Monday, March 30, 2009

NJ and NY Small Companies - Insurance Solutions

Maybe it is finally time for consumer-directed health plans...as a married, father of 4 myself, we are now moving ourselves in to a high deductible health plan - most carriers have products available whether HRA or HSA, BUT it is important to look closely at prices...for example Aetna loves the products, has had its own employees in them for many years now, and publishes annual trend in the middle single digits and in some cases close to zero. Other carriers like Empire Blue Cross, Horizon Blue Cross, Cigna, Health Net and Oxford have not caught on with pricing, YET. I do feel there will be a race to the products with the recent economic meltdown. We must all remember that insurance carriers INVEST your premium, and we all know what happened to investments over the last 4-6 quarters!

Anyway, get savvy, and research CVS's generic drug program as well Target's and Walmart's....lots of my family's day-to-day healthcare needs are things like non-sedating antihistamines, generic thyroid meds, etc...so if we move to a high-deductible plan with say a 5,000 deductible for our family annually (even meds go towards deductible) but save 40-50% in premium for our family, and save 1/2 to 2/3 of the 5k deductible each month in an investment vehicle like a health savings account, we could save all the way around. In addition we can have this HSA tied to a debit card and bank of our choice, and at the point-of-sale we are just transferring pre-tax medical savings amounts.

I urge everyone, especially in an area like metro-NYC, to take the time and speak to specialists about these plans. Obama can only do so much with all of the "hands in the healthcare pot", as such, single payer healthcare is a LONG WAY OFF. Insurance carriers on the other hand are going to be given ultimatums to find ways to make health plans affordable. They have smart actuaries, they can do it....

Tuesday, March 24, 2009

For folks looking for a new health plan, the first stop should be to check and see which carriers have your docs...it is quite easy, and we provide tools where you can search right on our website (which links to the carrier doc searches directly)...www.empireblue.com for Empire Blue Cross Blue SHield, click visitor, then find a doctor....www.oxhp.com for Oxford Health Plans, lower left corner, click "search for a doctor or hospital" easy to follow from there. www.Aetna.com, top left search for doctor, pharmacy, lab or dentist, easy to follow....www.healthnet.com, upper right corner, click on "find a doctor or hospital" easy to follow from there. www.cigna.com, center of page "Find a doctor"....as in New York State, and New Jersey State whether you purchase a small group health insurance plan from a broker or directly from the carrier you pay the SAME PRICE BY LAW! So everyone in fact uses a broker as a broker can show everything from every carrier in one place. www.healthinsurancegeeks.com has streamlined that entire process all online, so it is easy to submit a request, and get back prices and plans in a matter of minutes. The above carriers are most of the leading carriers in the NY metro-market...www.horizon-bcbsnj.com is the site for NJ's version of Blue Cross, find a doctor is right in the middle of the landing page!

Monday, March 23, 2009

Small NJ Companies take heed...if you are a small company in NJ, with at least 2 employees, you may currently be purchasing individual health insurance, which from a cost and benefit perspective is more limiting than a small group plan.

If you have at least 2 employees (including LLCs with 2 partners, you count!) you should visit a comparison shopping site like www.healthinsurancegeeks.com. With just a census document of age, gender, zip code and family status for each employees, they can quickly load you in to their quote engine and produce hundreds of alternative plan designs from leading carriers like Blue Cross Blue Shield, Aetna, Cigna, Oxford/United Healthcare, Amerihealth and Health Net for example. Sites like the geeks have licensed experts (that are not pushy/salesy, yet knowledgable and helpful) that will compare everything and take the time to help you understand what you may need, and how to effectively put it in to place.

Thursday, March 19, 2009

Small Companies with Big Insurance Problems

Small companies make up the economy in the US plain and simple. Unfortunately they are not the ones that killed the golden goose (Wall Street earnings, and the money supply chain) the giant multi-national companies are the ones who hve, though the little guys are going to be left with lots of pain. The pain I am talking about is, how as an employer I pay my employees, and keep them as employees by giving them competitive health insurance and other valued plans.

The key to survival in my opinion is understanding the 3 buckets of most benefit plans: inpatient/outpatient medical services, office visits, and pharmacy benefits. Maybe soon insurance carriers will cease to have pharmacy cards? Walmart, Costco, Target, CVS, and even Walgreens are now offering their own pharmacy plans. With market consolidation, there will be more...as such, I believe I will be buying a "catastrophic" major medical plan (for hospital services, surgeries, catastrophic illness) and perhaps limited medical or "office visit" driven copay plans for the few visits a year to the doc, and then as far as medicine is concerned, I will see consumerism at its best, and be left to compare the "copay" to get my prescription at Costco, versus Walmart. As both an expert in this field, and a consumer, it sounds good to me.

