Showing posts with label group health insurance. Show all posts
Showing posts with label group health insurance. Show all posts

Thursday, March 6, 2014

Group Health

Group Health Info from Federated Insurance

Federated Insurance

Group Health

Value-Added Group Health Products


Federated’s group health insurance plans called Federated Health Choice® (FHC) are specifically designed for small- to medium-sized businesses. Our plans are available in these states (highlighted in maroon):
Contact your Federated representative in these states for more information or a quote for Federated Mutual® group health insurance plans. See Locate Your Federated Representative.
Federated Health Choice® is offered exclusively through your local Federated representative and includes group medical,life, disability income, and dental plan options.
Group Medical

Group Health Products with Value-Added Service

Federated offers business owners affordable employee benefit plans with choices. Our plans include these features:
  • Plans of choice – Preferred Provider Organization (PPO) – You choose your provider – no referrals needed, no gatekeepers.
  • National PPO Networks – Network doctors available to you while traveling, on vacation, or for children away at school.
  • Open formulary list for prescription drugs – No list that omits certain drugs.
  • Case management for catastrophic claims – We work with you and your providers to make sure care is appropriate and cost-effective.
  • Claims service with personalized, individual attention – When you call our claims office, you speak with a friendly, caring person.

Value-added premium savings choices

  • Employee Choice—Federated offers employers an opportunity to buy multiple plans for their employees while contributing a defined amount of premium. This allows the employer to better control costs while offering choice to each employee.
  • Quality service – Local marketing representatives offer quality products and service for all lines of coverage you choose to purchase from Federated.
  • Medical management program – Helping you get the right care at the right time in the right setting. Federated partners with a utilization management program to help you make an informed decision about the appropriateness of the care you receive.
  • Prescription drug plan – Federated works with Express Scripts, a leading provider of prescription benefit services in the United States. As one of the nation’s leading prescription benefit managers, they are recognized as being at the forefront of pharmacy and medical cost management. Use of preferred brands on your drug list may save you money.
  • Defined Reimbursement Plans (DRP) – A DRP offers options to help you and your employees control health care expenses.Freedom Services is available to provide administration services for your DRP.
  • Vision discount program – Federated offers this program through Careington International, one of the largest, most comprehensive, privately-held discount health care companies in America. The program provides significant savings opportunities across a broad spectrum of vision products and services.
More than 100 local, state, and national trade associations recommend Federated’s group products to their members.

Group Dental

Sign On

Dental Coverage for Your Employees

Many employers like to offer their employees dental coverage along with their group medical benefit. Group dental insurance is available to businesses with five or more employees covered under a Federated Group Medical Plan. Firms with 50 or fewer employees that do not purchase dental coverage will be issued a dental policy to provide the pediatric dental coverage required as an essential health benefit by the Affordable Care Act (ACA) for those age 18 and under.

Benefit options available

  • $500 for each covered individual (per calendar year)
  • $1,000 for each covered individual (per calendar year)
  • $1,500 for each covered individual (per calendar year)
  • $2,000 for each covered individual (per calendar year)

Calendar-year deductible

  • For each insured family member - $50
  • Aggregate family deductible - $100
The deductible does not apply to preventive services.

Coinsurance

  • Dental plan pays 100 percent of preventive services
  • Dental plan pays 80 percent of basic services
  • Dental plan pays 50 percent of major services
Contact your Federated representative for more information on all Federated Group Plans.

Group Life

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Do Your Employees Have Life Insurance?

You can include life insurance among your employee benefits with a Federated Group Life Insurance plan. This important protection is available to businesses covered under a Federated Group Medical Plan.

Level amount option

Employer chooses a flat amount of coverage for all employees, with amounts between $15,000 and $50,000 (or up to $100,000 if 10 or more employees are enrolled).

Class-based amount option

Employer chooses the schedule. The amount for each employee is based on the employee’s occupation or position – $15,000 to $50,000 (or up to $100,000 if 10 or more employees are enrolled).
Accidental death and dismemberment coverage is included for both the level amount and class-based options.
Contact your Federated representative for more information on all Federated Group Plans.

