own past experiences. Although this can be done only in cases of minor injuries and a very few basic diseases, it is always recommended to see a physician or a specialized doctor. Insuring your child's health provides an opportunity for parents to keep aside their worry of the expenses involved in the treatment of their child and get the best possible medical care.


According to different studies conducted on children across America, it was found that those with insurance are more likely to:

be in a better position to do well in school.
get health care service whenever needed.
receive the needed immunizations as toddlers.
receive treatment for illnesses such as asthma and ear infections. A survey conducted by the United States Department of Health and Human Services (HHS) and National Center for Health Services Research (NCHSR) revealed that almost half of the uninsured children with asthma problem and one-third of the uninsured children with ear infections, never consulted a doctor.
obtain dental and preventive care at regular intervals.

Lack of health insurance is a substantial barrier for low-income families in obtaining timely and appropriate health care for the child. Sometimes, the idea of insurance is taken casually by parents, thinking that the health-related problems can be taken care of, as and when they occur. But, the trouble starts when they fall short of money to cover up the medical expenses incurred during the treatment of the child. So, it is always better to get the child insured in time to avoid problems in future.

The State Children's Health Insurance Program (SCHIP) of the Social Security Act, which is one of the steps taken by the American Government to ensure child health, is jointly financed by the Federal and State governments and administered by the States. The Social Security Act provides multiple waiver and demonstration authorities to allow states' flexibility in operating Medicaid programs and SCHIP programs. According to the Federal guidelines, each stState determines the design of its program, benefit packages, eligibility groups, and payment levels for the coverage for the maximum benefit of its people.

According to a survey conducted by Georgetown University Health Policy Institute for the year 2006-07, out of 78,425,000 children in America, 11.7% were uninsured, and the rest insured either through private (59.8%) or public (28.5%) coverage. Texas, with a striking 21.8% of 6,989,000 and Florida with 19.5% of 4,332,000 were two of the states with the largest figure of uninsured children with respect to their population in the state. This large number of uninsured children in the country is because of factors like a family's inability to pay for either forms of coverage, and their limited access and non-eligibility for public programs.

Saturday, July 26, 2014

What is Temporary Health Insurance?

In the US, typical health insurance plans are either traditional or managed care plans. Employers provide insurance to employees via group insurance plans, that carry a lower premium as compared to individual plans. Since managed care is cost-effective, employers started drifting towards them in the nineties.

It is basically a short-term health insurance plan meant to protect an insured person against unforeseen events. It is generally provided for a period of 30 to 180 days. Some plans may be operative for 360 days. This type is meant for people who are temporarily without coverage. Lack of coverage is likely in case of unemployed people, students, people moving from one town to another, and those waiting for their permanent coverage. Although it is a short-term plan, it has a number of benefits, hence, it is suitable for people who enjoy the decision-making flexibility of traditional plans, but are unable to pay the premium for them.

Why Is It Needed?

Not Employment Based: In the US, nearly two-thirds of the population below the age of 65 avail health insurance through their employer. In the year 2000, 69% employers offered it to the employees. Since then, the number has fallen drastically, and today only 60% employers are willing to provide it. Recession has resulted in a number of people becoming unemployed. Temporary health insurance has thus become invaluable for people who are in between jobs, since the cost of the plan is low and can be paid in installments or as a lump sum. Moreover, the plan can be modified to extend coverage to the spouse and dependent children as well.

Alternative to COBRA Insurance: The Consolidated Omnibus Budget Reconciliation Act (COBRA) allows former employees, retirees, spouses and dependents, the facility to avail affordable health coverage at group rates. Generally, a person can continue on his previous employer's group insurance plan for 18 months after getting laid off. Although the premium for this coverage is lower than the premium for individual coverage, it is still higher than the premium paid by a person before he got fired. This is because, when a person is employed, the employer may pay the entire amount of premium, but on getting fired, the former employee is expected to pay 35% of the amount of premium, while the remaining amount is borne by the Federal government.

Indemnity Insurance: In the US, the main types of managed health care plans are: Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), and Point-of-Service (POS) plans. In case of HMOs, a person has to choose a doctor in his or her network, and in order to meet a specialist, he would require a referral from his primary care physician (PCP). PPOs are not as restrictive as HMOs, but there are financial incentives for seeking treatment within the network. POS, on the other hand, is a hybrid between HMO and PPO. In case of temporary health insurance plans, a person is free to choose his doctor. No referrals are necessary in order to meet specialists. Some temporary plans have a network of doctors and hospitals, and a person can lower his medical bills by visiting these doctors. However, a person has the freedom to seek medical assistance outside the provider's network. Thus, the plan offers indemnity insurance, which is a feature of the traditional health insurance plan, but at a lower premium.

