Calling all folks who are enrolled in the Starmark PPO 250 Plan take note.  Watch our video where we’re describing in detail how this Starmark plan works.

at the end of the day, you want an insurance agency that is going to try to get your technology company the best rates.  watch our latest video on how we’re trying to help one of our clients get health insurance for…just a few of his employees!

The election results are in and the Republicans have retaken the House of Representatives.

Talk about the healthcare bill will once again be brought to the forefront of Congress. The Congress will attempt to change the present Health Care Initiative and this will put the entire Health Care system in turmoil again.

The new initiatives from the first bill have mixed reviews and have caused carriers to increase premiums. Options to employers have minimized while the premiums charged continue to escalate.

My clients ask me what they can do and I try to give them viable options to maintain the healthcare programs for their companies.

There will come a point where the choice will between giving a healthcare program or keep an employee working. The healthcare plan for that company will end. There will be a time when a small employer with less than 50 employees will NOT offer health plans.  It will be simply unaffordable.

So what steps do you take now as an employer?

Get the employees involved!  Either have them all in on the meetings or have them choose an employee representative to hear what the plans and costs are.

Most companies believe that they alone need to choose a plan.

This will not reduce the costs from the carriers but you might be surprised at the input from the employees.

Get the employees involved.

Editor’s note: This is a special post from insurance broker Alan Levenson.

Like it or not, healthcare reform has passed and the first portion of the bill, the patient protection portion is implemented.

New group health insurance plans that are started after September 23^rd of this year will have a whole set of new protections that will expand coverage, but unfortunately may increase your rates. The costs of the added protections have to come from somewhere.

The second portion of the bill, the affordability portion is set to go in to effect in 2014. So what can your business do now with the outlandish increases and high rates that you are facing?

Two words. Shop now.

There are insurers out there that offer alternatives to traditional coverage and may be able to offer you immediate relief in the way of lower premiums. These insurers may not be right for every company out there, but it is worth looking in to. Some of these insurers are also exempt from the added costs of state regulation.

You have a choice right now. You can either take your increases and high premium costs and hope that in 2014 you will see relief, or you can take a hard look at your  current group health insurance plan and come up with a strategy to contain costs.

I recommend that you develop a strategy now with an insurance broker who specializes in health insurance.

If your broker just hands you a couple of spreadsheets, you owe yourself, your company, and your employees the appropriate due diligence that a broker from CG Benefits Group and Technology Insurance Associates can provide. The plan that your company has, may not be the best option for you and the traditional marketplace may not be best either. Either way, you need to have your benefits reviewed.

Here’s what you need to do now:

• Gather your employee census information to get ready to submit to a broker
• Get copies of current plan benefit summary and rates
• Prepare to take a serious look at your contributions as an employer and how much your employees contribute
• Contact us now and a licensed insurance broker who specializes in health insurance will contact you to start getting quotes from all available carriers. You will discuss your strategy, goals, and needs with the broker to assist him or her in getting a proposal that meets all of your company’s requirements.

So you have applied for new group health insurance for your company, or you are an employee at a company that is moving to a new health insurance carrier, one thing that you want to know is when do I receive my medical ID cards?

After your company has submitted the application to the insurance company, your application goes into underwriting. Underwriting is the process of reviewing your company’s application and can take a couple of days or weeks depending on the complexity of your new insurance and the amount of submissions that the insurance carrier has received.

Generally speaking, after your group’s insurance is approved, the employees’ information is loaded into the insurance carrier’s computer system in about 3-4 business days. After the members and their dependents are setup in the health insurance carrier’s system, the medical ID cards are shipped to the employees’ home. You can expect to receive the medical ID cards within 5-10 business days after the employees’ information is setup.

Almost all health insurance carriers send the medical ID cards to the employees’ home, but there are exceptions where the insurance carrier will send the medical ID cards to the broker’s office or directly to the employer. If the medical ID cards are not sent directly to the employees’ home, then your broker will notify you of this.

Time to receive the medical ID cards can vary, but the time frame above is generally what happens based on our experience at Technology Insurance Associates.

If you have not received your medical ID cards in a timely manner, it is best to contact your broker and let him or her know so the health insurance carrier can be contacted to check to see where the medical ID cards are.

This guide is intended to assist employers when shopping and getting quotes for health insurance in New Jersey. Please contact us if you have any questions.

