Lowering the Cost to Insure Your Family

When a business chooses to offer its full time employees health insurance, the employer must contribute a certain amount toward the monthly cost of that group plan.  The minimum contribution is typically 50%, and some larger companies may even pay the full premium for their employees.  When there are several plan options from which to choose, the employee may elect to receive coverage from a health plan which offers richer benefits than the basic plan.  In that case, the employee will be charged for the cost difference of the higher-priced plan.

Most companies will not contribute toward the premium for health insurance coverage for an employee’s dependents.  The employer must make such coverage available for the employee’s family members, but the cost of this additional coverage is usually the employee’s responsibility.  However, the rates for adding a spouse and/or children to an employee’s health insurance plan are sometimes unaffordable for many families.  This financial hardship sometimes leads to inadequate or no health care coverage for dependents.

If the employee’s dependents are healthy and have no pre-existing health conditions in their medical records, they could possibly qualify for an Individual Major Medical Plan for a more affordable rate.  This is especially true if those dependents are young, or if the family selects a plan with a higher deductible.  Healthy dependents can lower their price even more if they choose not to include certain benefits like doctor visit copays and prescription drug copays.

On January 1, 2014 a key component of the Affordable Care Act will go into effect.  Americans will be required to have health insurance, or they will be assessed a penalty.  Each year the amount of the fee increases from the previous year.

There will be an “Open Enrollment” for health insurance through Federal and State Exchanges (or health insurance marketplaces), beginning in October, 2013.  A variety of health plans with different deductibles and benefits will be offered through major health insurance carriers.  It’s a good idea to consider your situation, benefit needs, and budget limits now.

An independent insurance agent can help you objectively compare options for your family’s situation.  AustinHealthPlans.com has nearly 200 different options to choose from, offered through 8 major health insurance companies.  Call us at: (512) 535-3556 or send an e-mail to: tom@austinhealthplans.com.  We’ll provide you with a fast, free quote comparison of plans that will best suit your situation.

Posted in Affordable Care Act, health Insurance, Healthcare Reform | Tagged , , , , , , , , , ,

Higher Health Plan Rates in 2014?

If you wait until next year to purchase a health insurance plan in the individual market, you will likely pay a higher rate than if you choose one by Dec. 31st, 2013.  I will mention a few of the factors which will influence next year’s rates.

Currently, personal health plans are medically underwritten…underwriters review one’s health history to assess risks for coverage.  Those with the most serious health issues are typically denied coverage.  Due to this evaluation process, insurance companies minimize their odds of covering potentially large claims.  This means an insurer can offer a lower premium to healthier applicants who meet a certain standard of good health.

As you may know, on Jan. 1, 2014, no one can be denied access to health insurance because they have a serious pre-existing health condition.  All major medical health plans will be offered on a “guaranteed issue” basis.  Insurance companies will be faced with paying some extremely expensive claims as a result of this situation.  To help compensate for this added expense, rates for all new participants will be higher than today’s premiums.

Another reason that rates will be higher in 2014 is due to the new Essential Health Benefits mandate.  This requires an insurer to cover 10 benefit categories for all insurance plans starting in 2014.  This coverage is likely more extensive than what most American’s currently have.  Providing these additional benefits will increase the insurer’s expenses.  This added cost will be factored in when the new insurance rates are determined.

Premium subsidies will be available for those of low income, based on a percentage of the Federal Poverty Level.  Federal and State Health Insurance Exchanges will make several different levels of coverage available, and their rates will be structured accordingly.

If you would like more details about the impact that the Affordable Care Act may have on your future health care coverage, please read the other articles in my blog regarding healthcare reform.  This is an ideal time to review your current health insurance.  Decide if you want to renew it, or choose a new, more affordable, individual health plan before 2014 arrives!

