Florida Health Insurance Broker

 

Florida Health Insurance Broker

You’ll probably find that just like with shopping for a Lawyer, doctor. even a plumber most Florida health insurance agents simply do not know what they are doing. With health insurance agents compensation being cut by 50% by healthcare reform you must make sure you do your due diligence and find an agent who simply knows what he’s doing. One of the most important facts about Florida health insurance agencies and insurance rates is that medical insurance premiums in the state of Florida are filed with the state insurance commissioner. So it doesn’t matter if you speak to 20 agents,  the same plan with the same benefits you will get the same rate. Many people still think they can save money by purchasing insurance directly from the carrier, however you would need to call every carrier, all for the major Florida health insurance companies and know which questions to ask. As a broker with Aetna -Blue Cross -CIGNA -Humana and UnitedHealthOne it really doesn’t matter to me which carrier a client signs up with as long as it is the plan that  makes sense for that client.   Something to look out for–Blue Cross and Blue Shield of Florida has a deal where they want their agent to only offer them first. So if you go to another website and fill out a quote report request form and then an agent calls you or e-mails you Blue Cross Blue Shield plans know that they are contractually obligated to recommend Blue Cross first and foremost, and then if you don’t take the Blue Cross policy or are declined then they could offer you another plan from some other carriers such as Humana CIGNA Aetna and United healthcare. This arrangement certainly is not in the client’s best interest. This is great if you know beyond the shadow of doubt that you want a Blue Cross plan, but if you’re like 90% of the folks on online looking for florida health insurance insurance quotes you looking for guidance and unbiased recommendations. Here at Floridahealthinsurancenow.com, we take a look at every Florida health insurance carrier and make the best recommendation possible. If Blue Cross ends up being the best solution for a client we have a relationship with a sister agency who can write that business.       Basic differences between Florida individual and group health insuranceThe Florida insurance Commissioner sets the rules that every Florida health insurance company must abide by. Small group is usually referred to as groups of less than 10 employees and large group is usually 50 or more eligible employees. Florida group health insurance plans are guaranteed issue, meaning you cannot be declined coverage behind because of any kind health issue, nor can they exclude coverage for condition if you have prior creditable coverage ( if you don’t have prior coverage there is usually a six to twelve month waiting period on any pre-existing conditions). Also if you wanted maternity benefits, getting a  group health insurance plan for your business actually is a viable solution because the only individual carrier in Florida  that offers maternity benefits is Blue Cross and Blue Shield. With most Florida group plans maternity expenses are covered the same as any other illness. It’s also quite common for large group health insurance plans to have an open enrollment. So that’s where members can make a plan change once a year and during certain qualifying events such as marriage,  divorce and adoption etc etc. This is an important matter for employees to consider after weighing the options of an individual health insurance plan versus their group medical benefits offered to their employer. A common situation is when an employee must decide whether to add his spouse and children to their group health plan and are only able to drop them once a year. Usually employers do not pay towards the cost of insurance for dependents, this can get quite expensive for the employee. This is why it’s important to verify if your group health insurance plan has an open enrollment period. if you’re contemplating starting up a group insurance plan for your business here are couple bullet points to keep in mind:

• Florida health insurance groups require at least two eligible employees.

 

 

• Most if not all Florida health insurance companies have participation requirements. It’s usually around 75%, that means if you have 10 employees that are eligible to enroll in the plan you must have at least seven enroll or you will be declined coverage or possibly lose your existing coverage because of being below the participation requirement level.

 

  Group health insurance plans are not cheap.These insurance products are guaranteed issue so your individual health history does not come in to play in the same way it does for an individual health insurance plan. It more effects the cost for the entire group versus anyone individual employees. On average it runs $300-$500 for an employee and about 800-2000  a month for a family plan. You might ask why so much when individual Florida health insurance plans are about one third of the cost of of Florida group health insurance policy. The answer is it’s guaranteed issue. You could have cancer -heart issues and take 5 meds  a day but as long as you met the eligibility requirements for a Florida group health insurance plan you would be covered. Think of it like going to your local car dealership, and the finance manager gives you two options either they can run your credit  and offer you 2% interest or they do not run your credit but you would have to pay 25 percentage interest rate, while group health insurance is like paying 25% interest on the used car. It usually is only a good deal for those that are sick and in use of paramount medical services on a routine basis.    

Florida Groups of One Health Insurance Plans

A lot of sole proprietors in Florida work by themselves and of course have a difficult time qualifying for Florida group health insurance plans without any other eligible employees. So what the Florida insurance Commissioner has done is set up an annual open enrollment where Florida business owners can set up a group health insurance plan with just one eligible enrollee. You must apply in the month of August for an October the first effective date. This is the only time of the year when you can set up a group of one in Florida. The cost for a group of one in Florida starts at $700 a month approximately. You may find a few plans around $600 or even maybe $500 but these the are few and far between. Usually a self-employed businessperson in Florida is is looking at a group of one usually due to a pre-existing condition issue. Sometimes it works to where a client has a major heart issue or recent cancer treatment and can’t qualify for an individual health insurance plan so they go with the group of one medical plan since it will cover them with  any pre-existing conditions as long as they’ve had prior creditable coverage.

Limited Benefit Plans

The most popular marketers of these types of plans are AIM Health Plans and Cinergy. These are not actually health insurance, these plans aren’t even governed by the Department of Insurance, so if you have any problems with the plan you need to go to your state attorney general to get any assistance. These are two-part plans. First most of them include some kind of discount card through Multiplan or Beech Street PPO network.   So if you have one of these kinds of plans and your doctor is in the discount or limited benefit network you’re supposed to get the discounted rate the doctor agreed to charge for clients of the discount card company. The discount card portions of plan covers things such as doctors visits, lab bloodwork and any hospital stays. Basically what it does is give you a discount like a coupon where you save so much off your bill if you can pay your doctor the balance at the point of service. Example, doctor is part of the discount card network and gives clients a 30% discount, if you normally are charged a  hundred dollars for an office visit with a discount card a client potentially would only pay $70 for the visit just for illustration purposes. And the second part of the plan, is called an indemnity insurance reimbursement, this is simply a fixed amount such as $50 for an office visit or $500 a day per hospital admissions that is paid directly to the client. As you can see this is not insurance in this sense that when most clients think of health insurance they think of a plan that will cover most of their major expenses. That’s why they call this limited benefits or “Mini-Meds”. while these plans have their place in a limited number of situations they are not an alternative to having major medical health insurance in place, but they could be better than nothing if someone cannot get short-term health insurance or even the government’s PCIP plan.