Immediate Coverage: Generally, a person can obtain short-term or temporary insurance within 24 hours. The procedural formalities are definitely less than those in case of permanent health insurance.


Temporary Coverage: The coverage is temporary and meant for a short period of time. Some plans may allow a person to extend the coverage by paying additional premium, but generally, this plan is meant for a maximum of 6 months.

Limited Coverage: Unlike traditional and managed health care plans, preventive and routine medical checks are not covered under the temporary plan. In this respect, traditional health insurance is much better than managed health care, although the latter allows preventive and routine medical checks. Temporary coverage, on the other hand, is meant only for illness and injury. Moreover, most temporary plans do not provide dental and optical treatment.

Since temporary health insurance providers are not covered under Health Insurance Portability and Accountability Act (HIPAA), they don't have to guarantee renewal, issue, or waive pre-existing conditions, for individuals eligible under federal rules. It is clear that temporary insurance has a number of advantages and disadvantages, which need to be borne in mind before opting for such a coverage.

Thursday, July 10, 2014

Various kinds of dental insurance

The exorbitant cost of dental care has made it mandatory for people to have dental insurance. It is always better to get a dental plan before the problem arises to get competitively lower rates. In December 2011, 42% of the American senior citizens had faced tooth loss to an extent of replacing it with dentures and implants. Like this, there are several other dental problems that people have to face as they age.

About 97% of the insured population opt for dental health insurance plans that are employment-based. This is because employer-based dental insurance is a group insurance plan that has lower premium requirements as against individual dental insurance. Such plans are available for senior citizens also. As far as senior citizens are concerned, cost-effectiveness is one of the parameters that an insurance plan must fulfill. Here, we will discuss each of the plans in detail with its pro and cons.

Dental Plan Types Available in the Market Today

PPO Dental Insurance Plans
(Good Coverage, but High Prices)

Preferred Provider Organizations (PPOs) are attractive due to the flexibility they provide while choosing a dentist. These plans can be regarded as gold for those who can afford it.

Big companies provide these plans to their employees as a privilege. Although their annual payment is more expensive than other options, PPO plans are easily available to individuals as well as groups. They offer the maximum benefit to members who choose dentists from within their provided network. Nevertheless, members have the freedom to opt for any dentist of their choice at the cost of some benefits.

Alternately they reimburse the member or directly pay the dentist. Before getting attracted to its perks, be aware of all the costs that accompany it. Also, it requires you to pay the deductibles before the coverage actually starts.

HMO Dental Insurance Plans
(Affordable Care, Reduced Flexibility)

Health Maintenance Organization (HMO) plans are cheaper than PPO plans and indemnity plans. They are commonly known as Dental Health Maintenance Organizations (DHMO). Just like PPOs, DHMO also covers a group of dentists that provide service at predetermined prices. They are famous among the employers who buy them for their employees, but an individual can also approach a DHMO policy conveniently.

For senior citizens, the low cost attached with this plan is the appealing factor. This plan does not provide you with any comfort while choosing your dentist. In fact, if you are required to consult a specialist, the insurance carrier will pay only for that specialist referred by your dentist.

The unique feature about this option is the way DHMO pays their network of dentists. The dentists are paid on the basis of number of patients they treat and are also required to accomplish a target. This leads to unprofessional treatment and discommode to the patients. In spite of the shortcomings, these plans are preferred due to their cost-effectiveness.

Dental Indemnity Insurance
(Traditional Dental Coverage for Seniors)

This was the basic plan introduced for the purpose of dental insurance. In this type, the policy holder has the freedom of choosing any dentist of his choice without any prejudice. It has a reimbursement mode of payment. The policy holder files a claim which is reimbursed by the insurance carriers.

It covers 50-80% of the cost incurred in a dental treatment; rest is to be borne by the patient. For this reason, this is not a favorite among the senior citizens.