AustinHealthPlans.com has nearly 200 different affordable major medical health insurance plans available.  Let us give you a free quote for an inexpensive health plan that will suit your particular situation and needs.  We offer plans from “A” rated major insurers only.  You won’t find lower prices for our plans anywhere else in Texas.  Please call us now at: (512) 535-3556 and let us become your independent Texas Health Insurance Agent!

 

Posted in Affordable Care Act, health Insurance, Healthcare Reform | Tagged , , , , , , , , , , , , , ,

Adding “essential health benefits” will require increased premiums!

In a recent article I mentioned that health insurance rates will likely be higher after Jan. 1, 2014 when a major component of the Affordable Care Act goes into effect.  One significant reason is because health insurance companies will be required to provide coverage regardless of a person’s pre-existing health conditions.   Treatment for certain health conditions can cost thousands of dollars per month for specialist’s fees and brand name prescription drugs.  Those exceptionally high claims affect monthly premium costs.

 When someone applies for an individual health plan during the remainder of 2013, they will still be required to answer health questions to be considered for health insurance.   The healthier one’s medical record is, the more inexpensive their cost would be.  Conversely, having high health-risk factors can cause applicants to be “rated” with higher premiums, receive an exclusion rider for their health condition, or even be declined for coverage.  After Jan.1, 2014, no one can be declined for even the most serious (or most expensive-to- treat) health conditions.

Another reason premiums will likely be more expensive is due to the healthcare reform requirement for all health plans to include 10 essential health benefits or EHB’s.  The following is a list of those mandatory health benefits:

1. ambulatory patient services

2. emergency services

3. hospitalization

4. maternity and newborn care

5. prescription drugs

6. habilitative and rehabilitative services and devices

7. laboratory services

8. mental health and substance abuse disorder services, including behavioral health treatment

9. pediatric services

10. preventive and wellness services and chronic disease management. 

Some of these benefits are already included in many major medical plans which were issued in the last few years, specifically a free annual preventive exam.

 Insured small group plans and individual major medical health plans that are not “grandfathered” are required to cover EHB’s starting in 2014.  This obligation applies to all plans whether they are sold within the state or federal health insurance exchanges or outside of the exchanges.  All non-grandfathered health plans that cover EHB’s must provide a cap (or maximum amount) for member out-of-pocket expenses (in-network) for essential health benefits beginning on Jan.1, 2014.

 If you are not currently covered by an individual major medical plan, and you are not working for an employer who offers group health insurance, you will likely face higher premiums after Jan, 2014, when the health insurance requirements go into effect.  Fees will be assessed on the uninsured with the help of the IRS for collection! 

Get a quote now from an independent licensed insurance agent, while the current lower 2013 rates are still available.  Call AustinHealthPlans.com at: (512) 535-3556 for a fast, free quote.  We can help you find an affordable health plan which will best suit your particular situation and budget.  You won’t find a lower price for our inexpensive plans anywhere else in Texas!

 

    

Posted in Affordable Care Act, health Insurance, Healthcare Reform | Tagged , , , , , , , , , , , , ,

The Affordable Care Act- Significant Provisions

On 3-23-2010, the Affordable Care Act became law. Since then a number of provisions of healthcare reform have already become effective, which I will discuss in a moment. However, the most significant element of this law will directly affect millions of Americans and their healthcare coverage on 1-1-2014. The law’s main intention is to make affordable healthcare available and accessible for every American. Each citizen will have the responsibility of choosing a major medical health plan. Financial assistance will be available for those whose incomes are within a certain percentage of the Federal Poverty Level.

Beginning in 2014, if you are already insured through individual health insurance, or an employer’s group plan, you can keep that coverage if you so desire. However, you will also be allowed to choose from dozens of options through either a State or Federal Insurance Exchange, if you prefer that alternative. As of this writing, it appears that Texans will probably use the Federal Exchange. Certain guidelines will apply, based on a person’s situation. If you do not choose a health insurance plan, you will be assessed a penalty, although there are a few exceptions.

