March 2010 - InsureYourCompany

I have been selling employee benefits to employers across the US for over 12 years. It still amazes me that many of my clients and most employers think of the benefits as an EXPENSE for their company. Developing a benefits package to offer to your employees actually can enhance the quality of your labor force. If you use the benefits properly it can be an amazing recruiting and retention tool. I have shown employers how to offer a package that includes health insurance, dental, vision, long term and short term disability and life insurance. Incorporating all of these coverages and picking up the ENTIRE cost can not only save you thousands of dollars on what you currently have but going will enable you to be compliant to any current or future government regulation. An employer also has to make the employee more aware of the cost of the benefit. An annual statement of these costs in addition to the W-2 that is sent annually really provides the employee with an insight to how important they are to the employer. Taking the time each year to survey the employees with regards to the benefit programs makes all parties aware of what is truly important to both. I usually suggest that the survey be done mid contract year, this way the employer is aware of issues to be concerned about for the next renewal. You will be amazed at how beneficial bringing the employees in on the process truly is.

Editor’s note: This is a special post by Insurance Broker Jerel Levenson of Technology Insurance Associates.

Every business owner is talking about the new health insurance reform signed into law by President Obama today. How will this affect me, what are my responsibilities?

The questions are overflowing.

As of today, there are no changes to the system, those changes that will occur, we will not see till calendar year 2014.

There are many legislative hurdles that must be jumped before the final legislation is enacted.

What I can tell all my clients is not to jump to conclusions and nothing will change today, remember the changes are down the road.

Anything I report is not the final law and will be changed many times before 2014.

Businesses that employ under 50 individuals will see no changes. Those over 50 employees will be required to OFFER health insurance. NO definition of contribution or participation levels have been discussed.

Every individual will be required to have insurance, how this will be policed has yet to be announced.

There will be standards established for every health insurance policy – these have yet to be announced

As time goes by, we will learn how the new law will affect all of us. For today, the system will remain exactly the same.

Some minor changes will occur within 6 months, children will be covered under parents till age 26.

Pre-existing conditions will phase out over time.

These are good ideas and ones that will help everyone. Remember, as the rules change , we will all be notified . We will all have time to make and plan for the changes.

Today’s system is definitely in need of repair, hopefully our legislators will make the correct changes and we will all see a better system.

American policies and laws have evolved over hundreds of years, the reform of health insurance will take time. Support those that support you and the system will evolve into one that is better for all of us.

There are a number of small business resources on the Web where you can learn more details.

Editor’s note: This is a special post by our Customer Service VP, Gail Levenson

I am a health insurance producer in New Jersey and I get this question all the time. A patient receives a bill and wonders why the doctor is billing them. The best way to keep track of what you owe your healthcare provider is to keep the Explanation of Benefits (EOB) that is sent to you by the insurance carrier each time you see a provider. Instead of opening up the envelope and discarding the papers inside take the time to look at them and you will see that this document tells you what you owe your doctor and why. By the way, for most carriers you can also get your EOB online at member services so you don’t even have to wait for the mail.

The EOB will contain the following information:

Name of the Insurance Company
Subscribers name and address
Patient’s name
Provider’s name
Provider’s tax ID#
Claim date of service
Total billed charges
- the amount the provider sent to your insurance company
Allowed amount
- the payment a provider has agreed to accept for the service under the terms of a negotiated contract with the insurance company. This amount applies to in-network providers only. The allowed amount can also be the maximum the insurance company will allow for a specific service.
Discount amount
- the amount the insurance carrier adjusts the bill because of the negotiated rate agreed upon between the provider and the carrier. This is for in-network providers only.
Copays and CoInsurance
Deductible amount
Patient responsibility amount
Total payment and to whom it was paid
A remark section
- The patient responsibility amount is what you owe the provider. Be aware that some EOB’s include the copay, coinsurance and deductible amounts and some don’t so it is up to the subscriber to know what they already paid the provider and deduct that amount from the patient responsibility amount if necessary.

Learning to read and use the EOB will help you keep track of your payments to your providers.

The calls were coming in from many of my clients today. They are all concerned on how President Obama’s new healthcare reform law affects them. Here is my take, RELAX! Your current group health insurance plan is active and will continue as is. At renewal the insurance carriers will offer you insurance quotes with all the new updates that need to be added ( if any). Your current contract just cannot be terminated. This new law is focusing on the uninsured and plans and States that deny coverage for pre-existing conditions. We are all busy here at Technology Insurance Associates and CG Benefits Group dissecting this new law and coming up with plans and strategies to help you continue to provide your employees with a coverage that is low cost and offers quality benefits.

RELAX. More to come…

As an employee of a company that has a group health insurance plan, you are only allowed to enroll during specified times. You are initially allowed to enroll when you are first hired. If your company has a waiting period for new hires, then you may have to wait 30 days or more to enroll in your New Jersey group health insurance plan.

Each year a special period called “open enrollment” occurs on the anniversary of the date that you policy has started. During this period any employee of the company that have previously waived coverage are allowed to enroll in the plan. In addition, if you do participate in the policy, you’ll be able to update or change your coverage during the open enrollment period.

