health

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.

“Stars: They’re just like us”

Hayden Panettiere has never been on my favorite actress list but for the first time I’m a fan. In case you hadn’t heard, she checked herself into a treatment facility for postpartum depression.

As women we are expected to be pillars of strength when it comes to families (and let’s face it, everything), especially after bringing life into the world. But just because someone suffers from a mental illness (and that’s exactly what postpartum is) doesn’t make them any less strong. A woman has just created and birthed a tiny person, this is warrior goddess stuff here and beyond all the hormonal and emotional responses that occur it’s not uncommon to experience deep depression. So why don’t more people talk about it?

Remember when Brooke shields came out and wrote a book about this same topic? Do you also remembered how Tom Cruise publicly criticized her for taking anti-depressants after giving birth to her daughter?

Do we really have to dig deep on the “why” behind so many women keeping quiet about postpartum? Or why so many keep quiet about any mental illness? Shame. And the shame keeps those that need help from getting it. So on top of the illness, add shame, and then sprinkle on judgement from society. What human can harbor all of that?

To go even further what if the treatment you need requires you to take time away from your job? What if you’re not a celebrity with a hit show and hit movies with a celebrity spouse both bringing in millions of dollars of income? How would you continue to earn an income and provide for your family, cover basic expenses, and medical expenses? How does one heal from this or any illness while anxious about money? The answer is Disability Insurance.

Did you know that treatment for postpartum depression is covered under disability insurance? Had I not grown up in this business, I most likely wouldn’t have known. A policy will provide you with a portion of your income for this and all other mental illness for up to 2 years.

While there is definitely a movement surrounding mental illness right now and removing the stigma, there is so much work to be done. Celebrities, someone at work, a neighbor, a family member, it doesn’t matter. Mental illness can effect anyone at any time. Let’s be more open and compassionate so that those that suffer will speak up and get the help and support they need.

Thank you for reading.

Melody I. Herman

Insurance Specialties, Inc. & Pine Street Insurance

Broker specializing in Disability Insurance, Holistic Agent

melodyherman@insurance-specialties.com 

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!

Business Owners and Disability…Keeping the Business Running: Broker Newsletter

Do you have business clients that:

  • Own a business?
  •  Are partners with 1 to 5 others?
  • Are members of a small corporation with less than 10 principals?
Business overhead is there to protect the business in the event the owner, partner, or working shareholder becomes disabled.  As agents and brokers, it is our responsibility to make certain we provide our business clients with Business Overhead Expense Insurance.

BOE will pay the expenses of the business in the event of a disability and is a 100% tax deductible expense to the business!

Here are a few covered expenses:

  • Rent
  • Utilities
  • Employee Salaries
  • Telephone
  • Loan Payments
  • Professional Services (Legal/Accounting)
  • Professional Replacement
  • Advertising

For a few pennies on the dollar, your business client can protect all that he/she has built. In the event he/she is unable to return to work, the business can be sold as a going concern.

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

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

800.358.8844

info@insurance-specialties.com

http://www.insurance-specialties.com

http://www.facebook.com/insurancespecialtiesinc

https://twitter.com/isi_psi

 

Join us for Health Insurance Awareness Day!

Due to the recent spate of inclement weather, the originally scheduled date of Thursday, February 19th has been changed to Tuesday, March 10th. Asheville Mayor Esther Manheimer, members of City Council, Buncombe County Officials, and citizens of North Carolina have been invited to participate in a community gathering to celebrate Health Insurance Awareness Day. The event will take place from noon to 1:30 P.M. at the Dr. Wesley Grant, Sr. Southside Center located at 285 Livingston Street (next to Fire Station #2), Asheville, NC 28801. Members of Western North Carolina Association of Health Underwriters will help educate the community at large regarding the vital role of the health insurance agent. It is essential that consumers fully understand that other insurance exists beyond The Affordable Care Act.  Our members are all licensed health insurance professionals whose careers are based on helping consumers with health insurance issues. Western North Carolina Association of Health Underwriters is the Regional arm of the North Carolina Association of Health Underwriters which belongs to the National Association of Health Underwriters headquartered in Washington, DC.

Light refreshments will be available.

For further information, please contact:

Andrea Block, WNCAHU Media Chair

828.667.1119

What’s Happening in our World of Insurance This Week

Our very own President of Insurance Specialties, David M. Block and Vice President, Andrea M. Block have headed to Washington, DC for the annual National Association of Health Underwriter’s (NAHU) Capitol Conference.  As Federal Law and Legislation Chair of both the Western North Carolina and North Carolina State Chapter, David and other Board Members will be lobbying NC Congressman Mark Meadows and Senators Thom Tillis and Richard Burr for changes to the Affordable Care Act for what David says, “would make an immediate impact on large employer groups.”

Here is what David had to say in his recent Letter to the Editor piece for The Citizen-Times, Asheville:

Let’s Get the Count Right – Full-Time means Forty Hours

Relief Needed for Employers in their efforts to comply with the Affordable Care Act

Many of you know I am a licensed insurance agent … I make no bones about my chosen profession and take pride in providing protection to individuals, businesses, and families.  I belong to several industry associations that serve the needs of agents and help keep us updated on pending legislation and its ramifications.

As a member of the National Association of Health Underwriters, representing over 100,000 employee benefit and individual health insurance professions, I am writing to address one easily fixed aspect of the Affordable Care Act — knowing who is actually eligible for employer sponsored health insurance.

The law requires employers with fifty or more “full-time equivalents” to allow their “full-time” employees (those working 30 or more hours per week on average) to enroll in the company’s health insurance plan.  The issue is, many business owners are finding it nearly impossible to know who those people are because they don’t have the time to figure that out, or money to buy software or services that would identify those folks.

 The fact is, that every other set of federal laws considers Full-Time to mean 40 hours per week.

Thus, they are left frustrated and confused by the process and the requirements of documenting why an employee was included or excluded from coverage.  In addition, by having this lower number of hours equal full-time, many employees (who already consider themselves part-time) cannot obtain subsidized coverage through the Health Insurance Marketplace.

The United States House of Representatives has already passed a bill (HR 30 – Save American Workers Act of 2015) and similar bipartisan legislation is being considered in the Senate (S. 30).  As someone who works with employers of all sizes, I know that if this legislation is passed and signed by the President, it will make the burdens of implementing the Affordable Care Act a little more bearable.

 Please encourage Senators Burr and Tillis to pass this legislation.  In addition, do not forget to write or call the President to ask for his help getting this law passed!

Best of luck to the all of the NAHU representatives from around the country in making an impact; as their motto says, “stand up and be heard.”