Public health poster at the national museum of health and medicine.

The new provisions in the health care law can be complex and difficult to understand, especially in how they relate to employer-sponsored group health plans. It is important for employers to understand and plan for the changes in their obligations under the new plan, as failure to do so can mean fines or penalties for any violations.

Grandfathered Plans - Health Care Reform allows plans that were in effect on 3/23/10 to have grandfathered status. This means that these plans can delay implementation of certain required provisions. These existing plans can change only very slightly to maintain their grandfathered status. This means no increases to participant costs or decreases in benefits.

Coverage for Adult Children up to Age 26 – Plans beginning on or after 9/23/10 must provide dependent coverage for members with adult children until they reach age 26. Children no longer have to be full-time students, reside with parents, or be unmarried.

Pre-existing Conditions for Children under Age 19 – Plans beginning after 9/23/10 may not impose pre-existing conditions on children less than 19 years of age.

Lifetime Limits and Restrictions on Annual Limits – All plans after 9/23/10 are prohibited from imposing lifetime limits on essential health benefits, and are restricted in the dollar amount of annual limits imposed. After 1/1/14, these limits will be banned. Currently, these essential benefits include ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, including behavioral health treatment, prescription drugs, rehabilitative services and devices, laboratory services, preventive and wellness services and chronic disease management, and pediatric services.

Equal Treatment of In-network Versus Out-of-network Emergency Services – After 9/23/2010, plans must treat out-of –network emergency services like visits to the E.R. the same as they do for in-network emergencies. Plans will no longer be able to pre-authorize emergency services.

Provide Preventive Care Benefits without Costs to Participants – After 9/23/10, plans may not impose cost-sharing requirements on preventative care services and benefits. This means plans cannot impose co-pays, deductibles, or co-insurance on services like annual physicals, immunizations, and mammograms.

Rescissions Allowed Only in Limited Circumstances – After 9/23/10, plans may not rescind existing coverage or terminate existing plans except with notice to enrollees and then, only in the case of fraud or misrepresentation.

New Appeals Processes – After 9/23/10, plans must have written internal and external appeals procedures. The law stipulates specific methods and structure for these appeals.

Reimbursement of Over-the-Counter Medications Without a Prescription – Beginning 1/1/11, a health care flexible spending plan, health savings account, or health reimbursement arrangement may no longer reimburse over-the-counter medication without a prescription.

Health FSA Contributions Are Capped effective January 1, 2013 – Regardless of plan year, employees may only defer up to $2,500 into a health flexible spending account plan.

Tax Credits for Small Employers – For tax years 2010 through 2013, small employers (those employing fewer than 25 full-time equivalents with average annual wages of less than $50,000) who purchase health insurance for their employees may receive a sliding scale tax credit. Small employers with 10 or fewer workers with an average wage of $25,000 or less may receive the full value of the credit. To qualify for a tax credit, an employer must contribute at least 50 percent of the total premium cost of a benchmark premium.

Subsidy for Retiree Coverage – Effective immediately and available until 1/1//14, group health plans may be reimbursed for certain expenses they incur for early retiree medical coverage. Early retirees are between age 55 and the age at which they become eligible for Medicare.

Provide Breast-Feeding Breaks to Nursing Mothers – Effective in March of 2010, employers must give employees who are nursing mothers reasonable break times to express milk for their children during the one-year period after birth. A private space, other than a bathroom, must be made available.

If you want to know more about health insurance policies or get a free quote, click here for a free Chicago Health Insurance quote.

When an employee gets hurt on the job or has a work related illness, they still have to pay their bills and meet other financial obligations. That’s where worker’s comp comes in. Health insurance won’t pay the rent, utilities, or for medical deductibles. Worker’s comp, however, can help with these expenses. Depending on which state you live in, full or part-time employees can be covered by worker’s comp, and in some states business owners, partners, or company officers can be covered as well. Coverage is even available for workers injured while traveling on business outside of the state where they normally work. As a business owner, the rates that you pay will depend on the type of business you are in, your worker’s comp track record, and how much you pay your employees.

