The Perfect Accident Insurance Supplement to a High Deductible Plan For an individual Contact us for your best accident supplement options. There are many accident supplement products on the market to choose from. The rates typically vary according to age and location. For a family WBA is typically a much less expensive option. This is… Read more about Accident Insurance Supplement
Search Results for: accident supplement
Anthem Introduces New Accident And Critical Illness Benefits In Colorado
[…] For individuals and families who are healthy and rarely need their health insurance benefits, an accident may be their primary concern. Obviously we’re all susceptible to illness aswell, but accidents have a more “out of the blue” quality to them, and can happen to even the healthiest of people. We’ve never needed our health insurance due to illness, but we’ve had a few injuries over the years that have been pretty costly. Stitches and x-rays on our son’s finger alone came to $1,400. The charges can add up quickly when you’re in an emergency room, and if you have a high deductible health insurance policy, you’d be responsible for the entire bill for an incident like that. An accident supplement that will cover all or a portion of the deductible can help people feel more at ease with a high deductible (ie, less expensive) health insurance policy.
The accident supplement portion of Balance will coordinate with your health insurance, so it will pay you either your out-of-pocket amount or the Balance benefit maximum, which ever is lower. For example, if your out-of-pocket expenses for an accident – after health insurance has paid its portion – come to $1750 and you have the $2500 benefit Balance plan, you’ll get $1750 in supplemental coverage. But if your out-of-pocket expenses come to $4500, you’ll get the full $2500. The critical illness benefit is a lump-sum payment, but the amount paid depends on the specific diagnosis.
With the introduction of Balance, Anthem Blue Cross Blue Shield has added another solid plan to the options available for individuals and families in Colorado who are looking for an accident and critical illness supplement to go along with their health insurance policy.
Subsidies Are Key To Limiting Rate Shock for Coverage in Exchanges
[…] because it provides premiums for bronze-level plans as well as the standard silver-level (subsidies are calculated based on premiums for silver plans, and premiums that have been discussed in the media thus far have been almost entirely for silver plans). Healthy individuals and families who currently opt for higher deductible plans will be the ones who see the biggest change in premiums, since the ACA generally shifts plans towards richer benefits. So while benefits will be greater in the future, premiums will be too – and families who would rather have lower premiums and higher out-of-pocket exposure will be herded onto higher-priced, richer-benefit plans. Bronze-level plans will be their obvious choice, although even those plans will have richer benefits than many of the high deductible plans that are currently available in the individual market. Families and individuals who prefer richer benefits already will find that their premium changes are not as dramatic, since they will likely end up with an ACA-compliant plan that is more similar in design to what they currently buy (they will be more likely to opt for silver or gold plans).
I’m using a family of four modeled after my own family so that I can compare premiums with what we pay now. Our current plan is $403/month for two adults (mid/late 30s) and two small children. That’s $4836 per year, and we spend an additional $540 per year on an accident supplement that would cover most of our out-of-pocket exposure if we were to have a claim because of an injury.
According to the KFF subsidy calculator, a bronze plan for our family would cost $9330/year – almost double what we pay now. The benefits would be richer than what we have now (more in line with HSA-qualified plans, which we’ve opted not to have anymore because of their higher cost), but the premiums will be significantly higher too. Of course we have to assume that even if the ACA had not passed, our premiums would continue to increase each year. Over the last several years, premiums in the individual market in Colorado have increased for most of our clients by double digits most years, so we can safely assume that we’d probably have had at least a $500/year premium increase next year anyway. But that’s not even close to the 93% increase to the bronze level premium for an ACA-compliant plan.
Those numbers don’t take subsidies into account though. The $9330 is the base price for a bronze plan for a family similar to ours. The actual amount the family will pay in premiums depends entirely on the family’s modified adjusted gross income (MAGI). Here are the premium amounts that the family would pay for a bronze plan at various income levels, assuming that they purchase their coverage through their state’s exchange and take advantage of the available subsidy:
- $40,000 annual income: Bronze plan premium = $38/year (subsidy pays $9292)
- $50,000 annual income: Bronze plan premium = $1438/year (subsidy pays $7892)
- $60,000 annual income: Bronze plan premium = $2986/year (subsidy pays $6344)
- $70,000 annual income: Bronze plan premium = $4667/year (subsidy pays $4663)
- $80,000 annual income: Bronze plan premium = $5673/year (subsidy pays $3657)
- $90,000 annual income: Bronze plan premium = $6623/year (subsidy pays $2707)
- $95,000 annual income (and above): Bronze plan premium = $9330/year, with no subsidy.
