Since when is being proactive a waste of time? At least it would be a funded mandate through a federal grant, whereas if we are RE-active, Idaho foots the bill. Maybe, just maybe, even if the Supreme Court reverses PPACA, Idaho could benefit from the process of pursuing the exchange.  That would be forward thinking, wouldn’t it?

Why should you care?

If you’ve found the services of licensed agents, me for example, to be helpful in navigating choices, assisting with claims, reviewing coverage in light of your big picture, then you should be concerned about losing those services.  Then you, yes you, need to contact your Idaho representatives now – today – to tell them they better not mess with your choices by squandering Idaho’s only shot at having some say in the process.

If you like one-size-fits-all (ultimately universal) coverage, with the compassion and individualized expertise that comes with the largest bureaucracy on the planet that also happens to be $15 Trillion in debt, then enjoy.  Do nothing.

PPACA has already reduced the pool of  competitive carriers in Idaho.  PPACA has already slashed our compensation by over 50% while actually increasing costs to consumers.   (In other words, those of us who still do this, do it to be helpful, not to get rich – that is essentially impossible.)  Should we not take advantage of what little control Washington, DC is offering?

Great things never happen by doing nothing.  Let’s take control while we still have some.

Most health (and other types of) insurance policies do not go into effect immediately.  Rather, underwriting can take weeks to complete.  Many health insurance plans won’t go into effect sooner than the first of the following month.

Major medical deductibles are usually based on a calendar year.  Synchronizing your policy with the calendar year can simplify tax issues for those who are self employed, and can avoid instances of paying back-to-back deductibles should you be switching from another company.  If you’ve met your CY deductible with your current carrier, then you likely do not want to consider switching mid-year.

Besides, underwriters will not look favorably upon unresolved medical issues on your application. As much as it should not need to be said, the importance of being honest on applications can’t be overstated.  Most health insurers will not incur the hefty expense of pulling attending physician statements (APS) just to underwrite an application.  However, they just might do so in the course of reviewing a significant claim.  If the APS indicates that the medical issue existed but was not stated at the time of application, then there will be no coverage for the claim.  Ouch!  But it makes sense if you think about it.

Back to the present opportunity – apply now to get all your options on the table before festivities consume your time.  Online applications process much more quickly than paper.  Applying for major medical insurance online costs only time – no payment is required.  Even though the application process asks you to choose a particular plan (deductible, etc.) do not worry about that step.  Upon underwriting the application, the carrier will generate an offer letter that lists all the applicable plans and the premium.  The offer letters give the last set of information needed to engage the process of choosing your specific plan.  As independent agents, we’ll help you.

Receiving offers early also arms you with budgeting information you’ll want as you consider other 2012 costs, including paying off holiday bills!

“No benefits are provided for any Normal Pregnancy or Involuntary Complications of Pregnancy for enrolled Eligible Dependent children.  However, tests to determine pregnancy are covered.  All other diagnostic x-ray and laboratory services related to pregnancy, childbirth, or miscarriage are not covered for dependent children.” (Emphasis added)

So, should your 24 year-old daughter marry, she better get her own policy with maternity coverage if she’s wanting to start a family.  Same applies if your teenage daughter is sexually active.  Don’t let the government’s new rules lull you into false assumptions.

Confused?  Then talk to a professional while they are still available, because health insurance reform is partly designed to remove your access to professionals to increase your dependence on Washington, D.C.  Take control while you can.

Here are some key considerations (some general, some geared to the Idaho market):

Even if the individual coverage is from the same company as your group policy, the coverages  are totally separate.  That means separate deductibles, copays, coinsurance, and other limits.  This is especially true for maternity coverage, where in Idaho the deductible on individual plans is separate from the medical deductible.

Individual plans will likely have higher deductibles than group coverage, especially for name brand prescriptions.

Payroll deductions for group premiums are almost always pretax.  Premiums for individual plans will not have a tax advantage unless the dependent is self employed (for details ask your accountant).

Make sure you are comfortable with the PPO network associated with the individual plan.  If you are keen on a particular physician, then check this before applying.

Moving to an individual plan will not credit any current year’s expenses paid toward deductibles or coinsurance.  You are starting over.  This is very important if those types of costs have been significant for your dependents.

Some groups might require you to elect the medical insurance in order to also get the dental or vision coverage.  You need to consider the entire package.  Ask your benefits manager.

Allow a minimum of 2 weeks to apply for individual coverage so you can make an informed decision before your election deadline.

A good independent agent is your friend, and will help you make that informed decision.  Remember, once open enrollment is over, you are committed for the entire plan year, barring an IRS qualifying life change event for a mid year change.

With all of these caveats, it can make loads of sense for some employees to apply for an individual policy for their dependents rather than checking the dependents block on their election form.

So what?

