- Group Health Insurance
- Dental Insurance
- Group Disability Insurance
- Group Life Insurance
- Key Person Life Insurance
- Wellness Program
- Voluntary Benefits
- Network Analysis
- Health Benefits Consulting Services
- Retirement Plans
Group Health Insurance has evolved into a combination of alternatives and options to meet employer, employees and dependents and budgetary needs to these groups. InsuranceCheckRate.com will provide options to ensure that one group of benefit that meets one set of needs while at the same time another set of benefits that uses the concept of group health insurance to facilitate these needs.
For example, the administrative employees may request a high benefit HMO or PPO plan and also a Flexible Spending Section 125 Cafeteria Plan and Voluntary Cancer or Accident plan. The younger subset of this group, may request a High Deductible PPO plan with a Tax Savings Account for themselves and family. Lastly, the remainder to the of the group requests a middle to high benefits PPO for themselves and dependents with the Section 125 Cafeteria plan and a Voluntary Accident plan.
This is why InsuranceCheckRate.com is in touch with you and your employees. To meet individual needs and fiscal boundaries of your organization as a whole.
The incorporation of a dovetail Health Maintenance Organization plans, Preferred Provider Organization Plans, Health Savings Accounts, Health Reimbursement Accounts, Flexible Spending Cafeteria Programs and Voluntary programs make our services unique and competitive.
InsuranceCheckRate.com also ensures your group plan is in compliance with the following:
COBRA: Consolidated Omnibus Budget Reconciliation Act
HIPAA: Heath Insurance Portability Act
NMHP: Newborn and Mothers Health Protection Act
WHCRA: Women’s Health and Cancer Rights Act
MHPA: Mental health Parity Act
Form 5500 Annual Return/Report of Employee Benefits
What is available for Dental insurance for both employer group plans and individuals
and families? Dental plans available fall into three categories: Fee for Service Indemity
plans, Dental Health Maintenance Programs, and Dental Preferred Provided Programs.
The first contracts were first established by Unions and Private Employers.
The real benefit of dental plans is that a quality plan will improve wellness and reduce
the overall general health of individuals by reducing serious illnesses such as diabetics, overweight and improved well being and physical appearance of a person.
InsuranceCheckRate.com will assist in selecting the plan and provider network
truly fits your group needs.
Fee for Service Indemnity Plans:
These plan are what historically used by insurance companies with dentists to pay for dental claims. Insurance companies pay a pre established fee called a Usual and Customary fee to the subscriber and the dentists accept payment from the insurance company. If a Dentist charges a high fee than is paid for by the insurance contract, this overage or balance bill is then charged to the subscriber. The subscriber receives a Pre negotiated percentage paid for services, for example 80% for Basic Services.
Dental Health Maintenance Plans (DHMO)
These plans pay a specific co-payment or fee for the service provided. The co-payment is pre negotiated between the insurance company and dentist. As the dentist provides services, the co-payments are accumulated to create a total charge when the total service is complete. Usually a select panel of dentists is used, this panel is much smaller than the Fee for Service dentists that are available and due to this, the DHMO is usually much better priced for the subscriber.
Dental Preferred Provider Organization
These plans operate with a pre established Usual and Customary fee that there is no balance bill passed on to subscriber since the dentists join a PPO panel in order to receive referrals from both the employer and insurance companies. There is significant cost savings to the subscriber since typically a Fee For Service dentist is utilized. Dental service pre negotiated percentages paid for services enhance the benefits for individuals and families.
Fee for Service Indemnity Plans:
These plan are what historically used by insurance companies with dentists to pay for dental claims. Insurance companies pay a pre established fee called a Usual and Customary fee to the subscriber and the dentists accept payment from the insurance company. If a Dentist charges a high fee than is paid for by the insurance contract, this overage or balance bill is then charged to the subscriber. The subscriber receives a Pre negotiated percentage paid for services, for example 80% for Basic Services.
Dental Health Maintenance Plans (DHMO)
These plans pay a specific co-payment or fee for the service provided. The co-payment is pre negotiated between the insurance company and dentist. As the dentist provides services, the co-payments are accumulated to create a total charge when the total service is complete. Usually a select panel of dentists is used, this panel is much smaller than the Fee for Service dentists that are available and due to this, the DHMO is usually much better priced for the subscriber.