Group Disability Income

Protection When You Can’t Work

Disability income protection is important to your employees if they can’t work because of an illness or injury. Federated offers a group disability income plan, available to businesses covered under a Federated Group Medical Plan.
You can select from Weekly Income Benefit schedules for 26 weeks:
  • $100
  • $150
  • $200
  • $300
  • $400
  • $500
The amount in the schedule is paid for time lost from work due to illness or injury not covered by workers compensation.
Payments are limited to two-thirds of an employee’s weekly earnings up to a maximum of $500.
Contact your local Federated representative for more information on all Federated Group Plans.

Health Care Reform

Patient Protection and Affordable Care Act (“PPACA” or “ACA”)

Enacted March 23, 2010
The highly publicized health care reform bill (Patient Protection and Affordable Care Act (PPACA or ACA) – what is commonly known as Health Care Reform (HCR) is now law and the arduous task of interpretation and implementation has begun.

ACA only created the outline for what will happen over the next several years – most provisions take effect in 2014 and many do not come into play until years after that. It is only as regulations implementing ACA are written that we are beginning to know what it really means. Regular updates will be posted to this website. This site will provide you with links to information from the various sources involved in implementation of HCR. This information will help you determine how ACA may affect you and your employees.

Affordable Care Act – General Information

Affordability

Age Rating

Employer Penalties

Essential Benefits

Exchanges

Fraud

Grandfathered Plans

Guarantee Issue

Health Care Costs

Health Insurance Tax

Medical Loss Ratio

Notices

Personal Coverage Requirement

Preventive Care Benefits

© 2005-2014 Federated Mutual Insurance Company. All rights reserved.

Lewis Insurance
2525 S. Lamar Ste 11
Austin, TX
78704

www.austinhealthbrokers.com
www.nationwide.com/joshlewis
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Monday, February 24, 2014

Individual and Family Health Plans

Health Insurance plans for BXBS



Individual and Family Plans

Choosing the right individual health insurance plan to fit your needs is important to you and your family. Compare our insurance plans to find the coverage you need, and get a quick quote before you apply.

All of our plans follow the Affordable Care Act guidelines and provide the same set of essential health benefits, quality and amount of care. The differences are how much your premium costs each month, what portion of the bill you pay for things like hospital visits or prescription medications, and how much your total out-of-pocket costs are.
If you need major medical coverage before Jan. 1, 2014, contact the sales call center or an authorized agent.

Platinum Plans


To help you compare all of the platinum plans, we are providing the Summary of Benefits and Coverage (SBC) documents below. These SBCs describe key features such as the covered benefits, cost-sharing provisions, and coverage limitations and exceptions.
All platinum plans offer the same set of essential health benefits, quality and amount of care. The differences are how much your premium costs each month, what portion of the bill you pay for things like hospital visits or prescription medications, and how much your total out-of-pocket costs are.
Platinum plans have the highest premium and often the lowest out-of-pocket costs. In most cases, platinum plans cover 90% of costs, while you cover 10%.
Information in these SBCs represents an overview of coverage. It is not a complete list of what is covered or not included. Information may change. The full terms of coverage are located in the insurance policy.

Gold Plans


To help you compare all of the gold plans, we are providing the Summary of Benefits and Coverage (SBC) documents below. These SBCs describe key features such as the covered benefits, cost-sharing provisions, and coverage limitations and exceptions.
All gold plans offer the same set of essential health benefits, quality and amount of care. The differences are how much your premium costs each month, what portion of the bill you pay for things like hospital visits or prescription medications, and how much your total out-of-pocket costs are.
Gold Plans have a higher monthly premium and often lower out-of-pocket costs than silver plans. In most cases, gold plans cover 80% of costs, while you cover 20%.
Information in these SBCs represents an overview of coverage. It is not a complete list of what is covered or excluded. Information is subject to change. The full terms of coverage are located in the insurance policy.

