Investing in health insurance for your employees is essential to ensuring a happy and healthy workforce. Navigating employee benefits that your employees actually want, can be a challenge. Not to mention the various requirements necessary for employers with 50 or more employees. So, why should you invest in health insurance for employees?
Your Guide To A Healthy 2021!
The New Year is upon us! I think we all can agree, 2020 has been a year unlike any other. As we look to the new year and reflect on the past 365 days, how are you planning on keeping your health a top priority in 2021?
Prior to the pandemic, most patients opted for in-person doctor’s visits over telehealth options. With the onset of a contagious airborne virus, telehealth options grew dramatically. New, easy-to-use options became available for nearly all health insurance providers. With the large influx of telehealth appointments becoming the new normal, what does that mean for insurance and healthcare costs?
Transamerica’s partnership with SBMA brings you quality, affordable health insurance that fits into your budget and removes the hassle of excess submissions to insurance carriers. Many people go to the doctor and never file their claims with their insurance company. Whether it is because of a language barrier or a simple lack of understanding, many people will leave their medical bills unpaid rather than try to navigate the complexities of insurance filings and submissions.
Since the start of the global pandemic, the number of outpatient clinic visits has decreased immensely. While this makes sense, due to the highly contagious virus, it can be a troubling sight.
Preventative care services have truly never been more important. Now, more than ever, patients need to be proactive about their health. How can you ensure you are being proactive with your preventative care during COVID?
What are the dangers of waiting for your routine appointments?
While visiting the doctor’s office during a global pandemic may seem unsettling, the risk associated with avoiding ongoing, preventative health care is high. Small health issues can turn into larger health problems if left untreated. Especially during this time, when the highest risk patients for contracting COVID-19 are those with chronic illness or worsening conditions.
Now is not the time to begin ignoring your wellbeing.
Eating well, getting sleep, and exercising regularly is more important than ever before. Ensure you make your health a top priority during these uncertain, stressful times. Stressful situations, like the one we’re all experiencing right now, can lower your immune system. Take care of your mental and physical health to ensure your immune system is prepared for whatever comes your way.
If you feel you need to go into the doctor’s office, contact your doctor first!
If you feel unsure about returning to the physical doctor’s office, reach out to your doctor. See what precautions your provider is taking to ensure their patients remain safe. Most outpatient clinics are taking these measures to ensure their safety:
- Enforcing masks at all times
- Temperature checks when you enter the facility
- Limited number of patients allowed in the waiting room at once
- Reconfiguring their space to ensure proper social distancing requirements are met.
If you still are unsure about returning to a physical doctor’s office, book a telehealth visit!
Telehealth services have grown immensely since the start of COVID-19. There are many potential uses for telehealth services. Here are a few:
- Screen patients with potential COVID-19 symptoms
- Provide low-risk urgent care for those with non-COVID-19-related conditions
- Mental and behavioral health check-ins
- Chronic health condition check-ups and medication management
- Support for patients with chronic health conditions, like nutrition counseling
- Doctors can monitor clinical signs of some chronic health conditions
- Case management
- Follow-up appointments
With a variety of options, it is important that you don’t put your preventative care on the backburner during COVID-19. Not only does it help ensure you don’t contract COVID-19, but preventative care can also help detect early signs of other diseases and illnesses. Do you have proper healthcare to cover your needs during this uncertain time? At SBMA, we understand that you need a health insurance plan that covers all your needs, visit the site today to learn more.
The open enrollment period for 2020 is here! It’s time to consider whether or not to enroll in a new health insurance plan or change your health insurance plan. To begin, you need to understand what benefits you can receive with minimum essential coverage. If your employer offers Minimum Essential Coverage and you’ve been hesitant to enroll, let us help you understand how MEC can give you the essential health benefits you need most.
What is MEC?
Minimum essential coverage is an insurance plan that meets the Affordable Care Act requirements for health insurance coverage. Plans under MEC include marketplace, job-based plans, Medicare, and Medicaid.
Before the Affordable Care Act, insurers would not cover people who had preexisting medical conditions. Those who had used too much of their medical coverage in the past were also at risk of not receiving insurance coverage. MEC ensures that insurance is offered to all enrollees regardless of health status, or the plan selected.