I am frequently asked if you go on vacation, are you are allowed to cancel your coverage and restart it in a few months after you return? Insurance carriers do not allow employees to do this. You are only allowed to leave a plan and come back on in open enrollment, otherwise you are allowed to come back on the plan if a qualifying event occurs. An example of this is, if you waived coverage for existing coverage during open enrollment. Then you lost your coverage, you would be allowed to enroll in the health plan from the date your coverage terminated.

Please be aware that pre-existing conditions of 12-18 months may apply if you have a break of coverage of over 63 days. While employee benefits programs change based on the employer, these types of changes to your health insurance policy are fairly standard.

I have been selling New Jersey Employee Benefits and group health insurance to small and medium sized businesses since 1997. Each year I see the plan design change slightly; there was higher co-pay, a split co-pay, higher drug card, two tier drug card, three tier drug card, and Hospital deductibles, in network deductibles. During this period the rates were rising. It was a challenge to bring a plan to the employer that was a slight increase over last year. Well things have changed, there are very few insurance carriers now offering the plans. The ones that do have raised the rates so much that a thirty percent increase over last year’s is the norm. I sit at my desk wondering what is happening, I have no options for the employer any longer, the rates go up, the plans keep offering less and less benefits. I do not see people utilizing the services less, what I see are companies forgoing the benefits all together. Is this what the insurance carriers want? Do they want to make it so the only people that take the insurance are the very ill and wealthy? What are employers supposed to do? Their employees think it is the employer that is reducing the coverage or lowering their contribution to raise the rates. I have no answers, all I have are questions. The most important one I have is what is Washington going to do to address these issues? The bickering between the Democrats and the Republicans and an ineffective President only delays and stalls the issue. Seems to me the Insurance and Drug companies are in control. In the end it is the American worker that is bearing the brunt of this problem and the final resolution is not even flicker of light at the end of a very dark and long tunnel.

One question I am often asked by my clients and friends, is why do I need life insurance? The answer can be complicated, but it comes down to the following purposes of life insurance:

Pay off a home mortgage if you were to pass away
Fund a business transfer
Create an estate
Create a charitable gift
Provide income to beneficiary
Provide an equal inheritance.

Life insurance is a very unique product it can be used to solve many of life’s financial problems. Many people see advertisements online for life insurance and simply purchase the cheapest term life insurance. It is a disservice to yourself and your family if you do not have a licensed life insurance professional evaluate your needs and accurately determine the correct type and amount of life insurance that you need. It’s important to figure out how much life insurance you need so you don’t buy too much (or too little). Many New Jersey businesses offer supplemental life insurance as part of their benefits package. Check with your New Jersey employee benefits administrator or your Human Resources Manager to find out how much life insurance your employer offers and how you can purchase.

I wanted to share a story about one of my clients. He was expanding his IT staffing business and hired a female recruiter /salesperson. This salesperson was emailing and interacting with the client’s operations staff at their offshore operations center. The emails started to turn more and more inappropriate, in a sexual way. The client is not sure who initiated the inappropriate emails but he now sees himself on the other side of a sexual harassment lawsuit. Needless to say the legal costs are great and he is scared to let any of these employee go. There is an insurance product that can protect your company from this type of exposure, Employment Practices Liability Insurance (ELPI). EPLI covers a business against claims by workers of the company, that their legal rights have been violated. Protection is provided against many types of employee lawsuits, including claims of: Sexual Harassment, Discrimination, Wrongful Termination, Breach of Employment Contract, and many others. The policies will reimburse your company against the costs of defending a lawsuit in court and for judgments and settlements. The policy covers legal costs if you win or lose the suit.

To prevent employee lawsuits, educate your managers and employees so that you minimize the problems in the first place. Create effective hiring and screening programs to avoid discrimination in hiring. Post corporate policies throughout the workplace and place them in employee so policies are clear to everyone. Show employees what steps to take if they are the object of sexual harassment or discrimination by a supervisor. Make sure Supervisors know where the company stands on what behaviors are not permissible. Document everything that occurs and the steps your company is taking to prevent and solve employee disputes. Contact us if you would like to learn more about employment practices liability insurance.

I recently had the extreme pleasure of reading a well thought out opinion column in the Wall Street Journal by the Republican Governor of Indiana, Mitch Daniels. Mr. Daniels shared his experience with Indiana state employee’s usage of Health Savings Accounts.

In review of the usage and cost savings, Indiana will stand to save $20 Million Dollars due to high enrollment in the HSA. An HSA is an outstanding addition to a company’s benefit plan and in the case of Indiana State workers in my opinion is successful due to high contribution rates provided by the government.

For example, the whole deductible of $2,750 is put into the HSA for the employee to use for any qualified medical necessity. For employees, “about 6 percent last year, who use their entire account balance, the state shares further health costs up to the maximum-out-of-pocket of $8000, after which the employee is completely protected.”
This generous level of contribution by the state is seldom seen in the private sector. Our New Jersey Employee Benefits Specialists have implemented many HSA plans and usually the deductible is funded by the employer, but beyond that it is the employees responsibility to pay out of pocket for expenses or contribute themselves to the HSA plan.

I would like to see a wider adoption of HSA plans in the public and private sector. I hope the current administration in Washington makes consumer directed healthcare a bigger priority and looses the mentality that regular workers can not afford HSA plans due to the high deductibles present. The focus should be on providing incentives for employers to at least contribute to the HSA in the amount of the deductible since the savings on the premiums are so significant.