Silver Plans


To help you compare all of the silver plans, we are providing the Summary of Benefits and Coverage (SBC) documents below. These SBCs describe key features such as the covered benefits, cost-sharing provisions, and coverage limitations and exceptions.
All silver plans offer the same set of essential health benefits, quality and amount of care. The differences are how much your premium costs each month, what portion of the bill you pay for things like hospital visits or prescription medications, and how much your total out-of-pocket costs are.
Silver plans have a higher monthly premium and often lower out-of-pocket costs than bronze plans. In most cases, silver plans cover 70% of costs, while you cover 30%. Silver plans are the only plans that offer cost sharing discounts. These discounts help lower the out-of-pocket costs like your deductible, copayment and coinsurance.
Information in these SBCs represents an overview of coverage. It is not a complete list of what is covered or excluded. Information is subject to change. The full terms of coverage are located in the insurance policy.

Bronze Plans


To help you compare all of the bronze plans, we are providing the Summary of Benefits and Coverage (SBC) documents below. These SBCs describe key features such as the covered benefits, cost-sharing provisions, and coverage limitations and exceptions.
All bronze plans offer the same set of essential health benefits, quality and amount of care. The differences are how much your premium costs each month, what portion of the bill you pay for things like hospital visits or prescription medications, and how much your total out-of-pocket costs are.
Bronze plans have the lowest monthly premium and often the highest out-of-pocket costs. In most cases, bronze plans cover 60% of costs, while you cover 40%.
Information in these SBCs represents an overview of coverage. It is not a complete list of what is covered or excluded. Information is subject to change. The full terms of coverage are located in the insurance policy.

Catastrophic Plans


To help you compare different plans, we are providing the Summary of Benefits and Coverage (SBC) documents below. These SBCs describe key features such as the covered benefits, cost-sharing provisions, and coverage limitations and exceptions.
Catastrophic health care plans are available for people under 30 and to some low-income people. A catastrophic health insurance plan has a lower premium than other health plans, but has a high deductible. It is meant to serve as a "safety net" to cover large medical costs in case of a serious illness or injury.
Costs vary by deductible, coinsurance, copayment, out-of-pocket expenses. Some plans qualify for a cost-sharing discount which can lower your monthly costs. Cost sharing discounts vary by plan, income level and Native American status. See details in the Summary of Benefits and Coverage.
Short-Term Plans
Short-term health insurance can give you temporary coverage for 1-11 months. It covers many of the most costly health care services and keeps you and your family protected.
Dental Plans
If you enroll in a Blue Cross and Blue Shield health plan, you may be eligible to enroll in a dental plan. For more information, call us at 1-888-697-0683.
A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association.
© CopyrightHealth Care Service Corporation. All Rights Reserved.

Lewis Insurance
2525 S. Lamar Ste 11
Austin, TX
78704

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Tuesday, February 11, 2014

Affordable Health Insurance Is The Name Of The Game

Everything you need to know about Health Insurance from State Farm

State Farm

INSURANCE
Affordable Health Insurance is the Name of the Game


Make a Play for State Farm® Health Insurance Plans

You buy health insurance plans for the same reason you buy other types of insurance — to protect your family.
State Farm Mutual Automobile Insurance Company offers various types of affordable family health insurance, so you can choose the plan that best suits your personal situation.

Pick the Plan That's Right for You

Primary medical insurance coverage, designed for people who don't have this type of coverage through their employer or another group.

Individual Medical Coverage

Primary medical insurance coverage, designed for people who don't have this type of coverage through their employer or another group.
Learn more about individual medical health insurance

Medicare Supplemental Insurance

Medicare Supplemental Insurance is designed for senior citizens who participate in Medicare. It provides additional coverage to help with many of the expenses that Medicare does not pay.
Learn more about Medicare Supplemental plans

Medicare Part D Coverage

Medicare Part D is prescription drug coverage available to those enrolled/eligible for Medicare Part A and/or Part B.
Learn more about Medicare Part D

Supplemental Health Insurance

Supplements primary health insurance coverage by providing you with a pre-determined benefit amount for those extra, unbudgeted expenses that arise.

