Archive for the ‘Group Health Insurance’ category

Health Care Reform Needs The Right Leaders

January 21st, 2013

As the exchange era approaches and the reform bills take affect, many are still wondering what the overall result will be.  As of late, many have seen there health insurance premiums double with no explanation.  Also, many are still without health insurance because it is still way too expensive.  It is estimated that there are still over 40 million Americans without health insurance today.  That number is obviously why President Obama is trying to overhaul the system with his laws that were passed over two years ago.  In California, there are currently over 8 million uninsured, one of the highest figures in the country.  So, how will the exchanges get these millions of Americans insurance?  How long will it take for everyone to get health insurance?  5 Years?  20 years?  Another question, will people simply pay the fees associated with not having insurance because that it is still much cheaper than actual health insurance premiums.

Many people who make $10 dollars an hour, trying to make a living, do not have and can’t afford to get health insurance.  America needs quality leaders to oversee the health care system and the implementation of it coming next year.  Most are predicting that the healthy will pay for the poor, just like the rich pay for the poor when it comes to government programs, etc.  Next year everything takes affect, we will find out soon.

Higher Health Insurance Premiums On The Way

January 7th, 2013

Obamacare has been at the forefront the last three years and has been one of the most important issues the Obama administration has handled in their term.  As Obama’s four year term is coming to an end and the new term is starting, many consumers are wondering why insurance premiums are continuing to rise.  Also, many are now questioning how it will all of sudden start to decrease starting in 2014.  Aetna, one of the largest insurers in the United States, says health insurance premiums may go up as much as 20 to 50 percent in 2014.  Blue Shield mentioned that some markets may even double by the time the health care reform really starts in 2014.  So why is this really happening?  Many critics of the health care reform saw this coming from a mile away.  This is because, starting in 2014, no one can be denied health insurance coverage.  Anyone can apply through the health insurance exchanges, or direct, and get approved for health insurance even if they have a pre-existing condition.

From a care standpoint, this is obviously a great thing because everyone should have access to care.  However, from a pocket book standpoint, everyone will pay the price.  The main reason for this is because the healthy will have to pay for the sick.  There are 8 million uninsured in California alone that might be entering the market starting in 2014 when its required to have health insurance.  The sick pool will need the most money to pay for their claims, and that will only come from the healthy.

The health care laws also state that the premiums can not vary too much based on age and that it will be a community rating.  This will probably benefit the older more than it will the younger.  Since the older population have higher health costs, the younger segment will pay for this difference.  So what do we do at this point?  Well, there actually is no easy answer to that.  We have to all hope that the reform rules and regulations will not effect the market as much as all these top insurance carriers do.

Presidential Debate Tackles Health Care

October 4th, 2012

President Obama and former Governor Romney had a very heated debate last night in Denver.  Many topics were covered, including economy, tax codes, and government regulation.  However, perhaps the most heated and important topic discussed was about the health care reform and the future of health care.  President Obama of course backed up his plan that he put in place over two years ago.  He sited many benefits of the reform, such as no pre-existing condition clause and no lifetime maximum.  Mitt Romney actually passed a similar plan on the state level.  When he was governor, he passed a reform similar to what Obama passed on the federal level.  The main topic that was debated though was about state versus federal regulation when it comes to health care.

Mitt Romney wants states to take control and have the freedom to implement strategies and reform as they see fit for their state.  President Obama thinks that the federal government should have the ultimate control.  The both went back and forth, talking about control and power.  Also, health care costs was also at the forefront.  Romney maintains the position that the reform passed by Obama will make health insurance premiums rise and make it even more unaffordable for Americans to purchase health insurance.  President Obama wants the health insurance exchanges to be a foundation for competition, which he thinks will ultimately drive down the price of health insurance.  There are two more debates left before the election.  Many issues, including health care reform, wait in the balance.

What Is The Difference Between Anthem Blue Cross And Blue Shield?

October 1st, 2012

In California, Anthem Blue Cross and Blue Shield are actually different companies and are competitors.  In most other states, they are the same company and formed an association, the Blue Cross Blue Shield Association.  Anthem Blue Cross is a for profit company in California, and Blue Shield is a non-profit.  Both insurance companies have large networks and very good doctors.

Anthem Blue Cross does more volume in California than Blue Shield does and they have more members.  Also, the network of hospitals and doctors is the largest under Anthem Blue Cross.  Ous website, sells more Anthem Blue Cross plans than any other carrier.  That being said, many other carriers have strong plans and networks – Blue Shield, Aetna, Cigna, Healthnet, and Kaiser.  Depending on what types of benefits you want and how much you want to spend, picking a carrier will become easier once you narrow down the options.