Whether or not your business carries worker’s comp coverage may not be a choice because it may be mandated by law, but you do have power over the decision over who you purchase worker’s comp insurance from. Rates and coverage can vary, and the rules and requirements vary from state to state. The same price may get you different levels of coverage from different companies. That’s why it is important to ask questions from different providers, compare coverage, and look at the reputation of the company from whom you want to purchase coverage. Fifty-four percent of the costs of claims are for medical expenses. It is crucial to be careful about who you choose to manage these claims. The more you understand as a business owner, the more confident you will be in your worker’s compensation insurance buying decision, a decision that could mean a lot to your business, and to your employees.

Worker’s Comp Tips for Business Owners

• If you have a claim, big or small, report it right away to help your employees get the care they need and to protect you in case their injury turns into something bigger down the road. The sooner they are healthy, the sooner your employees can get back to work for you.
• Audits aren’t a bad thing. The purpose of an audit is to make sure you are paying the right premium so that you don’t pay too much or too little, and that you have the coverage you need. The result of an audit could even be a refund. Something as simple as a safety program or ergonomically designed workstations can be suggested and implemented to lower your premiums.

Click here to contact us to see how we can provide Chicago Insurance – worker’s compensation insurance for you and your company.

Business Insurance for Tech Businesses

Business insurance is a must for tech businesses. The technology business is constantly changing. With that comes an ever changing level of risk for businesses as well. Whether your company’s operations include software development, programming, systems integration, IT consulting, or communication and consulting services, insurance coverage can provide you with the ability to protect your business and remain competitive in today’s marketplace.

Types of Technology Business Insurance

The types of coverage for tech businesses are comprehensive and varied.

One type of tech business insurance you may want to look into is Technology Errors and Omissions Coverage. This protects your company from claims if your client holds you responsible for programming errors, software performance, or the failure of your work to perform as promised in your contract. The coverage includes legal defense costs, and will pay for any resulting judgments against you, including court costs, up to the coverage limit on your policy. Another, Information Risk and Media Liability endorsement, can be bundled with this coverage, protecting you against claims arising out of the gathering and communication of information. Liability Insurance provides valuable coverage against defamation and invasion of privacy claims, as well as copyright and trademark infringement.

Other types of technology business insurance coverage to consider include: Business Personal Property, Business Income, and Utility Services and Direct Damage. Business Personal Property Insurance permits a business owner to cover all of the buildings, fixtures, machinery and equipment, and personal property used in business and the personal property of others for which the business owner is responsible. Coverage also can be extended to insure newly acquired property, valuable papers and records, property temporarily off the business premises, and outdoor property. On the other hand, Business Income insurance is intended to compensate the insured for income lost during a “period of restoration,” if a business is physically damaged and can no longer operate. It begins when the direct physical damage occurs, and ends on the date that the damaged property should be repaired, rebuilt, or replaced. As for Utility Services and Direct Damage coverage, tech business owners can expect to be compensated for losses due to an interruption in water, power, communication, or other utility services.

Tech businesses may also want to look into Advertising Injury coverage. This is typically designed to cover offenses such as defamation, invasion of privacy, misappropriation of advertising ideas or style of doing business, and infringement of copyright, title, or slogan. Additional types of coverage include Primary Non-Contributory Coverage. This term is commonly used with contract insurance requirements to stipulate the order in which multiple policies triggered by the same loss respond. For example, a tech contractor may be required to provide liability insurance that is primary and non-contributory. This means that the contractor’s policy must pay before any other applicable policies (primary) and without seeking contribution from other policies that also claim to be primary (non-contributory).

Lastly, one other type of technology business insurance to investigate is for Additional Insured or a person or organization that enjoys the benefits of being insured under your insurance policy in addition to yourself. The term generally applies to liability insurance and property insurance, but can include an element of other business technology policies as well.

