Full-Service Insurance Agency ClaimLinx

How A Health Insurance Agent Can Help You Find the Best Plan for You

Ohio residents pay an average of $471 a month for their health insurance if they’re 40 years old. When you go through the marketplace or exchange, you’re at the mercy of an algorithm that uses a few base questions to show you the options that you have available. A health insurance agent in Ohio can work with you on a deeper level to find the right plan for you.

How a Health Insurance Agent Can Help You Find the Best Plan for You

Help Navigate Marketplace Plans

Marketplace plans are available that may best suit your needs. An insurance agent can help you browse through these plans and explain the options that you have available to you. Since the agent’s services come at no cost to you, the information they provide can be invaluable.

Alert You to Non-marketplace Plans

The marketplace is just one avenue where you can search for plans. Sometimes, the best plans are not listed on the marketplace. The insurance agent will assist you in finding these plans so that you have a clear picture of the healthcare options that are available to you.

Assist You with Subsidy Plans

Subsidies may be available to you, and a health insurance agent will be able to:

• Recommend subsidies that may fit your needs

• Assist you in applying for these plans

• Lower your out-of-pocket expenses

Most states allow agents to access plans so that they can provide the best options to their customers.

The agent can help you both apply for these subsidies and may enroll you into these plans to save you significant time in the process.

Advocate on Your Behalf

When you sign up for a plan, you’re often left alone and have no one to help you the following year. However, an agent can work as your advocate year after year so that when open enrollment comes around or there’s a major life change that you go through, the agent can help you find the best plans available.

Additionally, they can:

• Ask questions about benefits

• Walk you through the claim process

Learn and Understand Your Needs

Your needs are unique, and when you go through the marketplace, your needs are often not considered in the same way that an insurance agent can offer. An insurance agent will work to understand your unique needs so that they can:

• Narrow down plan options

• Eliminate plans that won’t work for you

• Find only the best insurance options available for your needs

Often, the insurance agent will assist you in finding the plan that matches your needs and budget. However, when you sign up for the marketplace and don’t work with an agent, you’re missing out on potential plans that may offer you better coverage and benefits.

Ohio’s health insurance costs are expensive, but you need coverage to ensure that if a medical emergency does occur, you’ll receive the care you need most. Health insurance agents in Ohio can help you find a plan that best fits your unique needs and budget. They’ll even help you work through subsidies that can save you money.

 

 

Health Insurance Policy

5 Things You Should Understand About Your Health Insurance Policy

What is Health Insurance?

Health Insurance is the kind of insurance that mostly can pay for prescription medical, surgical, and even the dental charges incurred via way of means of the insured. It is frequently covered in business enterprise advantage programs as a manner of engaging great employees, with charges partially covered by the company. However, more commonly this amount is deducted from worker paychecks. The payment charges are certain to the customer, and therefore the rewards are assessment-free, with positive exceptions for S Corporation Hands.

CHIP (Children Health Insurance Program) and Medicare are public medical health insurance plans that concentrate on older people and children, respectively. Medicare additionally serves humans with disabilities. This is a kind of coverage insurance that will pay for clinical and surgical costs incurred with the aid of using the insured.

The process of selecting health insurance is very delicate because of its specific rules:

  • Coinsurance
  • Redundancy
  • Process of network services

 

Things You Should Know About Your Health Insurance Policy:

Uncertainties in life are common and medical needs are one of them. But we can plan a hassle-free healthy life by buying Health insurance for times that are uncertain. There are many options present but finding an insurance policy that is the perfect fit for your requirements is very difficult. Through this article, we aim to present a quick rundown of the 5 things that you have to review to buy the health insurance plan for your family and yourself.

Criteria Regarding Age:

Age is one of the key deciding factors when it involves insurance. While copping a medical policy do confine mind the age of the individual that you’re planning to insure. Like during a family floater policy, the value of premium would depend upon the age of the eldest loved one.

Also, it is recommended to thoroughly inspect the regulation criterion when buying an insurance cover. There are health plans that have the minimal entry regulation of 91 days and therefore the maximum entry regulation of up to 60 periods. And some plans have a minimal regulation of 25 periods up to a most of fifty periods.

Your Doctors Expenses May Not Be Covered:

If you’re planning on keeping your current doctor for future treatments, it is imperative that you check if they’re covered by your insurance. HMO Plans can be very restrictive, and you may only get access to doctors in the current network. There are PPO plans that let you visit other doctors that aren’t in the network for a higher premium. Good health plans protect the medical expenditures that are suffered during hospitalization. Hybrid plans such as POS plans allow going outside the network by paying extra.

