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ClaimLinx helps businesses cut costs on their health plan without changing benefits. As a combination consultant, insurance agency and third party administrator, we use an alternate strategy for purchasing insurance that works for everyone.

How Small Businesses Save

ClaimLinx combines the best of traditional insurance with a self-funded plan. It cuts costs without changing a company’s benefits. We call it the Simple Option Solution.

Step 1: Make a change

First, ClaimLinx helps you choose a high deductible insurance plan either with a major carrier. We shop for the best rates and provide the company with the best options. Moreover, this plan provides:

  • Wide physician and facility network
  • Discounts on office visits and procedures
  • Stop loss in case an employee has high medical costs

Step 2: Keep your benefits

Then, ClaimLinx combines this plan with a self-funded Medical Expense Reimbursement Plan (MERP) administered through ClaimLinx. This plan is custom to the each client. Additionally, this part of the plan provides:

  • Customized copays and deductible
  • Real data on employee usage
  • Tax benefits of self-funding your medical plan

Why it works

The ClaimLinx Solution saves companies thousands on health insurance. Combining these two types of plans creates a seamless benefits package.

What’s more, your employees will love it, and you will love the price. On average, our customers save 20% or more in the first year. Then, we continue this savings trend year after year. Each year, we take a look at your company’s budget and needs and adjust your plan accordingly. Our service is personal to you and your company.

Finally, we know how important it is that your employees have the benefits they need without busting your company budget. It’s a challenge for all business, but we have a unique solution you won’t find anywhere else. So let us guide you on a path to a new type of plan.

health plans ohio

Medicare Ohio Health Plans To Consider When Shopping Around

Medicare Health Programs are another way to cover Medicare Part A and Part B. Sometimes referred to as “Part C” or “MA Plans”, they have to comply with regulations provided by Medicare-approved private companies. A lot of Medicare Ohio health care programs include Drug Coverage (Part D). In most cases, you will need to use a healthcare provider involved in local and regional network services at a very low cost.

 These plans not only reduce the cost you pay annually for the services but you can also avoid unexpected expenses with it. Some of the Medicare Ohio health plans provide out-of-network services but the cost of those services is higher. Keep your red, white, and green Medicare Ohio cards in a safe place as you will need them when you return to the original Medicare. Following are some common types of Medicare Ohio health plans that you must consider when looking for health plans

  • Health Management Organization (HMO) Program
  • Provider Organization (PPO) Program
  • Private Fee Service (PFFS) Program
  • Special Needs Program (SNP)

Here are some uncommon types of Medicare Advantage plans you can find:

  • HMO Point of Service (HMO-POS) Program
  • Medicare Medical Savings (MSA) Account System

Health Organization (HMO)

For HMO programs, you usually need to obtain your care and services from network providers, without the facility of:

  • Emergency care
  • Emergency care outside the area
  • Dialysis outside the area

Some of the health care providers might not provide some of the network services too. However, it usually costs less if you divert your attention from the provider outside the network. This is known as HMO with Point-of-Service (POS) option.

Are there prescription drugs in Health Management Agency (HMO) programs?

In many cases, HMO programs include prescription drugs. Ask the program providers. If you are looking for Medicare drug coverage (Part D), you must join the HMO program that provides access to prescription drugs.

Preferred Provider Organization (PPO)

PPO is a kind of Medicare Advantage Program (Part C) that can be availed through a private insurance company. The services under PPO include physicians, hospitals, and other health care providers. You are charged less if you utilize network services and you will be charged higher for utilizing services outside the network. 

You can avail health care services from different providers in PPO programs or hospitals. You can also receive out-of-network services for higher costs than the services provided within the network. 

Are prescription drugs included?

In many cases, prescription drugs are included in PPO programs. Ask the program. If you are looking for a drug prescription in Medicare, you must enroll in a PPO program that provides medical coverage. Remember, if you join a PPO program that does not offer prescription offer drugs, you will not join the Medicare Drug (Part D) program.

Private Financing Schemes (PFFS)

How PFFS programs work

A variant of the Medicare Advantage Plan (Part C), PFFS programs are not similar to Medigap and Medicare. Through this plan, you can determine how much cost you will be charged for different medical health facilities. 

Is it possible to utilize another hospital, doctor, or healthcare provider for medical help? 

Healthcare services from a doctor, hospital or any other healthcare provider are provided in most cases in PFFS programs. If you join a PFFS program offline, you can check with any network provider who regularly agrees to deal with program members. You can also choose a doctor, hospital, or another non-network provider that accepts the terms of the program, but your costs are usually lower when you are on the network.