If you want more information on these different insurance coverages or to see how we can help with insuring your business, use the Contact Us form on the right to get a free Chicago Insurance quote.

Auto theft is covered under the comprehensive section of your auto insurance policy and applies to the loss of the vehicle as well as parts of the car such as tires, rims, airbags and catalytic converters. This may sound strange until you consider that nationally, more than 75,000 airbags alone are stolen every year from vehicles.  Comprehensive coverage for your vehicle (which is not mandatory) also pays for events such as fire, vandalism and weather-related damage like hail or a windstorm, including damage from floods and earthquakes.

The premium that you will pay for comprehensive insurance is affected by the risk of loss, or the likelihood that an insured car will be stolen or damaged, as well as the car’s value at the time of the loss. Certain types of cars are more likely to be stolen than others, and are more expensive to insure, for example. According to the National Insurance Crime Bureau (NICB), the 1995 Honda Civic is the most stolen vehicle in America, followed by the 1991 Honda Accord, 1989 Toyota Camry and 1997 Ford F-150. Other favorites of thieves are the 2004 Dodge Ram pickup, Acura Integra, Toyota Corolla and Nissan Sentra.

Older vehicles top the list and are targeted because there is still a large market for their parts. Carjacking, while covered more prominently in the media, are not as common as people might think, attributing to only about 3% of auto thefts each year. The FBI reports that the value of stolen cars in a typical year is approximately $6.4 billion, with the average value of a motor vehicle stolen at $6,751.

This means that crooks aren’t stealing Mercedes Benz and BMW’s from the well-to-do, they are stealing average, everyday vehicles owned by regular people. A recent statistic shared by the FBI says a motor vehicle is stolen in the United States every 33 seconds, with the odds of a vehicle being stolen at 1 in 210. The odds of theft are highest in urban areas. About 38% of thefts occur in the South, 34% in the West, 18% in the Midwest, and 10% in the Northeastern U.S. Of all of these, only 12% of cases were solved. These statistics should be enough to convince any driver to fully insure their car to protect against theft.

For more information on auto insurance and how it can protect you, please fill out a free Auto Insurance Quote at Premier Insurance Services of Chicago.

Co-insurance – This is the amount that is considered the insured person’s responsibility.  On average, the split between a person’s co-insurance responsibility and the company contribution is 80/20; meaning that you pay 20 percent of your health insurance premium and your employer pays 80 percent.

Coordination of Benefits – If the insured has two or more sources that would pay for a certain condition or treatment (such as being covered by a spouse’s insurance plan along with your own) the insurance company would not pay double benefits. Instead, they would coordinate benefits to make sure that each plan pays their portion for the service or treatment.

Co-payment – The fixed amount that the insured is required to pay at the time of service. A co-payment is usually required for basic doctor’s visits and when purchasing prescription medications. The amount can range depending on which play you subscribe to and your premium payment level. Many group plans like those provided by your employer will have payments of around $15-$20 for doctor visits and prescription drugs.

Deductible – Deductible refers to the amount of money that the insured needs to pay before any benefits from the health insurance policy can be used. This amount is generally a yearly figure that resets at the beginning of the next year. Some services such as doctor visits may be available without meeting the deductible amount first. Usually there are separate amounts for individual deductibles as well as family deductibles.

Exclusions – Exclusions are the things that an insurance policy will not cover.

Grace Period – This is the amount of time a person has to pay for their health insurance premiums before their coverage is cancelled. This is important if your state or insurance company rules require that you not have any gaps in your coverage, and especially important if you do not want to lose your coverage because of non-payment.

Lifetime Maximum – This is the most amount of money a health insurance policy will pay for the entire life term of the policy. There are different individual lifetime maximums and family lifetime maximums, so pay attention to both amounts.