One month later can mean a new pricing quarter — for major medical, companies increase their initial rates every quarter, and not all companies operate on the same quarterly schedule. That extra month can mean paying more for all 12 months than you would’ve had you obtained coverage a month earlier.

Depending on when your last coverage ended, one month could create a gap in coverage of greater than 63 days, which means for adults (and kids on high risk pool plans) that pre-existing conditions can be excluded from coverage for 12 months.

One month without coverage means just that. Murphy’s law could strike, finding yourself with 5 and 6 figure medical bills without insurance. It happens…. Often…which contributes to the mess our society is in when it comes to health insurance.

Dental and vision coverage is usually not life changing should it start a month later. But should you forget your coverage hasn’t started and you incur expenses that turn out not to be covered, it will be more than a little annoying.

Plan ahead. Want coverage Aug 1? Get’r done before playing weekend warrior! Our online applications make it fast and easy!

Until early 2011, Aflac allowed the stacking of two of their plans, but that is no longer the case — the applicant must choose one or the other (I’ve noticed some competitor sites have not been updated to reflect this change).  People who were smart enough to obtain both policies can keep them.  ICU coverage may and should be added, either as a separate plan (Aflac) or rider (Humana).

It is possible to stack a plan from another company as well, e.g. Humana.  However, these plans are disappearing (because they work!).  Case in point – Utah.  Humana no longer offers its Hospital Cash Plan in Utah.  An Aflac plan may be obtained in Utah through a payroll account, but it may not include the initial hospitalization rider, wherein lies most of the benefit for a short period of confinement.  Otherwise, for a Utahn to obtain a supplemental plan with significant maternity benefits, she would need to be on an Aflac group account outside of Utah; or have obtained the plan (Aflac or Humana) while a resident of another state*.  This raises another issue – that of dropping the plan either intentionally or unintentionally.

It is imperative to work with your producer (agent) in order to make informed decisions.  Some people cancel or lapse their plans after delivery without considering the consequences.  Once obtained the policies may be kept for as long as the policyholder wants.  Aflac policies obtained via payroll deduction may be ported with no change in premium.  But should the insured cancel, it is not guaranteed that the insured could obtain the policy again.  This is especially important if the newborn was admitted to the NICU.  Depending on the situation, that child might not qualify for that supplemental policy again. Likewise, the child might have a hard time getting major medical or life insurance coverage, which elevates the importance of the supplement policy the child could have kept.

Bottom line:  plan ahead and consult your producer before making changes to your plans (or moving to Utah).

* Not available in all states, and the list changes – another reason to work with an appropriately licensed producer.

As an independent producer (the term that has generally replaced “agent” and “broker”), I get to choose which companies I represent, and I represent dozens for the purpose of being able to customize solutions with great value. Like people, no company is perfect, yet some tend to shine. I’m proud to represent Aflac.

The Duck is more than just a funny bird. It symbolizes a down to earth company that delivers when its customers need it most. Although Aflac is supplemental insurance, sometimes “supplemental” is an understatement.  I have the privilege to time and again witness how it helps people in drastic circumstances, to see tears of joy, hear sighs of relief, or receive hugs when I hand them a check only days after helping them file their claim.  The Duck — so much more than funny.

NEW - HumanaOne Hospital Cash Plan now available in Colorado!

Contact us to find out why this plan is a no-brainer for young couples

Welcome to East Idaho Insurance! We are your neighbors and trusted advisors right here in East Idaho! Unlike the preponderance of web sites for obtaining quotes (which are always based on best case), this site is the starting point to accessing personal service. We want you to be exceptionally informed. We want your surprises to be pleasant ones!

Our goal is to be your lifelong source for securing best value solutions to your personal and business risks, goals, and dreams. This means that whether we are helping to optimize your wealth, providing insurance coverage for unforeseen events, or even helping you with your business, you can be assured that we will leverage our expertise to provide you with the greatest benefit. You will have peace of mind knowing your family or employees have the best plans for your hard earned dollar, and that your fortune will grow no matter what life or the economy may throw your way.

We are the East Idaho Insurance solution for thousands of grateful customers as we continue to grow and thrive in these trying times. Call us today – together, we will design your solution!

Not from eastern Idaho? Welcome! As much as we focus on our local community, many have recommended us to friends and family in neighboring states, and we are glad to be of service! We are currently licensed in:

• Colorado
• Idaho
• Montana
• Oregon
• Utah
• Washington
• Wyoming

Live elsewhere? Call us, and we’ll do what it takes to help you!

We have been providing East Idaho Insurance to thousands of grateful customers as we continue to grow and thrive in these trying times. Give us a call today to see what we can do for you.

East Idaho Insurance

Whether you are new to insurance and don’t know where to start, or a seasoned professional seeking optimal coverage and service, we are your source for trustworthy advice, service, and reputable companies.