The estimated median income for FY 2013 for four-person households in the US is $74,964 (note that this is higher than the overall estimated median household income, because it’s specific to four-person households, which often include two working parents and people who are further along in their careers, as opposed to people who have just finished school and entered the workforce for the first time). And keep in mind the math[…]
Compare Colorado Health Insurance Options
There’s no upside to searching for a Colorado health insurance policy on your own. The price for health insurance is the same whether you use a broker or not. We can help you find the right plan, either through the exchange (Connect for Health Colorado), or you can choose from one of the carriers offering… Read more about Compare Colorado Health Insurance Options
Don’t Get Caught By The ACA Individual Mandate Penalty – It’s much higher than it used to be
This post was originally written in March 2014, but was updated in November 2015 to reflect the changes in the penalty calculation for 2016, and again in November 2016 to address the penalty for 2017. The penalty in 2017 will remain unchanged from 2016, but it’s considerably higher than it was in 2014 or 2015,… Read more about Don’t Get Caught By The ACA Individual Mandate Penalty – It’s much higher than it used to be
2017 Rate Increases for Colorado Individual Health Insurance Market
EDIT, 9/25/2016: Rates were approved recently by the Colorado Division of Insurance. The following average rate changes (actual changes will vary by plan) will take effect January 1, 2017 for the seven carriers that will offer individual market coverage through the exchange. They will also apply off-exchange, as all of these carriers offer their plans both… Read more about 2017 Rate Increases for Colorado Individual Health Insurance Market
Should open enrollment end by December 31 to prevent adverse selection?
A year ago, I wrote a post in which I expressed the opinion that open enrollment should continue into January every year. At that point, the proposed guidelines from HHS had called for the 2016 open enrollment period to end on December 15, 2015 (ie, next week), and I noted that this would mean people… Read more about Should open enrollment end by December 31 to prevent adverse selection?
Universal healthcare in Colorado – does one size really fit all?
Universal healthcare coverage could be a reality in Colorado a few years from now, although it admittedly has some significant hurdles to overcome in the meantime. Supporters need to gather 99,000 signatures in order to get the ColoradoCare initiative on the 2016 ballot. And then voters would need to approve the measure in order to… Read more about Universal healthcare in Colorado – does one size really fit all?
Short term health insurance is your best option if you missed open enrollment
Short term health insurance plans don’t have an open enrollment period Short term health insurance plans may be the best option if you missed open enrollment and you don’t have a qualifying event. Get short term health insurance quotes Qualifying events include marriage, divorce, birth, adoption, moving to a new area where different plans are… Read more about Short term health insurance is your best option if you missed open enrollment
Comparing Individual Marketplace Premiums to Small Group is Disingenuous
After a lot of confusion late last month regarding 2014 health insurance rates in Colorado and information about which carriers would be offering policies in the exchange (Connect for Health Colorado), off the exchange, or both, a lot of the dust started to settle late last week and more information has become available both in terms of rates (although they won’t be finalized for another couple months) and carriers. The Colorado Division of Insurance has released a full list of the carriers that submitted rates for next year, including details regarding whether each plan will be for individual or small group, and sold on exchange, off exchange, or both. Detailed rate information is available from some carriers on the Colorado Division of Insurance website, although there will likely be a lot of change between now and October.
As soon as rate data started becoming available in a few states, both supporters and opponents of the ACA jumped on the info and used it to paint two very different pictures. HealthBeat’s Maggie Mahar (who has astutely and accurately rebuked a lot of political spin and fear-mongering from opponents of the ACA ever since it was signed into law) called out Avik Roy for his critical view of the new rates, noting that he was comparing “apples to rotten apples” in his Forbes article about rate shock. But Roy did make a very good point is his article, which was based on the release of rates in CA. He noted that
“The rates submitted to Covered California for the 2014 individual market,” the state said in a press release, “ranged from two percent above to 29 percent below the 2013 average premium for small employer plans in California’s most populous regions.”