Out-of-Pocket – This is exactly what it sounds like: The amount of money the insured pays out of their own pocket. The term may be used to refer to how much the co-payment, coinsurance, or deductible amounts are. The term annual out-of-pocket maximum refers to how much the insured would have to pay for the whole year out of their pocket not including premiums.

Pre-existing Conditions – This term refers to health conditions, ailments, or situations that exist before an individual obtains a health insurance policy. Group plans do not prejudice based on pre-existing conditions, but individual health plans generally require that health questionnaires be filled out and a medical exam to test for pre-existing conditions be completed before an individual applies for coverage. Individual plans will often deny or limit coverage based on the results of their findings, especially in the case of pre-existing conditions. This is a major difference between group and individual health insurance plans.

Waiting Period – This is the amount of time a person must wait until health insurance coverage becomes available or they are eligible.

For more information on individual health insurance please visit Premier Insurance Services of Chicago for a free Chicago health insurance quote.

If you’re frustrated with the amount of money being deducted by your employer from your paycheck each month for health insurance, you may have considered going out on your own and buying your own individual health insurance at one point or another. Or perhaps your employer has hit upon hard times and decided that they can no longer provide you with health insurance. In either case, you might want to crunch some numbers and see if buying your own health coverage is a smart, money saving option.

Doing Your Homework

Some people may not even realize how good they have it until they leave their job and try to buy their own insurance. In most cases, they can’t afford to purchase comparable coverage on their own. That’s because large businesses and corporations benefit from buying in bulk and try to pass that benefit on to their employees. That’s why they call it a benefit. Employers are trying to use their benefit package to attract and keep good employees.

There’s also no guarantee that you will be accepted for an individual policy. Individual plans are more restrictive and pre-existing conditions may exclude you from consideration of coverage by some individual health insurance companies. Do your homework, though. Some states have “guaranteed issue” laws that require health insurers to offer you a policy regardless of which medical problems or background you have. Check your local laws and regulations before you decide to make the jump. Individual insurance providers may also increase your rates over time as you age, so take that into consideration as well.

Think Price

Price is probably the main reason you want to shop around for your own coverage, so you should know ahead of time that you can shop for bargains on premiums, which can sometimes vary by as much as 50 percent for the same person with the same health background and age, depending on which company you are getting a quote from.

Don’t fall into the belief that you’re healthy and can save all of your money by foregoing coverage completely, either. All it takes is a one serious accident to put you into “medical bankruptcy.” You can also lose your rights to coverage of pre-existing conditions if you go without insurance for 63 days or more, a time period set by the Health Insurance Portability and Accountability Act (HIPAA).

Here’s a list of questions to ask when shopping for individual health insurance:

1. Do you want to keep your doctor? – Finding a good doctor whom you enjoy working with is important. That’s why you want to make sure that you can keep your doctor when you switch from your employer provided plan to your own individual provider.
2. What are your anticipated health care needs? – Think of the services you use regularly. Do you need optical, dental, chiropractic? Do you or members of your family need some type of special, regular care for a particular health condition? Will you be covering your children or a dependant parent? Will your needs increase over the next few years, in turn increasing your premiums or costs?
3. What can you afford? – You’ll need to figure out two different average yearly costs for your healthcare. One is the premium, and the other is your out of pocket costs. Each one can affect the other. A higher premium may lower your out of pocket expenses and vice versa. You’ll need to figure out what will fit within your budget. You’ll also need to figure out if the amount you’ll pay will end up being less than the amount your employer is currently deducting from your paycheck.

