The WellPoint Revelation: How the Senate’s Public Option Plan will Impact Private Insurance

Public Option Plan could triple private insurance premiums, says a new study released by the insurance company WellPoint, Inc., and as reported by the Wall Street Journal.  Unlike previous studies, WellPoint’s used its own actuarial data to model a Public Option Plan in the 14 states it currently runs plans.  The study included market and demographic differences. 

The results?  Small businesses and individuals would experience increased premiums, with young and healthy consumers seeing the largest increases.

Click here for the Wall Street Journal Article.

Health Reform Legislation Passed by Senate Finance Committee

If you haven’t heard already, the Senate Finance Committee passed health care legislation today.  The President and CEO of America’s Health Insurance Plans, Karen Ignagni, released a statement, which we have provided below.

Recent key findings from a report by PricewaterhouseCoopers has shown that if these provisions are implemented, the cost of health plans will rise more than what the trend will be under current law.

http://hosted.verticalresponse.com/306797/370c519fe7/1362001578/a43f5d2d91/

24/7 Nurse Line Service and Precertification

As any new parent can tell you, having a 4 month-old baby with a temperature of 101° at 9 o’clock at night can be downright scary when you’re not sure what to do. Your child is miserable, but does it warrant an emergency visit to the doctor?

The above and other scenarios is why BEST Life has implemented a 24/7 Nurse Line service for all medical plan members. With this new service, callers have the option of accessing an extensive health information library, speaking directly to a Registered Nurse for counseling or advice, or get information on national health care resources. Mostly it will help members decide if and when they should see a doctor.

This important service has great value for employers, too! By helping to cut back on unnecessary visits to the doctor, a Nurse Line that is actively used can help a company lower their medical costs.

Another cost-saving tool we offer is Precertification. Unnecessary or excessive medical costs are a waste that no individual or company can afford. The increasing cost of hospitalization and health care is one area that can be avoided by simply remaining alert to proper utilization.

Precertification is required on our medical plans. Most of the time, doctors will file a Precertification on a member’s behalf, but members can also call the phone number provided on the back of their ID cards to talk to a Registered Nurse and get a Precertification.

Newly enrolled members will receive a brochure about the 24/7 Nurse Line along with their medical ID Card. Other customer pieces, like check stuffers, are also available upon request.  To make a request, please call our Customer Service Department at 800.433.0088.

Important: Our Enrollment Forms Have Been Updated

In order for Medicare to properly coordinate Medicare payments with other insurance and/or workers’ compensation benefits, the Federal Government is now requiring insurance carriers to collect the Social Security Number of subscribers and their dependents.

Effective immediately, BEST Life has updated all employee enrollment forms to capture Social Security Numbers for dependents and these forms are currently posted on the BEST Life website. We are advising our clients to discard any old forms they may have and to make sure their employees use the new forms when they enroll. A notice explaining this change was sent along with our June billing statements. If you have any questions about any of the above, please contact the BEST Life Customer Service Department at (800) 433-0088.

Updated Enrollment Forms can be downloaded by visiting:

http://www.bestlife.com/forms_employers.html

Negotiating Can Help You Save on Medical Bills

Getting medical care outside of your plan’s network can be costly. However, did you know that you may be able to get those costs lowered simply by asking the hospital or your health care provider for a discount?

Doctors and hospitals can be much more eager to receive payment of a lesser amount immediately than to receive full payment for the balance owed over a long period of time.

How much can be saved? That varies according to how much doctors and hospitals are willing to discount and if they are open to a payment plan.  Just remember it never hurts to ask.

To learn more about negotiating medical bills and an explanation on how medical insurance works, download this free e-book, My Healthcare is Killing Me.

Link: http://www.myhealthcareiskillingme.com/

What is the difference between a discount card and an insurance plan?

A discount card is not insurance, instead it offers discounted prices through a group of doctors, dentists, or vision care providers.

Discount cards can be less expensive compared to an insurance plan, and can offer certain advantages.  Because they are not insurance, discount cards are not subject to lifetime or annual maximums, co-payments, waiting periods, or pre-existing condition limitations.

However, a discount card does not provide benefits the way a good insurance plan can.  And that can make a big difference when you are in need of a lot of care.

Freedom of Choice
Choice is limited on a discount card.  Healthcare providers use discount cards to get people to come to their offices. The discounts are only available through this “network” of providers. Any treatment or services received from a provider outside of the discount card’s network would not be covered, meaning you would be charged the full price for those services.

Most people want to choose which doctor or dentist they want to go to.  While an indemnity is not tied to a network, PPO plans will reimburse services from a non-network provider based on what the plan covers.  These types of insurance plans offer the most freedom of choice.

Reimbursement
Discount cards do not pay for healthcare costs.  Instead, they provide a discount at the time you are billed. 

A good insurance plan can help substantially lower your out-of-pocket costs through the use of reimbursements.