Benefits of Free Hospitalization:

Hospitalization is care in a clinic that requires admission as an outpatient and normally requires a midnight stay. Midnight stays for observation could be inpatient care. The best health insurance plans typically cover all your medical expenditures. In case of free rehabilitation, the insurance company takes all the expenses of medical treatments and directly pays the bill to the hospital.

Health Insurance companies have a clear connection with network hospitals where the persons who take insurances from them, can take free care in case of any medical emergency. This process saves you from all the hurdles should bear to take an appointment or other processes.

So, if you buy any health insurance you do not need to arrange money for your checkup. Your checkup will be taken in the hospitals that are connected with insurance companies. Quality checkups and the best health care are provided to insurers in insured hospitals.

Cashless Health Insurance is a policy in which the sanitarium outgoes are settled directly between the hospital network and an insurance company. Policyholders have no restriction to pay.

Health Insurance policies should be bought because it provides a lot of facilities and advantages in life.

With the cost of healthcare being incredibly high, it is extremely difficult to come up with the cash required for good quality healthcare if you do not have insurance. The free medical policy offers the advantage of free checkups and virtual visits to doctors. A free medical policy is a health insurance plan which gives the advantage of free rehabilitation in the hospitals of their network. The payless medical insurance policies pay all the expenditures of its member. Once you buy the insurance you should not worry about anything but to enjoy life happily.

Free Health Checkup facility:

The check-up of the whole body is known as a medical check-up. The essential body checkup includes a checkup of heart, brain diseases, and blood pressure, etc.

The cost of protective health check-ups for MRIs, cardiovascular infirmities, and screening of cancer, etc. has gone up. You can save your money by buying health care insurance from reliable health care providers. When you go to buy an insurance policy you make sure by checking the index of health checkups.it would be better for you and you can save your money in this regard.

Importance of free check-ups:

  • Diagnose life-threatening diseases earlier
  • Increase treatment chance
  • Improve Health
  • Enhance Life span
  • Lessen the risk of complications

Coinsurance Section:

Many people get confused about the term co-insurance and at the time of purchase, they ignore it. It is mostly the amount you should pay at the claim time, and the other payment will be paid by insurers. So, before you ink your medical policy check if there’s any payment clause applicable that might impact your claim quantity. You should always aim to buy a plan that has no limits. Many insurance companies have a policy regarding age limit or the policy that you would not be able to get insurance if you have any pre-existing problems regarding your health. It is always recommended to get these facts straightened out beforehand to avoid any unforeseen complications later down the road.

Purpose:

Insurance companies use coinsurance to divide health care costs to help moral haz

Small Business Health Insurance

5 Reasons Small Business Health Insurance Is Critical For Employees

Small business health insurance has a variety of programs. For example, personal plans, specific disease plans, etc., as appropriate, should be covered under one type of health insurance. This way, you can get financial help from the insurance company if there are any health problems.

Small business health insurance can be purchased by an employer. Here, the employer buys small business insurance from an insurance company by paying insurance premiums to ensure the health risks to employees in terms of the terms and conditions of the policy. Keep reading to find the value of small business insurance for employees.

There are many options available to businesses looking to provide medical insurance to employees, but usually, small business health insurance comes in the following form:

  • Health Benefits: Basic: Patient Care, Dependence, International/Regional Availability, Covered Circumstances.
  • Additional known benefits: maternity and birth control, vision, and dental insurance.
  • Extended / full benefits: Health screening and vaccination, general health support, and mental health support.

Small Business Health Insurance is health insurance bought by the owner of a small business that covers the company and its employees and provides numerous benefits. 

Three characteristics make small business health insurance different from any other type of insurance

  • They are made functional specifically for a small group 
  • It is available throughout the year. 
  • The employer can contribute to the premium charged to the employee

Now we will look at these characteristics in detail.

Small Business Health Insurance designed for small scale companies:

First, small business insurance schemes are usually run by less than 50 groups. Company owners that have less than 50 full-time employees working under them are not obligated to provide their employee data under the ACA.

Most small business policies include groups of five or fewer people. If your employees were only 1099 contractors last year you may be eligible for health care for small businesses. 

Purchase through the year

Second, a difference of small business health insurance is that it is available throughout the year to make purchases. With Small Business Health Insurance, you are not obliged to register during the special registration period open, as much as possible when purchasing special coverage.