Benefits may be Paid for Necessary

  • Hospitalization
  • Accidental injury
  • Outpatient surgery
  • Extended care
  • Intensive care
*Specifically, Hospital Income Policy, Hospital Indemnity Policy, Hospital Confinement Indemnity Policy, Supplemental Hospital Indemnity policy.
Learn more about supplemental health insurance
Relax … We Have Health Insurance Plans to Meet Your Needs

Talk to Us About Individual Medical Health Insurance

Individual health plans are designed to address all of the health insurance needs of our individual customers. Through a marketing agreement with Assurant Health (Time Insurance Company, Milwaukee, WI), your State Farm® agent may be able to help you with:
  • Individual medical insurance coverage (including health plans which can be used with a Health Savings Account).
  • Short term medical coverage.
  • Fixed Indemnity Plan with a limited benefit.
Help Pick Up Where Medicare Leaves Off


Talk to State Farm® Mutual Automobile Insurance Company About Medicare Supplement Insurance

Medicare Supplemental Health Insurance

The purpose of this communication is the solicitation of insurance. Contact will be made by an agent/insurance producer or insurance company.
Explore Humana's Medicare Advantage Plans

Medicare Advantage Plans - Medicare Part C

Looking for information on Medicare Advantage Plans?

It's important you know what options are available when selecting your Medicare health benefits. You can enroll in Original Medicare or select from a variety of Medicare Advantage plans that include prescription drug coverage and other benefits that may better fit your health care or financial needs.
State Farm® has joined with Humana® in an alliance to offer Medicare Advantage Plans. These simple and easy to use plans may also include prescription drug coverage and other valuable benefits.

Medicare Advantage Plans

Humana's Medicare Advantage plans offer more benefits than Original Medicare. These include prescription drug coverage that is the same as or better than Medicare's defined standard drug plan, so there is no need for a separate prescription drug plan or Medicare Supplement plan. Humana's Medicare Advantage plans also offer services which may save you money and help you manage chronic health conditions.

Different Plans for Different Needs

Humana offers the following Medicare Advantage plan choices. Not sure which plan is best for you? Just think about what you want and need most from your coverage.
Not all Medicare Advantage plans are available in all markets.

Is Flexibility Most Important to You?

Humana Gold Choice (PFFS) plans deliver flexible coverage that's still affordable. Some of the advantages are:
  • You can receive care from any Medicare-approved doctor, specialist, or hospital that accepts Medicare and Humana's payment terms and conditions.
  • Built-in prescription drug coverage that's equal to or better than the standard Medicare Part D plan. In some areas Medicare Advantage plans are available without prescription drug coverage built-in. 
  • Prescription mail-order benefits. 
  • You pay only a fixed amount — called a copayment — or a percentage of your costs — known as coinsurance. Copayments are per visit for primary care physician and specialist offices, or per day for inpatient acute care. 
  • No copayment for most preventive services, including cancer screenings and immunizations. 
  • Most include a fitness program that, in most areas, includes a fitness center membership. 
  • Coverage for emergency care anywhere in the world.
Even though you can choose any doctor, most of our PFFS plans offer some form of a network, either full or partially contracted, which gives you an additional way to save money on your care.
For example, in a plan with a partial network, certain Durable Medical Equipment and home health providers, as well as some freestanding labs and hospitals, have agreed to cover services for an amount that may be lower than the fee charged by out-of-network providers.
If you get covered services from these network providers, you may pay less — even if your coinsurance is the same for both in-network and out-of-network services. However, you may use any Medicare-approved participating provider.

Want to Balance Choices with Your Bottom Line?

HumanaChoicePPO plans can give you freedom to choose and ways to save. With HumanaChoice PPO, you enjoy:
  • Freedom to choose any doctor or hospital that accepts Medicare and Humana's terms and conditions; however, you'll probably pay less for services from in-network providers.
  • All the benefits of Original Medicare — plus much more. 
  • Referral-free visits to any provider nationwide. 
  • Most include built-in prescription drug coverage equal to or better than the standard Medicare Part D plan.1 
  • Most include a fitness program that, in some areas, includes a fitness center membership. 
  • Emergency coverage anywhere in the world. 
  • Affordable co-payments for doctor visits and $0 annual routine physicals.
1 In some areas, Medicare Advantage plans are available without prescription drug coverage.