That’s the sentence that led to all of the triumphant commentary from the left. “This is a home run for consumers in every region of California,” exulted Peter Lee.
Roy went on to point out the key words there, which might have gone unnoticed by people who aren’t in the health insurance industry or paying very close attention to the details: The rates for the new individual market are being compared to the existing rates in the small group market.
It is not at all surprising that the new individual rates are looking similar to existing small group rates. Earlier this year I wrote about how difficult it was going to be for the individual market to be priced significantly lower than the small group market once medical underwriting was no longer a factor.
But I’m not sure that most people (other than business owners) are completely aware of how high small group health insurance premiums are. As we’ve noted many times, people who have employer-based health insurance are often insulated from the true cost of the coverage, thanks to the fact that at least a portion of the premium is paid by the employer. Some people started […]
The Downside Of Limited Benefit Association Health Plans
We recently worked with a client who is a Colorado REALTOR and a member of the National Association of REALTORS. She mentioned that she was eligible for coverage through NAR, but wanted to compare her options in the individual market with the policies that she could get as a NAR member. She sent over the details for us to look at, and we noticed that the coverage that NAR was touting as a benefit for members is basically just a guaranteed-issue limited benefit indemnity plan. Members have a choice of three different policy designs: The Physician Plan ($200/month for our client’s family of four) doesn’t include any inpatient benefits at all; it covers up to $100 per visit for office visits and ER visits, and up to $1000 for accidents. The Value Plan ($300/month for our client’s family) and Platinum Plan (almost $500/month) included limited inpatient and surgery benefits, but even the Platinum plan capped its benefits at $1000/day for inpatient care and $3000 per operating session for inpatient surgery. The plans are all guaranteed issue, but they have a 12 month pre-existing condition exclusion for any hospital or surgical expenses.
NAR makes it clear on their website – for people who are detail oriented – that the coverage offered through the REALTORS Core Health Insurance is not major medical and that the benefits are limited. They also provide a good informational page on their site about the struggles that self-employed people face when it comes to securing health insurance, and the efforts that NAR has made and continues to make in terms of making true group health insurance available to independent contractors who are part of a large association-type group like NAR. Presumably all of this will be a moot point as of next January when the individual mandate and guaranteed issue individual health insurance are implemented, but for now, it does appear that NAR is cognisant of the problems faced by many self-employed people who are trying to obtain medically-underwritten individual health insurance.
My concern is […]
Consumer-Driven Healthcare Debate
[…]prior to reading Ungar’s article I wasn’t aware of the agreement between the Independent Physicians Association and Rocky Mountain Health Plans with regard to Medicare and Medicaid reimbursement. The doctors in the IPA were so determined to treat every patient equally that they worked out an arrangement with RMHP to have the insurance carrier accept payment directly from Medicare and Medicaid and then pool that money together with premiums collected from RMHP insureds.
[…] Hixon argues that patients with more financial responsibility for their own care do indeed make better decisions regarding efficient use of healthcare dollars. Furthermore, he cites a study that found that patients with high deductible health insurance policies (eg, HSA qualified plans) had more preventive care, lower rates of hospitalization, and were more compliant in terms of following their doctors’ recommendations. They were also more likely to question their medical bills and had overall lower medical costs than people with traditional low-deductible policies.
[…] In addition to probably being above average in terms of financial savvy, I would assume that the demographic that opts for high deductible health insurance is also probably healthier than average. It makes sense that the more health problems a person has, the more likely he’ll be to choose a lower-deductible policy, since he knows he’s likely to be using the policy at least somewhat regularly. On the other hand, a person with no health conditions at all is probably making a good gamble to select a high deductible policy, since there’s a decent chance he’ll be able to go for several years without having a major claim. So the fact that people with HDHPs have lower medical costs isn’t really surprising. It’s largely a self-selected group (employers who offer an HDHP usually offer another plan as well, and everyone shopping for individual health insurance who picks an HDHP has other options from which to choose). I’m not sure that medical costs would still be lower for people with HDHPs if they policy designs were assigned randomly across the entire population.
