All posts by Debbie Sears

How Do I Purchase Health Insurance?

Health Care Reform, Health Insurance

Health insurance can be purchased in many different ways, not just through the exchange.

The majority of working people have benefits offered by their employer. The employer is mandated to pay 50% of the individual employee’s premium. Any additional spouses or children are the responsibility of the employee. Your employer may be more generous than just the State Mandate. Many times at the end of a week, we look at our paycheck and we think, “I wish my take home pay was more than it shows”.

The Affordable Care Act requires employers to report the cost of the coverage under the employer sponsored group plan on the W-2 form. So, for instance, if I had a premium of $500 per month and I see that my employer is deducting over the course of the month, $250 from my check, I know that my total cost for coverage was not just the $250 that came out of my check. So, the value that my employer provides me is not just my take home pay. If my employer is providing benefits in addition to my take home pay, I must realize that this is their money and my money that provides necessary health insurance for myself and my family.

If you notice that your premium shows as $500 per month and your employer is paying greater than half, please note – you must have a very good employer! They value you and your skills and consider you an asset to their operation. Providing you a benefit nets you more money in the end than if they gave you an increase in your pay less taxes on both sides as a comparison. This link comes from the IRS and it explains in detail how this reporting from employer sponsored health coverage really works. For the most part, we have excellent employers with very good intentions.

Happy New Year!

Uncategorized

I’m a strong advocate of fun and laughter. Here is the Catch Des Moines, Greater Des Moines CVB Directory to all there is to see, hear, eat and drink in our Capitol City! I know your mothers told you this before, but please be safe. Laughter IS your best medicine. And the side effects are covered by your independent insurance agent’s suggestions! Ha!

Thank You!

Uncategorized

Thank you to all of my existing clients for your friendship, the professional confidence that you have placed in Sears Insurance and myself, your referrals and your continued business.

We are measured throughout the year by the companies we represent in many ways. Production always comes to your mind first. We are proud to say that we are again, recognized as a top producer for Wellmark Blue Cross Blue Shield and a nationally recognized producer for EMC.

Why is our production so high? The fliipside of this story is the quality of the carriers we bring to our Clients and their families.

The two companies that I mentioned are a couple of many that we represent, but they are local, and we support local, and they are nationally recognized for their quality. Another measure is our persistence. Persistence means we place a Client’s business with an insurance company and if it was placed properly, this policy continues to stay with that same carrier for extended periods of time.

As life changes, as your needs change, we adjust your insurances accordingly. We are in touch. Thank you for making us a leader in our industry. Merry Christmas, Happy New Year and we wish you good health and great prosperity for 2014.

Scammers and Discount Health Plans

Health Care Reform, Health Insurance, Healthcare updates

We’ve been warned by the Iowa Attorney General (Tom Miller) and the Iowa Insurance Commissioner (Nick Gerhart) to be aware of “discount health plans” connected to Obamacare.

The enrollment process for affordable health care starting with the individual mandate effective January 1, 2014, has some uncertainties in the marketing and enrollment process. Part of the marketing for the government subsidy plans could include someone trying to solicit your business.

We are being warned that there are cases under investigation presently where scammers are pretending to be government officials seeking your personal information. You should also know that through the enrollment process, the government employees “navigators” that can assist you. These individuals are not licensed insurance agents, may not be bonded or insured and will be the ones to whom you provide your personal information, including your social security number. This is a breeding ground for fraud if your information ends up in the wrong person’s hands.

Please beware. Know who you’re doing business with. Even if you are looking for a subsidy, please seek the guidance of an independent, licensed agent. Please take a look at this most recent publication from our attorney general and insurance commissioner. Here’s the difference between Navigators and Brokers/Agents…

Sticker Shock

Health Care Reform, Health Insurance, Healthcare updates, premium increases

Americans have several options for their health care insurance.

As we all know, there are employer-sponsored plans where you could pay a portion of your premium and the employer pays an agreed upon portion as a benefit. You can stay on your parent’s plans until age 26. You could have a student policy of your own through most colleges and universities. You can purchase individual coverage at any time.

If you are looking for a subsidy, the government plans may be a direction you should explore. Wellmark Blue Cross Blue Shield of Iowa has ACA (Affordable Care Act) plans available as well. These plans require no medical underwriting. This is a great option for persons to explore that have been rated up or denied coverage in the past.

For my existing clients, I have taken each and every file, compared what they have currently including their 2014 rate increases against rates available within their same plan, lowering benefits as well as run rates on the ACA plans. I have yet to find a lower premium on my existing Clients. Therefore, your independent agent can be a great service to you in shopping your options and giving you full disclosure so your decision making becomes relatively easy based on the facts and the premiums.

