Health Insurance and Employee Benefits


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Learn more about Health Insurance and Employee Benefits as it relates Golden & Cohen's services and philosophy.

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Health Insurance and Employee Benefits

  1. 1. Client Services and Information Golden & Cohen LLC www.Golden–
  2. 2. <ul><li>Health Insurance </li></ul><ul><ul><li>Traditional Plans (HMO, POS, & PPO) </li></ul></ul><ul><ul><li>Consumer Driven Health Plans (HSA & HRA) </li></ul></ul><ul><ul><li>Medicare Supplements </li></ul></ul><ul><li>Other Insurance </li></ul><ul><ul><li>Dental & Vision </li></ul></ul><ul><ul><li>Life </li></ul></ul><ul><ul><li>Short Term Disability (STD) </li></ul></ul><ul><ul><li>Long Term Disability (LTD) </li></ul></ul><ul><ul><li>Long Term Care (LTC) </li></ul></ul>
  3. 3. <ul><li>Additional Services </li></ul><ul><ul><li>Employee Assistance Programs (EAP) </li></ul></ul><ul><ul><li>Wellness Programs </li></ul></ul><ul><ul><li>COBRA Administration </li></ul></ul><ul><li>Partner Services </li></ul><ul><ul><li>HR Solutions </li></ul></ul><ul><ul><li>Property & Casualty </li></ul></ul><ul><ul><li>Retirement & Pension </li></ul></ul>
  4. 5. <ul><li>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. </li></ul><ul><li>What is a “General Broker”? </li></ul><ul><ul><li>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. </li></ul></ul><ul><li>Benefits of Using a General Broker: </li></ul><ul><ul><li>Unbiased Opinion of Products </li></ul></ul><ul><ul><li>Complete Understanding of the Marketplace </li></ul></ul><ul><ul><li>Flexibility in Plan Design </li></ul></ul>Expertise
  5. 6. <ul><li>Our Group Client Base spans every metropolitan industry including: </li></ul><ul><ul><li>Construction Firms, Non Profits, Retailers, Bio-Tech, Restaurants, IT Firms, Financial Planners, Schools, Doctors, Associations, Theatres, and more </li></ul></ul><ul><li>Over 50% of our service team have previously worked for the large regional carriers - Giving them the advantage of: </li></ul><ul><ul><li>Direct Contacts with the Carriers </li></ul></ul><ul><ul><li>Superior understanding of processes associated with: </li></ul></ul><ul><ul><ul><li>Claims </li></ul></ul></ul><ul><ul><ul><li>Billing </li></ul></ul></ul><ul><ul><ul><li>Enrollment </li></ul></ul></ul><ul><ul><ul><li>Termination </li></ul></ul></ul><ul><ul><ul><li>Appeals </li></ul></ul></ul>Expertise
  6. 7. <ul><li>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. </li></ul><ul><li>How We Help: </li></ul><ul><ul><li>Streamline your process </li></ul></ul><ul><ul><li>Do the shopping for you </li></ul></ul><ul><ul><li>Help with compliance to state and federal regulations </li></ul></ul><ul><ul><li>Resolve claims and billing disputes </li></ul></ul><ul><ul><li>Help process new hires & terminations </li></ul></ul><ul><ul><li>Proactively “shop-out” renewal before renewal date to shift pressure from client to carrier </li></ul></ul>Support
  7. 8. <ul><li>Having a broker costs you: $0.00 </li></ul><ul><ul><li>How is that possible? </li></ul></ul><ul><ul><ul><li>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. </li></ul></ul></ul><ul><ul><li>What does this mean for me? </li></ul></ul><ul><ul><ul><li>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. </li></ul></ul></ul><ul><ul><ul><li>For most brokerages that means getting someone who passes along information to you once a year – generally at renewal </li></ul></ul></ul><ul><ul><ul><li>For Golden & Cohen clients it means access to a support team working for you all year long. On all issues concerning: </li></ul></ul></ul><ul><ul><ul><ul><li>Claims </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Billing </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Enrollment </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Termination </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Appeals </li></ul></ul></ul></ul>Cost
  8. 10. <ul><li>In choosing a health insurance plan, you have to decide what is most important to you. All plans have tradeoffs. </li></ul><ul><li>Ask yourself these questions: </li></ul><ul><ul><li>How comprehensive do you want coverage of health care services to be? </li></ul></ul><ul><ul><li>How do you feel about limits on your choice of doctors or hospitals? </li></ul></ul><ul><ul><li>How do you feel about a primary care doctor referring you to specialists for additional care? </li></ul></ul><ul><ul><li>How convenient does your care need to be? </li></ul></ul><ul><ul><li>How important is the cost of services? </li></ul></ul><ul><ul><li>How much are you willing to spend on health insurance premiums and other health care costs? </li></ul></ul><ul><ul><li>How do you feel about keeping receipts and filing claims? </li></ul></ul><ul><ul><li>We Pride Ourselves in Our Ability to Balance Cost with Comprehensive Coverage for All Our Clients </li></ul></ul>
