Category Archives: Health Insurance

It Can Happen to You

The State of Iowa has a long and rich history of family values that is second to none. We may work our way through our education to get jobs elsewhere. Nine times out of ten, an Iowan will return to their roots.

Our family farm heritage is sesquicentennial farms. Families are being honored every year with governor’s awards for their entrepreneurship and family farming is a beautiful site to be hold. We are first in the nation for our corn production. We are second in the nation for our soybean production. We now have the longest standing governor in American history, recently selected to be our ambassador to China. How cool is that!

With all of these neat things, we have a huge responsibility that should not be overlooked. As times have changed, laws have changed. Regulations have become knee-deep. Education is now essential whereas before, you could learn the trade. We need to have a complete and total assessment of our insurance needs done on an annual basis because life changes and life happens. And our needs and our budget fluctuate accordingly. To continue this heritage with our agricultural families, it is necessary that they have proper health insurance, proper disability income coverage and proper life insurance to sustain them through any transition from generation to generation without incurring costly and unnecessary debt.

Life Happens has several one, two and three-minute videos that are very informational and I encourage you to poke around on that site and educate yourself on your responsibilities. Please call us. Our consultations are free. We will work with your legal staff and your CPAs to make a plan that is well-suited for your family’s needs, spanning however many generations necessary. If you do not have these professionals in place and you want references, please ask.

Stress Awareness

Sometimes the unknowns cause stress. Stress can be defined as “normal wear and tear”. But when “your normal” becomes uncomfortable, you can actually do damage to mind, body and spirit. Sometimes stress is the unknown, sometimes stress is time management. Sometimes stress is who you choose to “let in”.

As this pertains to health insurance, we have a lot of unknowns at the moment. As you are aware, Wellmark has made the decision not to renew individual policies that were written after January 1, 2014 under the individual mandate of the affordable care act. And they’ve also made a decision, starting January 1 of 2018 not to sell any individual health insurance products. This was very quickly followed-up with Aetna removing themselves from the individual market as well. So, 4th quarter of this year is going to be a stampede for an approximate 75,000 people trying to figure out what is their next best option.

We can help you solve that problem. I need to meet with you one-on-one. This could be through a telephone call, through email or it could be a face-to-face appointment in my office. We will look at your current financial and insurance situation and explore your options. Align benefits that are appropriate for your home and your budget. If by chance, you have an EIN number (Employer Identification Number) issued by the IRS, and you are considered a “business”, you should not be in the individual health market to begin with. There are answers and there are solutions. We can take what looks like doom and gloom and create sunshine. This has opportunity written all over it. Don’t pass up this chance to improve your health insurance situation and your finances. Give us a call.

Spend your Dollars Wisely

This link is designed to help you make more informed decisions and spend your dollars wisely.

  • Doctors office vs. Urgent Care vs. ER?
  • Which way do I go?
  • If I go to the ER there will be lab work done.
  • Do I know who reads the images?
  • Where is your lab work sent?
  • Are the professionals “reading” or interpreting these results an employee of the hospital or are they 1099 employees?
  • Are they in or out of network?
  • Will my insurance pay for them?
  • How do I find that out?
  • Am I in network or out of network?
  • Cost Estimator tools?  Know where you can get the best bang for your buck on scheduled procedures
  • Prescription drug costs

Be sure to use the preventative wellness exams to maximize your time and dollars in addition to all of the “right” reasons to have this information a part of your medical record

 

 

Why I Wellmark

Sears Insurance prides itself in providing you with nothing but the best. It is quite the compliment to have you ask me to help you with your finances and your health. I consider these your two most valuable assets outside of your first born.

When it comes to health insurance, we are an independent agent and we represent several carriers. However, getting back to the integrity and quality that we stand for, Wellmark is our premier insurance carrier for your health insurance needs. There are a lot of reasons for that.

One of the greatest things that comes to my mind is the strength of the provider networks that you would have access to when using Wellmark. In the State of Iowa, they have 100% participation of hospitals and 99% participation of doctors. Their payment innovation yields the lowest cost of care without sacrificing quality of care. 95% of every dollar is spent on health care costs, which has netted Wellmark an A financial security rating from AM Best.

Their story is contained in this article and I think it’s imperative that you understand that they started over 100 years ago, they have been extremely well managed and consequently have adequate reserves to pay even the most catastrophic claims you may imagine.

Please enjoy this article and call me for quotes. Within this company, there’s a product that is suitable for everyone’s needs and their budget. Whether you are an individual under age 65, an individual over age 65 or if you are a business owner with a small or large business, this information is very important. Our quotes are free and I’m always happy to help.

Make the Fourth Quarter Count!