Steps to a Perfect Choice

Today there are many ways of researching in order to find the perfect plan that solves all your problems. There are companies like Spirit Dental, Dental Plans, Medicoverage, etc., which offer easily accessible websites to search and compare a variety of dental insurance options. Four fundamental steps that one must follow while buying a dental insurance for seniors are listed below:

Step 1
- Use the online tools provided to search for all the dental plans available and narrow it down according to your need. Look at the procedures offered, some of them are not covered under various plans or covered at low percentages.
Step 2
- If you already have a family dentist, visit him for advice or to learn about the plans that he is covered in. If not, then call up few referred dentists and ask them for the schemes that cover them and check for the success of their practice.
Step 3
- After going through the above-mentioned steps, narrow down your selected plans to two or maximum three that represent the best combination of your preferred services and your favorite local dentist.
Step 4
- To make your final selection contact a licensed agent. He can help you with all the issues that you haven't noticed and fill up the remaining loopholes, after which your final dental insurance plan will be ready.

Problems Associated with Dental Insurance

Managed care plans are the cheapest, and as a consequence, most employers have shifted to these from the erstwhile popular traditional insurance plans. Managed care plans force the insured to choose from the given network of doctors and do not provide coverage for preexisting conditions.
Traditional insurance plans result in the insured receiving only the cheapest treatment according to the Least Expensive Alternative Treatment (LEAT) clause, although one has the option of choosing the doctor. Again, preexisting conditions are not covered by the plan.
The best dental insurance plan for people who are employed, is definitely the Direct Reimbursement Plan, which in addition to being the only plan that covers preexisting conditions, also provides the benefit of deductible premiums to employers. However, there is the danger of the amount not being reimbursed by the insurance company.
Since the aforementioned plans are usually employment-based, and have certain restricting clauses as far as treatment and payment is concerned, these are not suitable for seniors.

The Best Alternative

Dental Discount Plans
They have assumed a great deal of significance from the perspective of ensuring cost-effective treatment without the usual hassles that are associated with dental insurance. These plans are an alternative to insurance. The plan works by allowing members to save up to 60% on various procedures like cleanings, fillings, braces, checkups and more. Some of the advantages of dental discount plans include:

No Waiting Period
: People have to pay an annual or a monthly fee in order to become members. The membership card generally arrives within 7 to 10 days of joining the plan. The procedure for becoming a member does not require extensive paperwork. Moreover, there is no waiting period clause unlike Traditional dental insurance and Managed Care plans. Direct Reimbursement plan is the only insurance plan that does not have any waiting period requirement, but costs more and is typically employment-based.

: The annual membership fee is generally around $100. The members have the option of visiting participating dentists nationwide and availing discounts by showing the membership card. Members receive a discounted fee schedule for almost all procedures and the least savings may be to the tune of 10%. The maximum savings, as mentioned earlier, is around 60% for certain procedures. Amongst dental insurance plans, managed care plans are the cheapest, but force people to choose from a narrow network of dentists. In addition to discounts on dental procedures, people may receive discounts related to vision, hearing and chiropractic care as well.

Less Encumbrances
: These plans have less encumbrances as compared to other dental insurance plans, since they do not involve filing claims and other forms for predetermined benefits. In most cases, there are no plan deductibles or limitation on benefits. Unlike insurance - that does not cover cosmetic dental procedures - dental discount plans may provide discounts on procedures such as bonding or veneer.

It's evident that dental discount plans provide a number of facilities that may be unavailable to people opting for dental insurance. Seniors, who cannot rely on employer-based insurance, can benefit to a great extent from these dental discount plans; so much so that dental discount plans have become synonymous with dental insurance for seniors.

Thursday, February 27, 2014

Temporary Health Insurance Coverage

COBRA (The Consolidated Omnibus Budget Reconciliation Act) allows a person to continue on the former employer's group health insurance plan for a period of 18 months after layoff. The former employee is expected to pay 35% of the insurance premium, while the remaining 65% is covered by the Federal government. Prior to March 1, 2009, the employee had to pay the entire premium for the policy. Even then, the policy was preferred to individual health insurance plans because of the lower premium. A person trying to set up his own business can avail health insurance at a reasonable cost for a period of 18 months.

Temporary Health Insurance
This is a good option for people on their way to self-employment. Temporary health insurance is an indemnity insurance. Hence, unlike managed care plans that tend to be restrictive, temporary health insurance plans provide the insured person the benefits of traditional health coverage. The procedural formalities are limited and one can get immediate coverage. However, as the name suggests, this insurance is of a temporary nature and a person is covered for a maximum period of 6 months. Moreover, temporary insurance does not allow preventive and routine care. Dental and optical care are not included in this policy. This policy is only meant for illness or injury.