Dental Preferred Provider Organization
These plans operate with a pre established Usual and Customary fee that there is no balance bill passed on to subscriber since the dentists join a PPO panel in order to receive referrals from both the employer and insurance companies. There is significant cost savings to the subscriber since typically a Fee For Service dentist is utilized. Dental service pre negotiated percentages paid for services enhance the benefits for individuals and families.
The financial security one has for oneself and family security can be addressed on the most powerful benefit available, group disability. InsuranceCheckRate.com will ensure that the group disability plans provide the protection and care for an individual and family an affordable option and accessible for both owners and employees. Typically composite rated, both owners and employees gain access that would probably not be affordable on the street.
Short Term Disability: Will typically pay for either accident or illness of up to 60-70% of salary of up 12 to 26 weeks. This benefit also includes a Residual benefit that pays for salary when an employee/owner is only to work part time. Monthly Premium on this plan ranges anywhere from $8.00-$25.00 per person per month depending on the industry.
Long Term Disability: Will typically pay for either accident or illness of usually 60-65% of salary to age 65 after a 90 day waiting period. Included are Cost of Living Adjustment, Return to Work Incentives, Residual benefit, Education Benefits and a Survivor Benefit. Premium range from $18.00-25.00 per head per month.
Dovetailing both LTD and STD congruently creates a seamless and worthwhile benefit.
Short Term Disability: Will typically pay for either accident or illness of up to 60-70% of salary of up 12 to 26 weeks. This benefit also includes a Residual benefit that pays for salary when an employee/owner is only to work part time. Monthly Premium on this plan ranges anywhere from $8.00-$25.00 per person per month depending on the industry.
Long Term Disability: Will typically pay for either accident or illness of usually 60-65% of salary to age 65 after a 90 day waiting period. Included are Cost of Living Adjustment, Return to Work Incentives, Residual benefit, Education Benefits and a Survivor Benefit. Premium range from $18.00-25.00 per head per month.
Dovetailing both LTD and STD congruently creates a seamless and worthwhile benefit.
Group Life Insurance is an inexpensive and valuable benefit that is
offered to employees at a very high benefit and low cost. As an employer,
offering benefits to keep and retain employees is truly one of the secrets of
successful businesses. InsuranceCheckRate.com will ensure that offering a
secure group life benefit for an employee makes the statement that “we want you to
take care of your family” and the organization will be rewarded with loyalty and performance.
Group Life is available up to $50,000 on a tax free basis and 100% of the premium is a business expense. One may also include AD&D coverage as add on to offer benefits for accidents and dismemberments at a very small fraction of the cost.
The employee may elect a beneficiary of a spouse or children and is a much valued benefit for many employees to not carry individual life insurance.
Premiums on this plan vary per industry and usually cost from $5.00 to 12.00 per person.
Group Life is available up to $50,000 on a tax free basis and 100% of the premium is a business expense. One may also include AD&D coverage as add on to offer benefits for accidents and dismemberments at a very small fraction of the cost.
The employee may elect a beneficiary of a spouse or children and is a much valued benefit for many employees to not carry individual life insurance.
Premiums on this plan vary per industry and usually cost from $5.00 to 12.00 per person.
Most small business maintain a partnership, spouse or stockholder that this individual
possess a unique understanding and skill set that without this person, the entity as
a whole would flounder without this person in the event of a death. Investors and
lenders also request this coverage to ensure the continuation of the entity in case of accident or sudden death.
InsuranceCheckRate.com will ensure the Key Person Life contract places coverage so that in the event of a death of one of these unique person, the entity will have financial support to continue operating and replace this skill set.
Premium is typically paid by the employer and usually paid for the life of partnership or until one of the key employees retires or dies. This plan can be transferred to the leaving employee as a retirement benefits or to another key employee.
InsuranceCheckRate.com will ensure the Key Person Life contract places coverage so that in the event of a death of one of these unique person, the entity will have financial support to continue operating and replace this skill set.
Premium is typically paid by the employer and usually paid for the life of partnership or until one of the key employees retires or dies. This plan can be transferred to the leaving employee as a retirement benefits or to another key employee.
The InsuranceCheckRate.com Wellness Programs that helps prevents long term chronic illnesses and provides solutions to maintaining a healthy lifestyle and reduce days missed at work is a program worth implementing. This behavioral program will reduce the
prevalence and severity of possible illnesses which will result in lower claims
costs for your groups health and welfare plans.
Prevention and Nutrition: A program that includes annual checkups, quit smoking, Health eating habits and concepts to handle cold and flu are the cornerstone of a good healthy lifestyle.
