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When shopping for an individual health insurance plan for yourself or your family there are many plan and carrier options to choose from.  In fact, the choices can seem overwhelming.  However, if you know what to look for when comparing plans it can make the task of choosing a plan much simpler.

The first benefit feature to compare between plans is the annual deductible.  This is the amount you will need to pay before some or all of the other plan benefits start.  Deductible amounts can range anywhere between $400 and $10,000 and are usually broken down between individual deductible (one member on the plan) and family deductible amount (two or more members on the same plan).  There can be differences between how charges are applied towards the plan deductible so read the fine print so you are not surprised.  The general rule is the lower the annual deductible the higher the monthly premium.

The second benefit to compare is the coinsurance.  Coinsurance is defined as the splitting of medical costs between two parties, in this case you and the insurance company.  The coinsurance amount is usually listed as a percentage and can range anywhere between 90 and 50 percent with the insurance company paying the larger piece.  Again, plans with the smaller percentage of coinsurance that the member is responsible for, the higher the monthly premium.

The third benefit, and arguably the most important plan benefit to compare when shopping for individual health insurance, is the maximum out-of-pocket amount.  This is also sometimes referred to as the stop loss amount.  In the event you incurred an extraordinarily large set of medical bills this is the maximum amount you would be responsible to pay out in unreimbursed medical expenses in a calendar year.  The lower the maximum out of pocket amount, the higher the monthly premium.

The fourth benefit to compare is the prescription drug benefit.  Now days many individual health insurance plans have limited or no prescription drug benefits.  So if you need to fill a prescription and your plan doesn't cover drugs, you will be left to pay for the medication by yourself.  Be aware that even though you might not be taking any prescriptions now, if you ever needed to in the future and your plan didn't cover drugs, you would not have coverage.  Once you become ill it is very hard to upgrade your plan.

The fifth item to compare between plans is the monthly premium.  If money were no object we all would have the best plan a dollar could purchase, however most people live on a budget and premium needs to be considered.

There are many other benefits that are important to examine before making a final decision on which plan is best for you.  However, if you start with the five most important features listed above you will be able to narrow your search down to a limited number of plans that have the right balance of deductible, coinsurance, maximum out of pocket, drug benefit, and monthly premium to fit your needs.

If you have any questions about how to select an individual health insurance plan or if you would like to have a proposal emailed or faxed to you please contact us at 831.459.9140 or at info(at)drewmillerinsurance.com.

With the holidayseason almost upon us and 2010 quickly approaching we wanted to take this opportunity and address some insurance related issues that a new calendar year always brings up. Whether you have an individual or employer sponsored Health Insurance plan, a Life insurance policy, Dental and Vision plan, or some combination thereof, here are a few things to keep in mind as we close out 2009 and usher in 2010.

Health Insurance:
For most policies, your Medical plan’s deductible (or copay maximum amounts for HMO plan holders) and maximum out-of-pocket limits are based on a calendar year regardless of when your coverage became effective. All deductibles, copays, and out-of-pocket maximum amounts will therefore be renewed on January 1, 2010. If you are unsure about your policy please refer to your policy booklet or call our office.

Dental and Vision Insurance:
If you have Dental insurance, your deductible and annual benefit maximum(s) also most likely follow the calendar year and will reset January 1, 2010. If you have Vision insurance this is the only set of benefits that track to your last date of service. For example, if you visited a provider on March 15th of 2009, and your plan provides for an exam every 12 months, you would be eligible for another exam after March 15th 2010.

Health Savings Accounts (HSA):
As set forth by Congress and the IRS, the annual HSA contribution maximums will be changing for 2010. Individual contribution maximums will increase by $50 and Family contributions by $200. If you are age 55 or older your catch-up contribution will remain $1,000. Please refer to the table below.

 

For some, being laid off from a job and in turn losing Group Health Insurance benefits can hurt as much as not receiving a paycheck. If this has happened to you or someone you know it’s important to understand all of the options that are available to you in order to maintain coverage.

In 1986 The United States Congress passed The Consolidated Omnibus Budget Reconciliation Act (better known as COBRA). In essence this law gives workers and their covered dependents the right to continue their current group coverage for a limited time period due to certain life circumstances such as job loss (either voluntary or involuntary), divorce, a reduction in hours causing a change in eligibility, or over-age dependent status among other things.

If you are covered by an employer’s Group Health, Dental or Vision plan, and you’re laid off or choose to leave your position, by law you will be offered COBRA continuation. The cost of coverage varies from 102% of the premium amount if your employer is only subject to Federal COBRA but can be higher if your state has its own COBRA laws. For example, here in California if your employer is subject to California COBRA laws the rate can be as high as 110% of the premium amount.

For a lot of people who are losing coverage and have little or no money coming in, paying 102% or more in order to continue their Health Insurance coverage is just not an option. Congress and the President have tried to address this issue with a limited subsidy provision as part of The American Recovery and Reinvestment Act of 2009. While helpful if you qualify for the subsidy, once it has been exhausted you are still responsible for the full COBRA premium.

So you are finally taking that dream vacation to Mexico, South America, or Europe.  Or maybe you are sending your child away for a semester abroad.  You have spent several months planning the flights, accommodations, and activities.  You even purchased the trip cancelation insurance from your travel agent that protects you in case one of your flights gets canceled.

But wait!  Before you lock up the house and head off to the airport take a moment to consider what would happen if you or a family member were to have an accident or get severally ill while on your vacation.  How would you deal with the emergency?

If you are covered by a traditional health insurance policy, either through your employer or an individual policy obtained on your own, you might have some limited foreign travel benefits.  However, it’s a good idea to check with your insurance company before flying the friendly skies so you understand what is and what is not covered.  Most might be surprised what you find out.

Typically a traditional health insurance policy only provides limited foreign travel benefits.  The limited coverage that may exist usually only applies to true emergency care.  Without a supplemental Foreign Health Travel Insurance policy, if you have an emergency situation while traveling outside of the U.S., you take on the following responsibilities by yourself:

IRS Increases 2010 HSA Contribution Maximums


The Internal Revenue Service (IRS) announced the 2010 annual contribution limits for HSAs and the minimum deductible and maximum out-of-pocket limits for single and family HSA compatible health plans.

Tax Year 2009

Tax Year 2010

HSA Annual Contribution Limits

Single - $3,000
Family - $5,950

Single - $3,050
Family - $6,150

HSA Catch-up Contributions

$1000 per individual age 55 or older

Same as 2009

Minimum HSA Compatible Health Plan Deductible

Single - $1,150
Family - $2,300

Single - $1,200
Family - $2,400

Maximum Out-Of-Pocket Expenses

Single - $5,800
Family - $11,600

Single - $5,950
Family - $11,900

If you have any questions please contact a Drew Miller Insurance Services Agent at 831.459.9140 or by email at This e-mail address is being protected from spambots. You need JavaScript enabled to view it