Why Does Insurance Keep Rising?

August 7th, 2012

Each year, consumers see their health insurance premiums increase and there are no signs of it getting better anytime soon.  Why do these premiums keep going up and not down?  Why hasn’t the government stepped in and tried to help?  Well the quick answer is that the government passed the health care reform with the exact attempt to make health insurance more affordable for everyone.  The reason premiums increase each year, and why the health reform was passed, is obviously very complex and confusing.  Starting with the health care system, all the way from hospitals to doctors, is very broken and tiered.  Meaning, there are many doctors that are incentivized by different things.

Some want to see as many patients as possible, which obviously lowers quality of care.  And some doctors, only deal with certain markets, providers, carriers, etc. and that leads to other hosts of issues.  The only way that health insurance will become affordable is if people do not game the system.  The major reason health reform might not succeed is that adverse selection might become a big issue.  Since pre-existing conditions will not be an issue starting in 2014 to get approved for health insurance, many fear that the sick will only get health insurance right before a major surgery and then cancel the plan.  This means that the healthy will end up paying for the sick.  This will not make health insurance more affordable.  In fact, it will probably make health insurance more expensive in the years to come.

What The Supreme Court Decision Means To You

July 5th, 2012

Last week, the Supreme Court ruled not to throw out the health care reform which was passed over two years ago.  Two major issues were being watched by many people.  The first one, was the Medicaid expansion and the qualifications to get insurance through Medicaid.  And the second, was whether or not the individual mandate was constitutional.  The Supreme Court ruled that the mandate is constitutional and that they will enforce the mandate as a tax.  The original pitch and what was Obama’s selling point, was that the mandate would be penalized as a fee not a tax.  So this decision is huge and can have some falling out by supporters of Obama.  Anyone who does not health insurance by 2014, will pay $95 or 1% of their income, which ever is greater.  The figures go up if you have a family that is not covered.  Also, if you still do not have health insurance by 2016, the tax will go up to 2.5%.

So the question here is, will people that are healthy still go without health insurance and pay the tax.  Or, is the tax enough to make them change their behaviors.  Most likely, the former because it still is a lot cheaper to pay the tax then pay the monthly premium on a health insurance policy.  Another issue will be how each state will proceed with implementing the health insurance exchanges by 2014.  Still, there are 26 states that are opposed to the ruling and it will be a challenge for the federal government to manage the exchanges without support on the state level.

Supreme Court Decision Drawing Near

June 4th, 2012

The health reform was passed well over two years ago and has not gone without debate.  Many parts of the reform have already been implemented and have had a positive impact.  For instance, the lifetime maximum was lifted so no one can be limited by the amount of medical services they can receive.  This is very important for those patients who are terminally ill and rely of medical services to keep them alive.  Also, the age was increased for dependents to be on their parents’ health insurance to age 26.  As the economy continues to struggle, many are relying on others to pay their health insurance premiums.

However, the most important part of the reform is still being debated, and that is whether or not the individual mandate is constitutional.  Starting in 2014, the reform says that everyone must have health insurance and they will face a penalty from the government.  The Supreme Court is ruling on this and the results will have a huge impact on health care and the economy as a whole.

Small Business Health Insurance – The Wise Choice

May 30th, 2012

Many employers offer group health insurance for their employees.  It is a great way to attract good talent to your company, and also to create strong loyalty.  Over 90 percent of companies with 100 or more employees offer group health insurance.  However, many smaller employers are struggling to offer health insurance to their staff because it is expensive.

As the economy continues to struggle, employers are looking for ways to cut their health insurance costs.  Many are either opting to reduce the benefits so the monthly premiums come down or not health insurance at all.  In order to offer group health insurance for your staff, you must have the majority of your staff participate in the insurance program.  Most carriers require around 75% participation in order to offer group health insurance.  Employers are also required to contribute to the monthly premiums.  Usually at least 50 percent of the employee cost.  This is why many prefer to get health insurance through their company because it is more affordable.