Exercise and Fitness that includes a plan for Aerobic, Strength Training and Flexibility plans assist in maintaining a healthy lifestyle that leads to improved body health and reduces the needs for medications on one’s life.
Mind and Body plans include relaxation, imagery, health thinking and time priorities leads to a healthy balance of Mind, Body and work that enhances a truly balanced and positive lifestyle that is good for oneself and those around us.
Prevention of Illnesses is a byproduct of the Wellness program that each person applies. Illnesses such as allergies, cancer, depression diabetics, heart condition, blood pressure can be maintained and avoided with proper Prevention, Exercise, and Mind and Body applications. A recent study monitoring the effects of community based diabetes management program reduces participant claims 18% in the first year and 39% by the end of the fifth year.
Women’s and Men’s Health Issues can be independently address in a quality Wellness program. Women’s issues regarding annual checkups, mammograms, birth control and be included and part of the program. Men’s issues such as inclusion in annual checkups and a commitment to a Wellness program can be established and maintained within the Wellness program. Educational programs and Self help courses are the key to these programs.
Prevention and Nutrition: A program that includes annual checkups, quit smoking, Health eating habits and concepts to handle cold and flu are the cornerstone of a good healthy lifestyle.
Exercise and Fitness that includes a plan for Aerobic, Strength Training and Flexibility plans assist in maintaining a healthy lifestyle that leads to improved body health and reduces the needs for medications on one’s life.
Mind and Body plans include relaxation, imagery, health thinking and time priorities leads to a healthy balance of Mind, Body and work that enhances a truly balanced and positive lifestyle that is good for oneself and those around us.
Prevention of Illnesses is a byproduct of the Wellness program that each person applies. Illnesses such as allergies, cancer, depression diabetics, heart condition, blood pressure can be maintained and avoided with proper Prevention, Exercise, and Mind and Body applications. A recent study monitoring the effects of community based diabetes management program reduces participant claims 18% in the first year and 39% by the end of the fifth year.
Women’s and Men’s Health Issues can be independently address in a quality Wellness program. Women’s issues regarding annual checkups, mammograms, birth control and be included and part of the program. Men’s issues such as inclusion in annual checkups and a commitment to a Wellness program can be established and maintained within the Wellness program. Educational programs and Self help courses are the key to these programs.
InsuranceCheckRate.com will provide Voluntary benefits that are made available ona an employee paid basis either to an employer group or on an individual basis.
Individual Voluntary plans provide protection for specific illnesses or accidents
that can affect an individual or families with plans that are Guaranteed Renewable.
Consider these facts in the U.S.:
Average 2200 Disability Injuries occur every hour during the year
Every two seconds, someone suffers an Accident
Men have 50% chance and women 33% chance of developing cancer
Dental Plans: Plans available include an Indemnity, Preferred Provider Organization
PPO plan or a Pre-Paid Dental plan. Benefits fit the desired benefit schedule requested
or budget. The website www.deltaplandental.com is a good site to consider these options. These plans are available on a group or individual basis.
Short Term Disability plan will offer monthly benefits from $500 to$3,000
for a benefit duration of 3, 6, 12 or 24 month with elimination periods for
accident or illness for 0/7 days to 180/1380 days. Total Disability is defined
as continued inability to perform the material and substantial duties of your full
time job that affect Activities of Daily Living such as Continence, Transferring,
Dressing, Toileting and Eating.
Personal Recovery Plan will pay specific dollar amounts for specific
illnesses that occur for items such as:
Health Attack
Coma
End Stage Renal
Stroke
Paralysis
Major Human Donor Transplant
Third Degree Burns
Coronary Artery Bypass Surgery
The plan pays specific dollar amount for First Occurrence, Reoccurrence,
Hospital Confinement, Continuing of Care, Ambulance, Transportation,
Lodging of friends and family.
Cancer plan also pay a specific dollar amount for the following:
First Occurrence
Experimental Treatment
Anti Nausea Benefit
Nursing Services
Surgical
Anesthesia Benefit
Skin Cancer
Prosthesis Benefit
Ambulance
In and Out Patient
Blood and Plasma
Transportation
Bone Marrow Transplantation
Cancer Screening
Stem Cell Transplantation
Hospice
Home Health
Bone Marrow
Radiation and Chemotherapy Benefit
Accident Plan pays a continuing benefit of accidents that may occur
both on and off of the job. Benefits include Emergency room visit, Hospital
Confinement, Intensive Care Confinement, Physical therapy, Ambulance,
Prosthesis, Appliance, Transportation, Blood and Plasma and Family Lodging.
