Health Insurance Company
COBRA, Low Cost Plans and More
The State insurance commissioner oversees health insurance companies, particularly so in terms of their capital base and overall financial capability. You can contact your State insurance commissioner's office for direct details on any licensed health insurance company. Several thousand health insurance firms operate in the USA and offer a variety of personal health insurance or group health insurance plans to consumers. The "market face" of these firms appears like many consumer marketing firms. These firms advertise on TV, send out millions of direct mail promotional pieces, underwrite theatre and sports events in an effort to gain the consumer's attention and to develop”brand awareness". However, behind Madison Avenue marketing theory lies a statistic-driven enterprise where actuaries continuously examine data in order to price health insurance according to the changing rate of incidence for disease, accident, or death in each population segment.
Often times the best strategy for obtaining personal health insurance is to "buy" via your employer in the form of group medical insurance. For you, this strategy generally results in lower costs. For the health insurance firm, it results in operating efficiencies as well as reliable revenue streams, accordingly they can offer discounts on your cost of premiums. Low cost insurance can also be located, outside your employer, through trade associations, or other professional groups.
In the event that you lose your job, you may be able to convert your group medical insurance to personal health insurance, with some likely reduction in the range of benefits as compared to the original group insurance plan. In certain situations such as when you switch jobs or alter your work hours, you can continue the group insurance plan coverage by way of the protections described in the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA). You, your spouse, and qualified dependents qualify for group insurance plan coverage for up to eighteen months. In the following thirty-six months, your spouse and dependents can continue to receive group insurance plan coverage under COBRA if you divorce or die. If you qualify as eligible for group insurance plan coverage with another employer's group insurance plan, then the COBRA coverage ends. Employers are required by law to advise you of your personal health insurance coverage options under the COBRA act if you leave your job.
Not surprisingly, when you elect personal health insurance coverage, even temporarily, your coverage can be as much as 15 percent to 40 percent higher than comparable group coverage. Out-of-pocket expenses, deductibles and co-payments will be higher for your personal health insurance coverage. The good news, however, is that you're back in the "driver's seat" and you have full decision-making control over the selection of health care providers, plus you'll likely be able to pick the deductibles and coinsurance arrangements.
Prior to enrolling in any health plan, you need to determine which services are covered and how much you will pay in deductibles and coinsurance based on your budget and financial circumstances. Many states offer health insurance risk pools, which provide coverage for high-risk groups, such as persons with pre-existing medical conditions.
There are instances when a consumer has purchased a health insurance plan that is not a proper fit for their needs. Too many choices and too many health insurance products make the consumer's job confusing if not outright annoying to sort out. Coverage details and costs involved in a health insurance policy are often times difficult to sort out. In order to identify then buy the correct health insurance plan, you and your agent or advisor must set out a clear description of your health insurance needs, whether for private health insurance or family health insurance. By taking a disciplined approach that "profiles" you and your family's health insurance needs, you and your advisor may conclude that a short term health insurance policy is the best possible solution.
The sort of health insurance policies that you'll examine will be exactly the same as from any of the major health insurance companies as represented through their local retail office. The difference, and advantage for you, is that by applying online you save on administration and overhead costs associated with "bricks and mortar" retail operations. And so, the commission normally given to the agents is discounted from your total premium price for health insurance. These savings can result in discounts as high as 40%.