Employer contribution to employee premium:

Third, for small business insurance, a business usually has to pay at least 50% of its employees’ monthly health insurance premiums. Exact percentages may vary depending on the situation or system.

It is important to remember that the money you pay in employee premiums is usually deducted from the rules of your business. Ask your auditor or tax adviser how you can save money in this way.

The main goal behind introducing small business health insurance is providing employees of the company a chance at better health facilities and assisting them in managing their health care expenditures. Other benefits, such as financial aid or educational benefits, can be beneficial, but effective medical insurance often adds to global wage benefits.

Most employees rarely ask you to pay for medical expenses out of your pocket, at least without making too much money for the savings they have. Protecting health insurance from your employees will cost less than what they bought for themselves – and, as a group, you will have more control and negotiation power to ensure that the money you spend on insurance is spent wisely.

The importance of small business health insurance for employees

The following points highlight the importance of a small business insurance scheme for employees.

1) Availability of basic insurance

Employees can benefit from basic insurance coverage such as hospitalization due to their employer. The employer usually pays the policy. Therefore, an employee can avail of the benefit of the insurance scheme free of cost.

2) Sub-conditions

Personal health insurance systems have stronger terms than group health policies. For example, the terms of the waiting period, health checkup, and maternity cover are not small compared to a group health plan.

3) Family coverage

With small business health insurance plans not only you can avail of the benefits but your family members are also secured  In this way, the financial security attached to the coverage is extended to other family members. You can easily avoid a stressful situation by making the right decision at right time and secure your and your family’s future.

4) Insurance management

Once you are covered under the health insurance policy provided by your employer and after learning about the start and implementation of the plan, you can consider better coverage by opting for a single health insurance plan. For instance, a small business health policy offers all the facilities of basic health insurance ad allows you to buy a critical illness policy.

5) Peace of mind

A medical emergency can quickly lead to a financial emergency. This puts a lot of stress on the patient and family members. A health insurance policy can provide great assistance in difficult times like these.

Be informed

Covering only under the Health Team will not help you. You need to know its availability for insurance. That way, you know what’s included in the system and what’s not.

You must go through the details of the policy of small business health insurance thoroughly whether you are a company owner looking for an insurance company to buy insurance or an employee who is availing the coverage. Do not hesitate to ask the insurance company about your queries and ensure that you understand everything.

As mentioned above, small business health insurance is a quite helpful facility for employees as well employers. Where employees avail numerous benefits and are secured through this type of insurance, employers get a chance to grow their business by providing strength to the most important resource of their business. You must decide smartly and choose the right company along with the right package. Making the right decisions will help in the future and give good results. Go through policies before making any decision.

unitedhealthcare-health-insurance

Everything You Need To Know About Unitedhealthcare Insurance

Among the top five insurance companies, UnitedHealthcare is one with a lot to offer to you. Following are few important things you might want to know about UnitedHealthcare. 

Business Fundamentals 

  • With its headquarters in Minneapolis, UnitedHealthcare works under the supervision of the parent company, UnitedHealth Group. UnitedHealth Group started its operations in 1974 under the name Charter Med by a group of medical practitioners and doctors. In 1977, The United Healthcare Corporation was set up and became the parent organization of the Charter of the Med. In 1998, the United HealthCare Corporation known as the UnitedHealth Group started with six independent business divisions, one of which is UnitedHealthcare Today. 
  • UnitedHealth Group is the second support line to Optum, a medical services platform, offering solutions for the people and the administration of the health care setup. Optum has three platforms-OptumHealth, OptumInsight, and OptumRx to provide health management services, consulting services, and management services, respectively. 
  • David, and Wichmann, President, and Chief executive officer of UnitedHealth Group, are currently monitoring UnitedHealthcare’s business. He took up the position in February 2015, the then-UnitedHealthcare CEO of Gale Boudreau stepped down from her post for unknown reasons, after serving in the post since 2008. 
  • UnitedHealth Group consists of approximately 168,000 people in 21 countries, including us, Australia, Canada, China, India, the Philippines, Ireland, Italy, Luxembourg, and the United Kingdom. 

 

Financial statements 

  •  In the first quarter of 2015, UnitedHealth Group (including Optum financial), reported a turnover of 35.8 billion, which is 12.6% more than in the first quarter of 2014 i.e. $31.8 billion. In the first quarter of 2015, UnitedHealthcare’s revenue was 32.6 billion, which is 11.3% more than in the first quarter of 2014. UnitedHealth Group’s earned $1.4 billion in the first quarter of 20210,  in comparison with what it earned in the first quarter of fiscal 2019 that is $1.1 billion.
  • Over the past three years, UnitedHealthcare has nearly tripled its payments to suppliers based on the costs incurred, which now amount to about $37 billion. The payer is expected to double that number in 2018, it paid $65 billion and is bound to have a better quality of results. 