Please refer to this link from the National Association of Health Underwriters (NAHU) explaining the sticker shock as reported by NBC, CBS, Fox News, USA Today, Washington Post, Bloomburg News, etc…

Important Dates to Remember

Health Insurance, Healthcare updates, Medicare, Part D

As you prepare to make your health care decisions, you compare the premiums and benefits as closely as you can and the insurance companies. Medicare supplements were uniformed in 2006 so that a plan F is a plan F is a plan F. They are cookie cutter plans, so the question is, why wouldn’t I just purchase the least costly one and be on my way. The difference comes in how the insurance companies are contracted and reimburse the providers. Wellmark reimburses the providers from the least qualified to the highest qualified medical professionals nationwide, therefore, your access to providers when the unthinkable happens, through either an injury or illness are yours to have. This made a huge difference in our lives in 2008 and 2009 as my husband, Dan, utilized MD Anderson Cancer Center in Houston, Texas, after an inaccurate diagnosis in Des Moines. Fall/Winter 2013 Blue, a publication for Wellmark Medicare supplement members.

Medicare’s open enrollment period is October 15th through December 7th. Just as a friendly reminder, you have the balance of this week if you want to make any changes to your insurance.

You can enroll or re-enroll in Medicare Part D Prescription Drug or an Advantage Plan with prescription drug benefits. This period of time is called the “annual enrollment period” (you will hear this referred to as the AEP) for an effective date of January 1, 2014.

Going into next year, the AEP is scheduled again October 15 through December 7, 2014. If you have any travel plans taking you away during that time, please contact us for arrangements. If you are turning 65 or becoming eligible for Medicare, you have your birth month plus 3 months prior, plus three months after, or a 7 month window in which to enroll. Once you are enrolled in your Medicare for an effective date of the first of the month of your birth month, we can schedule an appointment to make recommendations for your Medicare supplement and your prescription drug coverage so the dates coordinate and you have a timely period to dis-enroll from your current insurance.

Hey, Why Are My Premiums Going Up?

Health Care Reform, Health Insurance, Healthcare updates

Premiums increase because the cost of health care increases for everyone. The rising cost of health care is a concern. It’s frustrating when premiums increase, but without understanding the basic concepts, people feel that the insurance industry is the problem.

When we looked at how our rates are calculated today, and how they are going to be calculated going forward, we may have a better understanding of how this works. As an example, today, health insurers rate people by age. The average cost of medical care for an older person is usually higher than the amount needed to cover the cost of a younger person. Health insurance companies vary the premiums to reflect these cost differences.

Another premium factor is the health status and the gender. Health status is whether you are healthy or not, and gender is used to determine premiums. For example, a person with health problems costs more in claims than a person who is considered healthy. Therefore, the person with the greater needs pays the greater premium because the insurance company pays the greater cost in claims. Other things that can make a difference are whether you smoke or not, and where you live.

Starting in 2014, new mandates will change the way your premium is calculated. Let’s start with age. Health insurance companies can only rate an older person three times the amount of a younger person. To accomplish this, premiums for older individuals will be reduced and premiums for younger people will be increased. The premium factors of health status and gender can no longer be a factor in calculating the premiums. This will cause drastic changes in premiums from 2013-2014. 2014 everything will be guaranteed issued. There will be no pre-existing exclusions and all carriers will be required to cover “essential health benefits”.

There Are So Many Choices That You’re Confused!

Health Care Reform, Health Insurance, Healthcare updates

There has been such a massive amount of information being brought to you via many different mediums as well as compliance on what you HAVE to do, that most folks find themselves somewhat overwhelmed.

Anybody can go to the Federal Exchange or to the State Exchange. You can keep your current coverage, whether that is through your employer or something you’ve purchased individually, or you can make changes to your current coverage to better assess your wants, needs and budget. We can help you with this process, and by process of elimination, you will clearly see what choice you feel best about for you and your family.

Here are two short videos that I feel come from extremely credible sources (Wellmark and The Kaiser Foundation) that may give you the general idea and concept in just a few moments. Feel free to call me and I will be happy to review your options for you and assist you with the choices that are most appropriate for you and your family.

Be the Best to Attract the Best

Health Care Reform, Health Insurance

As a small business owner, we always want to attract and retain quality employees in an effort to make us stronger and better at our craft. But if we want the best, we need to give them a reason to stay with us, so we need to be the best we can be also.

When it comes to employer sponsored benefits, health insurance is always at the top of the list. Many times in visiting with clients or prospective clients, they will comment, “I have Blue Cross Blue Shield”. But what plan do you carry? Sometimes I get a blank expressions. You might have heard people say they have a PPO, or Blue Choice or Access or an HSA. But do you really know what that means?

Wellmark has a one page user-friendly, easy to look at comparison of all of these plans side-by-side. We all have different wants and needs and I try to craft your wants and needs to match your budget. And still leave you with access to the best network of providers possible. If you have questions, please call me. I cannot urge you enough to take advantage of my offer to have a free analysis of your benefit package.

Medicare Open Enrollment

Healthcare updates, Medicare

Open enrollment for Medicare is October 15 through December 7th 2013 for effective dates starting January 1st, 2014. If you happen to be a snow bird, please take care of this before you shift gears. Then you’re done with it!

This article comes from www.cms.gov and has a quick and easy read for what position Medicare is in as we go through the Affordable Care Act. If you are satisfied with what you have and it seems to be working for you, stay put. Call me if you have any questions. We can make a quick review over the phone and you can be on your way.

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