In 2014, the penalty will be 1% of one’s income, or $95. In 2015 the amount increases to 2%, or $325, followed by 3% of one’s income or $695, in 2016. In each case the greater amount will be assessed, whether a percentage or fixed fee, with annual increases following thereafter. The penalty will be collected by the IRS, just like taxes.

Here is a list of some of the improvements to healthcare coverage that are effective now:

  • A “free” annual preventive exam; visit this link to review what is included http://www.healthcare.gov/news/factsheets/2010/07/preventive-services-list.html
  • Another current provision of the ACA prevents an insurer from declining coverage to anyone under age 19, because of pre-existing health conditions.
  • Expanded coverage now allows a parent to continue to insure their young-adult children until age 26.
  • Adults who have been uninsured for at least 6 months and have been denied coverage because of certain pre-existing conditions, may now get coverage through the “PCIP”, or Pre-existing Condition Insurance Plan.
  • Lifetime limits on what insurance will cover have been outlawed.
  • The Act has also lowered the cost of many prescription drugs for seniors on Medicare.
  • Additionally, some small businesses with fewer than 25 employees can now get help paying for the cost of providing health insurance benefits. Small business tax credits will cover up to 35% of the employer’s cost to provide health insurance for their employees. Investigate this opportunity with your business advisor or tax consultant for details on how to participate and save money.

You can begin to compare a variety of health insurance plans for yourself or small business right now. Don’t wait until 2014 to find a top-quality health plan that will best suit your needs. Many major medical plans have recently experienced reductions in their premiums. One company will actually reduce your annual deductible if you don’t meet it, which is a reward for healthy applicants! This would be an ideal time to get several free quotes for more affordable health insurance.

Licensed independent insurance agents can help you choose the ideal plan for your goals…they are not restricted to offering you insurance plans from just one insurer. This flexibility, along with their experience and knowledge, can increase your range of choices, benefits and prices. They are not obligated to promote a certain insurance company’s products, and can therefore offer their clients a more objective assessment of each plan’s advantages and drawbacks!

Contact AustinHealthPlans.com to receive personalized customer service from a licensed independent health and life insurance representative. Your unique insurance objectives will be the focus of any health insurance plans that we recommend for your consideration. Based on one’s particular goals and budget, we will find the best possible health plan for our client.

We can also provide coverage for these other types of health insurance supplements: Dental, Vision, Life, Critical Care, Accident, Disability, Cancer, and Long Term Care. If you would like to save for your retirement, we can assist you with tax-deferred annuities, as well.  Please call us at: (512) 535-3556 or send an e-mail to: tom@austinhealthplans.com for your fast, free quote. We serve the whole state of Texas, and want to be YOUR local agent!

Posted in Annuities, health Insurance, healthy living, Investments, life insurance, Long Term Care, Retirement Planning, Uncategorized | Tagged , , , , , , , , , , ,

Thanks For Your Time and Attention!

As we enter the 12th. month of 2012, many American’s thoughts are of the Holiday’s just ahead.  We will be busy shopping for just the right gifts for our families and friends.  There will be lots of time spent on festive decorations, mailing greeting cards and packages, and preparing delicious treats in our kitchens!  Although we may get carried away with these external aspects of the Season, the underlying spirit of love and giving still prevails for most of us.  We can create enduring positive memories when we share the gifts of our time and talents with others!

I want to thank everyone who has taken the time to read my articles these last 2 years.  Not many people find the topic of insurance to be an exciting subject!  In recent times, most of us don’t even want to think about health insurance.  None the less, I have tried to present some insightful information about many different aspects of health-related insurance.

My goal has been to present informative, educational, and challenging articles.  I have encouraged you to learn about your options, discover ways to lower your premium costs, and reward yourself for being healthy.  (Don’t just accept your health plan because it was your father’s insurance.)  If you don’t see your doctor often and do not rely on expensive prescriptions, why have a health plan with copays for those features?  They add to the cost of your premium!

