Individual and Family Health Insurance Overview

Simply put, people purchase health insurance to pay for their health care. In the US, it is the mechanism for financing the huge and growing amount of healthcare we demand and consume. 

As insurance, we depend upon it to protect us from HUGE unexpected medical bills that would otherwise wreck your budget, or run you into bankruptcy, literally overnight.  It further assures your ability to get the best healthcare available.  Without it, you, or a family member, may be at the mercy of government welfare, and even with that, be unable to get the care, therapy, or operation you need for a quick recovery, or to improve your quality of life. 

Health insurance usually provides either direct payment or reimbursement for expenses associated with illnesses and injuries. The cost and range of protection provided by your health insurance can vary dramatically and will depend on your insurance provider and the provisions of the particular policy you have purchased.

If your employer does not offer a health insurance plan, you'll want to purchase individual/family health insurance on your own.  Even if your employer does offer a good group plan, you may find that it appears to cost less to insure your dependents on an individual policy rather than your employer's plan.  I'll be happy to explain why this happens; but be careful if you are considering, or someone is suggestion you put your dependents on an individual policy; there may be significnat differences in coverage and benefits that may not be immediately apparent. Also, there may be significnat differences in the tax treatment of insurance premiums paid through payroll deductions, or paid from your personal bank account.  Be sureto ask us to explore this option with you first, to be sure you understand all the facts. 

Today more than ever before, health plans vary widely in what they cover and what they cost.  Less expensive plans are not necessarily better, and vice versa. Some consumers have been led to think they were purchasing comprehensive health insurance, only to find out later that they have purchased a very limited benefit policy, or even a "discount" plan, which was not insurance at all.

Reacting to rapidly rising claims, and in an effort to keep premiums low, carriers have flooded the market with plans that offer much more limited benenfits and coverage than just a few years ago.  For people in a hurry, or that shop based on price alone, not reading the fine print in policy brochures, or dealing with an agent that just wants a quick sale, can be a very costly mistake. 

A common example today is the large number of plans that do not cover  prescriptions, or cover only generics, or severely limit the annual maximum a carrier will pay for prescriptions.  Don't assume that's OK because you don't take many prescriptions!  If you develop certain kinds of cancers, hepatitis, or other cronic long-term diseases, you could easily face monthly prescritions charges of $1,000, $2,000 or more... every month!  Even with the "best" plans from one very popular carrier (practically a household name) here in Texas, you could use up your entire annual Rx benefit in two or three months, and face thousands of dollars in Rx bills without even so must as a discount off full retail prices, with no insurance coverage.  Be sure you understand not only the benefits of a plan, but the exclusions and limitations as well.

As national healthcare reform takes effect over the next several years, we'll keep you up to date and help you take advantage of new options and opportunities to improve your coverage and keep your costs low.

What goes into our analysis? How can we really help you?

As a professional broker and advisor acting on behalf of my clients and customers to identify the best health insurance plans available, I constantly search and track every major plan available.  I begin by examining a company's financial health, stability, and ratings.  Then I lexamine the specific plan or policy benefits they offer: the type of plan, deductibles, copays, and coinsurance, plus other important benefit provisions like routine exams, ambulance (ground and air), chiropractic and physical therapy, and more.  

Of course, cost is always a critical factor, so I compare a plans premiums against comparable carriers and plans. The available provider networks can be critical to some people wanting to keep their doctors,as well as reduce monthly premiums .  If a carrier and plan looks solid, reasonable and a good value, I'll look further at a carrier's underwriting practices to see how that carrier might deal with pre-existing conditions, height/weight profiles, and other factors to determine what may be covered, excluded, or perhaps when someone might be charged an extra risk premium. 

I am always exchanging information with other professional brokers I respect and network with regarding carrier claims and service issues, and closely monitor renewal pricing practices, and whether a plan offers multi-year rate guarantees. 

Like someone once said, "We are all different and unique... just like everyone else".   And so we are.  As you can see, making a specific choice of the best health plan or recommendation can get  complicated.  What sets me apart from most brokers, I believe, is I WILL TAKE THE TIME to do what may brokers will not do: ask, listen and understand YOUR concerns and situation;  No, there is no "perfect" company or healthplan for everyone; but one may offer clear advantages to one person which may not be important or relevant to another. I help get my clients sort through all those variables, and keep up with changing market conditions.

I cannot possibly give you every detail of knowledge and insight I have aquired in my nearly 30 year career, and you don't want to hear about anything that isn't meaningful and helpful to YOU personally.  What I will do is help educate you on what to look for in better carriers and plans, and why I may recommend a particular carrier, or plan, for YOUR situation. 

Can You save money by shopping around for quotes from different brokers?

Maybe. Maybe not.  Here's the deal:  Life and health insurance premiums are regulated by the state.  It is against the law for one agent to sell a policy for less than anyone else, even if a consumer buys directly from the carrier: the premium is always the same.

That means you pay the same, whether you get superior help and assistance from the broker you use or not.

Certainly, one broker may show you plans from more competitive carriers, or SHOW YOU why another plan may be a better value, idea or fit for your situation and needs.  They may be able to identify a carrier that may cover a pre-existing condition rather than exclude it.  There may be many ways one broker may help you save money that another broker may not know about, or may not be willing to take the time to explain.

How are agents and brokers paid?

Agents and brokers are paid by commissions as a percent of the premiums you pay. Though commissions are generally uniform among major carriers, some carriers may pay slightly more, or less, than another.  You shoud never have to pay an agent any additional fee for helping you.

That means, great service never costs you more than poor service. 

OK! Ready?  

Now... let's discuss your situation and concerns.  If there is a better idea or option, we will know what it is and help you decide what YOU want to do.

Is there any reason to wait another day?  Call or email us today.  

Jim Archer  877-365-4966