Frequently Asked Questions

Health insurance plans for individuals under the Affordable Care Act are purchased through the exchange at healthcare.gov. DHill health insurance counselors can assist with enrollment on the exchange at no additional cost. Small group plans for groups up to 50 Full-time employees are purchased directly from insurance companies, or through a broker, and again, there is no added cost to work with a local broker to assist at plan selection and for plan administration. Self-insured plans are available starting at 5 enrolled lives, and more common over 20 enrolled employees.

For employer groups of under 50 lives, health insurance rates are fixed. The first step to lowering health insurance rates is to find the network plan option which works with your chosen medical providers. Take advantage of cost saving opportunities with check-ups and registration on carrier portals. Look at medical insurance plans which include a health savings account to reduce health insurance premiums and get more engaged in effective strategies for consumption of medical services. Find a plan that matches your typical needs for healthcare service during the previous year.

A Health Reimbursement Arrangement allows an employer to make contributions towards the cost of medical services received during a plan year. Dollars are committed by the employer on behalf of their employee population; however, the funds are only dispersed if covered medical services are provided. The advantage to both the employer and the employee is often a lower premium for the underlying medical insurance, and the employer has the added advantage of only paying when services are utilized. New QSEHRA plans allow an employer to contribute towards individual health insurance.

A Health Savings Account (HSA) is available in combination with a High Deductible Health Insurance Plan (HDHP). The advantage of a health savings account is in the tax savings for medical services. Contributions to a Health Savings Account are typically tax-deductible, so when you pay for medical services from the HSA, you are paying for medical services with pre-tax dollars. There are limits to how much may be contributed to the account each year, and the contributions remain in the account until they are withdrawn. A funded HSA account allows you to maintain a lower-cost medical plan.

The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives qualified employees and their eligible family members the ability to continue health insurance coverage due to loss of employment, reduction of hours, or other life events. Termination of employment can be voluntary or involuntary, and requires timely notice be given to the employee of their right to continue coverage. Employers with at least 20 employees in the prior year are required to adhere to COBRA regulations.

Health insurance premiums are calculated based upon the ages of all the participants (employee, spouse, dependents) in a given plan year. Employers have the option to share the premiums equally amongst all members, converting the plan from age-based rates into composite rates. Composite medical rates provide one rate for the employee, a rate for employee with spouse, employee with children, and a dedicated rate for families. Composite priced plans are adjusted at the health insurance plan renewal each year based upon the actual participants in the plans.

Multiply your current income by the number of years you plan to continue working as the starting point for consideration. The number of children you have and their ages, your financial liabilities, current cash flow, retirement income goals, philanthropy objectives, and your interest in legacy planning will influence how much insurance you should own. These factors will also influence for how long you need the insurance and will help to identify the type of insurance that is right for you.

Many companies will require an applicant wait at least 12 months after a Driving Under the Influence conviction before they would accept an application for a new life insurance policy. Insurance companies would want a clean driving history during that year and would charge an additional premium based upon the increased risk. Driving history plays an important role in establishing a pattern of safe behavior; five years after a DUI, you could see life insurance rates return to normal risk levels.

Weight alone may not impact pricing of a life insurance policy, but when combined with height, and overall Body Mass Index (BMI) can have a direct impact to the pricing of a life insurance policy. A higher BMI can be attributed to an increase in co-morbid risk exposures including diabetes and heart disease. When purchasing life insurance, insurance companies have pricing tables based upon height and weight ratios, often up to 14 different levels of pricing, to get the most accurate rate possible.

Disability Income is available to self-employed professionals with a track-record of income. Insurance companies provide discounted pricing for disability income protection to higher wage earners, and those in specialized professions. Ratified contracts for future work can be utilized to establish a pattern of future earning potential, especially when transitioning from full-time W-2 employment into the same line of work as a contractor or under a newly established company.

Long Term Care Insurance policies pay expenses to cover a home health care aide, or to defray the cost of a nursing home or assisted living facility. Hybrid long term care insurance pays for the cost of these services and may include a death benefit payable if care is never needed. Hybrid LTCi policies could be funded with a lump-sum payment, or with premiums paid over your lifetime. With a more certain outcome, Hybrid LTCi plans have a higher premium than a comparable stand-alone LTCi plan.

Apply for Medicare as soon as possible to verify eligibility and make changes to your medical coverage if needed. Medicare is health insurance for people turning age 65, and you may apply three months before your 65th birthday and up to 3 months after you turn age 65. Application for Medicare is done through the Social Security Administration and is still suggested for individuals who plan to work past age 65. For employer groups of at least 20 FTE’s, Medicare is considered as the secondary payer of medical insurance claims to the group health insurance plan.

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