Tag : health-plan

Sean Sheffer Avoid These False Health Insurance Tactics


Real health insurance plans have standards set by state health insurance regulators and the Affordable Care Act. You may think you’re insured, but if you are fooled into having a “junk” health plan, aka “limited-benefits plan” - as soon as you wind up in the hospital, you’ve reached your yearly limits and may be left fronting all the costs!

Earlier we discussed the problem with Mini-Med/Limited-Benefits plans

Other misleading products, most notably fixed indemnity plans and discount medical cards are targeted at people who don’t have employer sponsored health insurance because they either can’t afford individual ...

Sean Sheffer Identifying Limited-Benefit Health Plans – Mini-Meds


Real health insurance plans have standards set by health insurance regulators and the Affordable Care Act. You may think you’re insured, but if you are fooled into having a “junk” health insurance plan - as soon as you wind up in the hospital, you’ve reached your yearly limits and may be left fronting all the costs!

Following the tale of Judith and her unfortunate incident with her Cigna plan, the Talbots Cigna Starbridge plan is one of the many mini-med insurance products targeted to industries such as retail, food service, and temporary staffing agencies.

How do I identify a ...

Sean Sheffer Beware of False Health Insurance Plans


If it seems too good to be true, well, it probably is. Sometimes, so-called “health insurance plans” just don’t add up, and if you don’t investigate enough, you may be in big trouble. You may think your insured, but as soon as you wind up in the hospital, that telemarketer who sold you the plan is conveniently out of reach… and you’re left fronting all the costs!

Real health insurance plans have standards regulated by the health insurance commissioner of the state and more recently by the Affordable Care Act. Health insurance providers cannot put outrageously low ...

Sean Sheffer Understand Your Health Plan using this Sample Brochure


If your looking to buy health insurance or want to gain a greater understanding of your health coverage, take a look at this coverage sample and see the framework of an insurance plan. This sample will make sure you are up to par with any and all confusing terms to make you get the best value out of your health plan.

Some important takeaways from the sample brochure:

This sample pamphlet will answer many insurance related concepts and why they are important:

What is the overall deductible?

You must pay all the costs up to the deductible amount before this ...

Sean Sheffer Final Regulations Released for Consumer Health Insurance Summaries


One of the initiatives of the federal health reform law was to implement new requirements for summaries of health insurance plans. This would enable consumers to make more informed coverage choices and have more clarity into the many health plans available to them.

"For too many Americans today, choosing a health plan means reading through a human resources book usually the size of a small phone book, and important information about eligibility and benefits is often buried in the fine print," said Marilyn Tavenner, the acting head of the Centers for Medicare and Medicaid Services, the agency within the Department ...

Sean Sheffer What are the "Essential Benefits" New Health Plans Must Include?


One of the many changes that the Affordable Care Act brings is determining a group of “essential benefits” that health insurance plans must provide. The Act requires that the Secretary of Labor conduct a survey of employer-sponsored coverage to determine benefits that should be covered by employers.

In a report from the Secretary of Labor to the Department of Health and Human Services, here are the twelve essential benefits and their respective descriptions:

  • Emergency Room Visits - This benefit includes visits to a hospital emergency facility or emergency room due to accidental injury or a sudden and serious medical condition.  Emergency ...

Sean Sheffer 6 Tips to Help You Choose Your Health Insurance Plan


Health insurance policies come in all shapes and forms, how are you to decide what health insurance plan is best for your employees if you are running a small business? Your decisions make tremendous impacts, and deciding on your company’s health insurance policy can give you a competitive edge to get the best employees while maintaining it all in your budget.

Here are six tips to help you decide your health insurance plan

  1. Don’t be afraid to ask for help – ask the experts! –  Know your resources that are available to you. There are many variables that factor in ...

Sean Sheffer The "Essential Benefits Plan" Requirements Released by the HHS – What is it?


Are you familiar with the policies that are required in an “essential benefits package?” Knowing what will be in the essential benefits plan is key if you are looking for health insurance or want to know what changes the Affordable Care Act will bring by 2014.

Released on Friday, Dec 16th, the Department of Health and Human Services released guidance in a bulletin for feedback before final rules are set out.

You can find the bulletin from the HHS here.

The health reform law will require small group and individual health insurance plans to cover a core group of ...

Sean Sheffer Porting your individual health insurance? Follow These Five Essential Tips


So you have done some research and really think that another insurance provider fits your needs better, now what?

What’s the first step?

Here is a general outline on what to expect and be prepared for. The first step is to approach the new health insurance provider and fill out a specific application for porting. They will process the application and post the request and on the IRDA site within one week. Meanwhile, your original health insurance provider will have to fill out all the data about your policy and credits through the IRDA site as well. Once this ...

Sean Sheffer Health Insurance Portability – Transfer benefits with confidence!

Say that I’m in the market for car insurance. We’ll call the company I’ve been with Lizard, and that I’ve paid my premiums on time every month for twenty years, I’ve never been in an accident and over time Lizard has rewarded me by reducing my premiums and other loyalty incentives.

Now, say I’m really enticed by another car insurance provider Aggressive, because they have a family insurance policy for my children.

I transfer – what happens to my record of on time payments and premiums? Aggressive recognizes my history, and replicates those benefits by ...