What is open enrollment?
Open enrollment is a period where individuals and employees can change or enroll in health insurance. During this period employees can also set up a flex spending account or health savings account. They can also sign up for and adjust the amount of various types of insurance, including
- life insurance
- disability insurance
- vision insurance
- dental insurance
- legal insurance
- supplemental benefits
What coverage uses open enrollment?
Most types of health insurance use open enrollment periods, including Medicare, job-based health insurance, and individual market health insurance. Outside the open enrollment period, individuals must show proof of a “life event” such as marriage, childbirth or new employment to be able to change insurance coverage. However, Medicaid, CHIP, travel insurance, and short-term health insurance do not use an open enrollment period.
Why should I consider MEC during open enrollment?
MEC covers ten essential benefits in order to ensure everyone can receive proper coverage. These benefits include:
- Laboratory services: preventative screening tests and diagnostic lab tests
- Emergency services: emergency care at a hospital, even at a hospital out of network.
- Prescription drugs
- Mental health and substance abuse: includes counseling, psychotherapy, mental health, inpatient services, and treatment for substance abuse.
- Maternity and newborn care: services during pregnancy, delivery, and after delivery
- Pediatric services (including oral and vision): These services keep your children healthy. They include dental checkups, eye exams, vaccinations, and well-child visits.
- Rehabilitative services and devices: A patient with disabilities, injuries, or chronic conditions receive coverage for physical, occupations, and speech therapy visits.
- Habilitative services and devices: A patient can receive coverage for services and devices that help them learn and improve daily skills.
- Ambulance patient services: services in outpatient care
- Preventative/ wellness services and chronic disease management: including cancer screenings, annual checkups, and more at no cost.
- Hospital visits: if you are in the hospital for inpatient care, your plan will help you pay your medical bills. However, it may only cover you for a certain period of time.
Minimum essential coverage can be an affordable option to ensure you and your family are covered during times of need. At SBMA we provide affordable coverage for all of our clients, with a variety of options, including telehealth, vision, and dental voluntary benefits.
Captive insurance programs offer a creative solution to insurance policies. What is the difference between standard market insurance programs and captive insurance programs? We’re here to breakdown the differences.
What is a captive insurance company?
A captive insurance company provides coverage to its owners. In other words, the insurance company is owned and controlled by its insured. When you invest in a captive insurance company, you see all the components of the premium and play a part in the pricing and delivery of the premium.
Among captive insurance companies are group captives. These are an insurance facility for unrelated participants who join together to share risk. You are able to control what you add and subtract to suit your specific situation.
So, what is the difference between standard market insurance programs and captive insurance programs?
In a traditional insurance program, the insurance carriers take on all risks and retain all profits. With captive insurance, the captive participants share in the risk for a potential reward of lower costs, underwriting profits, and investment incomes.
Captive insurance programs and traditional insurance programs are not mutually exclusive. In fact, a lot of traditional insurance companies work with captives to reimburse claims.
Why should you take the risk of a Captive Insurance policy?
Companies typically take the risk on Captive because the opportunity to capture the profits your fully-insured carrier typically takes in.
When you compare traditional and captive programs risk, the captive may appear to have more risk initially. However, Captives offer long-term solutions and control your risk over time. If you are unhappy with your current traditional health insurance program, consider whose interest your large insurance company is looking out for.
How exactly does Captive insurance protect you from catastrophic losses?
Captive programs include the protection of reinsurance/ stop-loss agreement that limits any catastrophic or aggregation of risk. The program’s reinsurance structure limits the participant’s maximum loss. In addition, this means the participant will never need to fund more than the premium and collateral.
Why do Captives require collateral?
Captives require collateral to ensure the funding of the captive assumed risk above the premium, net expenses. This ensures all potential losses are funded up front and participants are not required to contribute more money.
Captive insurance programs can be extremely beneficial to business owners. Employees will notice an increase in wellness, personalized guidance, and technology advancement that bridge the gap between healthcare and benefits. At SBMA, we can partner with other networks that may meet your employee needs better.