An easy way for me to share with you some important dates would be to provide you my Women of Worth (WOW) article. I contribute an article for every publication of the Women of Worth magazine that you will find in many professional locations, such as your doctor’s office. This particular article is for the October/November publication which takes into account the time frames for open enrollment, annual enrollment, initial enrollment, many important dates, whether you’re under age 65 or over age 65. I have also included in this article some information for small and large group owners and/or administrators as well as some basic information on life insurance and long-term care. Please know that we are always focused on disability income coverage as well. If you have any questions, any needs, or would like to know more specific information as it pertains to your specific information, please call us.

 

Fall means many things to many people. The weather changes, we start wearing warm, comfy clothes, and for some, it’s a time to watch football all season long! The fourth quarter is by far the most important part of the game. The teams with the most depth often come back from near defeat to pull out a victory in the final minutes of the game. Why are they able to win? Because the coaches and players have prepared for adversity, planned well, and were able to draw upon the inner strength needed to finish strong.

In the insurance world, the fourth quarter is important, too. It’s that time of year when businesses and individuals need to start positioning themselves for the New Year. Whether or not you are a group or individual, take this time to start thinking about your insurance “game plan” for 2017. This article will serve as a reference guide for important dates and information that you need to know.

Under Age 65 • Important Dates for 2017 Enrollment:

November 1, 2016 – This is the first day you can enroll in a 2017 Marketplace plan.  2017 plans and prices will be available for preview the third week of October 2016.  Until then, you can still get coverage for 2016 if you qualify for a special enrollment period due to a life change like marriage, having a baby or losing other coverage, etc.

December 15, 2016 – The last day to enroll in or change plans for new coverage to start January 1, 2017.

January 1, 2017 – Coverage starts for those who enroll or change plans by December 15.

January 15, 2017 – The last day to enroll in or change plans for new coverage to start February 1, 2017.

January 31, 2017 – Open Enrollment ends; any enrollments or changes made between January 16-31 take effect March 1, 2017.

If you miss the January 31 deadline, you can’t enroll in a health insurance plan for 2017 unless you qualify for a Special Enrollment Period.

Over Age 65 • Important Dates for 2017 Enrollment in Medicare Part D:

  • Initial Enrollment Period – This is the first time you can enroll and it is a seven-month period that begins three months before you first become eligible for Medicare.
  • Annual Enrollment Period – The timeframe when you can enroll or switch plans is from October 15 to December 7 with changes effective January 1.

The determination of which plan you should choose is done by providing a list of your meds and dosages. The plans work with a premium, sometimes an annual deductible and co-pays for the different tiers of the meds you are taking.  I could recommend one plan for you and a different plan for your friend. Monetarily, it is well worth the while to get this right.

Small & Large Groups

On the group side, there are a lot of changes happening now and also scheduled to take place in the upcoming year. Schedule an appointment so that I can look at your current benefits and past reports to understand better what your members utilize. Do you have the right plan? Is it in direct correlation to the amount you a re paying?  Let’s look and see just exactly where you are and if you need to make a change; you will have options.

Life Insurance and Long-Term Care

From basic coverage to extreme estate planning and business succession, there is something for every need. Long-term care protection is a necessity, but did you know that it can be incorporated into your life insurance? If you do not use it, you have not paid premiums for no gain. Disability income protection is also extremely important. If your income stops it affects a lot of people… your family, your co-workers and your business partners.

Let us help you make the transition into 2017 without the rush and the pain that usually goes along with the insurance process. As always, we are so thankful for your business throughout the year as well as your referrals. The professional confidence that you have placed in me and my agency is the greatest compliment you could express.

Sears Insurance has been trusted by families and businesses spanning four generations for their health insurance needs.  We have been recognized as being in the Top 1% for Wellmark Blue Cross and Blue Shield in Iowa. Learn more about us on our website www.searsinsurance.info, or follow our RSS feed and “like” us on Facebook to receive the most current information.

Ask about Blue Rewards – a product that is a collaborative effort utilizing the homegrown and trusted resources of Wellmark, Hy-Vee and UnityPoint.

Under Age 65 – Open Enrollment

If you are under age 65, this is the time of the year referred to as “Open enrollment”. You will be able to enroll or change your plan for an effective date of January 1, 2017.

In the meantime, I have an opportunity to share with you some basics. Why you need health insurance, the cost, the coverage and the benefits and how to choose a doctor.

The first article that I’d like to share with you is called, “Helping you understand health insurance“. This covers the importance of health insurance starting with the basics, including the affordable care act.

The next article is health insurance costs. This will explain to you how to keep your costs down, how to get the facts on the premiums and how to control your out of pocket costs.

By law, every health insurance plan has to cover a few of the basics, called EHB or essential health benefits. There are 10 benefits and I have those for your reference by category.

And the final ones are referred to as, “Your benefits in action“. This entails choosing a personal doctor and knowing where to go an explanation of your benefits when to file your claims and pre-service reviews along with information on your ID card as well as what is referred to as your blue card.

I will be posting important dates for you going forward, so please stay in touch. If you have questions, I’m always here.

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