Learn About Medicare

May 4th, 2012

As baby boomers continue to retire, Medicare will play a vital role in their health care and the overall care of the U.S..  Once you reach the age of 65, you have the option of going on Medicare.  The government provides the insurance for those who qualify.  As you earned income throughout your life, some of your tax dollars has been going towards Medicare.  When you do turn 65, you can immediately enroll in Medicare.  However, if you do not enroll when you turn 65, then the only time to enroll in Medicare is during the annual enrollment period that is every December.  Some people, however, work for another company that offers health insurance and they choose to stay on that plan.  If that is the case, Medicare benefits may still help you.  If the company has over 20 employees then Medicare benefits will still be applied to most situations.

The Medicare benefits are mostly for hospitalization and basic services.  To further beef up your benefits, you can purchase additional insurance that will work with your Medicare coverage.  This additional insurance is sometimes known as supplemental insurance.  The additional insurance covers benefits such as prescription drugs and doctor visits.  Medicare is a much cheaper option to getting traditional insurance in the open market.

What Is Group Health Insurance?

April 9th, 2012

There are two main ways to get health insurance, one is through your employer and one is the individual or family market.  Many companies offer group health insurance to their employees.  Usually, it is more advantageous to get health insurance through your employer because the company is required to contribute to the premium.  Also, group health insurance plans are usually better in benefits than individual plans by themselves.  Another important factor to consider is the underwriting process.  With group health insurance, each individual does not have to go through underwriting and get approved.  As long as your employer meets the requirements of participation, then you are approved for your health insurance in California.  However, when you apply for individual health insurance, each applicant goes through underwriting and you may get denied.

Group health insurance plans are offered to companies of at least 2 people and you usually have to be in business for a few months.  Basic documentation is required from the corporation and then you can start to apply.  Each company has to have most of their eligible employees participate on the insurance plan.  For most carriers in California, 75% of the eligible employees must enroll in the health insurance.


Do All Individual Health Insurance Plans Have Maternity Coverage?

March 28th, 2012

The fast answer is no.  In fact, most individual health insurance plans do not have maternity coverage.  The reason is simply, it is very expensive for both the carrier and unfortunately the patient.  When looking at the health insurance plans, make sure you research the benefit details to see whether maternity is offered with that particular plan.  All the health insurance carriers do offer plans that have maternity coverage, the issue is that it can be very expensive from a monthly premium standpoint.

Also, health insurance carriers know that most people get the health insurance right before they are giving birth and will probably cancel the health insurance afterwards.  In these cases, most will be denied.  The best thing to do is to get the health insurance before you start planning the pregnancy.  As a consumer, the best thing to do is plan ahead and make sure you look at the fine print.

Guide For Buying Health Insurance

March 21st, 2012

Their are many ways you can approach buying health insurance.  Many look at health insurance plans and make a decision based on cost only.  Sometimes this works, and many times it does not.  Also, some consumers may or may not look at carrier, network, plan benefits, type of plan, etc.  When trying to look for affordable health insurance, it is important to do your full research.  Health Insurance Outlet has a guide to buying health insurance that helps consumers filter down the health insurance quotes into a couple of choices that fits their needs.

It is important to comparison shop and see which carriers are providing the best rates, while keeping the benefits desired the same.  Also, making sure the deductible and out of pocket maximum are appropriate for your health history.  If your a healthier person, then it might be ok to pick a health insurance plan with a higher deductible.  You will end up paying less for the coverage per month, and since you are healthy, you probably visit the doctor less and won’t eat into your deductible.  Another important factor is the hospital and ER coverage.  Visiting the hospital is very expensive, so picking the right health insurance plan that has good hospital coverage is key.

Small Business Owners Worry About Health Care Costs

March 13th, 2012

Many small business owners are worried that they may not be able to afford to provide health insurance to their workers in the future.  Currently, about 43 percent of small business owners provide group health insurance to their employees.  Providing health insurance is a valuable benefit because business owners know that it will attract talent and also promote loyalty their company.  The survey showed that 83 percent of small business owners think that health care costs and how much it is rising should be a top concern for government officials.

More surprisingly, it how little business owners knew about the health reform and all the features of the new legislation.  First, 75 percent of the owners surveyed did not know about the health insurance exchanges set to be launched by each state in 2014.  Another 77 percent said that they were unaware of the tax credits that they could receive by offering health insurance to their employees.  These are important benefits that many owners still are not aware of.