 

The information of the members 

  • UnitedHealthcare is one of the largest networks with 45 million members around the globe. UnitedHealth Group’s services are in more than 6,100 hospitals and 855,000, doctors and health care providers. 
  • UnitedHealthcare offers health benefits in five different groups. The heads of state and heads of government of the plan, the payer has to provide information to help manage the authority of solutions for the government’s Medicaid program. Both the employer and individual plans must provide benefits to the consumer. UnitedHealthcare facilitates medical care plans and retirement plans to people of age more than 50 years to the best of their capacity.
  • UnitedHealthcare offers its products on the 23 state franchises, including the 15 member states in which the payer may offer Medicaid plans. 
  • Your payer will offer you the health plans that are designed for people with certain chronic medical conditions, such as diabetes. UnitedHealthcare began its specialized treatment of the diabetes program, and in 2009, making it the first-ever medical plan that is specifically for those with diabetes or pre-diabetes. According to this plan, it is the routine treatment of diabetes that has not yet been paid, but the participants are required to adhere to the preventative, evidence-based recommendations from the American Diabetes Association. 
  • Research with Mark Associates indicates that UnitedHealthcare’s total membership was the only one of its primary competitors, growth declined in the fourth quarter of 2013 to the fourth quarter of 2014. According to the data obtained, UnitedHealthcare of the membership increase by 1 percent., while in the Etna, the membership was increased by 5.9 percent, Cigna, with 2.7 percent, and the National Anthem, with only 5.2 percent of the time. 

 

Responsible Care Agreement 

  • UnitedHealthcare plans to increase 250 more responsible organizations in the healthcare sector in the list of programs, bringing the total number of programs up by more than 720 ACOS. In February, the payer is well-known that more than 11 million participants, support-oriented values of the ACO. 
  • A few of the latest relationship updates of Responsible Care are that, UnitedHealthcare, which contain the plan of Downers Grove, Ill., Attorney at law, Health care Expansion, the institutes are increasing to over 5,500 Medicare Advantage beneficiaries with more than 80,000 and UnitedHealthcare members, Raleigh, North Carolina, New York, New York WakeMed Key Community Care to improve care coordination for more than 175,000 beneficiaries receiving care from physicians WKCC, Mountain View, Ca, Palo Alto Medical Foundation for the launch of a new ACOS to more than 63,000 beneficiaries of the program. 
  • UnitedHealthcare of this year and has been involved in a dispute between insurance companies and hospitals, as it was supposed to be working on a change to the contract with the Town, in the state of New York-based company-Carolina in the Health care system. The contract made between the two companies got ineffective by the date, February 28, 2015. It took about two months after the contract has expired to agree on a new one in April, but the agreement is retroactive to March 1, so that the beneficiaries will not experience disruptions in payments. 
  • In 2009, UnitedHealthcare established a patient-centered medical practice in primary health care in Arizona, Colorado, Ohio, New York, and Rhode Island, New York. In this model, practitioners can act as individual health care coordinators, helping to reduce fragmentation across the country.

 

Ratings and reviews 

  • In 2015, UnitedHealth Group scored the first position in the “World’s most Pre-Eminent Companies” list of the business of insurance and Managed Health care department for consecutively five years due to its outstanding performance. In addition, it has received a top score of 100% on the Human Rights Campaign’s Corporate Equality Index for the year 2015 and was named one of the Top 100 Military-Friendly Employers, and Military Spouse-Friendly Employers 2015 by Victory Media, the publisher and editor of the journals of ‘G. I. Jobs’ and ‘Military is Suffering’.
humana health insurance

Everything You Need To Know About Humana Health Insurance

Humana was founded in 1960 as a medical company, and the company has grown immensely by offering a variety of insurance plans and health services. Humana has i’s headquarters in Louisville, Kentucky, and is known to be one of the largest commercial insurance companies. 