During these difficult times, more employees are faced with securing their own affordable health insurance, as small business owners find it too cost-prohibitive to pay for group plans.  It has become our own responsibility to decide which individual health plans are best suited to our situation.

Be aware that there are “limited-benefits” health plans which offer discounted premiums, but also often have reduced coverage and fixed allowances for surgeries, hospital stays, etc!  I recommend that you select a major medical health insurance plan from an “A” rated reliable insurance carrier.  Those health plans should clearly state your yearly maximum out of pocket responsibility for each insured person.

In searching for the ideal health insurance plan, remember that healthy Americans can save money on their taxes with an HDHP (High Deductible Health Plan), when coupled with an HSA (Health Savings Account).  These allow you to reduce your taxable income by the amount with which you fund your HSA.  Plus your funds earn interest tax-free!  I suggest that you review the details and guidelines for HSA’s in IRS Publication 969, by visiting this link: http://www.irs.gov/publications/p969/ar02.html

Additionally, I strongly recommend that you inquire about your choices for LTC (Long Term Care) plans. If you had to self-pay for nursing home expenses, it could exhaust all of your assets before Medicaid would begin to help.  (Medicare only covers a short period of time.)  There is an LTC combo or “hybrid” option that utilizes either a life insurance policy or a deferred annuity with an LTC rider.  It provides a tangible cash benefit to your beneficiary, if you never use the long term care services.  Don’t wait until you are a senior citizen to apply for this important safeguard!  Your age and your health conditions will affect your cost.  You should not count on the government for your Long Term Care needs, unless you live at the poverty level!

For more helpful messages relating to the subject of health insurance,  please read the rest of the articles in my blog.  There are articles which describe many different health insurance supplements including: LTC insurance, life insurance and annuities, disability insurance, dental and vision insurance, cancer insurance, critical illness plans, etc.

After reading  an article, let us know if you have any questions.  If you would like a free quote for any type of health-related insurance or annuity, contact AustinHealthPlans at: (512) 535-3556 or e-mail at: tom@austinhealthplans.com .  A licensed independent  agent will be glad to help you find the best coverage based on your situation.    We appreciate the comments that we have received from you, and encourage your continued feedback.  If you prefer to shop on your own, visit us online anytime at: www.austinhealthplans.com .  Thanks Texas, and Happy Holidays!

Posted in Annuities, health Insurance, healthy living, life insurance, Long Term Care, Retirement Planning, Uncategorized | Tagged , , , , , , , , , , , , , , , , , , , , , ,

A “Win-Win” Option for Long Term Care Insurance

Most of us are unprepared to meet the challenges that accompany an extended hospital stay. It can be devastating if this occurs to an elderly family member. Nearly 70% of those beyond age 65 will need long term care at some time. Once you have witnessed the mental, emotional and financial strain that a loved one experiences when they require long term care, you realize the gravity of the situation. It can become an exhausting strain on the whole family and a life-changing event for the senior citizen.

Medicare will only cover up to 100 days of nursing home care after a hospital confinement. Unless a person has Long Term Care (LTC) insurance, they will be required to self-pay for any additional days in a nursing home. The national average for private nursing home care is around $75,000 annually. Unfortunately, many uninformed Americans assume that government assistance will pay for their nursing home costs, should that need arise.

However, Medicaid will not help with those expenses until the patient has spent-down nearly all of their savings and other assets, reducing their finances to the poverty level. This would also severely diminish inheritance funds for their heirs, as well! Who wants to endure having all of their retirement savings drained, in order to qualify for assistance from Medicaid?

Some people argue that the expense of LTC insurance would be a totally wasted investment if they never need home health aides, assisted living, or nursing home care. However, without the protection offered through LTC insurance, one’s hard-earned assets are at risk if they should be required to self-pay for extended care! Until recently, this was the dilemma that some folks faced when considering the option of applying for LTC coverage.