GOP Governors Stall Health Insurance Exhange Plans

March 5th, 2012

Many state heads are for the health reform and its intentions.  The reform was enacted to provide better health care to Americans and also to provide health insurance at a lower cost.  However, many state governors are opposed to the fact that the law requires everyone to have health insurance as they think that is unconstitutional.  The supreme court will be ruling in June on whether or not the health reform is unconstitutional.  That is why many states are waiting to build their own health insurance exchange

State governors who are holding off because they do not want to waste resources to build a full health insurance exchange if the law might be thrown out.  The health insurance exchange that each state has to have up and running by 2014 will be very hard to implement and manage.  Some states that have had them for a long time have failed to make them work.  State governors know this and that is why they are being careful.

Will The Health Care Reform Help Me?

March 2nd, 2012

We have heard this question many times and our answer is always the same, it may or may not.  Seems frustrating, right?  The health reform which was passed over two years ago has an ultimate goal of providing affordable health insurance and health care to all Americans.  Already implemented, are such benefits as no lifetime maximums and increased student age requirements.  Those changes have been welcomed and many are benefiting from it.  What has not changed in two years are the costs associated with health care.  Unfortunately, the cost of using health care is still really high and only those who can afford it, have it.  That is why California has over 5 million uninsured and why Texas has over 25% of their population without health insurance.

Starting in 2014, health insurance exchanges will be available and that should hopefully increase competition and drive down the cost of health insurance.  Not all will qualify for the subsidies to get the really good discounts on health insurance.  We will have to wait a couple of years to see how this all pans out.

What Are My Options When My COBRA Health Insurance Ends?

February 16th, 2012

If you are currently on Federal COBRA and it is coming to an end, you have some options to get health insurance and to also save some money.  Federal COBRA lasts for 18 monhts, and sometimes you can get an extension if you have a qualifying event to get another 18 months.  However, if you were on COBRA for that long of a period, chances are that you were over paying for your individual health insurance.  Employer sponsored plans can get pretty expensive once you go on COBRA because you no longer have the benefit of the employer contribution to your monthly premium.  To state the obvious, landing another job that offers health insurance would be the best bet as sometimes employers cover the entire cost of health insurance. 

Another option would be to shop and compare individual or family health insurance plans.  By visiting our website,, you can easily and quickly compare hundreds of plans and filter the search results to pick the right plan that works for you.  Many times, individual health insurance plans will be less expensive than COBRA plans and you would be making the right choice to explore your options.

Health Insurance Exchange Challenges

February 14th, 2012

In 2014, each state is required to have an operating health insurance exchange ready for consumers to buy health coverage.  The exchange will have many different features, including portals for both individuals and small businesses to buy health insurance.  Many individuals, as much as 2-3 million, will qualify for subsidies when they buy their health insurance.  Also, many small companies may be able to find more affordable health insurance for their employees while also taking advantage of tax subsidies. 

Their are some major challenges though when 2014 finally comes around.  First, adverse selection could be a big issue for these health insurance exchanges.  Many critics of the health reform claim that only unhealthy individuals will migrate towards the health insurance exchange and that will force the premiums to ultimately increase.  This is because healthy individuals see health insurance as a waste of money and will not buy health insurance.  Another big challenge of the health insurance exchanges is marketability.  Especially in the small group market, many of the relationships are currently with health insurance brokers.  If the exchanges do not properly compensate the brokers, then they will not take their clients over to the exchanges.

Is COBRA Right For Me?

February 8th, 2012

Many people are faced with this question when they are no longer working for their company; is COBRA right for me?  It is actually not as easy to answer as you might think.  COBRA is basically federal law that mandates employers to offer coverage through their group health plan to people once they leave the company.  The laws are a little different depending on how many employees are in the company as well. 

COBRA offers protection to the former employee because it allows no break in coverage.  For instance, if you have a pre-existing condition, it might be best for you to stay on COBRA.  Also, if your pregnant, then taking advantage of COBRA is the best bet.  However, the downside to COBRA is that it can be quite expensive.  The health insurance coverage no longer has contribution by the employer so the monthly premium you are used to goes way up.  Shopping around to find cheaper health insurance coverage might be a great option for you.

Health Care Reform And The Changes For You

January 12th, 2012

Starting in 2014, the health care reform will take full affect.  Many employers that do not offer insurance may be required to offer health coverage or they will face a penalty.  On the individual side, everyone must have health insurance coverage by 2014 or they will face penalties.  The main purpose of the health care reform is to make health insurance more affordable and give Americans quality health care, or at least a chance to get it at a reasonable price.