 

Special Needs Programs (SNPs)

How Medicare SNPs work

A Medicare SNP is a type of Medicare Health program (such as an HMO or PPO). Medicare SNPs reduce membership in people with certain diseases or symptoms. Medicare SNPs organize all their resources together to serve a specific group with specific needs.

 

Is it possible to utilize another hospital, doctor, or healthcare provider for medical help? 

You can usually get all the services provided by the doctors and health care providers under the SNP health plan, except:

  • Emergency care in case you need immediate medical attention as a result of a sudden medical emergency.
  • If you are a renal failure patient and require out-of-network dialysis treatment. 

Medicare SNPs usually have a panel of professionals that have specialization in the condition or disease of the group allocated. 

 

Are prescription medications included?

All SNPs must provide medical treatment. In most cases, you may need a primary care physician for SNPs or you might need a caretaker to take care of your health necessities.

 

Do I need referrals to get an appointment with a professional doctor?

Referrals are needed in most cases to get an appointment with experts on SNPs. Some services do not require a transfer, namely:

  • Annual memory test
  • In-network POP testing and pelvic examination (covered at least annually)

 

Some important points to keep in mind

Planning must limit membership to the following groups: 

  1. People living in certain organizations (such as nursing homes) or need of home care, or
  2. People who are eligible for Medicare and Medicaid, or
  3. People with disabilities (diabetes, end-stage kidney disease) (ESRD), AIDS, Chronic Heart Failure, or Dementia). Programs can continue to limit membership. You can join the SNP at any time.
    • Programs should guide the services and providers needed to help you stay healthy and follow the instructions of your doctor or other health care provider.

If you have Medicare and Medicaid, ensure approval of your health care plan by all the doctors and your healthcare providers

 

Hopefully, this article was helpful for you to get the required information about Medicare Ohio. You must make your decision very smartly to get maximum benefits at the lowest cost possible. Choose the plan according to your requirements. The best plan is one that covers the maximum of your health care requirements and is also within budget. 

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Reasons To Choose Claimlinx For Health Insurance In Ohio

Claimlinx Insurance Options 

There are a variety of options that you can use to meet your insurance needs, no matter what your family situation and budget. Here are just a few of the most popular plans Claimlinx can help you get for your business, along with their benefits. 

Flexible Spending Accounts (FSAs) is the plan in which you and your employer will be able to save tax-free money to cover health care. Money can be deducted from your salary if you want to.

According to the rules for the employer, He is not going to be able to transfer any unused funds to the next year. You can extend it to a certain amount.

Claimlinx provided amazing services to its customers to help them with deposits, withdrawals, and other necessary issues and assistance. 

February 18, 2021. The Internal Revenue Service has provided employers with the option to transfer any unused amounts from 2020 and 2021 within an FSA plan due to the pandemic. They can also change the extension of the exposure period, the FSA plan year 2020, 2021, allow the retirement of the FSA plan to be eliminated, and leave in the middle of the year.

Health savings accounts (HSAs) are similar to FSAS, but the money is only to be used for medical expenses. People also use this account to raise money. The advantage of this is that you can still save money on a tax-deductible, as well as the use of lower-cost health insurance to high-risk. Insurance premiums for HSA plans are not taxable.

Health Reimbursement Agreement (HRA) plans are available to employers who can’t afford to get all the health benefits, but it provides some support to the health services providers. Employees will be paid by a pre-determined amount of money for special medical expenses for themselves and their families. The reimbursement of expenses for professional medical care is not subjected to tax.

The Health care Organization to Plan (HPO) provides comprehensive health care at a low cost by allowing participants to make use of the health care providers in the healthcare organization. The cost savings from the HMO plans can be significantly high.

A Preferred Provider Organization (PPO) plan is similar but has a bit more flexibility. With a PPO, you can go out health care organization for service, although a smaller proportion of the costs will be covered if you have to do it. 

 

Services for Our Members

Claimlyix has a wide range of services for its clients. On the website, you will find the answers to all your questions, and find out the cost of a medical procedure, details of your subscription, you can make changes to your coverage plan, you can check the status of your application, find out the status of your account, you will get a replacement member ID card to gain access to all of the benefits and services to you. 

 

 

Talk

When was the last time your health insurance agent took a look at your company’s plan usage? How about when did he or she last bring you a DECREASE in your overall plan costs?

We’re willing to bet that’s never happened with your traditional insurance broker.

That’s something only a true consultant like ClaimLinx can do.