Fortunately, there is an LTC “hybrid” (or combo) option that utilizes either a life insurance policy or a deferred annuity with a Long Term Care rider. It provides funds for long term care expenses if the policy owner should require home health aide attention, assisted living, or nursing home care. If the insured should not require any long term care assistance throughout their lifetime, their beneficiaries/heirs would receive a cash benefit upon their death.

That means a tangible benefit is paid, even if the insured never needed the available LTC coverage. This preserves assets from the threat of the Medicaid spend-down requirement, and eliminates the concern over potential waste of premiums for unused long term care benefits. It also rewards you and any family members with peace of mind and assurance that you have prepared for the future. It certainly is a win-win option for either you or your heirs!

Contact an independent licensed insurance agent at AustinHealthPlans.com, to see which plans will suit your situation. There are many “A” rated insurance companies from which to choose. The younger you are when you apply, the lower your cost will be. Your current good health will also be an advantage, as applicants will be required to answer health questions for underwriting evaluation. Do not procrastinate and assume that you will be able to qualify later in life. Call us now at: (512) 535-3556 for a free quote. Remember, peace of mind is priceless!

Posted in Annuities, Investments, life insurance, Retirement Planning, Uncategorized | Tagged , , , , , , , , , , , ,

Consider an Annuity for Retirement Savings

It’s true that many Americans are not familiar with the meaning of the term “annuity”. Some people mistakenly believe that annuities are products which are only available to, or obtainable by the wealthy class. This is not true at all! An annuity is a methodical way of saving money and earning interest. Annuities could be described as unique financial planning instruments, which are suitable for accumulating money for future systematic distribution. They are financial contracts issued by insurance companies. An annuity can even create an income flow which cannot be outlived!

When you purchase an annuity, you deposit money (a premium) into this financial contract. These premium dollars are then invested by the insurer. Those deposited funds earn interest, or grow in value in relation to the performance of the fund in which they were invested. Your earnings will accumulate on a tax-deferred basis. Annuity funds compound at a greater rate because no earnings are taxed away.

At some point in the life of the annuity contract, the insurance company can convert all or some of the contract’s funds, into a series of periodic income payments. This is determined by the owner, to suit his/her intentions. These payments are calculated to continue for a given number of years, or for the owner’s lifetime. (This process is known as “annuitization”, which means applying capitol to purchase income.) Annuities are designed to accumulate, and later distribute assets, making them ideal for retirement planning.

Today Americans face some serious challenges regarding their financial ability to meet their retirement goals. Many employees no longer enjoy defined pension plans, which guarantee a certain predetermined cash flow. Constant changes to our Social Security System continue to whittle away at our future retirement fund. More members of the Baby Boomer Generation (approximately 76 million seniors) are reaching an age where they will be drawing on this ailing system’s resources. Add to that an increase in our current life expectancy, and it’s easy to see that we will need to be personally responsible to provide most of our own sustainable support for our “Golden Years”!

We need to take proactive measures and choose a suitable means to provide for our own personal retirement fund. It is critical to establish a retirement investment plan now, rather than later, in order to have a sufficient time for your money to grow. You will want to consider your attitude toward risk, before committing to any certain long term investments. Fortunately, there are some types of annuities which guarantee a certain minimum rate of return on one’s investment. There are also annuities which invest the owner’s funds in the stock market, where there is the potential for greater profit or loss.

There are lots of options available when considering what type of annuity to choose. The two fundamental categories are either immediate or deferred annuities. A licensed insurance agent can give you details about fixed, indexed and variable annuities, and explain the basic differences and advantages of each option. You should be certain that all of your questions and concerns are addressed to your satisfaction before making a final decision. Whatever you do, please don’t rely solely on Social Security, and do not procrastinate in starting your retirement savings!

Contact one of our licensed insurance agents at AustinHealthPlans.com by calling: (512) 535-3556 or send any e-mail questions to tom@austinhealthplans.com . We can help you determine what method of retirement savings will serve your particular situation the best. We are available to assist you with free quotes for your insurance and annuity needs, no matter where you live in Texas! We can save you time, trouble and money! We are “Texas friendly” and want to be your agent. Give us a call today.