Specific co-payments will pay for the following:
Burns
Fractures
Dislocations
Internal Injuries
Skin Grafts
Eye Injuries
Ruptured Discs
Lacerations
Broken Teeth
Torn Rotator Cuff
Concussions
Exploratory Surgery
Paralyses
Comas
Tendons and Ligaments
Partial Amputation
Torn Knee Cartilages
Insurance Carriers include the following:
AFLAC
UNUM
The Standard
Colonial
Allstate
StateFarm
Guardian
Anthem
Reliance Standard
Assurant
Blue Cross
United Health Care
nsuranceCheckRate.com works with multiemployer funds to create health-care networks that are cost-effective and comprehensive. We have experience with a variety of networks, including:
• Preferred provider (PPO) networks, which are based on a combination of diagnosis-related group (DRG) and per diem payments to hospitals.
• Health maintenance organization (HMO) programs in which primary care physicians (PCPs) are paid a capitation rate, hospitals a per case rate, and specialty physicians a fixed schedule of fees
• Point-of-service (POS) programs in which PCPs function as gatekeepers for all in- and out-of-network care.
• Specialty networks of behavioral health practitioners and facilities.
• Dental PPOs, in which dentists are paid according to a pre-determined fee schedule, or DEMOs, in which each patient selects a primary care dentist who then coordinates all dental care needed by the patient..
• PPO networks of vision providers that offer significantly discounted rates for examinations and a selection of frames, lenses and contacts at reduced prices.
Our network analysis services include:
• Adding a PPO network if none currently exists and creating a plan design for in- and out-of-network services
• Investigating the current network to see if it is comprehensive enough for participants' current needs. This includes hospitals, physicians, skilled nursing facilities, home health, hospice, rehabilitation facilities, physical/occupational/speech therapists, chiropractors, and durable medical equipment (DME).
• Using data to guide participants to Centers of Excellence to improve treatment outcomes and promote patient safety. This includes all procedures prone to high rates of quality variability.
• Investigating why participants are using non-PPO providers
• Reviewing PPO savings reports
• Implementing a tiered network concept to steer participants to more cost-effective providers and hospitals
• Soliciting competitive bids for PPO network options to assure that the fund is receiving the most competitive rates and best access available
• Preferred provider (PPO) networks, which are based on a combination of diagnosis-related group (DRG) and per diem payments to hospitals.
• Health maintenance organization (HMO) programs in which primary care physicians (PCPs) are paid a capitation rate, hospitals a per case rate, and specialty physicians a fixed schedule of fees
• Point-of-service (POS) programs in which PCPs function as gatekeepers for all in- and out-of-network care.
• Specialty networks of behavioral health practitioners and facilities.
• Dental PPOs, in which dentists are paid according to a pre-determined fee schedule, or DEMOs, in which each patient selects a primary care dentist who then coordinates all dental care needed by the patient..
• PPO networks of vision providers that offer significantly discounted rates for examinations and a selection of frames, lenses and contacts at reduced prices.
Our network analysis services include:
• Adding a PPO network if none currently exists and creating a plan design for in- and out-of-network services
• Investigating the current network to see if it is comprehensive enough for participants' current needs. This includes hospitals, physicians, skilled nursing facilities, home health, hospice, rehabilitation facilities, physical/occupational/speech therapists, chiropractors, and durable medical equipment (DME).
• Using data to guide participants to Centers of Excellence to improve treatment outcomes and promote patient safety. This includes all procedures prone to high rates of quality variability.
• Investigating why participants are using non-PPO providers
• Reviewing PPO savings reports
• Implementing a tiered network concept to steer participants to more cost-effective providers and hospitals
• Soliciting competitive bids for PPO network options to assure that the fund is receiving the most competitive rates and best access available
Health Benefits Consulting Services
- Health Plan Design InsuranceCheckRate.com’s health consultants have extensive experience in the design and redesign of all health benefit plans for employees and retirees, such as medical, dental, prescription drug, vision, behavioral health, short- and long-term disability, life, accidental death and dismemberment and flexible benefits.