Not only that, ClaimLinx sits down with you to find out what benefits are important you and your employees. We take a look at the age, health and needs of your employees because we know every company is different. Some companies may have employees with low cost prescriptions. Others may want to prioritize keeping premiums as low as possible for workers.

We listen to what you need and then show you how to make it happen. Best of all, you know you’re getting a great deal on all of it.

Related Post: See ClaimLinx’s Complimentary Elite Services for Clients

What we offer our clients:

  • Plan analysis from a consultant when making benefit decisions
  • Personalized service from a team with experience
  • A customized benefit plan just for your company
  • Annual savings on a comparable plan

Our highest priority is to make sure our clients receive the employer-paid benefits they want at the very best price possible.

How we do this:

We do this through our unique ClaimLinx Simple Option Solution, an innovative strategy for purchasing benefits that combines a high-deductible plan from a major insurance carrier with a self-funded medical expense reimbursement plan (MERP). That way you get the best of both.

The high deductible plan provides a comprehensive physicians network and a stop-loss in case an employee has high medical costs. The company MERP provides the benefits people are used to, including a lower deductible and copays for regular office visits and procedures. That way you’re always only paying for the services your employees are actually using.

Related Post: What a Full-Service Insurance Agency Can Do for You

But it’s not just about getting health insurance benefits at a great price. It’s also about having a resource and true ally in an ever-changing industry. With our solution, clients have the opportunity to make employer-paid benefit decisions based on employee usage and company priorities. We aim to finally close the gap between your ideal benefits package and what your budget will allow. ClaimLinx helps both business owners and employees save money on health insurance costs.

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ClaimLinx Health Insurance Strategy

ClaimLinx Offers a Full-Service Insurance Strategy

ClaimLinx offers more than just a way to provide health insurance to your employees. We offer a holistic solution to give great benefits to employees while saving money for business owners. Our ClaimLinx Solution blends a high-deductible insurance plan with a company-funded medical expense reimbursement plan (MERP). The result is an optimized health insurance plan for everyone at your business. ClaimLinx explains how we make this full-service insurance strategy work in today’s blog.

High-Deductible Health Plan

A high-deductible health plan allows for lower monthly premiums. Lower premiums mean you pay less money to have the health insurance plan in place. Normally, higher deductibles mean employees must pay more money before insurance coverage begins to pay for medical expenses. But ClaimLinx has a different strategy.

In 2019, the IRS defined a high-deductible plan as one with at least $1,350 for an individual or $2,700 for a family. These minimums mean individuals must pay the first $1,350 of medical expenses before the health insurance plan starts to cover certain costs. But ClaimLinx typically chooses plans with deductibles much even higher to really slash expenses on premiums. This is a part of our full-service insurance strategy.

Related Post: What is an employer-sponsored, or self-funded, plan?

MERP

Employers can use a MERP to help fund an employee’s costs before reaching his or her deductible. When paired with a high-deductible plan, MERPs offer a health insurance strategy that is cost-effective for employees and employers. 

For example, John Smith goes to the emergency room for a minor injury and receives a bill for $2,500. His insurance carrier sends him an Explanation of Benefits (EOB) that says he owes the full amount because he has not yet met his high deductible of $3,500. John’s employer, Acme Brick, has a MERP that covers emergency room visits with a $350 copay. That means John only pays $350 instead of $2,500. 

The ClaimLinx Solution is a win for everyone. John Smith experiences lower costs for medical expenses. Also, John’s employer is happy because he can afford to offer such great benefits since the cost of the company’s monthly premiums has gone down so much. Our full-service insurance strategy identifies the optimal combination of high deductible plan and MERP.

Related Post: What Is a MERP?

How This Strategy Saves Money

A high-deductible health plan lowers the monthly premiums for each employer. Instead of paying $1,000 per month for a family’s coverage, an employer might pay $700. A MERP continues the savings because it’s a tax deduction. Every time an employer reimburses an employee’s medical expenses, it lowers the amount of money the IRS figures into business taxes. Business owners not only pay lower income taxes, but they also lower onboarding costs by retaining employees for longer periods of time. Employees who remain healthier are more productive and miss less work. ClaimLinx shows you how we deliver for both business owners and employees with our full-service insurance strategy.

The ClaimLinx Solution: A Full-Service Insurance Strategy

ClaimLinx is here to find the best possible solution for health insurance at your business. We educate business owners and employees on the best practices for combining health insurance plans with a MERP. Our team provides third-party administration, employer benefits consulting, and complimentary elite services to our clients. Contact ClaimLinx or call toll-free 1-800-858-1772 for more details about our full-service insurance strategy.