Business Talent

The famous names in Humana’s past and present, include the following: 

  • The founders, David A. Jones, Sr. H. Wendell Cherry who were from the field of law. 
  • CEO Bruce D. Broussard, who has been working in the various sectors of health care, such as oncology, medicine, residential care/ housing for the elderly, nursing management, medical practice management, surgical, and dental network 
  • The company’s Chief Financial Officer Brian Kane whose previous care work includes national and state health care organizations. 
  •  Kurt J. Hilzinger is Board Chairman who is a partner of a firm named “Court Square Capital Partners”. 
  • Humana started as a Nursing home company by the name of Extendicare. 
  • After the corporation shifted its focus to hospitals in 1974 and the decision to change the name to Humana was made. 
  • Humana has medical membership in all 50 states, including Washington, D.C., and Puerto Rico. 
  • On December 31, 2013, Humana had approximately 12 million medical plan members and approximately 7.8 million specialty members. 

 

Will competing insurance companies acquire Humana? 

  • Humana has recently attracted a lot of media coverage, including rumors that have surfaced that Humana could be acquired by a competitive health care provider. 
  • Humana is on the lookout to broker any deal to sell their business. Cigna is interested in purchasing and is in contact with the health care provider to pitch a reasonable offer to buy the corporation According to reports of Bloomsberg and Wall street journal,  Cigna is not only an interested party. Etna has also reached out with an interest in brokering a deal with Humana.
  • Many big insurance companies are interested in the acquisition of Humana because the vast majority of the company’s revenue will come from the administration. These include Medicare Advantage plans, which insurers are trying to grow and expand. 
  • The Goldman Sachs Group is advising Humana  regarding the possible sale

 

Finance 

  • Humana reported a net profit of $ 430 million on revenue of $ 13.8 billion in the first quarter of fiscal 2021, compared with a net profit of $ 368 million, on revenue of $ 11.7 billion a year earlier. 
  • This year, Humana, took part in a wide range of transactional activities. In April, Humana announced that the home care department of Humana “Humana at Home”, acquired Deerfield Beach, Fl. 
  • In March, Humana announced the sale of Concentra health physical therapy division, for $ 1.06 billion. 
  •  Humana plans to increase funding by 0.8 percent as of 2022 from the Medicare Advantage payment rates.

 

Accountable Care Agreement 

  • Humana has signed up to plenty of accountable agreements. An agreement was made between the Downtown office of Integrated Health Network of Wisconsin and Humana in March for a three-year accountable care deal for Humana Medicare Advantage beneficiaries. 
  • In February, A new long-term accountable contract was announced with the HealthSpan Physician. It is a large network of 200 GP’s whose headquarters is in Cincinnati. 
  • According to stats of March, 53% of Humana’s members were in accountable care relationships. 
  • Humana accountable care agreements have been successful, As a part of the accountable care agreements, Humana has announced better costs, reduced emergency room visits, fewer hospital admissions, and better compliance with screening for several measures, such as cholesterol, and cancer of the large intestine, in comparison to Humana members, who receive the traditional, fee-based, and the original Medicare’s settings. 
  •  Humana was on track to have more than 75 percent accountable care relationships in 2017. 

 

Any comments, claims, and initiatives 

  • According to a report published in Athena health PayerView. Humana acquired the first position in the ranking of largest contributors to the payer, and it was the only national commercial payer who made it to the list of Top 10 Payers. Payers have been evaluated based on information such as the days of past-due receivables, resolution rate, failure rate, and more. 
  • For Humana considered to be the # 1 for the complete satisfaction of its members of the East and South regions of the United States, according to the annual survey J. D. Power. The health plan study now in its ninth year of operation measures the participant’s satisfaction against 134 of the health plans in 18 regions of the United States of America. The study is based on six main factors: the type of coverage and benefits, at the discretion of the service provider, information and communication, resolution of any complaints, pricing, and customer service. The calculation of the satisfaction of participants was on a 1,000-point scale. 
  • The Humana project has recently been in controversy. In February, it was announced that the 20-year-old relationship between Humana and the University of Medicine ends on the 1st of April, which is estimated to affect 1,750 patients. 
  • Humana has recently been a part of the legal process. Humana announced that has been the subject of a federal investigation related to a whistleblower’s claim against a health care provider.  Humana was requested by the U.S Department of Justice to release the data regarding health insurer’s Medicare Part C risk adjustment practices.
  • Humana is one of the payers who became part of Health Care Payment Learning and Action Network, which is an advisory group that was made to provide a platform for public-private cooperation to help in making US health care system payments, to meet the goals of recently made Medicare payments, value-based and alternative payment models. 
  • This year, Humana launched two of the public health management packages. In March, the insurance company announced that Transcend and Transcend Insights, comprehensive management services are designed to support the health sector, medical doctors, and the medical team’s efforts to improve public health and management.