• Vendor Selection InsuranceCheckRate.com creates custom requests for proposals (RFPs) for fully insured and/or self-funded plans. We create and analyze vendor/bidder responses from the full array of managed care organizations (MCOs): health maintenance organizations (HMOs), preferred provider organization (PPOs) and point-of-service (POS) plans. Our analysis covers vendors' fee projections. InsuranceCheckRate.com also negotiates with vendors and helps clients coordinate vendor management.
• Projection and Forecasting of Benefit Plan Costs InsuranceCheckRate.com’s consulting services include projecting claims, setting contribution and COBRA rates, determining reserve requirements, performing incurred-but-not-reported (IBNR) calculations required for retiree health accounting, analyzing the impact of proposed plan design changes, underwriting and funding methodology, creating budget and renewal projections, preparing annual health benefits reports, determining pricing for flexible benefits, conducting merger studies and analyzing the development of health care purchasing coalitions.
• Evaluation and Formulation of Provider Reimbursement Methodology Evaluation and formulation of provider reimbursement methodology includes per diems, diagnostic-related groups (DRGs), outliers, discounts, capitation and physician services and procedures.
• Health Care Quality Assessment (Q-ValSM) For more information on this unique service, click here.
• Collection and Analysis of Cost Utilization Data Collection and analysis of cost utilization data includes monthly claim experience, health care trends and cost savings.
• Medical Claims Auditing InsuranceCheckRate.com’s claims auditors review medical, dental and/or prescription drug plans for fully insured and self-funded administrative-service-only claims administrators to assure financial and procedural accuracy in claims processing. We can benchmark results for clients to industry norms.
• Reviews of Pharmacy Benefit Managers (PBMs) Rapidly rising prescription drug costs are driving overall increases in the cost of health coverage. InsuranceCheckRate.com’s health consultants conduct PBM reviews that yield information that can be used to manage the cost of prescription drug coverage.
• Design and Implementation of Prevention and Medical Management Features InsuranceCheckRate.com designs and implements health promotion/wellness programs, employee assistance programs (EAPs), managed disability programs, disease management programs, centers of excellence programs, 24-hour, telephone-based nurse "triage" programs, executive physical exam benefits and long-term care coverage.
• Health Compliance Updates and Research InsuranceCheckRate.com keeps clients informed about health compliance news through publications, including the Web-based Capital Checkup, a periodic electronic newsletter summarizing activity in Washington with respect to health care and related subjects. InsuranceCheckRate.com’s health compliance consultants can be retained to research plan sponsors' specific questions about compliance issues, update or create plan documents, create amendments and investigate vendor compliance with state and federal laws (e.g., ERISA, HIPAA and COBRA).
• Participant Communications InsuranceCheckRate.com’s communications consultants write and design general or personalized participant communications, including summary plan descriptions (SPD), participant communications required by state and federal laws, announcements about plan amendments, brochures highlighting plan features. In addition, InsuranceCheckRate.com publishes Health Report, a quarterly subscription newsletter for plan participants that is devoted to wellness and promotion of a healthy lifestyle.
• Design and Tabulation of Participant Surveys Participant satisfaction with their benefits contributes to a content workforce, and content workers are less likely to seek alternative employment. InsuranceCheckRate.com can draft, conduct and tabulate custom surveys to assess participant satisfaction annually or periodically. Our communications consultants can draft and design summaries of survey results for distribution to participants.
InsuranceCheckRate.com will help you offer the right one for your employees.
A group retirement plan – often known as a 401k, 403b or 457 plans – can do more than help your company attract and keep qualified employees.
Group retirement plans can offer:
• Create tax advantages for them – and for your business
• Encourage employees to save and invest for the future
• Show that you want to invest in them
We make it easier for you to do what’s right for your employees – and for your business. We offer diverse services:
• Mutual fund choices
• Accounts for most every level of investor involvement, risk and reward
• Solid legal protection
• Straightforward fees and cost savings concepts
• Index Mutual Funds
Asset Allocation strategies to minimize risk and increase the potential to diversity your portfolio for yourself and employees.
Group retirement plans can offer:
• Create tax advantages for them – and for your business
• Encourage employees to save and invest for the future
• Show that you want to invest in them
We make it easier for you to do what’s right for your employees – and for your business. We offer diverse services:
• Mutual fund choices
• Accounts for most every level of investor involvement, risk and reward
• Solid legal protection
• Straightforward fees and cost savings concepts
• Index Mutual Funds
Asset Allocation strategies to minimize risk and increase the potential to diversity your portfolio for yourself and employees.