Looking for Predictability at Affordable Prices?

With Humana Gold Plus you get:
  • Your choice of a primary care doctor from our wide network to coordinate your care*.
  • Coverage for office visits, including annual routine physical exams. 
  • Coverage for medically necessary hospital care. 
  • Preventive services like mammograms and colorectal cancer screening covered at no extra cost to you. 
  • Affordable plan premium and predictable copayments on most services.
* You must use plan providers in your network. It may cost you more to get care from out-of-network providers.

Why Choose Humana?

Humana is one of the nation's largest publicly traded health and supplemental benefit companies. When you choose Humana you're making a smart decision:
  • More benefits than Original Medicare
  • Possible prescription drug savings 
  • Predictable, easy to budget costs 
  • An extensive network of doctors 
  • Years of experience 
  • Outstanding plan extras
As a Fortune 100 company with a solid history in the health industry, Humana is committed to offering valuable benefits, outstanding wellness programs, and reliable customer service.
Founded in 1961, Humana has been a trusted Medicare insurer for more than 25 years, helping the Medicare population manage their health insurance needs.
When you choose Humana for your Medicare coverage, you're choosing a company that has in-depth knowledge and experience with Medicare coverage options:
  • Humana offers Medicare Advantage plans, covering a full range of medical care with a variety of plans.
  • Or, you can supplement existing Medicare with a Medicare Supplement plan or with one of Humana's affordable prescription drug plans (PDP).
Explore Humana's Prescription Drug Plans


Prescription Drug Plans (PDP) - Medicare Part D

Looking for information on Medicare health benefit options?

It's important you know what choices are available when selecting your Medicare health benefit options. You can enroll in original Medicare or select from a variety of other Medicare Advantage health plans that include prescription drug coverage and other benefits that may better fit your health care or financial needs.
State Farm® has joined with Humana® in an alliance relationship to market Medicare Prescription Drug Plans – a plan that helps you balance your prescription drug needs and budget.

Managing out-of-pocket costs

When you choose a Humana Medicare PDP, you receive guidance to help you understand how Medicare Part D works, and how you can save money on your prescriptions. Plus, Humana makes it easy for you to keep track of your prescription drug costs. Each month you fill a prescription, you'll receive a SmartSummary RxSM statement that shows the prescriptions that you bought during the month, and their cost, including tips on saving.

Different plans for different needs

Humana offers stand-alone Medicare Prescription Drug Plans (PDPs) to help you balance your prescription drug needs and budget. Stand-alone PDPs let you add drug coverage to your Original Medicare or your Medicare Supplement plan. There are three plans available in most regions; two plans in PR.

Humana Walmart Rx Plan (PDP)

A prescription drug plan that features the lowest monthly plan premium nationwide, $12.60 ($12.50 in Alaska) of all Medicare Prescription Drug Plans. In-store copays as low as $1 on certain generics at preferred pharmacies after deductible, $310 deductible that applies to tiers 3, 4, and 5. Mail order copays as low as $0 on a 90 day supply of Tier 1 and Tier 2 drugs.

Humana Preferred Rx Plan (PDP)

A prescription drug plan with preferred retail pharmacy copays as low as $1 after deductible. This plan has a $310 deductible that applies to all tiers. This plan may be best for healthy people with minimum drug needs or for the budget-conscious individual. Mail order copays as low as $0 on a 90 day supply of Tier 1 and Tier 2 drugs.

Humana Enhanced (PDP)

Complete prescription drug plan coverage that features a comprehensive drug list. Fixed copayments and first dollar coverage for all plans to help save you money. Provides a broad drug list and preferred retail network that features both Wal-Mart and Walgreens pharmacies, with preferred pharmacy in-store copayments as low as $2. This plan also features coverage for select brand prescription drugs while in the coverage gap. Check with your agent for plan details.

Why Choose Humana?