Navigating insurance policies can be challenging for anyone. There isn’t a way to predict the future, how can you know what you will need? There are so many options available, how can you decide? Voluntary benefits can help supplement insurance policies that may not cover all of your employee’s needs. There are multiple options when it comes to voluntary benefits with a few differences. What’s the difference between hospital indemnity policies and accident insurance? Here’s a breakdown.
Accident insurance is an option to help supplement out-of-pocket expenses for potential expenses incurred when an accident occurs. This insurance is used to cover expenses that your standard health insurance plan cannot cover. Typical medical insurance directly pays the medical provider, and you get the bill later. Accident insurance pays the cash directly to you and you are able to choose the best way to utilize that money.
What exactly does an accident insurance policy cover?
There are quite a few expenses accident insurance covers that your traditional health insurance plan may not. These can include emergency room visits, ambulance rides, helicopter transportation, hospital admission charges, diagnostic exams, follow-up treatments, ICU and rehabilitation unit care, and physical therapy. If you have ever had to be transported in an ambulance, you know how expensive that can be, therefore accident insurance could save you thousands of dollars.
Deductibles for many medical insurance plans can cost thousands of dollars, other insurance simply doesn’t cover hospital stays, ambulance rides, or other non-preventative care. Accident insurance can be a great back up plan.
What is hospital indemnity insurance?
Hospital indemnity insurance is very similar to accident insurance, whether you choose one over the other or, get both, will depend on your lifestyle, expenses, and savings. It is also used to supplement any expenses incurred outside of your health coverage.
Hospital indemnity insurance provides a set cash payment to use for any bills you need to pay. This is especially helpful for paying housing, bills, and living expenses if you are unable to work.
What does hospital indemnity insurance cover?
Hospital indemnity insurance coverage depends on the plan and coverage options you choose. Some things covered under a typical hospital indemnity plan include: ICU stays, critical care unit stays, outpatient surgery, continuous care, outpatient x-rays and laboratory procedures, outpatient diagnostic imaging procedures, ambulances, emergency rooms, and physician office visits.
Generally, hospital indemnity plans have lower premiums compared to other insurance, but depending on your coverage that can increase.
So, how do you decide which coverage to invest in?
The important distinction between the two types of insurance is how often you frequent the hospital. If you have hospital indemnity insurance and do not go to the hospital, you will not get paid benefits. However, accident insurance applies to both hospital stays and treatment from your primary care doctor. Consider a few things before you make your decisions.
Consider your lifestyle.
Do you enjoy running, hiking, and other activities that may be more prone to accidents? Accident insurance might be your best choice. Do you have kids who play sports or are constantly playing outside? Accident insurance may be for you. If you lead a relatively healthy, active lifestyle, accident insurance might be a better option for you.
If you have a chronic health issue or have dependents with chronic health issues, hospital indemnity insurance may be a better bet for you.
How much money do you need to get by?
If you live alone, or if you are a relatively young person with fewer financial responsibilities, accident insurance is a great option to ensure you are covered for whatever comes your way. Sometimes, the best solution may be to have both coverage options. If you have children, own a home, own a car, and have other expenses, purchasing both will give you the best coverage.
Lastly, consider how much money you have saved for emergencies.
If you don’t have a large amount of savings, e.g. enough to cover 3 months of expenses, a small monthly premium for accident insurance may sense for you. On the other hand, if you have enough money to cover potential accident expenses and support your lifestyle, but a large hospital bill might drain your savings, hospital indemnity insurance may be the better option.
There are quite a few things to consider as you decide what coverage may be best for you. At SBMA, we offer multiple voluntary benefit options to ensure you are prepared for whatever comes your way. Contact us to learn more about our employment policies and how you can ensure you are covered in case of an emergency.
Attention Brokers: Are you offering your ALE clients the most affordable MEC?
Attention Brokers: Are you offering your ALE clients the most affordable MEC? How can you offer your applicable large employers a one-stop-shop for all their needs? Benefits are no longer about simply meeting Minimum Essential Coverage options. You need to offer worksite and voluntary benefits, telehealth options, call center availability, and easy portal management. Why should you offer these options to your employers? Because they want them.