The Obama administration faces a lot of pressure in the upcoming election as many think if a Republican wins the office that the health reform will be repealed or changed significantly.  The health insurance exchanges, that are required to be up and running in each state by 2014, should make the health insurance market more competitive and hopefully drive down the health insurance premiums.  Many critics do not think that the health reform will have much impact to the affordability of health insurance.  The next two years will be very interesting and crucial for many Americans.  Health insurance as continued to increase over the last ten years, by as much as 100% over that time span.

Survey Shows California Healthcare Costs Rising, Benefits Shrinking

January 9th, 2012

A recent survey shows that fewer companies offered their workers health insurance last year and the ones that offered health insurance made the employees contribute more towards the premiums.  The survey was conducted by the California Healthcare Foundation and their findings were worse than expected.  The economy has really taken its toll on employers and many companies are trying to find ways to cut costs everyday.

The survey showed that the number of companies that offer health insurance dropped from 73 percent to 63 percent.  That ten percent drop is very significant experts say.  Additionally, the plans that health insurance carriers offer are also going down as far as benefits are concerned.  That also puts many uninsured individuals in the marketplace.  That is partly why their has been such a large spike in applications for individual health insurance in California.  California health insurance has been a problem for many years, and now that the health reform is starting to take shape, many are hoping for better outcomes in the future.

Dealing With Health Insurance Premium Penalties

November 18th, 2011

Many people that get their health insurance through their job are being asked to contribute more towards the health insurance premiums.  As the economy continues to struggle, employers are doing everything they can to keep their health coverage for their staff.  Unfortunately, health insurance premiums are continuing to increase on a yearly basis and it is becoming very costly for a small business.

In fact, some employers are penalizing  employees that are more unhealthy than others.  Some companies are making overweight people and those who smoke to pay more towards their health insurance premiums.  Even one employee can affect a small business and the health insurance premiums they pay.  Companies are hoping by penalizing the unhealthy that it will motivate them to get healthier and change their lifestyle.

Getting Coverage For Your Business

November 14th, 2011

Group coverage works much different than individual insurance.  First of all, when you apply for individual health insurance, you may be denied because of pre-existing conditions.  Also, the plans are different than group sponsored plans.  Usually, when an employer decided to offer insurance to their employees, the coverage is much stronger and the benefits are much better than individual insurance. 

However, getting group insurance does have some hurdles to get through.  Employers must have a certain percentage of participation from their employees in order to get approved for the health insurance.  Also, health insurance carriers like to see a company to be around for a certain period of time before you qualify for group health insurance.  It is a great way for a company to attract and retain quality employees.

Blue Shield Opens Retail Store

November 7th, 2011

Blue Shield of California opened up a 500 square foot store in San Francisco.  The store was opened in a supermarket store so consumers can easily access the specialists to ask them questions.  The idea behind this is so current members can ask all the questions about insurance they may have.  Also, it serves as a retail store to attract new customers to Blue Shield of California. 

Blue Shield is the first health insurance company to have a retail store.  They believe that it is good timing because of the health reform and all the questions that are arising from the new laws.  Their are also many uninsured Americans that Blue Shield hopes to capitalize on.  In recent times, individual health insurance has been in high demand because many employers have either stopped offering insurance or have gone out of business.

Individual Health Insurance Market

October 25th, 2011

Many people are starting to get individual health insurance recently.  The majority of people that are purchasing health insurance have recently come off their group health coverage because they have either been laid off or fired.  The individual health insurance market has been increasing in volume, especially in the last few years.  With the economy continuing to struggle, experts think that their will be no slow down in applications in the near future.

Individuals and families that apply for individual health insurance coverage have to also worry about getting approved.  They did not have that problem when they got health insurance through their employer.  The process was much simpler and painless.  On the individual side, a health insurance carrier will take medical history into consideration when they apply.  If their has been a lot of claims and they forecast that more claims will come in, then the carrier may deny the application.

Advantages Of Having Group Health Insurance

October 20th, 2011

Many employers are seeking ways to provide health insurance to their employees.  As opposed to individual health insurance, group health insurance is not subject to individual underwriting.  If you have less than 51 employees in your company, each employee is given a rating based on their home zip code and age.  If your company has more than 51 employees on the health insurance plan, then the company as a whole is underwritten.  What that means is that individual employees do not have to worry about pre-existing conditions and getting denied because of it. 

When applying for individual health insurance, pre-existing conditions and medical history play a big role in the decision of approval.  Many consumers get denied for individual health insurance because they do have some conditions that health insurance carriers do not like.  However, their are high risk pools that individuals can still get health insurance in California on an individual basis.