Why Is Health Insurance So Complicated?
Because, health plans are complicated.
The reason are aggravated is they are confused about what they have just purchased.
Consumers are primarily concerned with:
- Pricing
- Terminology
- Coverage
- Compliance with the law
Pricing: Are You Getting The Most For Your Money?
When people are done shopping for health insurance the two biggest questions they have are: what am I paying and what is my cost?
The answer is, it depends. And, the only way to really find out is to do competitive shopping from a variety of insurance companies. However, comparing insurance policies and against each other is difficult. Because they often call the same type of treatment by different words.
The first step to comparing pricing is you need to make sure you are comparing similar service between the companies. Once you have a handle on that, you will be able to accurately compare one company to another.
In particular, you need to ask what specific services are offered by the company. For example, if they list an emergency service benefit, ask if that covers ambulance transport, and ask how the company defines an emergency.
Terminology: What Do All Of These Letters Mean?
The insurance industry loves acronyms. Constantly reading them throughout the literature creates confusion.
What is a co-pay? What is the difference between a copay and coinsurance? Who counts as a PCP?
If you’ve ever asked yourself any of these questions as your reading insurance paperwork, you’re not alone.
For most insurance policies, all the acronyms are similar. So, for most companies, copays are what you pay when you actually have to go see your health practitioner. Coinsurance is what you pay outside of what your insurance policy covers. If your insurance policy covers 90% of your medical bill, then the other 10% is your coinsurance.
The point is, before you shop for insurance, you should have a good understanding about the acronyms.
This site provides a well rounded list of health insurance acronyms.
I chose a policy, but is it legal?
Individuals and small companies are often concerned if they are meeting all the requirements of the Affordable Care Act. It’s understandable, because there are many ins and outs of health insurance law.
Furthermore, they are concerned if they will remain compliant if there are changes to the law.
The only way you can be sure if you are within the confines of the law is to have your insurance policy reviewed every 6 months by either your attorney, or your insurance professional. Insurance professionals stay on top of changes in the law, and always consider the upcoming changes to health insurance regulations when recommending programs.
Is this enough? Are we covered?
When choosing a health plan there are two ways to view the plan. Is it legally compliant, and does it support your employees?
Check out this site that explains the requirements of your health insurance plan.
As for the amount of coverage, this is determined by your budget. Health insurance remains the number one benefit employees value, so make sure the dollar amounts of coverage will help them and the required copays aren’t high.
Inadequate insurance has a big influence on employee retention and company morale. Providing inadequate insurance could drive away new employees or cause employees to leave for other companies.
When speaking with your insurance professional, ask how your plan compares to companies of your company’s size.
Yes, You Need To Use A Health Insurance Professional
At Flagler Financial, we work daily with local companies and help them establish insurance packages. We thoroughly explain to our customers everything they are purchasing and make sure employees know how to access their benefits.
Before open enrollment begins, contact us for a free insurance review. Chances are your health insurance is in order, but you want to be sure. We will sit down with you and review your insurance program, offer suggestions, and show you how are product offerings and service can make insurance shopping easier.