An insurance plan reimburses a percentage of the costs, and in some cases, fully covers the cost of preventive care.  PPO plans offer you the “best of both worlds”.  If you use a network provider, you will have access to network discounts, and will be reimbursed for those discounted amounts.

Regulated
Discount cards are not as highly regulated as insurance.  Insurance plans must be filed and approved by a state before they can be sold.  By regulating insurance, governments can ensure that your rights are protected. 

What is right for you?
While a good discount card has its place, just remember that it will only provide a discount from a group of providers and nothing more.  An insurance plan can offer you better coverage for those times when you need a lot of care.  By reimbursing you for a percentage of the costs, and by giving you access to network discounts, insurance can help lower your out-of-pocket costs.  And that is the power of a good insurance plan.

New “How to Terminate Employee/Dependent Coverage” Flyer

A new flyer, titled “How to Terminate an Employee’s or Dependent’s Coverage” will be included along with May’s Billing Statements. In this flyer, we advise our clients to notify BEST Life of any terminations immediately.

Terminating coverage for an employee or dependent is easy with BEST Life.  Employers can do so by filling out a Termination Form and submitting it by fax or email.  BEST Life’s online administrative system also provides a way to submit a termination request directly online.

In order to ensure that a client’s account is credited by the next billing statement, clients are advised to notify BEST Life of any terminations immediately.  Requests received after one month’s time will not be credited to their accounts. 

A copy of the notice is available for downloading:

How to Terminate an Employee\’s or Dependent\’s Coverage

The Value of a Group Term Life Policy

Now that the economy has taken a downturn and your finances are taking center stage, we want to remind you of the value of purchasing a Group Term Life policy.

Group Term Life insurance is an inexpensive way to have money available during the event of a death.

To put this in another perspective, a Group Term Life insurance policy may guarantee $15,000 to $30,000 through one purchase compared to the years it would take to accumulate this amount in a retirement plan.

And the greatest part is that amount is not tied to the stock market.

Group Term Life is a valuable wealth management tool and should not be overlooked.

A recent Life insurance study showed that employees often overestimate the cost of a life insurance policy. To help you make a decision, here are some facts to consider:

Group Term Life Insurance can be inexpensive. In fact, it may be less expensive than an individual policy. Policies may be as cheap as 10 cents per $1,000 insured to $1.53 per $1,000 insured, per month, per person. The cost depends on your age, the amount of insurance purchased, the size of your group and the minimum age your benefits begin reduction; typically beginning at age 65 but may change upon request. All factors are spread across the employees of a group, making a group policy more affordable.

A Group Term Life policy offers other advantages.Smokers can get coverage, and getting a physical is not required.On certain voluntary life policies, where the employee pays for coverage, you may be asked to fill out a short medical questionnaire, but this is not required for plans fully paid by the employer.

The amount your Group Term Life policy covers may be 1 to 3 times your salary, based on your job title, or even a set amount; and payments are tax-deductible.

Having medical insurance may not be enough. While it helps to have medical insurance to cover those visits to the doctor, it may not provide the coverage you or your family may need if something goes seriously wrong. A traditional funeral can cost $6,000 to $15,000, and that does not even include debts, monthly income and the cost of education for your children.

How much coverage you need is another thing to consider. If your workplace provides a group life policy, make sure to review your plan documents so that you understand how much coverage you are getting. It is strongly encouraged that you review your finances to determine how much life insurance coverage you need. You may find that you need to purchase more coverage to supplement your Group Term Life policy.

Your policy can be used for other things, besides the event of a death. Your plan may provide coverage if you are terminally or critically ill, are diagnosed with cancer, or suffered an accidental injury that resulted in the loss of an eye or limb. The money you receive can be used to cover the cost of treatment or, in the case of a critical illness, to pay off debts, a mortgage and other expenses.

Again, it depends on the plan being offered by your company, which is why we recommend reviewing your policy.

Finally, do it for your family. Don’t let you or your family be taken off guard by a tragedy. Protect your family today.

Source: Guardian, Benefits & Behavior: Spotlight on Group Life and Disability Insurance, 2007.

New COBRA Subsidy Reminder

We just want to remind everyone that employers have until April 18th to provide notice and election rights to qualifying individuals.  Notice templates can be downloaded from the Department of Labor’s website: http://www.dol.gov/ebsa/COBRAmodelnotice.html.

For questions about COBRA, call our Customer Service Department at 800.433.0088 or email at cs@bestlife.com. For information about how the new subsidy works, visit our blog: http://bestlifeinsurance.wordpress.com/2009/03/18/more-on-cobra/

Why Purchase a Dental Insurance Plan?

Having group dental insurance can save money and more, it can help promote good oral health and keep work productivity up.  If you are considering whether or not to purchase a dental insurance plan, keep these facts in mind:

The Power of a Network
Dental PPO plans can save a lot of money through the use of a dental network. Dentists who are part of a network have agreed to provide dental services at a discounted price.  This can translate to a savings of 25% to 57% off what would normally be charged (depending on the procedure and the area in which you live in).