It’s incredibly important to find out all of the specifics for any health insurance plan you’re looking at. Here are some key areas to look at:

• See if the plan covers prescriptions and x-rays. Prescriptions are the most often used part of a health plan. X-rays are routine parts of many treatments and can become expensive if not covered.
• Make sure specialists are covered if you use them. This includes alternative medicine such as acupuncture or other specialties such as chiropractors and psychotherapists.
• Find a comprehensive plan that covers more even if the deductible is higher. You might be able to find a cheaper plan than your employer offers, but don’t sacrifice key coverage such as hospital stays, which can get pricey.
• Ask what the costs are for emergency care. This includes co-pays and deductibles. Also be sure to read the fine print on what your provider defines as “emergency care” as these definitions can and do vary from one provider to another.

This is by no means an exhaustive list of considerations to look at or questions to ask. Do your own homework and research all of your options carefully. Make sure that any “deal” you are offered is really worth gambling your family’s health on. If you are a careful shopper, you might be able to put a little extra money in your pocket each month.

For more information on individual health insurance please visit Premier Insurance Services of Chicago for a free Chicago health insurance quote.

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There is another health insurance option for Americans, however. As more companies have found it necessary to shift the costs of health insurance to their employees to help with their bottom lines, more workers are finding that they can seek to opt out of their employer provided insurance and strike out on their own by buying private individual coverage instead. For years this was a difficult prospect for most people as it was far too expensive to make it worthwhile. In recent years, however, individual insurance providers are finding that more people want to use their services and have adjusted their rates to make this a far more affordable option.

According to a Kaiser Family Foundation report, employer-sponsored health-care costs have risen between six and nine percent yearly over the last few years. Contrast that to what employers pay, on average, which equals about $3,785 a year for single-person coverage and $8,824 for family coverage. In turn, they pass 16% of that premium on average to their individual employees and 28% of it to families. Smaller employers, who cannot foot as much of the bill as large corporations, often charge their employees less for single coverage and more for family coverage. The situation is expected to get worse, as 40% of large employers say they are “very likely” to require more contributions from their employees for health care in coming years.

So is it worth your while to dump your company plan in favor of individual insurance coverage? The answer is: Not so fast. It’s incredibly important to get a clear value of your existing coverage from your employer or Human Resources department first along with a good estimate of how much is being deducted from your paycheck each week to cover these costs. With that information in hand, you can do some hunting for individual insurance with a realistic idea of how much money you can save (or lose) by dumping your work insurance.

Here are some of the pros of making the switch to individual insurance:

Keep more money in your pocket – It is possible for healthy families to find competitively priced insurance coverage on the open market. According to the website eHealthinsurance.com, the average individual insurance premium for a single person in California, for example, is just $139 a month, while family coverage costs $357 a month. In most cases, these individuals would pay several hundred dollars more per month through their employers.

Pay for only what you need – With many employer provided plans you don’t have a lot of choices or options. On the private market you have more of an ability to choose the coverage you need and ignore the coverage you don’t.  Paying for only what you need can save hundreds of dollars per month.

Take your coverage with you – When you buy your own insurance you won’t be subject to the volatility of changing jobs or layoffs. If you change jobs often, you have to take the gamble that comes with gaps in your coverage either.  There are no coverage gaps if you buy your own insurance. You also won’t feel like you have to stay at a dead end job just to keep your good health benefits.

There are some definite negatives you should be aware of as well:

Less coverage – Dollar for dollar, employer plans provide more coverage than individual plans. On the individual market you may pay less, but you’ll usually get less. Employer subsidies definitely work in your favor in a lot of cases.

Stricter rules – You could be out of luck with private insurance if you have a pre-existing condition. Employer plans must insure everyone in their plan, but individual plans can reject you for many different reasons.

Rates can increase – Premiums for individual insurance can rise with age, so you may be saving money by buying an individual plan now, but farther down the road you may wish that you stayed with your company provided insurance.

After heeding all of this advice, if you do decide to forego your employer’s health insurance plan, be sure that you have secured an individual policy first. The worst thing you can do is lose your coverage and have to wait until your company’s next enrollment period to get back in. Be smart and do your homework. Crunch the numbers and make sure that individual insurance is right for you. If done right, you could save a lot of money.

