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How to Understand Health Insurance from the Marketplace

by ClaimLinxJune 23, 2022August 1, 2022Leave a comment

If you’re new to the world of health insurance, there are several technical terms that may make it seem very daunting at first, but we aim to clear things up within this article. The health insurance marketplaces has provided insurance coverage to millions of individuals over the years. Selecting the right insurance plan is important, because getting an expensive plan that doesn’t contain coverage for what you need is of no use.

The Health Insurance Marketplace

This marketplace offers visitors an opportunity to purchase all types of health insurance plans ranging from individual to family health plans. The primary benefit of this marketplace is that it allows users to compare plans to evaluate pricing, coverage and more. Each state has their own version of the marketplace, while some only utilize the federal one. There is an enrollment period every year where you can purchase plans in the marketplace.
The insurance marketplace stems from Obamacare through the ACA in 2010. As the years passed, around fourteen different states have chosen to create their own health insurance marketplace. One of the biggest benefits is that the plans listed on these health insurance marketplaces provide coverage for the ten necessary health requirements.

Categories of Insurance Plans in the Marketplace

There are 4 different categories, i.e. Bronze, Silver, Gold and Platinum. Platinum level plans are the most expensive, but they also provide the maximum amount of expense coverage. Users can view and compare the coverage of each plan alongside their costs.

While you do need to keep your budget in mind as well, it is important to remember that the price of healthcare in the US is extremely high. Getting a plan that provides better coverage is always the best option.
One important thing to remember is that the platinum level plans do NOT guarantee quality care. You need to go through the list of accepted healthcare professionals to see if the plan is a good fit.

You may also be eligible to obtain financial assistance for your plans if you meet a certain criteria. This can help take care of the high costs of monthly premiums. Once you select a plan, more details about financial assistance will be available to you on the health insurance marketplace.

Eligibility Requirements

To shop in the marketplace, you have to meet certain eligibility requirements. For example, you must be a lawful U.S. Citizen, or a U.S. National. Individuals who are incarcerated cannot purchase healthcare. Another important thing to remember is that you cannot be enrolled in Medicare when purchasing the health insurance marketplace.

Conclusion

If your current employer offers healthcare benefits, do evaluate those options first instead of purchasing directly from the marketplace. This is because employer-based premiums are normally lower with better coverage since the employer obtains them at bulk pricing.
However, if you’re handicapped or unemployed, purchasing directly on the health insurance marketplace is a perfect choice. With numerous options available for you to compare and select from, it is important to take your time to carefully evaluate coverage, premiums, and more.

5 Reasons Small Business Health Insurance Is Critical For Employees

by ClaimLinxAugust 20, 2021August 31, 20214 Comments

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.

Senators to Vote on Republican Healthcare Bill

by ClaimLinxSeptember 22, 2017December 4, 2019Leave a comment

This week Republican Senators Lindsey Graham, of South Carolina, and Bill Cassidy, of Louisiana, introduced a new healthcare bill aimed at repealing and replacing the Affordable Care Act known as Obamacare.

The Senate is expected to vote on the bill next week, as any repeal and replace bill must be completed and voted on by September 30 in order for it to pass with only a simple majority of 51 votes.

This bill would mean a radical change to the current healthcare system. Here are some of the biggest changes in the bill:

Repeals the individual mandate requiring all individuals have health insurance.
Repeals the employer mandate requiring all businesses with more than 50 employees to provide an affordable health plan.
Allows insurance companies to reinstate lifetime benefit maximums.
Allows insurance companies to charge people with preexisting conditions more money for a plan.
Requires insurance companies still provide coverage to people with preexisting conditions.
Removes the optional Medicaid expansion for each state.
Dissolves the federal insurance marketplace known as healthcare.gov.
Gets rid of the federal subsidies to help pay insurance premiums for those that cannot afford them.
Combines the funds for the Medicaid expansion and insurance subsidies into large block grants given to each state to spend freely to improve healthcare in the state.

Funding in the form of federal block grants to states would continue until the year 2026, when funding would be cut off. Most harmed by this bill are those states that chose to implement the Medicaid expansion through the ACA. States that did not do this would see a large influx of cash through the federal block grants in the bill.

Because of the short time frame to vote on the bill the Congressional Budget Office will not be able to provide a full analysis of how this will affect coverage for Americans, though the CBO did say it would release a limited analysis early next week.

You can see how your state’s funding will be affected in this analysis by the Kaiser Family Foundation.

Senate Republicans Fail to Pass ACA Replacement Bill

by ClaimLinxJuly 19, 2017December 4, 20191 Comment

One of the highest priorities this year for the Republican-controlled Congress is to repeal and replace the Affordable Care Act (ACA).

Last week Senate Republicans released a new version of the Better Care Reconciliation Act, their repeal and replace bill, but were unable to corral enough support to bring the bill to the floor for a vote.

Republicans have now returned to an earlier plan to repeal the ACA first, with a two-year waiting period for implementation during which time they will continue to work on new healthcare legislation.

However, it is not known if a measure like this would pass either. Republicans passed a bill like it in the past, during the Barack Obama presidency when Republicans knew it would be vetoed. President Donald Trump would likely sign any bill that would repeal the ACA.

As this activity in Washington continues, all of us at ClaimLinx want to reassure our clients that we are prepared to adapt to any new healthcare bill and its resulting effects on the insurance market.

It’s important to remember that until a bill is signed by the White House, the ACA and the insurance market will continue as usual. But we will be ready for any changes if and when they occur.

Future for SCOTUS Still in Turmoil After Nomination

by Whitney FaberMarch 18, 2016December 3, 20191 Comment

President Barack Obama halted speculation this week when he nominated Merrick Garland, chief justice of the U.S. court of appeals for the District of Columbia, to fill the vacant seat on the Supreme Court left by Antonin Scalia.

The drama surrounding the decision to fill the office rages on though, as members of the Senate must now decide if they will confirm the nomination or leave the seat vacant until the next president is elected.

At stake during this time of turmoil are a number of cases waiting to be heard and those already awaiting decision, including three cases concerning the future of healthcare. With only eight members of the high court left, there is an opportunity for a 4-4 split of the justices’ votes.

In the event of a split, the decision of the lower court is upheld, and the case is not deemed to have set any sort of precedent. The power of the Supreme Court as a final word and decision is effectively diluted.

Senate Majority Leader Mitch McConnell has already pledged that he will not confirm, or meet with, any nomination from Obama in an effort to involve the American people in the decision.

“The American people may well elect a president who decides to nominate Judge Garland for consideration,” he said on the Senate floor. “The next president may also nominate somebody very different. Either way, our view is this: Give the people a voice filling the vacancy.”

Garland, who was confirmed in his current position by a majority of both Democrats and Republicans, is seen as a moderate politically.

He has already been involved in a number of healthcare-related cases, sometimes siding with hospitals and sometimes siding with the Department of Health and Human Services.

“The nominee that was selected is probable the exact type of nominee most moderate Americans would want – somebody that is in the middle of the political spectrum and is extremely qualified,” Stewart Verdery, the founder of the Monument Policy Group, said to the Wall Street Journal.

Democrats in Congress demand members of the GOP fulfill their duty and consider the nomination, but it is unlikely a decision be made until the results of the presidential election.

In the meantime, the remaining Supreme Court justices will hear arguments next week in the case of Little Sisters of the Poor Home for the Aged v. Burwell, regarding non-profit companies’ obligation to provide birth control at no cost to employees. A decision is expected in June.