young happy doctor high fiving little girl after open enrollment

Knowing Your Open Enrollment Options In 2018

Here are some important reminders to help guide you through the 2018 Open Enrollment process.

You may have recently received a letter from your health insurance carrier about the 2018 year. If the letter was confusing, don’t worry—a licensed Benefits Counselor will help you navigate your health insurance elections for the 2018 coverage year.

Need To Know For Open Enrollment 2018

Unlike years past, this year the Open Enrollment period lasts from a start date of November 1, 2017, and ends on December 15, 2017.

In order to obtain coverage on January 1, 2018, you must apply by the December 15, 2017, Open Enrollment deadline.

Plans and pricing will be available for review on November 1, 2017. We recommend that you evaluate your health insurance options every year in order to ensure that you are still receiving the benefits you need.

applying for health insurance on atablet during open enrollmentOpen Enrollment Is The Time For Changes

Open Enrollment is the time to make changes to your current plan.

If you are currently enrolled in a health insurance plan from the exchange, it may automatically renew if it is still available in your area. However, it is still important to review the details of your current plan, as providers may have made important changes that will be implemented for the 2018 coverage year.

If you have received a notice notifying you of upcoming changes to your plan, it is important to take the time to read it and determine what these changes could mean for you and your family. Be sure to check that your preferred doctors and hospitals will still be considered in-network. It is important to note that in some cases, you may not be covered at all should you receive care out-of-network.

It is possible that your prescription drug coverage could also change with the new year. Your plan may no longer cover the essential medications you, or your dependents, require in order to manage chronic conditions. This is why it is of the utmost importance that you review your existing plan’s drug benefits for 2018 before you allow it to renew.

Enroll Now Or Wait Until Next Year

So, what happens if you miss the Open Enrollment deadline? In the event that you miss the Open Enrollment cut-off date and still find yourself without insurance, you may be forced to wait another year until the next Open Enrollment period unless you qualify for a special enrollment period.

A Special Enrollment Period can be classified as a divorce, marriage, birth or adoption of a child, death of a spouse or a partner that leaves you without health insurance, your spouse or partner who has you covered loses his/her job and health insurance, you lose your job and with it your health insurance, your hours are cut making you ineligible for your employer’s health insurance plan, or you are in an HMO and move outside its designated coverage area.

In order to avoid paying a penalty on your taxes, you must have health insurance as per the Affordable Care Act.

Applying For 2018 Coverage

When you are ready to apply, make sure you have the details of your current plan, payment information, and any dependent information (social security number, birth date, etc.) on hand to make the application process easier.

Schedule an appointment with a licensed Benefits Counselor for a simple one-on-one approach to Open Enrollment. Our Benefits Counselors are specially trained to focus on your individual needs in a health plan and find you the best fit.

To schedule an appointment, please fill out our Online Appointment Scheduling form to secure your preferred date and time today!

young female asian doctor treating mother and daughter

What You Need for Open Enrollment 2018

Open Enrollment 2018 is just around the corner and for many, this is the only time to secure health insurance coverage for you and your dependents.

Since the beginning of the Affordable Care Act, the term Open Enrollment refers to the specific period of time each year when an individual can enroll in, or switch, their health insurance plan without the need to qualify for a special enrollment period. This is also when additional eligible members can be added to an existing plan.

Open enrollment only occurs once per year, so keeping an eye on the Open Enrollment deadlines is important in order to avoid losing coverage. This year the Open Enrollment window has been shortened and begins November 1st with a December 15th deadline.

young doctor explaining open enrollment 2018 to coupleKnow The Open Enrollment 2018 Terms

We know that Open Enrollment can seem stressful and completely overwhelming — but it doesn’t need to be! One of the best things you can do to make the Open Enrollment process easier is to know the most frequently used terms:

  • Coinsurance: Coinsurance is your share of the costs of a covered healthcare service calculated as a percent (for example, 20 percent) of the allowed amount for the service. You pay coinsurance plus any deductibles you still owe for a covered health service.
  • Premium: A premium is the amount of money charged by an insurance company for coverage. The cost of premiums may be determined by several factors, including age, geographic area, tobacco use, and number of dependents.
  • Copayment: A copayment, or copay, is a fixed amount you pay for a covered healthcare service, usually at the time of service. The amount can vary by the type of covered healthcare service.
  • Deductible: A deductible is the amount you owe for healthcare services each year before the insurance company begins to pay.
  • Out-of-pocket Maximum (OOPM): An out-of-pocket maximum is the most you should have to pay for your healthcare during a year, excluding the monthly premium. It protects you from very high medical expenses. After you reach the annual out-of-pocket maximum, your health insurance or plan begins to pay 100 percent of the allowed amount for covered healthcare services for the rest of the year. The deductible, coinsurance, copays and prescription drug copays are included in the out-of-pocket maximum.
  • Preventive Care: Rather than waiting for a patient to become sick, preventive care aims to keep people healthy, or at least catch illnesses at their earliest and most treatable stages. Preventive care includes preventive services performed by providers, such as annual physicals or mammograms. Under the provisions of the Affordable Care Act (ACA), policies must cover various preventive services for men, women, and children without sharing the cost for these services through coinsurance, deductibles or copayments. Certain Preventive care services are subject to frequency limitations.
  • Annual Limit and Lifetime Limit: In the past, health insurance carriers imposed Annual and Lifetime limits on the benefits you receive. You are no longer subject to these limitations and there is no maximum to the benefits you may receive.

Asking For Help

Our team of licensed Benefits Counselors are here to help! Schedule an appointment so you can get your questions answered —And don’t forget, Open Enrollment only runs through December 15th for the 2018 season!

family in white smiling and happy about ancillary benefits

Beyond Health: The Ancillary Benefits Your Association Needs

We’ve all heard of Health Insurance, but it’s not uncommon to hear the term “Ancillary Benefits” in the same sentence. But while everyone is familiar with health insurance, not everyone is equally familiar with ancillary benefits. So, what exactly are they and should you be offering them to your employees?

First and foremost, while health insurance is just health insurance, ancillary benefits can be made up of a variety of different insurance and benefits offerings made available to your employees. Oftentimes, instead of listing out each and every benefit and insurance offering a company may offer, the term “ancillary” may be used instead.

Potential Ancillary Benefits Offerings

But despite the unfamiliarity of the term, the types of insurance benefit offerings it can refer to are all too common. Offerings such as Dental and Vision insurance, Term Life insurance, Long-Term Disability Insurance, LifeLock, Pet Insurance, among many others are among the most popular ancillary benefit offerings companies and associations can offer their employees.

inside of dental office with toolsDental and Vision Insurance

Providing your employees with dental insurance can benefit you as much as them. According to the Mayo Clinic, regular dental check-ups can improve an individual’s personal health and having dental insurance can help save your employees from additional costly expenses should more serious treatments be needed. As is the case with anything health related, regular check-ups are the key to catching any potential problems early and avoiding costly procedures later on.

Like dental check-ups, regular eye exams not only diagnose vision problems but can also provide early detection of serious health problems. Vision insurance is frequently offered alongside dental insurance and can be every bit as beneficial for employees to have as poor vision can result in everything from migraines, to blindness, and more.

Term-Life Insurance

Life insurance provides crucial financial protection for your family if something were to ever happen to you. An offering like this would help to give your employees peace of mind and let them know that you are looking out for their family’s financial future. It is not uncommon for Accidental Death & Dismemberment (AD&D) insurance to be included as well.

man in a wheelchair rolling down street next to carLong-Term Disability Insurance

Long-Term Disability insurance has been designed to help protect your employee’s financial well-being in the event an accident or illness occurs outside of the workplace. It is estimated that just over one in four of today’s 20-year-olds will become disabled before they retire. Long-Term Disability insurance helps your employees replace their lost income if they have an accident or illness that prevents them from working. Leading Long-Term Disability Insurance provider Guardian, can provide your employees with up to $10,000 in monthly disability coverage.

LifeLock

In today’s internet age, you can never be too careful when it comes to protecting your identity. According to the 2017 Identity Fraud Study, conducted by Javelin Strategy & Research over $16 billion was stolen from 15.4 million consumers in the U.S. in 2016—up 700 million from the previous year. With cyber criminals showing no sign of slowing down, it falls on individuals to protect their identity with smart banking practices and services offered by companies such as LifeLock.

LifeLock is a great ancillary benefit for employers to offer to their employees and is becoming arguably as important as health insurance to have.

Pet Insurance

Nothing will show your employees that you value them and their happiness more than by offering pet insurance for their four-legged friends. Just like the health costs for your employees, vet bills can be every bit as expensive. But by offering your employees pet insurance, they will be able to make sure that their pets stay as healthy as possible and be reimbursed for their vet visits via their pet insurance company.