Business Services

We make it easy for business owners to provide benefits for their employees, improve their existing benefits, and plan for the specific needs of owners and key employees.

Here’s an illustration from an actual occurrence:

Employer group ABC allows employees to choose supplemental benefits from two companies, X and Y.  After all, if the companies were equivalent, there would be no point in offering them both.   Yet the employees have little idea such is the case.  Company X leveraged political connections to ensure that it meets with every employee, while keeping representatives from Company Y away.   Company X flies in enrollers who are more than eager to replace Company Y policies with Company X policies.  Many of the employees simply look at the cost of the premium and switch, not realizing the tradeoff.

Disability insurance highlights some of these types of tradeoffs.   Company X representatives were having employees replace Company Y short term disability policies with Company X long term disability policies.

Company X:
• “Group” policy, meaning it is not portable. Should the employee leave the employer, the employee may not keep the policy.
• Available elimination (waiting) periods are long, 4 months or more.
• Disability benefit to age 65, i.e. long term.
• Restrictive definition of disability. Does not pay if able to do any work at all.
• Relatively slow to pay claims.
• “800 number” customer support.

Company Y:
• “Individual” policy, meaning fully portable. Should the employee leave the employer, the employee may keep the policy without a change in cost, and without having to prove insurability.
• Short elimination periods available, even zero days.
• Disability benefit period up to 2 years, i.e. short term.
• Liberal definition of disability. Allows for 100% disability payment even while recovering until able to do 80% of normal work. This is a huge benefit.
• Typically very quick at processing claims.
• Local live customer support in addition to “800 number” support.

The Company X long term disability policy with equivalent monthly benefits for a given person was cheaper than a Company Y short term disability policy.  But is it better value?

The answer is, “it depends.”   For someone who is not concerned about short periods of disability or the possibility of leaving an employer, and who is more concerned about permanent disability, then Company X might be a better choice.   Conversely, someone who would want the benefits sooner and even while working with restrictions, and might want to change jobs or become self employed and not worry about having to qualify for a new policy, then Company Y short term coverage would likely be superior.   Statistically, most disabilities last a few months, such as a broken leg from a skiing accident.  The longer the waiting period, the less likely the policy will yield benefits.

The question is, will an ABC employee grasp this differentiation during a couple minutes with an enroller who has the singular mission of selling policies from Company X?

Say you are an ABC employee.   Do you just want to check off the list that you “covered” a need, in this case disability, or do you want to really know when and how you are covered?  Do you want to know if the agent is local, someone you will actually be able to reach again?   Do you want to know if your agent is captive to selling policies from a single company, or does he have the knowledge, resources, and interest in your overall situation to make objective recommendations?  Does he care if he will see you around town, or does it seem as if he’s glad he’s, as the airline commercial says, “some place else?”

Deciding merely on cost is quick to do, but might be a costly mistake.   Determining value makes for sound decisions, but it takes a few more minutes of your time.  Your call.

Say you had a marketing representative for your business.  This person knows the differences, strengths, and weaknesses among the products from your various suppliers and how to optimize value for your clients so they will be happy and buy more parts from your business in the future.  Like most such positions, compensation consists of commissions because nobody should be paid for taking up space.  Now say the government says that these commissions – which must be earned through new and sustained business – must factor into your maximum percentage of overhead and profit.  Guess what?  You just lost your ability to reward your marketing rep for helping your business excel. 

 Enter PPACA.  This 3000 page law, brought to us by the legislators who’ve run up a $14 trillion debt, is mandating how efficient health insurers must be – called Medical Loss Ratios.  Ponder that. 

 Consequently, insurers have no choice but to cut commissions to agents, and that is happening right now.  Yet can you, the consumer, save money if you bypass an agent and purchase health insurance online from the carrier’s site? 

 No.  The premiums are the same.  And it could cost you dearly if you don’t really know what you are getting. 

 Health insurance companies are already regulated to ensure their solvency – ability to pay claims in a worst case situation.  They can’t print money like Uncle Sam does when it needs more.  At the state level there is also a fund that carriers must pay into in case they can’t meet their claims obligations.  So, there are free market forces and a reasonable degree of regulation and reserves to protect consumers.  But that wasn’t enough for Uncle Sam.  PPACA is not health care reform, it is health insurance reform, and it has done absolutely nothing to reduce true costs. 

 We want you to be informed consumers.  You need to know that the government is systematically eliminating our near term incentive to serve you as agents for health insurance.  However, we will continue to serve you with integrity.  At the same time, we will inquire about your overall insurance needs, such as life insurance, disability insurance, dental/vision & cash plans, and estate planning.  We want you as clients.  Health insurance is becoming a loss leader for developing a trusting relationship to fill other insurance needs. 

This is the plain truth.  You expect that from us, and we deliver.