Tag Archives: insurance

The Lull Before The Storm

  We have received many questions about the changes that will occur in health insurance coverage with the change in the Administration.  People are most afraid of pre-existing conditions clauses re-applying and they are trying to make the best decisions possible for the January 1 Open Enrollment. Although I have no crystal ball, I think […]

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What Is On The Horizon?

Most of us have health insurance through one of three major channels: employer based coverage, Medicare or individually contracted coverage.  Today we will focus on the last group: those who must seek out and enroll in coverage directly with an insurance carrier. Since the onset of the Affordable Care Act there have been significant changes […]

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Which Employee Benefits Should We Choose?

As small businesses most of us have very limited budgets for non-essentials.  Materials, fixed facility & payroll costs, accounting, legal and required insurance premiums account for a major percentage of our discretionary income.  Are our businesses better served with higher salaries, greater investment into infrastructure or a greater level of benefits for our employees? We […]

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Employee Benefits ~ What Stage is Your Business?

In order for employee benefit programs to be well received they need to be developed with the interests of the employees in mind while meeting the objectives of the firm’s management. Young firms often implement benefits with the intent of attracting employees who are critical to the success of the business and create strategies to […]

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Patients Beware: Out of Network Providers

How many of us have had this experience:  we are told that we need a medical procedure so we select a participating provider, pre-certify the procedure, have the surgery and then . . .  the bills start coming in?  We go through them on a cursory basis until one or more catch our eye: the […]

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Step Therapy

This is a term with which many of us are not familiar, but which represents a nightmare for us when it is applied to our health insurance claims.  So what does it mean and when is it applied? Step therapy is a protocol used by insurance companies to determine whether a particular health plan will […]

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Cash Price or Insurance Discount

Many of us have been offered a discounted cash price for health care services recently instead of filing claims with our insurance carriers.  What is this all about? As insurance carriers negotiate deeper discounts with providers and healthcare offices have to fight to get claims paid, these providers sometimes find it more cost efficient to […]

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My Parent Has Fallen, What Now?

If we have not already, many of us will soon face our parents’ decline and the resulting decisions that will be required. A fall, a car accident, a hospitalization, each forces us to address our parents’ ability to continue in the lifestyle to which they are accustomed. Most of us prefer our independence and we […]

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Supporting Documentation for Marketplace Policies

Many individuals who enrolled in Marketplace policies during the Affordable Care Act open enrollment period may have received notification that supporting documentation (proof of income/citizenship) would need to be forwarded by a specific date to finalize qualification for subsidies. When required, this information is listed on the formal subsidy eligibility notice which is sent to […]

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I Will Just Work a Bit Longer……

Many of us recognize that we will be a bit short of money when we would normally stop working, so we prepare for our “final careers”. Rather than addressing our lack of preparation now we believe that a few more years in the workforce later will bail us out. If we can just find that […]

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