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.

An insurance shakeup? Three American corporations join forces to tackle healthcare

Amazon CEO Jeff Bezos, Berkshire Hathaway CEO Warren Buffett and JP Morgan CEO Jamie Dimon are joining forces to launch their own healthcare company, according to a press release today on Business Wire.

The goal of their new joint venture “is to create solutions that benefit our U.S. employees, their families and, potentially, all Americans,” said Bezos.

But what does that mean for everyone else in the health insurance industry?

Related Post: Drugmakers Pfizer and Allergan Merge for Tax Break

Right now — nothing. Aside from a quick, and might I add pretty painful, hit to stock prices of insurance carriers like Cigna, Aetna and UnitedHealth, there won’t be any immediate repercussions.

What can be speculated though is that these three enormous companies will make potentially huge waves as they pull employees off current major carriers’ services. Depleting members reduces the pool of money that insurance carriers will have for their own claims and administration. If the majority of those leaving are young, healthy people, some Americans could see an increase in costs for their insurance plan — on top of already rising prices in the industry overall.

On a more positive note, new enthusiasm and innovation might just be what the industry needs. Having new blood in an incredibly old, often entrenched system might spur creative strategies to encourage savings. Major carriers across the country will have to do something to shore up for the changes this new company could bring.

Related Post: Why Insurance Rates Are So High and How to Start Cutting Them

Ultimately employees of the three companies will benefit first as the new healthcare company will be staged to take care of just them as a starting point. If Bezos statement rings true after this initial step, it may benefit “potentially, all Americans” by providing healthy competition into an ever-shrinking market.

Health Insurance Jargon Spurs Widespread Confusion

With a language all its own and processes that mystify even veterans of its industry, health insurance is a problem among consumers of all ages.

“People are treating it more like care insurance: you don’t use it until something happens” Kathleen Call, a professor in the University of Minnesota’s School of Public Health, said to Kaiser Health News.

“You have an accident, then you use it. Otherwise you’re trying not to use it. And that’s not the way we want health insurance to be used.”

Related Post: ClaimLinx Glossary: Common Health Insurance Terms

Make sure you understand how your insurance plan works so you feel confident when using it.

To assist with this, here are five of the most commonly searched words in the healthcare industry along with their definitions.

  1. Deductible – The amount a person owes for healthcare services before future covered benefits are paid. Note, copays and other out of pocket expenses are often not applied toward a deductible.
  2. Copay or Copayment – The fixed amount you pay for a covered healthcare service, typically paid on the date of the service.
  3. Coinsurance – Your share of the costs of a covered healthcare service, calculated as a percent of the allowed, or discounted, amount for the service.
  4. Coverage determination – The decision made by your primary insurance carrier whether a service is covered. Note, your secondary coverage will follow your primary plan’s determinations.
  5. Explanation of Benefits – A statement, either from your primary insurance carrier or from ClaimLinx, with details about what your plan covers, how much was paid, how much money, if any, is still owed and more.

Related Post: How Coordination of Benefits Saves Money for Your Employees

Look for more details on health insurance jargon in the future or contact help@claimlinx.com with any specific questions.

If I have regular health coverage do I need any other insurance?

Having regular health insurance coverage is a good start. But when examining your overall personal profile, it is best to cover all the bases. ClaimLinx partners with consultants and brokers in the area who also offer products designed to enhance your existing health insurance coverage. Such products include supplemental insurance coverage, long-term care insurance, life insurance, tax consulting, and financial planning.

Related Post: ClaimLinx Glossary: Secondary Coverage

Contact the ClaimLinx sales team today to learn more:

What is a Section 105 Plan?

Section 105 is a part of the U.S. tax code that allows employers to reimburse premiums and/or any health insurance costs tax-free to the employees. This part of the tax code has been around for more than 50 years. Many large companies have implemented a Section 105 plan, but this cost-savings measure is also available to smaller employers. For more information, contact the Internal Revenue Service (IRS) directly or consult your tax attorney. The ClaimLinx Simple Option Solution can show you how to take advantage of tax-free disbursements to your employees to lower your costs.

Related Post: Section 105 Plans After Obamacare