In addition, your plan’s benefits are applied to the discounted amounts, which make your out-of-pocket costs less than if you had gone to an “out-of-network” dentist. 

Another great perk is that most network agreements include providing discounts for services not covered by your plan.  So if your plan doesn’t cover orthodontia or teeth whitening, your network dentist may be able to offer those services to you at a discounted price.

If you purchase a plan that offers access to a network, take advantage of it! Make sure your dentist is part of your plan’s network before you make an appointment.

If the dentist you wish to see does not belong to a dental network, your plan can still save money.  After all, the purpose of a dental plan is to provide you with coverage for the most commonly used benefits. See the next section for a better explanation.

Coverage Costs Vs. Dental Care Costs
Even a regular dental visit for an adult with healthy teeth can cost money.  A regular initial visit may include a periodic oral exam, four films of bitewing x-rays, and an adult cleaning.  All three of these are separate services and are charged as such.  Without an insurance plan, the total cost in Los Angeles, California, is around $251.00*.  If you go to the dentist twice a year that would be a total of $427 for those two visits (minus the cost of x-rays for the second visit). 

The cost of a dental plan can vary by the amount of coverage a plan offers. However, the plans that offer the best value cover preventive care at 100%, meaning the insured would pay 0% of those costs.  At BEST Life, such a plan with a $1,000 Calendar Year Maximum can cost around $30 a month (for the employee only, residing in Los Angeles).  That is $360.00 a year. 

For those two regular visits, the employee would spend $360.00 for dental coverage for the entire year instead of $427.00 for not having coverage. That’s an overall savings of $111.00. The employee can save even more if the employer covers some of the cost for the dental plan.

Here’s a table to better illustrate the above scenario with the additional cost of a crown. Keep in mind that this scenario applies if the employee were to fully pay for the cost of the dental plan.

 

	Without Insurance	Insurance With Network	Insurance Without Network
Yearly Cost of Dental Plan	$0.00	$360.00	$360.00
1st Periodic oral exam	$66.00	$30.00	$66.00
100% Paid by Plan	None	-$30.00	-$66.00
Subtotal	$66.00	$0.00	$0.00
Bitewing x-rays (4 films)	$75.00	$39.00	$75.00
100% Paid by Plan	None	-$39.00	-$75.00
Subtotal	$75.00	$0.00	$0.00
1st Adult cleaning	$110.00	$63.00	$110.00
100% Paid by Plan	None	-$63.00	-$110.00
Subtotal	$110.00	$0.00	$0.00
Porcelain Crown	$1,224.00	$782.00	$1,224.00
50% Paid by Plan	None	-$391.00	-$612.00
Subtotal	$1,224.00	$391.00	$612.00
2nd Periodic oral exam	$66.00	$30.00	$66.00
100% Paid by Plan	None	-$30.00	-$66.00
Subtotal	$66.00	$0.00	$0.00
2nd Adult cleaning	$110.00	$63.00	$110.00
100% Paid by Plan	None	-$63.00	-$110.00
Subtotal	$110.00	$0.00	$0.00
$50 Yearly Deductible	None	$50	$50
Total Yearly Cost	$1,651.00	$801.00	$1,022.00

*Costs are based on DenteMax’s provider database. Actual costs may vary. 

 

Promoting Preventive Care is Good for the Business

The National American Dental Plan (“NADP”) conducted a Consumer Survey in 2007.  They found that people who do not have dental coverage are 2.5 times more likely not to visit their dentist.

For business owners, this means that offering a dental plan for their employees can encourage people to get dental care and can help keep work productivity up.

The alternative can be costly to the employee and to the company.  Not offering dental insurance can result in lots of hours lost to dental visits. The U.S. Surgeon General’s 2000 report on oral health estimated that working Americans lose about 164 million hours annually due to dental disease or dental visits.  That includes the time parents took to attend to the needs of children with dental-related illnesses.  

Promoting preventive care saves money and hours.  The American Dental Hygienists’ Association estimates that every $1 spent on prevention in oral health care saves $8 to $50 on restorative and emergency procedures.  Restorative and emergency procedures can be very costly and may even require more than one visit to the dentist to be completed. 

Lastly, employees can avoid the image of having “bad teeth”. Being comfortable and confident at work can directly impact job performance. Bad teeth may result in problems with speaking, chewing, and swallowing. All or any of these can jeopardize confidence and bring discomfort to the job.  Additionally, if you are uncomfortable with the appearance of your teeth, the U.S. Surgeon General’s 2000 Oral Health Report found that you are less likely to smile … and that could also hamper the self-assurance you need to perform well at work.

 

Conclusion:

We hope this helps you decide whether or not to purchase dental insurance.  If you have any questions, send an email to marketing@bestlife.com.  Please include your name, company, number of employees and the state your company is in (if an employer), this will help us serve you better. Any personal information provided to BEST Life will be kept private and will not be shared with outside parties.