More Flexibility With An Individual Health Insurance Plan
[…] For the average person who has had an individual policy for a decade and is late 50s-ish, keeping that individual policy (even though a group plan may become available) might be the ticket to being able to have some flexibility in terms of when to retire. The group plan is guaranteed issue – health conditions won’t be a barrier to getting coverage. But the group plan is also tied to the current employer, and the policy will only be available for a maximum of 18 months after you leave that job (via COBRA). […] Linda’s article is an excellent reminder about the importance of looking at the specifics of your own situation – including long term issues that might outweigh short-term benefits – rather than following conventional wisdom or doing what everyone else is doing.
Only Two Health Insurance Options For Metro State Students
[…] But some students have done their own research and found an individual health insurance policy that better fits their needs and/or budget, and they would prefer to be given the option of keeping that policy. For those students, we feel that colleges should reconsider their waiver requirements and treat their students as adults who are capable of making their own decisions.
A petition to make pregnancy a qualifying event in Colorado – but something doesn’t add up
Last month, Broomfield resident Sean Jenks created a Change.org petition asking Colorado lawmakers to allow a special enrollment period for women who become pregnant. It’s picked up considerably steam in the last 24 hours, and now has more than 13,000 supporters. Jenks points out that New York and California have taken steps to make pregnancy… Read more about A petition to make pregnancy a qualifying event in Colorado – but something doesn’t add up
Burwell v Hobby Lobby – The Wisdom of Justice Ginsburg
I’ve spent the last two evenings reading the text of Burwell v Hobby Lobby. That might sound dull, but I highly recommend it – far more interesting than the text of the ACA or the thousands of pages of associated federal regulations that have been released to supplement it. It’s 95 pages, but it’s a relatively… Read more about Burwell v Hobby Lobby – The Wisdom of Justice Ginsburg
Going Without Health Insurance
You may already be familiar with the blog Zen Habits. It’s a very popular site with hundreds of thousands of readers. It’s written by Leo Babauta, who has authored numerous ebooks and paper books and has over a hundred thousand followers on Twitter (he’s following three people – all those followers he has are just interested in what he has to say). When he writes something, it gets read and shared and talked about. I’ve been reading – and enjoying – his site for a few years, and I usually find myself nodding in agreement with whatever he’s written.
But his most recent post threw me for a bit of a loop. He explains his rationale for not having health insurance for his family (he and his wife and six kids), and goes into a detailed description of how you, too, can make health insurance a bad bet.
I have no idea what his full financial situation looks like. He often writes about being a minimalist, so I know he’s not spending lots of money on material stuff. They do like to travel and recently spent several weeks in Europe – that doesn’t come cheap, but it’s a great experience for adults and children alike. He has a very successful blog and several books, so I have to imagine he’s not poor. And yet Leo Babauta considers going without health insurance to be a reasonable risk.
To be fair, I agree wholeheartedly with the tips he gives for “making health insurance a bad bet“. Things like eating well, exercising, avoiding excess alcohol, not smoking, driving safely […]
Health Insurance Glossary
Confused by the terms used to describe the plans? If this health insurance glossary doesn’t help, please feel free to contact us with your questions. A Accident An unforeseen and unintentional act identifiable in time and place. Actuary A person trained in mathematics whose job is to apply the theory of probability to the business… Read more about Health Insurance Glossary
AFLAC
AFLAC Has Many Options for Your Employees in Colorado AFLAC is a good idea for your business and your employees. The demand for greater group benefits choices makes it more challenging than ever as your business seeks to attract, motivate, and retain employees. Why AFLAC? With health care costs rising, the challenge for American employers… Read more about AFLAC
Profitability And The Health Insurance Industry
[…] The industry as a whole chalked up a profit margin of more than 10% in 2007, but that was carried by the life insurance side of the industry. Health insurance companies don’t fare nearly as well when it comes to making profits. Far more of their revenues are eaten up by claims, which continue to grow year after year as health care costs increase.