Why Your Association Should Offer Ancillary Benefits

When benefit programs meet employees’ needs, employers enjoy a significant competitive advantage in attracting and retaining valuable employees. In addition, employees are more satisfied and become more willing to stay with your company. When you go through your association program, you get access to rate and participation concessions on Dental, Vision, Life, Disability, and more!

To see the insurance benefits we currently offer, please visit your association page www.memberbenefits.com/associations/.

Visit a Dentist— ANY Dentist

The Comprehensive PPO is a dental plan that can help you save1 and get the care you need.

No matter who your dentist may be, with the MetLife Preferred Dentist Program, the power to choose and save is yours.

Here are the facts:

  • You can go to any licensed dentist, in or out of the network.
  • Reimbursement for your out-of-network dental care is based on the 90th percentile of “reasonable and customary” charges1. We look at what dentists in your area actually charge for services, and we calculate reimbursement based on the 90th percentile of those charges.
  • The way we determine allowable charges for the 90th R&C means your eligible benefit amount for out-of-network care is high relative to average dental charges in the community. This helps you pay less out of pocket.
  • Sometimes when you visit an out-of-network dentist you may have to pay part of the bill. This is called balance billing. But with a 90th percentile R&C plan, in most cases, you won’t be balance billed above your typical out-of-pocket costs – your deductible, coinsurance amount, and your plan maximum.

Take charge of your dental care

Talk to your dentist

Before you get any major dental work, you should talk to your dentist about getting a pretreatment estimate2. That’s when your dentist sends the plan for your care to MetLife.

For most procedures, you and your dentists will receive the estimate – online or by fax – during your visit. The statement shows amounts for what your plan covers. Then you and your dentist can talk about your care and costs before your treatment. It’s a great way to be prepared and plan ahead.

Get your plan information – fast!

Managing your dental benefits has never been easier. You’ve got MyBenefits – your secure member website. Just log on at www.metlife.com/mybenefits. With the 24/7 website you can3:

  • Review your plan information, including what’s covered and coinsurance
  • Track your deductible and plan maximums
  • Find a dentist or view your claim history
  • Read up on the oral health information you need to make informed decisions about your care

Take a look at the charts below. They will give you a better idea of how your plan works when you visit a participating (in-network) or a non-participating (out-of-network) dentist.

The 90th bar

This chart shows how often plan members across the nation usually go to a participating or non-participating dentist. It also shows just how rare it is for you to pay more than your typical out-of-pocket costs.

Savings example

This hypothetical example shows that whether you get a cleaning from a participating or non-participating dentist, you can still save money4.

Visit any licensed dentist. The choice is all yours!

Like most group benefit programs, benefit programs offered by MetLife and its affiliates contain certain exclusions, exceptions, waiting periods, reductions of benefits, limitations, and terms for keeping them in force. Please contact MetLife or your Plan Administrator for complete details.

For more information please click here.

1R&C fee refers to the Reasonable and Customary (R&C) charge, which is based on the lowest of 1) the dentist’s actual charge, 2) the dentist’s usual charge for the

same or similar services or the usual charge of most dentists in the same geographic area for the same or similar services as determined by MetLife.

2Actual benefit determinations are made when services are rendered and are subject to the following as applicable on the date of service: patient eligibility; plan and frequency limitations; maximums and deductibles; and other coverages.

3With the exception of scheduled or unscheduled systems maintenance or interruptions, the MyBenefits website is typically available 24 hours a day, 7 days a week.

4Please note: This is a hypothetical example that reviews an adult teeth cleaning (D1110) in the Chicago area, zip 60601.  It assumes that the annual deductible has been met.

5This example excludes non-participating dentists who charge more than what 90% of what other dentists in the area charge. Please note that if you receive care from a dentist that falls into this category, your out-of-pocket costs may be higher.

6Negotiated Fee refers to the fees that in-network dentists have agreed to accept as payment in full, subject to any co-payments, deductibles, cost sharing and benefits maximums.

happy family in car protected by AD&D insurance

The Unsuspecting Reason Why AD&D May Be For You

No one wants to think about their death, and for young professionals just starting their careers and families, the idea of contemplating the unimaginable can be even more unsettling. You are just getting on your feet and the last thing you are prepared to start thinking about are things such as life insurance and Accidental Death & Dismemberment (AD&D) insurance. But instead of dwelling on the complicated process of obtaining life insurance, is it possible that AD&D insurance may be the first and easiest step in protecting your loved ones should something happen to you?