In order for employers to attract and retain great talent, they need great benefit options. This means going beyond standard MEC requirements and offering services that provide value and attract the best workers..
Let’s start with voluntary benefits.
Worksite and voluntary benefits include accident insurance, term life insurance, critical illness insurance, and hospital indemnity.
- Accident insurance includes aid in payment for medical and out-of-pocket expenses that may occur due to an accident occurring.
- Term life insurance includes a way to provide financial protection for loved ones while employees are working.
- Critical illness insurance adds a safety net for those who are under-insured.
- Hospital indemnity benefits help to offset high deductibles and out-of-pocket expenses so a hospital stay does not become a financial crisis.
Next, consider offering your employees access to telehealth care.
With 24/7 access to doctors, telehealth, also known as Virtual Health, can help employees get care when they need it with added convenience. At SBMA, we offer telehealth options that include behavioral health and therapy access, to give employees the ability to speak to a therapist whenever they need it*. In addition, it helps employees receive necessary prescriptions without having to go to a doctor’s office.
Employers look for convenience when looking for benefits, as a broker you can provide a one-stop-shop for all your ALEs benefits needs. This means 24/7 call center support and easy access to portal management, single point billing, and US-based customer care.
At SBMA, we offer portal management access to provide employers with the ability to make plan changes, order ID cards, and have them shipped within a few days, check their claim statuses, and give employees the ability to manage their own profiles.
With bilingual call center support, you’re getting licenses representatives to help manage enrollment and provide year-round support. All of our representatives are in-house, which means they understand your client’s needs.
SBMA can provide a one-stop-shop for all employers to handle their benefit needs. As a broker, it is your responsibility to provide your employers with the best possible options for their needs. Contact us to learn more!
The implementation of telemedicine has risen immensely over the last few months, as social distancing requirements were put into place. Telemedicine can be a great way to communicate with your doctor in the safety of your own home. Virtual visits can be used to detect symptoms of COVID-19, fevers, rashes, cold and flu symptoms, aches and pains, minor musculoskeletal injuries, small infections, and UTIs. While telemedicine can be an effective way to treat patients, there are pros and cons to consider.
The pros associated with telemedicine include:
- Convenience. According to a study, 74% of patients prefer easy access to healthcare services over in-person appointments. Not only does this provide convenience for all patients, but it also helps those who live in remote locations have access to proper patient care.
- Cost-effective options. These services reduce healthcare service costs significantly. It helps to attract new patients, reduce no-shows, and reduce overhead for physicians who decide to utilize telemedicine.
- Patients minimize unnecessary visits. As a patient, it can be a waste of time and money to go to the doctor or ER for minor medical consultations. If your symptoms do not require an in-person visit, opt for a telemedicine appointment instead!
- Telemedicine can lead to improved healthcare quality. When it is easier for providers to engage with patients, and remotely track their health with monitoring systems, they can work to identify problems as they develop.
Now, let’s look at some of the cons linked to telemedicine:
- Sometimes in-person visits are necessary to diagnose. Physical exams are impossible over the phone, which may be necessary for the diagnosis or treatment of a patient. For example, the COVID-19 test requires a nose and throat swab, to diagnose, so you must go to the doctor physically.
- Security concerns. With the relaxation of telemedicine requirements due to the global pandemic, security concerns may arise. Cybercriminals can hack into telemedicine systems to steal personal healthcare information.
- You may not know the doctor providing your care. Utilizing virtual care services may mean you have a stranger on the other end of the call. These doctors will likely be unfamiliar with you and your medical history, and it may affect the level of care they can provide.
- Training and equipment can be expensive. Reorganizing IT staff to train and create effective equipment costs both time and money. To ensure ROI from implementing telemedicine, staff, physicians, and medical staff needed to be trained properly.
Although there are a few things to work out within the telemedicine technology, as you work to implement telemedicine into your benefit programs, the benefits of telemedicine can make a large impact. At SBMA, we believe in the power of telemedicine. That’s why we offer free telemedicine programs in all of our benefit programs. Learn more here.