Am I eligible to have group health insurance in NJ?

You must meet the definition of a small employer, meet participation requirements, and meet employer contribution requirements.

What is a small employer?

Employ at least two eligible employees, but no more than 50 employees.

You must also have a majority of eligible employees working in New Jersey.

What is the participation requirement?

At least 75 percent of your employees must participate in coverage as a condition of obtaining a small group health benefits plan.

Employees waiving for spousal coverage, another group health plan offered by the same employer or another employer, Medicare, Medicaid, or NJ Family Care are considered to be participating in your plan.

What is the employer contribution requirement?

A small employer must contribute 10 percent of the total cost of health benefits plan. This is calculated as the annual premium for the employee and dependents.

What information do I need to provide you to prepare a quote?

• We will need your company name and zip code.

• A complete census with each employee’s date of birth, gender, and insurance coverage status. Such as single, husband/wife, parent/child, or family.

• The effective date of when you want the insurance to start.

• Residential zip codes for each employee will be helpful to provide.

You do not need to provide any personal information for employees such as names or social security numbers. You may refer to them on the census provided by their initials or last name.

What paperwork or documentation do I need to start a plan?

• Master application for your company that includes a small employer certification form.

• Check for the first month’s premium on your business checking account made out to the insurance carrier.

• Each employee must fill out an enrollment form or a waiver depending on if they plan on electing the insurance.

• A copy of your quarterly wage and tax report (WR-30)-Any employees not listed on the WR-30 will need to be shown on your monthly payroll. Owners not on the payroll must be on the Schedule C or K1. Newly formed businesses can provide other documentation to prove employee eligibility.

• If your company has prior health insurance, then you will be required to provide a copy of your last bill.

• HSA plans will require documents to be filled out by the employer and employee.

What waiting periods can I have for employees?

An employer can have a waiting period of up to 6 months. You may have a different waiting periods for current employees and new hires.

When can employees enroll in my group health insurance plan?

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.

What types of plans are available?

PPO, POS and HMO plans are available. HSA compatible POS and HMO plans are also a popular cost effective way to insure your company.

What are the main differences between plan types?

HMO plans offer in-network benefits only. PPO and POS plans offer in-network and out-of-network benefits. Employees receive greater benefits when using in-network providers. PPO and POS plans are generally more expensive than similar HMO plans. Deductibles and co-insurance for major medical services can be added to lower your premium.

HSA compatible plans have a high deductible that must be satisfied for all services, except for preventive care. The health insurance plan may be used with a savings account that can be obtained from the insurance carrier or from another financial institution.

Will the plans in my quote cover employees outside of NJ?

Yes, after requesting a quote you will speak directly to a state licensed insurance broker who specializes in group health insurance. Provide zip codes of current employees and let the broker know if you intend on having employees outside of NJ. Only select plans will work in specific states. This varies for each plan type and insurance carrier presented in your quote.

When are referrals required?

Some plans require referrals from your Primary Care Physician before seeing a specialist. All of our quotes provided do not require referrals since a majority of employees prefer it that way.

Do I need to select a primary care physician?

Plans that have separate co-pays for your primary care physician (PCP) and specialist visits require you to choose a PCP. If you do not choose a PCP the insurance carrier will charge you the higher specialist co-pay when visit your PCP.

What is a deductible?

A deductible is a specified dollar amount that must be satisfied before the insurance carrier pays anything toward the member’s charges.

What is coinsurance?

The coinsurance is the percentage of the allowed charges that are shared by the carrier and the covered person, usually after a deductible. Quotes list a percentage, such as 80 percent that commonly refers to the insurance carrier paying 80 percent of your bill and the employee is responsible for the remaining 20 percent.

What is a co-pay?

A co-pay is a defined amount of money that is used by the insurance company to charge you for utilizing a service. Commonly you are charged a co-pay for doctor, specialist, and hospital visits. Typical co-pays can range from fifteen Dollars for a doctor visit to one hundred and fifty Dollars per day for a hospital visit.

What is the Maximum Out-of-Pocket?

The maximum of out of pocket (MOOP) is used to refer to the total amount of covered services that an employee is expected to pay in a calendar year. After the MOOP is met, the insurance carrier pays 100% of the employee’s bill.

How are rates determined for NJ small business health insurance?