Posted in Annuities, Investments, life insurance, Retirement Planning, Uncategorized | Tagged , , , , , , , , , , , , , , , , , , , ,

Celebrate Your Freedom of Choice

It seems to be human nature to automatically resist change.  This tends to be true even when one has spent years struggling with an unpleasant situation, job, relationship, etc.  People place a lot of importance on familiarity, because at least you know what to expect!  It’s what we are used to, so we just keep things the same, because everyone knows that change is difficult, right?

In a recent article, I wrote about how sometimes small changes in one’s lifestyle can make a significant difference in overall health over a period of time.  Well, sometimes just a bit of change in health insurance coverage can actually save a significant amount of money in a year!  Is your health plan suited to your present needs and budget?  If not, it’s time to shop for the type of affordable coverage that makes sense in your current lifestyle.  Why pay the extra cost for features you don’t use in your health insurance?

Most of us associate July as the month of American independence.  Freedom of choice is undoubtedly a right worth celebrating.  Can you imagine what it would be like if there was only one home furnishing store, one auto manufacturer, one clothing designer, one kind of breakfast cereal?  Fortunately, your current health insurance plan is not the ONLY ONE available to you.

There are ways to pay lower monthly insurance premiums if you are typically a very healthy person.  Healthy people who don’t usually meet their insurance plan’s annual deductible, can even be rewarded by having a reducing deductible.  Does your current health insurance do that for you?   There are some health insurance plans which are called HSA-qualifying HDHP’s, that even help to lower your taxable income.

When was the last time that you had a licensed independent insurance agent evaluate your current situation and needs?  You will have a wide variety of affordable health plans from many major insurance carriers from which to choose.  Quotes are fast and free, and you have nothing to lose!  Don’t settle for your father’s health insurance plan just for that one reason alone.  Change can be a very good thing if it improves your life…especially when it saves some of your hard-earned money.  You could save hundreds of dollars a year!

Call AustinHealthPlans.com at: (512) 535-3556 for a free quote for affordable health insurance.  You can also contact us via e-mail at: tom@austinhealthplans.com and let us know what your needs are.  You will receive free professional advise and helpful information.  There are no fees for our services, and you won’t find the same health plans for less anywhere else!  You have nothing to lose, except the money you are paying right now for higher premiums.  We look forward to serving YOU, no matter where you live in the great state of Texas!

Posted in health Insurance, healthy living, Uncategorized | Tagged , , , , , , , , , , , , , ,

Small Changes Can Bring Major Rewards

      Most of us would agree that it is easier to make small changes in our lives, than to attempt radical alternatives to our current habits.  A person’s health will often respond to small helpful changes carried out over a period of time, much like a boat which alters its present coarse by a mere few degrees over a period of time.  Each of us can decide to implement small adjustments to our daily lives that can result in positive changes.

     I realize that some people may have genetic predispositions to certain health conditions.  Aside from those things which are out of our conscious control, we can take charge of our present and future health by deciding to make a few small changes.  Over time, this can result in major rewards with respect to our well-being.

     Did you know that many major diseases involve inflammation?  Inflammation is frequently caused by excessive stress, whether that is from one’s diet, lifestyle, or environment.  It is the common link between such serious conditions as heart disease, cancer, Alzheimer’s disease, and arthritis, to name a few. 

     Food allergies and sensitivities are not the only dietary causes of inflammation.  Consuming too much sugar, fat, dairy or protein can also increase inflammation for many people.  Constant dehydration or drinking too much caffeine and/or sodas can also be at fault.

    Lack of proper exercise (especially habitual inactivity) and also lack of quality sleep could contribute to the problem.  Experiencing regular or constant emotional, psychological or physical stress raises one’s cortisol level, creating inflammation.  Exercising helps to reduce the effects of stress.  Meditating daily can calm those frazzled nerves!  Practicing good dental hygiene helps immensely also, by preventing the build-up of harmful bacteria around the gums, etc. 