Know Your Odds

According to a 2015 report issued by the Centers for Disease Control (CDC), if you are between the ages of 18 and 44 you are most likely to die in some sort of accident or “unintentional injury” rather than due to disease or congenital anomalies. Eating right, exercising often, and leading an overall healthy lifestyle may be a great way to guard yourself against health issues such as heart disease but when it comes to preventing debilitating accidents, these things have no effect on chance.

Of all accidents, car accidents are the most common with an estimated 1.3 million deaths a year, averaging out to 3,287 deaths per day with an additional twenty to fifty million people becoming injured or disabled every year according to the Association For Safe International Road Travel.

lonely woman in mourning looking at sunset on waterHow AD&D Insurance Can Help Protect Your Loved Ones

For those involved in serious accidents, recovery time can take anywhere from days to months, or even longer depending on the severity of the injury. Could you afford to be out of work for an extended period of time? If you were injured so severely that you required an amputation, forever altering your lifestyle, as well as potential job prospects, could you afford to be out of a job while recovering and retraining your muscles as well as your mind? And if the worst should happen, could your family sustain themselves without the aid of your income?

This is where the importance of Accidental Death & Dismemberment (AD&D) insurance comes in to play. No one ever plans for an accident to occur, but what if there were a way that you could? According to the 2012 Life Happens Disability Survey, approximately half of all Americans wouldn’t be able to cover their own expenses after just a single month without receiving a paycheck.

Statistics like these can be scary but they don’t need to be. AD&D insurance could help in the face of uncertainty. Your family’s welfare is important and with AD&D insurance, you can help to safeguard your family’s financial security in the event you are no longer able to provide for them should you experience a debilitating or fatal accident.

Learn More About AD&D Insurance

While the two can sometimes be purchased together, it is important to understand that AD&D insurance is not Term Life insurance. AD&D typically does not issue a payout on your policy in the event you pass due to a terminal illness; AD&D insurance will, in most cases, issue a payout should you fall victim to a serious accident resulting in the loss of limb, senses, or life. Exact payout amounts and covered circumstances are elaborated upon in your exact policy once it has been issued.

As an association member, you have access to anywhere from $10,000 to $500,000 in AD&D coverage amounts issued by leading insurance carriers. Acceptance is guaranteed with no medical exams or questions to schedule or deal with.

Want to learn more about AD&D insurance? Visit your association page for more information, view the AD&D schedule of benefits, or to sign up for AD&D insurance.

Young People Discussing Group Insurance Benefits with an agent

3 Benefits of Group Health Insurance For Employers

Group health insurance is usually provided by an employer and can cover just the employee or even the employee’s spouse and children.

Not providing group health coverage could be a major misstep for some companies regardless of size, as there are a number of benefits to providing Group Health Insurance coverage.

1. Lower Costs Than Individual Plans

There is no question that the term health care reform has been a hot-button topic and on the lips of nearly every politician regardless of political party over the course of the past 10 years. In light of the Affordable Care Act, it has now become more affordable to purchase Group Health Insurance than for your employees to purchase health insurance individually.

Level-funding insurance plan options have been growing in popularity over the past number years. Level-funded plans are ERISA compliant and may offer more flexibility for employers with virtually no risk and offered by several reputable insurance carriers with a nationwide network of hospitals and physicians to choose from.

What has many employers especially excited about these plans is the opportunity for 10%-15% in lower premium costs and the Return of Premium potential. Unlike other policies on the market, with level-funded options, if your employees don’t rack up a large number of claims throughout the year, your company may have a substantial amount of money (originally paid in premiums) returned.

Insurance Agent Explaining Group Insurance to employee2. Attraction and Retention

If looking at the cost of a group health insurance plan leaves you feeling queasy and the idea of paying the tax penalty sounds more appeal, you may want to think twice.

As job seekers now expect for their employers to at least partially cover their healthcare needs through group health insurance policies, walking into a job interview and being told that the company refuses to pay health care for full-time workers is a red flag. Even if a potential employee is in trouble financially, they may still take the job out of desperation but will jump ship as soon as they can afford to for greener pastures.

Providing Group Health Insurance for your employees shows a certain level of care and respect that new and existing employees will appreciate and keep in mind going further within your company.

3. Tax Benefits of Providing Group Health Insurance

In some cases, it’s possible that providing your employees with Group Health Insurance could give you a welcome tax write-off, not to mention added tax benefits for your employees.

Payments made to group health insurance premiums, reimbursement plans (HRAs), and Health Savings Accounts (HSAs) are generally all eligible for tax advantages as all of these payments can be made as pre-tax contributions.

