Health Insurance and Employee Benefits

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Client Services and Information Golden & Cohen LLC www.Golden–Cohen.com

Transcript of Health Insurance and Employee Benefits

Page 1: Health Insurance and Employee Benefits

Client Services and InformationGolden & Cohen LLC

www.Golden–Cohen.com

Page 2: Health Insurance and Employee Benefits

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)

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Additional Services Employee Assistance Programs (EAP) Wellness Programs COBRA Administration

Partner Services HR Solutions Property & Casualty Retirement & Pension

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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

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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

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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

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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

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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

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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.

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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 treatmentsWhat preventive care is offered, such as immunizations for children? What preventative health screenings are offered, i.e. mammograms & prostate exams?

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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.

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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.

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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

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