Stripping Down Group Dental

Group Dental: a complex topic that may seem simple on the surface, but if you truly want to make an employer and employees happy, there’s more to it than rates.
Did you know that next to medical benefits, dental is the next sought after benefit?
It’s our opinion that it is better to offer it on a voluntary basis than not at all.  This is one of the many benefits that can be deducted before taxes and still help the employer save money.
So why is dental not as simple as we may think? Let’s delve a bit into the inner workings:
  • Maximum Annual Benefits
More often than not, the standard maximum annual benefit is usually $1,000, but are you aware there are options for $1,500, $2,000, and depending on the group size, even higher?
Tip: Some companies won’t count the preventative dollars used towards that maximum, which can help increase the actual benefit by several hundred dollars.
  • Deductibles
Ranging anywhere from $0 to $250 per person and up to three times per family,  a carrier may often increase the family cap from 2 times to 3 times to be a bit more competitive in the marketplace.
Tip: Lifetime deductibles are an option to encourage a group to stay with a carrier.  Once the lifetime deductible has been met per person and family member, no further deductibles are required.
  • How are the benefits paid?
It’s important to analyze where Endodontics and Periodontics are paid. Together with surgery and anesthesia, these are means to get the pricing down (and lowering or raising benefits to the employees).
Tip: This is where a rate is not simply a rate and you are really doing your client a disservice if that’s all you are reviewing. 
  • What about networks & how they function?
Closed network HMO’s only allow a member (unless an emergency) to receive benefits from a listed provider, and referrals are required for specialist services to be covered. The same is true with some carriers when they quote a MAC (maximum allowable charge) plan or a DHMO (Dental HMO).
Tip: Comparing a carrier that quoted a MAC plan versus a UCR (usual, customary, and reasonable) would be a mistake.  Let’s not forget that many individuals aren’t so lax to change dentists and if forced to do so may resent the employer and insurance carrier in the end.
  • It’s all in the details!
Before you quote your next dental plan, make certain to take these variables into account.  If this is a daunting task (which it can be if you are truly quoting the dozen or so carriers that are out there), please feel free to allow us to do the work for you.  We will make the process painless and the sale will be easier than ever before.
We look forward to working with you on your ancillary group cases this year!  Thank you for your loyalty and let us know what more we can do to help you in your group and disability solutions.
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Vacation All I Ever Wanted

 It’s a pretty incredible time of year if you’re living where seasons change.  The grass is still green, the leaves are changing colors and beginning to float to the ground, and there’s a crispness in the air.  While we want to bask in the present moment and enjoy all things Fall, we know that the holiday season is soon approaching.  And for many, that means travelling!

As insurance industry professionals we are hardwired and/or trained to educate others on ways to plan for the unexpected.  So if you, a client, or someone you know is anticipating overseas travel, an International Medical Insurance policy should be taken into consideration.

Why? Anything can happen!

Picture yourself savoring the taste of delicacies from a foreign land then uh oh, food poisoning! Or taking in your exotic surroundings and oh no, twisting your ankle! It can be aggravating enough to have to tend to these small things at home let alone a new place where you may not speak the language or know the lay of the land. This is where an International Medical policy steps in to help, especially if you need to be transported to another area to get the care you need!

Policies will vary based on needs, travel time, deductibles, and amount of coverage…but that’s why we are here to simplify and guide you through the various products and options available.

Common plans include:

  • Individual & Family
  • Business Travel
  • Employer Sponsored Group Plans
  • Student Exchange Programs, International Students, & Student Travel
  • Extreme Athletics & Adventure
  • Mission Trips
  • Marine Crew & Captain Members

 

Even if you have a tendency to over pack, do not fret! An International Medical Insurance policy won’t take up any space and you and your clients will be happy to have “brought it” along!

 

 

Safe Travels!

 

Melody

 

 

“I’m Brian Fellows!”

I don’t know about you but I am geeking out a little over the return of Tracy Morgan to Saturday Night Live tomorrow. A super fan of SNL and 30 Rock, Tracy has made me laugh hysterically more times than I could ever count.

My happiness isn’t only about seeing an incredible comedy actor star on a favorite show but more so, alongside many of his fans, we’ve missed him and we’re relieved that he is once again capable of doing what he loves and comes so naturally to him…making us laugh.

If you hadn’t heard about it, Tracy was in a fatal 6 car crash back in June of 2014. After an 8 day coma he awakened to a broken femur, leg, nose, ribs, and a traumatic brain injury (TBI).