For more information on individual health insurance please visit Premier Insurance Services of Chicago for a free Chicago health insurance quote.

As with all life policies the primary reason for purchasing this policy is for death benefit.  Let’s cover the specific benefits.

Tax-Free Death Benefit – Under current tax laws, individual life insurance proceeds are income tax free to the beneficiaries.

Tax- Deferred Account Growth- The policy’s value earns interest on a Tax Deferred Basis.  Each company has varying interest rates and varying guarantees.

Security-A life insurance policy is generally purchased to protect one’s loved ones from hardship in the event of the death of the insured individual.

Flexibility-The insured determines the amount of insurance that they need based on their specific circumstances.  An advisor can help you determine that amount.  The Death Benefit of a UL may be adjusted up or down, unlike other life insurance products.  This is a wonderful benefit and very appealing to people of all ages.

Eligibility-The named insured must qualify health wise in order to obtain any coverage.  Generally the higher the death benefit amount, the more stringent the underwriting requirements.  See your agent for details

If you are looking for more information about Life Insurance coverage, please fill out one of our Chicago Life Insurance Quote forms.

Personal Property

Your personal property is covered while it is in your home or with you away from home.  Some renters policies cover you throughout the world.

Your personal property is covered against similar perils that a home would be covered for.  These perils are:

1. Fire or lightening
2. Weight of ice, snow or sleet
3. Smoke
4. Theft
5. Vandalism or malicious mischief
6. Explosion
7. Sudden or accidental tearing of heating and cooling systems
8. Freezing /bursting pipes and subsequent damage
9. Sudden discharge from plumbing or appliances

Liability

This coverage pays for your legal liability up to the limits of the policy for damages that you are responsible for due to bodily injury, property damage, etc.

Medical Payments

This coverage pays for medical expenses for individuals that are on your premises with your permission (up to the limits of the policy)

Loss of Use

This coverage pays additional living expenses incurred as a result of your home being uninhabitable due to an insured loss.

Inflation Coverage

This coverage automatically increases the amounts  of insurance coverage’s on your policy based on the rate of inflation.

Deductible

The deductible is the portion of the covered loss that the client is responsible for, prior to the insurance company paying any monies.  Deductibles are typically $500, $1000, $2000, etc.

Costs

Renters insurance is relatively inexpensive, compared to Homeowner’s or auto insurance.  Usually less that $10/month.

It only takes a few minutes to get a Chicago Renters Insurance quote.    Isn’t it worth that to protect your personal property which is usually valued at $20,000 or more to replace.  Take That minute!!

Property Coverage -A unit owners policy insures your property, including building additions and installations which are part of your unit are covered. Upgrades to your unit, as well as fixtures that you add, may not be covered under the Master Policy.

Personal Property - This insurance coverage protects your personal property in your home. Good examples of that are clothes, furniture , electronic equipment, dishes, etc. Anything that if you turned your unit upside down-they would fall out.

Loss of Use - If a loss occurs on your property and you can’t live in your unit you could need somewhere else to stay. Part of the coverage in our policy is the loss of use coverage. This coverage will cover the necessary expenses to continue living in the style in which you were living. Coverage may be stated as a maximum dollar amount or a specified period of time.

Loss Assessment - This coverage protects the owners of an association in the event that they are assessed for certain types of losses. An example is that the Association incurs a major fire loss and their deductible is $25000. Each unit owner may be assessed a dollar amount to help cover the Master Policy Deductible.

Personal Liability Coverage – Liability coverage protects the unit owner in others make a claim against them for bodily injury or property damage. This coverage is either in your home or elsewhere. This coverage also pays for defense costs.

Medical Coverage – This coverage pays for medical expenses for guests of the unit owner if they are on your premises and are injured accidentally.

There are many additional coverage’s available. Check with your insurance agent to discuss your family’s needs or click here to get a free Chicago Condo Insurance quote on our website.