So think about it, we bring the cost of health insurance down, as we unbundle services, and leave the consumer to be able to buy these 3 buckets independently at reasonable prices, without being deemed "uninsurable" as a result of being asthmatic for example.

My thoughts for the day.

Thursday, March 12, 2009

Wow, lots to talk about with small group health insurance these days....I spend lots of my time helping people who think they are trapped in a world where all they can buy is individual health insurance which is almost always medically underwritten - so to reiterate if you are some one with diabetes, high blood pressure, asthmatic, you are left out .... you will get declined - games these carriers play, you are the ones that need help!

Anyway, lots of folks are small business owners and in just about every state in the country, if you have 2 eligible employees including yourself, or 2 partners of an LLC or owners of a C corp for example, I can help! We can put a small group plan in place that is guaranteed issue, so if you have medical issues you can still get coverage. www.healthinsurancegeeks.com is the place to go to submit your information, we normally get back to you in minutes or can call and have an expert walk you through how we can help!

Monday, March 9, 2009

Small Companies with BIG Health Insurance Problems

Here is one of my brain dumps - President Obama is on the Health Care Reform trail just as the Clinton's were in the early 1990s. Will he succeed? Is the recent COBRA subsidy a start at deteriorating the employer-sponsored health system for both small and big companies? As a veteran of health insurance, health insurance brokerage, and various distribution channels for the sale of group-sponsored health insurance, I have MANY opinions - some may be spot on, others could be far off.

Small employers are faced with continued increases in health insurance premiums. It is now time to get savvy, and to take a look at consumer-directed plans (HRA's and H.S.As) as they will undoubtedly play a role in the future as consumers will be faced with gaining more education with the end cost of health insurance. Drug companies faced with pressure to compete in the generic market, and the exhorbitant cost structure of name brand drugs, and the ugly rebate structure most "layman" know nothing about!! Why does my health plan have certain drugs in cateorgy 2 name brand versus category 3, the higher tier and price...?? REBATES! They are not doing it for their health, your health, but the drug company's profit health!

Let me switch gears to the horrible tail of individual health insurance....they skim, simply put. They underwrite and insure folks who are completely healthy, rate up the folks who have "common and simple" health issues, and decline anyone with "some" chronic health issues, such as diabetes, obesity (according to them), asthmatic, depressed, have thyroid issues...the list includes almost EVERYTHING. Where do these folks get coverage? They should visit www.healthinsurancegeeks.com and find out....they focus ALL of their effort on finding ways to help the small employer (sole proprietor, 2 member LLCs, small companies) find ways to get good coverage at the best price AND figure out if you really should be buying small group coverage (guaranteed issue) rather than constant declinations in the individual market. Let them help.

Back to consumer direct plans...some say it is just passing the first few thousand of costs to the consumer (for example, Aetna has a Managed Choice Open Access Point-of-Service plan with a $3,000 deductible but then pays 100%)...though that is true it is only part of the deal. When you buy a high deductible plan, though you are responsible for and basically self-insuring those first few thousand of charges, you still benefit from the negotiated rate physicians must accept from insurance carriers when they are in the network. So let's look at an example like the one above, but use Oxford Health Plans as another example:

You have a $3,000 deductible, but then the plan pays 100%. If you are like me and have a wife and 4 small kids, that means the family deductible is usually 2 times or $6,000. Okay so every person in my family, or 6 of us has a $3,000 deductible per year, but any 2 of us that hits that FILLS the family $6,000 bucket, so the other 4 people in the family would have 100% coverage and no deductible to meet. That is a big deal especially if you are saving 40% in premium for example, and can now pre-save the family $6,000 deductible in monthly installments, a la the H.S.A.

I spend lots of my time educating consumers, as that is the only way we will learn and save in the U.S. as the government and carriers will not solve all of our problems. We need to better understand our alternatives, be better consumers, and not sign premium checks assuming what we are buying is the best thing for us. You need to engage with a trusting advisor (like healthinsurancegeeks.com) who will hold your hand through the difficult process of analyzing all of the alternatives.