Up until his recent appearance at the Emmys and one reported standup performance, Saturday’s SNL hosting gig will be Tracy’s first time back at it after having to put his life and career on hold in order to heal for the last 16 months.

If you missed him on the Emmy’s you can guess it was emotional. He cried, I cried, the audience applauded and gave a standing ovation and in true Tracy form, he made us laugh when he said that after he regained consciousness after the accident, “I was just ecstatic to learn that I wasn’t the one who messed up.”

Now because I’ve grown up in the insurance industry I can’t help but think about how disability insurance plays into this. I know that most people (including myself) believe that “something like this would never happen to me.” But let’s face it, it can happen to anyone. Car accidents happen every day and we could only hope for the full recovery that Tracy is beginning to experience.

So what happens in this situation if we aren’t able to perform our job for 16 months (or more or even less)? How do we pay for our homes, utilities, groceries, and other monthly expenses (while also potentially shelling out money for medical expenses)? If we have a spouse or family, how do also continue to provide for them? How do we keep from depleting our savings? And most importantly (I have said it before and I will say it a million more times), how do we heal when we’re stressed and anxious about money?

Disability insurance policies are there to provide you with a portion of your income if you can’t work due to injury or illness. If income protection is something you’ve never thought to look into, it’s worth the time. We can only control so much in this life and it’s important to have things in place to protect what’s most valuable to us; our families, our future, and our ability to earn an income.

I hope you will join me in celebrating Tracy’s recovery and return to the comedy world; welcome back Brian Fellows!

Melody I. Herman

Insurance Specialties, Inc., Pine Street Insurance
Broker specializing in Disability Insurance, Holistic Agent, Lover of Comedy
melodyherman@insurance-specialties.com
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Give Them What They Want

They’ll be jumping for joy…

As a couple of the most desired benefits you’d think more companies would offer dental and vision insurance to their employees. So why don’t they? Probably because you’re not talking about it!!

There’s no denying that taking care of oral and eye health is essential for overall health; problems in the eyes and mouth can cause or be indicators of problems in the rest of the body.

Fun facts:

  • About eighty percent of the U.S. population has some form of periodontal gum disease (yikes)
  • Many systemic diseases (including hypertension and prediabetes) are visible simply by looking into the eye, even before symptoms arise (who knew!?)

When you’re jumping into the ring, keep in mind there are more carriers than meet the eye (no pun intended), and we use our same methods of analysis and customization as all other ancillary lines.

One of the many things you can always count on from us is to get the 

BEST BENEFITS for the LOWEST COSTS, 

to both employer AND employee.

And just like all other group ancillary benefits the employer/business owner has the option to:

  • Pay the premiums in full
  • Share the cost with the employee
  • Offer the benefit as voluntary to either supplement employer paid benefits or just as a means to offer something to the employees and their families.

Don’t forget, a group can be as small as 2 employees!

I think it’s safe to say that all employers and business owners dream of having healthy and happy employees, and the more benefits they’re offering, the better.  Let’s help them make that dream come true; they’ll be jumping for joy!

Be Their Hero!

Having spent the first half of this year on Disability products in both the personal and business realm, it’s safe to say we are passionate about income and business protection!

For those that are business owners and/or selling to the business community, let’s now talk Group Short and Long Term Disability.

Why Group STD and LTD?

  • Providing these benefits helps employers protect a portion of their employees’ income (and their own income) should they become too sick or injured to work.
  • Offering benefits sets a business apart from other employers; it makes the company more attractive to quality talent, aids in employee retention rates, and are a way of saying thank you … we value you!
  • The plans are Guaranteed Issue regardless of employees’ health and group size!
  • Employers can include themselves in the plan to supplement their own individual protection.
  • Plans can be customized to be 100% Employer paid, 100% Employee paid (Voluntary), or a combination of both.
  • The portion a business pays for this insurance is considered a business expense and is tax-deductible.

Our Process

  • All we need is a census that includes gender, salary, occupation, and home zip code of each employee.
  • If the group has a plan in place, we need the current benefit summary in order to match benefits at a lower cost, or provide a better plan at the same cost.
  • We send a request for proposal (RFP) to as many of the top carriers in the country as possible.
  • We analyze all quotes based on cost, volume, and definitions (the latter being the keystone of our agency).
  • We create an easy to follow spreadsheet (including notes for the broker or employer allowing us to make the best and most knowledgeable recommendations).
  • When necessary we will go back to the carriers and negotiate better plans and/or rates to best fit the client’s needs.