Rates in the small business health insurance market in NJ are based entirely on your employee demographics or census, zip code of your office, and effective date of your new health insurance plan. Co-pays, deductibles, and plan types all change your insurance premium. Negotiating on price is not available in the small group employer market in NJ.

Do all insurance brokers and agents have the same rates?

If the exact census and other details are used for two quotes from different brokers or agents, then the quotes will be exactly the same price. Agents and brokers vary heavily on the strategy they use to insure your company, so no two brokers or agents will present the same plans to you. We recommend having an in-depth discussion with a broker about your company’s health insurance needs.

Contact us now to get a free no obligation health insurance quote. We quote all insurers available to your company in one easy to understand proposal.

The state of New Jersey has released pricing and plan information about their pre-existing conditions program for uninsured residents.

As you may recall from my original post about the new health insurance exchange, the Patient Protection and Affordable Care Act (PPACA) was started nationwide to provide subsidized insurance for American citizens that do not have insurance due to a pre-existing medical condition.

Each state has the choice to run their own plan or go under the federal plan. The New Jersey Department of Banking and Insurance has decided to run their own plan with Horizon Blue Cross Blue Shield as the sole provider of healthcare.

To be eligible for PPACA coverage an applicant must be a US citizen, a resident of New Jersey, been uninsured for at least six consecutive months, and have a pre-existing medical condition.

The plan in New Jersey will now be called, NJ Protect, and have premiums ranging from $212.63 to $767.95 for a single person depending on the age of the applicant and design of the policy.

Plans offered provide in and out of network benefits similar to a PPO plan. Treatments for pre-existing conditions are covered from the start of the policy and also offer preventive care with no additional cost to the policyholder.

Do you think healthcare reform will continue to provide affordable healthcare for un-insured Americans?

Post a comment or email me at blog@insureyourcompany.com.

Avastin, a popular cancer treatment drug may have its approval revoked by the FDA after studies have found that the drug may not extend patients lives beyond a month, according to The Daily Telegraph. This about face has provoked fears that the FDA is starting a death panel as insurance carriers will likely drop coverage for the costly medication.

The FDA advisory panel has now voted 12-1 to drop the endorsement for breast cancer treatment. The panel unusually cited “effectiveness” grounds for the decision. But it has been claimed that “cost effectiveness” was the real reason ahead of reforms in which the government will extend health insurance to the poorest.

The New York Times has stated that the original trial showed that tumor progression halted for five months, but in new trials that used a combination of different chemotherapy drugs the tumor progression halted for less than a month to three months.

Britain’s National Institute for Health and Clinical Excellence, a pace-setter in evaluating medical advances, issued draft guidance this month against using Avastin for advanced breast cancer patients in the National Health Service. It called the clinical trial data “disappointing” and the cost “too high for the limited and uncertain benefit it may offer patients.”

I don’t believe that this results in Palin death panel rationing as some publications would have you believe.

If a drug does not work as intended, the FDA is within their rights to deny approval for the drug. If someone wants to use a drug that is not approved, then can do so and pay out of their pocket. If someone want to spend $8000 a month on Avastin, then they have every right to do so. I hope this issue is not used as a political weapon by politicians on either side of the aisle in the US.

What do you think? Is the FDA starting a death panel to ration healthcare? Do you think healthcare reform will make the country worse or better off?

Post some comments or email me at blog@insureyourcompany.com. I want to hear your opinion!

I receive tons of spam email, and I’m sure you do too. You may even get email from friends who think they are being helpful and informing you about the current health insurance reform that is taking place.

Unfortunately, one email circulating lately is blatantly not true. The email that is going around claims that your employer’s contributions to your health insurance will be considered income and will become taxable to you. A health insurance premiums tax is not coming to the US. The Huffington Post debunks this email in a recent blog posting on their website.

The IRS will require employers to list their contribution amounts on your W-2 starting in 2012, but current law excludes health insurance premiums from taxable income. The reason for the new reporting, is due to the new individual mandates, requiring individuals to have health insurance coverage. There are also employer mandates to offer coverage and fines to individuals who have “Cadillac plans.” These are all reasons why your employer’s contributions will appear on your w-2.

Rest assured, there will be no taxes on the money your employer contributes to your health insurance premiums.

An explanation of why health insurance is expensive in America and an overview of current health care reform and other possible fixes that may alleviate high prices.