     Toxins in our environment and pollution in general, also cause inflammation.  How safe is your drinking water, the air quality in your neighborhood or place of employment, and the fast foods you eat?  Are your packaged foods full of artificial preservatives, additives, or other unhealthy ingredients?  How often do you purchase organic fruits and vegetables, when there is that option?  In many environments in America, pesticides, herbicides, industrial chemicals, and other pollutants are often at fault!

     We ALL have choices to make.  I suggest that you read more about this subject and formulate a plan to become healthier.  You may feel better, require fewer medications, live longer and become happier.  Always consult your doctor before making these lifestyle changes.  I am not giving any medical advise, just expressing my own opinion about what you might consider for a healthier way of life.  After all, it is YOUR life, and YOUR decision. 

     Remember that being healthy can $ave you money when applying for inexpensive health or life insurance.  Your good health is always your best asset!  Contact us at: AustinHealthPlans.com at (512) 535-3556 or send an e-mail to: tom@austinhealthplans.com for fast, free, quotes on  affordable top-quality health insurance plans.  Being without health insurance puts you at financial risk!

Posted in health Insurance, healthy living, life insurance, Uncategorized | Tagged , , , , , , , , , , , , ,

Attention Owner’s of Small Businesses

      If your business employs 2-50 people (including you), it may qualify for a special type of affordable small group health insurance.  Employees’ current health conditions and medical histories will not affect eligibility or the cost of monthly premiums, to participate or renew for future coverage.  The rates are merely based on employees’ age, gender, and zip code.  There are no health questions to answer on the application.  That could make a significant difference for some folks!

     To be eligible, the business must be located in Texas, and the employer must not have provided group health insurance for at least 12 months prior to applying.  A minimum of 30% of eligible employees must receive annual wages no greater than $32,670.  At least 60% of eligible employees must participate in coverage.  The employer must pay at least half of the monthly premium costs for covered employees, but can elect to pay 100%, if so desired.  Covered employees must be United States citizens or nationals, or aliens who are lawfully present in Texas.

     All eligible employees must work at least 30 hours/week.  They may be a sole proprietor, a spouse, or a partner in the business.  They must not be considered temporary, seasonal, or substitute workers.  If an employee is covered by another group plan-such as a spouse’s health plan, he/she would be ineligible.  Also if they choose not to be covered under the employer’s health plan, but instead are covered by Medicaid, Medicare, CHAMPUS, or another Federal program, they are ineligible.  Additionally, coverage on a benefit plan from another country makes one ineligible.

     An employer has the option to offer coverage to part-time employees, but these employees do not count as “eligible” for determining the employer’s status as a small business.  Dependents of employees can be covered through their spouse, but the employer is not obligated to share any related additional cost for those dependents.  The additional premium for dependents is the financial responsiblity of the employee only.

     Several excellent major medical plans are available with deductibles from $500-$2,500.  Benefits include coverage for: doctor office visits, maternity, hospital inpatient/outpatient/emergency room services, psychiatric services, and prescription drug copays.  (Did you know that individual and family health insurance plans in Texas normally do not cover maternity?)  A vision plan is also included at no charge. 

     Employees will receive their allowable benefits ONLY IF they use “In-Network” providers and facilities.  It is important to see if your preferred doctor accepts this health plan, if you intend to continue your health services with him/her.  Otherwise, you might have to find a new primary care physician or specialists. 

     For detailed information or to apply for coverage, contact AustinHealthPlans.com at (512) 535-3556 or send an e-mail to: tom@austinhealthplans.com .  This plan would be great for a married couple who own their own small business and are considering starting a family.  The rates are very reasonable and you cannot be declined because of pre-existing conditions or poor health!

Posted in health Insurance, healthy living, Uncategorized | Tagged , , , , , , , , , | 2 Comments