As an added bonus, qualifying health insurance plans may also be eligible for HSAs for their employees. HSA’s are 100 percent owned by the individual employee and not tied to you in any way. In a 2015 study conducted by Devenir compiled data from the top twenty HSA providers in the U.S. and found a 1775% increase in assets between 2006 and 2015, showing that now more than ever, people are choosing to invest their money in HSA’s rather than insurance plans with more coverage.

 

Member Benefits has been in the insurance brokerage business for over 30 years and is the Recommended Broker of a number of associations across the country. To see what Member Benefits can do for your business, visit www.memberbenefits.com.

Chip Trefry Member Benefits 2017 Inc. 5000 award

Member Benefits Ranks on the Inc. 5000 For Third Consecutive Year

JACKSONVILLE, August 21, 2017Inc. magazine has ranked Member Benefits, NO. 2007 on its 36th annual Inc. 5000, an exclusive ranking of the nation’s fastest-growing private companies. The list represents the most comprehensive look at the most important segment of the economy—America’s independent entrepreneurs.

“I am extremely proud of what we have accomplished, but this is just the beginning. With such a tenacious team and unique business model, I can’t wait to see what the future holds for Member Benefits,” said Chip Trefry Jr., Owner and CEO of Member Benefits.

A mere one in five companies featured on the list have made an appearance three times, and Member Benefits is excited to be one of them. According to Inc., Member Benefits has experienced a three-year growth of 186.87% according to Inc.

You can find the Member Benefits profile at www.inc.com/profile/member-benefits.

About Member Benefits

Member Benefits is a technology-driven insurance brokerage and third-party administrator that focuses on benefit programs and insurance exchanges for member-based organizations. Member Benefits specializes in the design, marketing, and administration of programs for employer groups, associations, affinity groups and franchises. Member Benefits operates in many states with locations in Jacksonville, FL and Austin, TX. For more information, visit www.memberbenefits.com.

 

man with long-term disability insurance and his son at a park

The Underestimated Value of Long-Term Disability Insurance For Attorneys

For many, the thought of investing in a long-term disability insurance policy may sound like an unnecessary expense. It is estimated that roughly 86 percent of Americans have desk jobs, therefore it is easy to understand why they might be under the impression that they have little to no chance of becoming disabled during the course of their career. This is a potentially dangerous mistake.

The Odds of Needing Long-Term Disability Insurance

While it is true that those who work more labor-intensive jobs may have an increased risk of becoming injured or disabled at some point in their careers, those who work in office settings also have at least a one in four chance of the same thing happening to them.

In 2015, the Bureau of Labor Services estimated that there were 1,153,490 cases of work-related injuries and illnesses that resulted in missing days from work. This statistic can be scary for both businesses and individuals alike. And while most states mandate that every business with one of more employees must have workers’ comp. insurance, what happens when workers’ comp. and social security disability benefits just aren’t enough?

man with long-term disability insurance and his son at a parkThe Cost of Becoming Disabled

If you find yourself injured or sick and unable to earn an income, mounting medical bills, combined with the general cost of living expenses can quickly become overwhelming. You are not alone… it is estimated by the Council for Disability Awareness that over one in four will find themselves disabled prior to retiring.

Could your family sustain the loss of your paycheck? Many, if not most, could not. According to the 2012 Life Happens Disability Survey, only half of working Americans have enough money in their savings to financially handle being out of work for one month before feeling any sort of financial strain. For members who opt to invest in member group long-term disability insurance plans, monthly benefit amounts range anywhere from a minimum of $1,000 to a maximum of $10,000.

While most people may equate being disabled with a workplace injury of some sort, in all actuality, less than 5% of disabling accidents and illnesses are work related according to the Social Security Administration, and even then the average monthly benefit in Social Security Disability is $1,165 a month. Could you support your family on only $1,165 a month?

Protecting Your Financial Security

The key to protecting your financial security is planning ahead. That is where Long-Term Disability Insurance comes in. Long-Term Disability insurance will help you pay for things such as your mortgage, utilities, child care expenses, and other everyday living expenses should you become disabled. To ensure members have access to the long-term disability insurance plan options that they need to protect themselves and their family’s financial security in the event they become disabled, Member Benefits programs provides Member Group plan through well-known insurance provider, to fulfill their need.

If you wish to receive more information about how you can safeguard your financial future in the event of being diagnosed with a long-term disability, please visit your association page to view the complete Long-Term Disability brochure or to download an application.

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