  9. 11. <ul><li>You also need to know whether the services that a health insurance plan offers meet your needs. </li></ul><ul><li>We’ll walk you through all the details of each plan’s coverage to eliminate any questions you may have. </li></ul><ul><li>We always Consider: </li></ul><ul><ul><li>Life changes you may be thinking about, such as starting a family or retiring. </li></ul></ul><ul><ul><li>Chronic health conditions or disabilities that you or family members have. </li></ul></ul><ul><ul><li>If you or anyone in your family will need care for the elderly. </li></ul></ul><ul><ul><li>Care for family members who travel a lot, attend college, or spend time at two homes. </li></ul></ul>
  10. 12. <ul><li>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. </li></ul><ul><li>For each plan you are considering, find out the following are managed: </li></ul><ul><li>Physical examinations and health screenings </li></ul><ul><li>Care by specialists (Referral vs. No Referral) </li></ul><ul><li>Hospitalization and emergency care </li></ul><ul><li>Prescription drugs </li></ul><ul><li>Vision care </li></ul><ul><li>Care and counseling for mental health </li></ul><ul><li>Services for drug and alcohol abuse </li></ul><ul><li>Obstetrical-gynecological care and family planning services </li></ul><ul><li>Ongoing care for chronic (long-term) diseases, conditions, or disabilities </li></ul><ul><li>Physical therapy and other rehabilitative care </li></ul><ul><li>Home health, nursing home, and hospice care </li></ul><ul><li>Chiropractic or alternative health care, such as acupuncture </li></ul><ul><li>Experimental treatments </li></ul><ul><li>What preventive care is offered, such as immunizations for children? </li></ul><ul><li>What preventative health screenings are offered, i.e. mammograms & prostate exams? </li></ul>
  11. 13. <ul><li>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. </li></ul><ul><ul><li>Do you have a Specific Network of Doctors? </li></ul></ul><ul><ul><ul><li>If you use doctors outside a plan's network, how much more will you pay to get care? </li></ul></ul></ul><ul><ul><li>Are there Deductibles? </li></ul></ul><ul><ul><ul><li>After you have met your health insurance deductible, what part of your costs are paid by the plan? </li></ul></ul></ul><ul><ul><ul><li>Does this amount vary by the type of service, doctor, or health facility used? </li></ul></ul></ul><ul><ul><li>Are there Co-payments? </li></ul></ul><ul><ul><ul><li>Do you have to pay for certain services, such as doctor visits, every time? </li></ul></ul></ul><ul><ul><li>Are your Prescriptions covered? </li></ul></ul><ul><ul><li>What are the Annual Maximums and Limitations? </li></ul></ul><ul><ul><ul><li>Are there any limits to how much you must pay in case of major illness? </li></ul></ul></ul><ul><ul><ul><li>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. </li></ul></ul></ul>
  12. 14. <ul><li>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. </li></ul><ul><ul><li>We help determine the total cost to you and/or your family for these services under each health insurance plan. </li></ul></ul><ul><ul><li>Golden & Cohen takes great care in identifying a client’s needs (both medically and financially) and selecting plans that account for these needs. </li></ul></ul><ul><ul><li>We Welcome the Opportunity to Meet with you. </li></ul></ul><ul><ul><li>We Want to Learn More about Your Specific Needs to Best Guide you through your Unique Insurance Process. </li></ul></ul>
  13. 15. <ul><li>Golden & Cohen is ready to begin helping you and/or your company with your insurance and benefits solutions today by: </li></ul><ul><ul><li>Preparing a detailed report of the plans currently available to you in the marketplace & explaining the highlights and drawbacks of each </li></ul></ul><ul><ul><li>Delivering you an analysis of your current benefits situation </li></ul></ul><ul><ul><li>Creating a proposal outlining the best plans and programs for your needs </li></ul></ul><ul><ul><li>Beginning to help you with your claims and billing issues </li></ul></ul>