Health Insurance and Employee Benefits

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    Health Insurance and Employee Benefits - Presentation Transcript

    1. Client Services and Information Golden & Cohen LLC www.Golden–Cohen.com
      • Health Insurance
        • Traditional Plans (HMO, POS, & PPO)
        • Consumer Driven Health Plans (HSA & HRA)
        • Medicare Supplements
      • Other Insurance
        • Dental & Vision
        • Life
        • Short Term Disability (STD)
        • Long Term Disability (LTD)
        • Long Term Care (LTC)
      • Additional Services
        • Employee Assistance Programs (EAP)
        • Wellness Programs
        • COBRA Administration
      • Partner Services
        • HR Solutions
        • Property & Casualty
        • Retirement & Pension
    2.  
      • Golden & Cohen has a 17 year history as one of the Top Producing General Brokers in the Washington Metropolitan Area – with over a 96% annual client retention rate.
      • What is a “General Broker”?
        • A general broker is a broker who works with many different insurance carriers. While most brokers focus on a specific carrier (such as Carefirst) at Golden & Cohen we work with every reputable carrier in the area, to provide our clients with the most accurate view of the marketplace.
      • Benefits of Using a General Broker:
        • Unbiased Opinion of Products
        • Complete Understanding of the Marketplace
        • Flexibility in Plan Design
      Expertise
      • Our Group Client Base spans every metropolitan industry including:
        • Construction Firms, Non Profits, Retailers, Bio-Tech, Restaurants, IT Firms, Financial Planners, Schools, Doctors, Associations, Theatres, and more
      • Over 50% of our service team have previously worked for the large regional carriers - Giving them the advantage of:
        • Direct Contacts with the Carriers
        • Superior understanding of processes associated with:
          • Claims
          • Billing
          • Enrollment
          • Termination
          • Appeals
      Expertise
      • Health insurance administration can be a very involved process. Carrier infrastructure, federal regulations, state regulations, and countless forms all add up to more work for you or your staff.
      • How We Help:
        • Streamline your process
        • Do the shopping for you
        • Help with compliance to state and federal regulations
        • Resolve claims and billing disputes
        • Help process new hires & terminations
        • Proactively “shop-out” renewal before renewal date to shift pressure from client to carrier
      Support
      • Having a broker costs you: $0.00
        • How is that possible?
          • Insurance rates are highly regulated. Brokers are paid commission directly from the insurance carriers. The broker commissions are built into all the rates for every plan.
        • What does this mean for me?
          • The difference between using a broker and not can be huge. For the exact same price you are getting access to all the services a brokerage provides.
          • For most brokerages that means getting someone who passes along information to you once a year – generally at renewal
          • For Golden & Cohen clients it means access to a support team working for you all year long. On all issues concerning:
            • Claims
            • Billing
            • Enrollment
            • Termination
            • Appeals
      Cost
    3.  
      • In choosing a health insurance plan, you have to decide what is most important to you. All plans have tradeoffs.
      • Ask yourself these questions:
        • How comprehensive do you want coverage of health care services to be?
        • How do you feel about limits on your choice of doctors or hospitals?
        • How do you feel about a primary care doctor referring you to specialists for additional care?
        • How convenient does your care need to be?
        • How important is the cost of services?
        • How much are you willing to spend on health insurance premiums and other health care costs?
        • How do you feel about keeping receipts and filing claims?
        • We Pride Ourselves in Our Ability to Balance Cost with Comprehensive Coverage for All Our Clients
      • You also need to know whether the services that a health insurance plan offers meet your needs.
      • We’ll walk you through all the details of each plan’s coverage to eliminate any questions you may have.
      • We always Consider:
        • Life changes you may be thinking about, such as starting a family or retiring.
        • Chronic health conditions or disabilities that you or family members have.
        • If you or anyone in your family will need care for the elderly.
        • Care for family members who travel a lot, attend college, or spend time at two homes.
      • Most health insurance plans provide basic medical coverage, but the details are what counts. The best plan for someone else may not be the best plan for you.
      • For each plan you are considering, find out the following are managed:
      • Physical examinations and health screenings
      • Care by specialists (Referral vs. No Referral)
      • Hospitalization and emergency care
      • Prescription drugs
      • Vision care
      • Care and counseling for mental health
      • Services for drug and alcohol abuse
      • Obstetrical-gynecological care and family planning services
      • Ongoing care for chronic (long-term) diseases, conditions, or disabilities
      • Physical therapy and other rehabilitative care
      • Home health, nursing home, and hospice care
      • Chiropractic or alternative health care, such as acupuncture
      • Experimental treatments
      • What preventive care is offered, such as immunizations for children?
      • What preventative health screenings are offered, i.e. mammograms & prostate exams?
      • No health insurance plan will cover every expense. To get a true idea of what your costs will be under each plan, you need to look at how much you will pay for your health insurance premium and other costs.
        • Do you have a Specific Network of Doctors?
          • If you use doctors outside a plan's network, how much more will you pay to get care?
        • Are there Deductibles?
          • After you have met your health insurance deductible, what part of your costs are paid by the plan?
          • Does this amount vary by the type of service, doctor, or health facility used?
        • Are there Co-payments?
          • Do you have to pay for certain services, such as doctor visits, every time?
        • Are your Prescriptions covered?
        • What are the Annual Maximums and Limitations?
          • Are there any limits to how much you must pay in case of major illness?
          • Is there a limit on how much the plan will pay for your care in a year or over a lifetime? A single hospital stay for a serious condition could cost hundreds of thousands of dollars.
      • You cannot know in advance what your health care needs for the coming year will be, but you can guess what services you and your family might need.
        • We help determine the total cost to you and/or your family for these services under each health insurance plan.
        • Golden & Cohen takes great care in identifying a client’s needs (both medically and financially) and selecting plans that account for these needs.
        • We Welcome the Opportunity to Meet with you.
        • We Want to Learn More about Your Specific Needs to Best Guide you through your Unique Insurance Process.
      • Golden & Cohen is ready to begin helping you and/or your company with your insurance and benefits solutions today by:
        • Preparing a detailed report of the plans currently available to you in the marketplace & explaining the highlights and drawbacks of each
        • Delivering you an analysis of your current benefits situation
        • Creating a proposal outlining the best plans and programs for your needs
        • Beginning to help you with your claims and billing issues
    4.  

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