Humana is one of the nation's largest publicly-traded health benefits companies. When you choose Humana, you're making a smart decision:
  • More benefits than original Medicare
  • Prescription drug savings
  • Predictable costs that are easy to budget
  • An extensive network of doctors and pharmacies
  • Years of experience
  • Outstanding plan extras
As a Fortune 100 company with a solid history in the health industry, Humana is committed to offering valuable benefits, outstanding wellness programs, and reliable customer service. Founded in 1961, Humana has been a trusted Medicare insurer for more than 25 years, helping the Medicare-eligible population manage their health insurance needs.
When you choose Humana for your Medicare coverage, you're choosing a company that has in-depth knowledge and experience with Medicare coverage options:
  • Humana offers Medicare Advantage plans, covering a full range of medical care with a variety of plans to choose from.
  • Or, you can supplement Original Medicare and Medigap plans with one of Humana's affordable Prescription Drug Plans (PDP).
We understand that you have many choices and we know you're looking for the best value for your health care dollar. We want to help make it easier for you to choose the plan that's right for your health care needs, your lifestyle, and your budget.
Humana is a Medicare Advantage organization and a stand-alone prescription drug plan with a Medicare contract. Enrollment in a/this Humana plan depends on contract renewal. The benefit information provided is a brief summary, not a complete description of benefits. For more information, contact the plan. Limitations, copayments and restrictions may apply. Benefits, formulary, pharmacy network, premium and/or copayments/coinsurance may change on January 1 of each year. This is not a complete listing of plans available in your service area. For a complete listing please contact 800-MEDICARE or consult www.medicare.gov (TTY users should call 877-486-2048), 24 hours a day/7 days a week. You must use network pharmacies, except under non-routine circumstances. Quantity limitations, copayments, and restrictions may apply.
Easy Does It — We'll Help You Plan for Unexpected Health Expenses

Talk to Us About Supplemental Health Insurance

Supplemental health insurance can help families deal with the extra costs associated with hospital stays. Things like:
  • Deductibles and co-insurance amounts
  • Private room and private duty nurse fees
  • Extra transportation, lodging, or meals
  • Extra phone calls to friends and relatives
  • Unexpected child care
Not only can the supplemental insurance help pay for things not covered by your primary health insurance policy, but it also has other advantages including:
  • Coverage begins on the first day of the hospital stay; there is no deductible or waiting period,
  • Covered hospital stays are payable for up to one year for the same or related condition, and
  • Reimbursements are paid directly to you, unless you tell us otherwise.
*Specifically, Hospital Income, Hospital Indemnity, Hospital Confinement Indemnity Coverage, Hospital Confinement Indemnity Policy, Supplemental Hospital Indemnity policy and Daily Hospital Confinement Indemnity.
For additional information, please contact a State Farm agent.

Let Us Help Guide You Through the Health Insurance* Claims Process

Filing a health insurance claim is simple and can be done in one of three ways. Pick the option that's best for you.

To File a Claim

Take your bill(s) to your State Farm® agent's office and ask about filing your claim using our "Hospital Income Claim Express" process.
OR
Call our Health Response Center at 866-855-1212 to request a claim form.
OR
Fully complete, sign and date the claim form and attach itemized bill(s) for the treatment received. Mail the information to one of the addresses listed below.
State Farm Insurance Companies
Greeley Health Operations Center
P.O. Box 339403
Greeley, CO 80633-9403

OR
State Farm Insurance Companies
P.O. Box 3070
New Albany Health Operations Center
Newark, OH 43058-3070

Considering Health Policy Changes?

If you are contemplating any change to your State Farm® health insurance policy, we strongly urge that you first contact your State Farm agent who will be happy to assist and advise you.
If, for any reason, your State Farm agent is unavailable, you may initiate a change by completing, printing, signing (if required), and mailing the appropriate Request Letter below.
Please do not submit your policy with the Request Letter. For security purposes, we are unable to accept Request Letters sent via email.
If you have a health policy through Assurant Health, please do not use this Request Letter, but contact Assurant Health at 888-853-3267.
Request Letter [PDF-62.3KB]
(Mail the Request Letter to your State Farm agent or the appropriate Health Operation Center listed on one of the tabs below.)
Related Links

© Copyright, State Farm Mutual Automobile Insurance Company, 2013.


Lewis Insurance

2525 S. Lamar Ste 11

Austin, TX

78704


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