Permanent Health Insurance Protection

Spouse's Health Insurance Policy
In case the spouse is working, he/she may be covered under the employer's group health insurance plan. It is possible to extend this plan to cover the family by paying additional premium. The main advantage of using the spouse's health insurance plan is the low probability of being denied coverage on account of pre-existing conditions. Moreover, the premium cannot be increased based on claims history.

Joining a Group
Joining a group may help in obtaining affordable health insurance. The reason is simple. Distribution of risk results in reduced per head risk and this, in turn, reduces the premium on the policy. Moreover, a person can get coverage for a pre-existing condition in case of group health insurance.

State Risk Pool
Each state has a risk pool which is run like a non-profit organization. These state pools were created to provide insurance to people ineligible for private insurance due to pre-existing conditions. It was also meant for people who could only access health insurance at exorbitant premiums due to the complexity of their medical conditions. There is no waiting period for people who have been continuously covered under any group insurance. A break in coverage for a maximum period of 63 days is allowed. A longer break will result in a waiting period for obtaining coverage. The premium for risk pool insurance is higher than that the premium for regular individual insurance. However, there are caps on the premium to ensure affordable coverage.

The premium paid on the insurance policy by self-employed people is tax deductible. This is a huge advantage of self-employment. A person should plan well in advance and make the necessary arrangements for health insurance before he decides to pursue his dream of entrepreneurship.

Wednesday, January 22, 2014

Denial of health insurance coverage

Health insurance is our bulwark against emergency medical expenses that can hit hard, anytime in life. However, in such a scenario, where one has gone through prolonged hospitalization, if one faces a denial of insurance coverage, life can be really tough.

Statistics related to denial of claims are not disclosed by health care insurance providers in the USA, but it is a fact there are millions of claims, which are rejected every year. Insurance denial is a reality which people have to suddenly face when they have no information about the insurance policy rules and regulations.

What are the major grounds on which a denial is met out by insurance companies, is not very clear. This issue has been in public debate for quite some time now and many people have demanded more transparency from health insurance providers, in terms of disclosure about denial statistics. Ergo, one needs to be very careful and read the rules and regulations of a health insurance policy. Be clear about what they promise in it.

How to Prevent a Denial?

All health insurance coverage policies come with certain inbuilt restrictions about the conditions under which you will be eligible for that insurance cover. Here are some points and tips to remember while availing health care facilities:

Check Referral, Network, and Pre-Authorization Restrictions
Most insurance policies have guidelines and pre-authorization requirements regarding which health care facilities you can take treatment from. The cover can only be restricted to certain health care facilities which are part of their affiliated network. They may also have separate guidelines regarding referrals. All this information is usually provided in the coverage certificate details.

Make sure that you are aware of these restrictions as in case you have taken the treatment, outside the affiliated network, you may be denied cover altogether or offered a reduced cover on those grounds. Often, the insurance companies require you to register a doctor as a primary physician. Make sure that you list one and the physician himself has been informed of this. Read what are the clauses regarding emergency medical needs. Contact the insurance company help desk for clarification, if required.

Ensure Authorization of Referrals
When taking consultation from any physician, other than your primary physician or any facility outside the affiliate network, see what are the requirements of coverage. It is better to ensure that the medical facility you are availing is a participating provider of the network and you have approval of the insurance company, prior to appointment.

Getting a referral approved by the insurance provider is important, even before making an appointment as otherwise, they can use that as grounds for not providing coverage. Same goes for any diagnostic test or surgery that you may have to undergo. Have somebody to be in close touch with the insurance provider company's help desk and get an approval from them, prior to it.

Ensure Correct Information in Claims and Billing
Many denial cases occur due to wrong information submitted in claims and billing information. Make sure that there are no errors regarding your full name, your social security number, and other billing data.

Knowing your policy details and your rights is a very important part, if you want to avoid being served a claim denial by any company. One can always make a health care denial appeal if one finds that the insurance company has been unjust. However, it is often a time-consuming battle which can be very taxing.

The best way out is to ensure that you are clear about the insurance policy guidelines, right at the start and ensure that the medical insurance claim, as well as billing information sent, provides the right information. Maintain all documentary evidence of hospitalization as well as correspondence with the insurance company, as you will need all that, in case of a denial appeal. I hope you don't have to face such a situation.