As experts in the field of employee benefits and disability insurance we can support you whether you are a broker or employer.  If you are an employee and your company doesn’t offer benefits, we will be happy to start the conversation!

At Insurance Specialties Inc., we are here to help you design and implement the most comprehensive and competitive plan(s) based on the carrier strength, occupation, health, and goal(s) of your client.

 

It is our advanced knowledge and understanding that drives us forward.  Let us share our expertise with you!

Who doesn’t love a guarantee?: May Broker Newsletter

Who loves exciting developments in the income protection arena? We do! And this month we’re talking about Guaranteed Standard Issue (GSI).

As many of you may already know, a few top tier carriers offer high quality disability insurance.  Most have the same requirements to obtain a Guaranteed Standard Offer.

The Purpose of GSI: This form of individual plan is designed to be employer paid (or mandatory contributory) and supplement the group offering.  Often group plans are capped and discriminate against the more highly compensated.  This offering makes it easy to obtain, WITHOUT UNDERWRITING (I’m sure many of you have seen where the president or a member of the “C” suite is often the uninsurable/unhealthy one), while still providing all of the benefits of an individual plan.

What does this mean?

  •  An own-occupation definition of disability (this plan is for executives or those earning at least $75,000 or $100,000 depending on the carrier).
  • A true residual is part of the plan.
  • COLA (Cost of Living Increase) options are available.
  • The policy is usually non-cancellable (some offer this as a rider).

Are you an ancillary lines group producer? If so, this product is an excellent way to cement your client relationships and help the executives secure their financial plan.

Are you working outside of the insurance field? If you are an employer, business owner, or member of a group, feel free to contact us for more detailed information and to see if your group qualifies.

As we have said in the past, we strive to make this process easy and understandable.  If and when you have a potential case we are more than happy to provide you with everything you need. Let us know how we can serve you!

Protecting Partners and Saving Business Relationships: Broker Newsletter

The Role of Disability in the Buy-Sell Agreement

In today’s article, we want to spend a few minutes discussing an often overlooked plan for your business clients … a Disability Buy-Out Policy.  We will not apologize for the plethora of information, its dry nature, and the newsletter’s length; we know of no other way to discuss an involved product such as this!

Similar in nature to life insurance sold for buy-sell agreements, this plan exists to cover a need.  Instead of death, the trigger is a disability.  These plans have long elimination periods, 365 days, 540 days, or 730 days depending on the carrier. Unlike triggering a life insurance benefit, clients may be able to return to work so you don’t want the benefit started too soon. Besides, what partner or shareholder would not want to return to their business?

Valuation

We won’t get into valuation methodologies (which are important to help determine the partner/shareholder value) as they are too intricate.  However, the amount of coverage allowed for each partner/shareholder is predicated on his or her ownership percentage.

Who and how many to cover?

As a rule, you do not have insurers willing to cover more than 4 or 5 partners as it would prove too costly.  In addition, the principals can more easily fill in if another partner/shareholder becomes disabled.  According to Principal Financial, “A buy-sell agreement is not required in order to purchase DBO insurance, but one must be in place at the time of a disability claim.  In the state of New York, the buy-sell agreement must be in place before purchasing DBO insurance”.

How is it purchased?

There are two methods of paying for the coverage: entity purchase and cross purchase.  Once again, just like life insurance, you select the one that best fits the needs of the client.  Too many policies are cumbersome (and expensive), so often with 3 or more partners/shareholders, the entity purchase will make the most sense.

How does the policy pay out?

The payout on these policies will rely on the total amount at risk.  With multi-million dollar agreements, the benefit is normally paid as a partial lump-sum followed by monthly installments.  They can also pay out in monthly installments only with no lump sum.  Lastly, smaller amounts ($1 Million and less) can be paid in a lump-sum, which is the cleanest and easiest.  No matter, a buy-sell agreement will be required at time of claim to determine the valuation method used, the benefit amount (percent of business), and the validity of the claim.

How can we help?

If you need assistance in forming a plan for your business clients, we are here to help.  We have built a successful track record in developing buy-sell agreements, that when combined with new individual disability policies, have generated substantial premium discounts for the client.

Please reach out to us so we can make your process easier!

800.358.8844

info@insurance-specialties.com

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