Thursday, February 23, 2012
11:00 AM - 11:30 AM Central Time  Add to Calendar
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We are naturally born procrastinators, especially in areas we are not thrilled about - but know we have to get it done. The good news is, it can be easier with the right tools and guidance.  Let's face it, most of us do not enjoy reviewing insurance.  This is why we hire insurance agents to do it for us.  However, not everything is covered with most insurance agents.  This is why it is important to find ways to make it easier to review your protection.  The worst time to find out how your insurance works is at claim time.  

In the newspaper and on the news we hear it everyday that someone has had a major mishap that could potentially cost thousands.  Is anyone in a position to be ready, financially, for that kind of tragedy?  Maybe you added an addition to the house, added an addition to the family or maybe your business is expanding at a rapid pace.  With so much going in your life, how will you know you have the right coverage as life moves forward?

Butch Zemar at Elite Benefits of America will be hosting a webinar to help ease the process of doing an annual review of your insurance. As insurance agents, we know how brutal reviewing insurance can be.  We do it every day with hundreds of people throughout the year. We are just trying to make it easier for you.

Those who register for the webinar will receive a copy of an annual review sheet that you can use on your own or with your current agent.  This way every year you will be able to use the review sheet to make sure you keep the insurance updated with the right coverage.

Consumers really know how to shop for goods and services.  Having options to save money or ask for better services comes second nature to us.  If we like or dislike something we usually take actions accordingly.  This is a process that we move away from things we do not like, also known as firing, and moving towards things that we do like.  Why is health insurance any different?

American's truly do not have enough 'skin in the game'.  The more skin we have in the game, the more control we have in working with people or companies we like.  This allows us to have a choice on keeping your situation the same or making a change.  We do it for restaurants, groceries, hair cuts and insurance.

 Every week I receive at least one phone call my client telling me they found a facility with same credentials and cost less money or provides a better service or credentials for about the same cost.  Shouldn't you have that choice to 'fire' who is not providing you the services or cost to your liking?  Or would you rather be at their mercy?

 Take a look at your current situation with your health insurance, especially if you are self-employed or you own the company.  Is there anything you would like different?  Is there anything you would like to remain the same?  Wouldn't you like the choice in firing a carrier or service to more closer to what you want as a business?  

 Video: Mitt Romney talking to Nashua Chamber of Commerce this morning.

According to the Supreme Court's argument calendar published Monday, the justices will spread discussions of four separate legal questions about the law over the three days, with the largest chunk of time going to the question of whether Congress had the power to compel the purchase of health insurance by 2014.

Can the federal government actually force American's to buy health insurance? On March 26, the legal challenge to require all American's to buy health insurance starting 2014 is set to be discussed. This will determine if Congress's passage of the individual mandate exceeded the legislature's powers to regulate interstate commerce or lay and collect taxes under Article I of the Constitution. Many local business's have had this discussion and many are not in favor of this requirement. Any change can be resisted among business owners. However, there are many business owners who choose not to buy health insurance or simply cannot afford it in this recession.

The center of the battle is whether or not congress overstepped it's powers by implementing the purchase requirement known as the mandate. Two hours will be allotted on March 27 for this.

March 28, ninety minute arguments on whether the rest of the law can survive if the mandate is struck down. An additional hour of argument will address 26 states' claim that the law improperly expands Medicaid by coercively conditioning states' receipt of federal funds on their participation in the new health care exchange system.

On March 23, 2010, Obama signed into law the ACA and the related Health Care and Education Reconciliation Act of 2010, which together created the most sweeping reform of healthcare in a generation, greatly expanding regulations in many areas and setting the goal of expanding insurance access by about 32 million people. Critics have called it an illegal expansion of federal power and oversight.

In November 2011, the court indicated it would spread the arguments on the health law’s four issues over just two days and was extended to three. The suit was brought by 26 states and the National Federation of Independent Business.

Ruling expected in June, right in the middle of 2012 elections.

Butch Zemar

www.EliteBenefits.net

Elite Benefits of America is currently helping business owners identify coverage mistakes in their annual insurance reviews to assure rates are locked in for the upcoming year.

“Many businesses are currently reviewing their 2012 business insurance to have it locked in for January 1st” says Butch Zemar, Chief Sales Officer at Elite Benefits of America. “As they claw their way out of this recession, cutting back is one of the only options. Insurance is one area that should not be cut. Businesses, as well as consumers, need to review all insurance programs annually with an insurance agent.”

During an annual business insurance review, a business will be reviewing employee benefits, general liability coverage, workman's compensation and commercial auto coverage just to name a few. All of the coverages are important but each business has a specific need based on their situation. Many businesses forget about adding coverage they should have and find themselves in a situation they do not want to be in at the time of a loss. It is very important for businesses, and consumers, to review all their insurance needs every year to make sure they do not leave anything to chance.

"Looking for areas to cut cost seems to be more of the norm and businesses are using insurance as one of those areas." says Zemar. "Businesses buy insurance to protect their financial health. By lowering insurance limits, or worse, eliminating coverage just to cut cost is not only making a huge mistake but it is also setting the business up for a negative financial impact that can push them over the edge to the abyss in this tough recession." Zemar continues.

Today, more than ever, the business world and life itself changes consistently. Anytime there is a change, your insurance should move needs to be adjusted. There is the possibility that despite the recession, a business could be growing and had an increase in building space, staff, or equipment and an increase of insurance coverage is needed. The insurance agent reviewing the insurance policy needs to know about these changes so they can address it appropriately with the insurance policy.

Elite Benefits of America is scheduling webinars with that change. Maybe a business has downsized or sold off equipment and the insurance next year to assist business owners as well as individuals in meeting their insurance needs. For more information or to schedule a business insurance review, call Butch Zemar, Elite Benefits of America at 708-535-3006. For more information, go to www.EliteBenefits.net.

Insurance companies in the state of Illinois are now taking applications for coverage with domestic partnership.  Talking health insurance specifically, this will allow a small premium reduction.  There is a 'hard cost' of insurance that everyone pays based on certain demographics.  Now that 'hard cost' is divided among two adults versus just having one.  This savings can be a little as $10 or $20 per month but it can add up over time.  If you are self-employed or an employee and pay for your own benefits this may mean you have to go through underwriting again.  At that point, is it worth $100-200 (possibility more) per year in savings?  That depends on the individual and their circumstances. 

If you are on an employer sponsored plan you can add your civil union spouse during open enrollment or during the 30 days "special enrollment" after the start of the new law, or when your civil union spouse loses their coverage. 

There could be tax consequences involving Civil Union spouses on a federal level.  This is because Civil Unions are not recognized on the federal level.  Be sure to check the details of the law and check with your tax advisor.

This could be good news for some.  There are many people that feel 'stuck' because they couldn't get health insurance coverage without being married to their significant other.  An opportunity for someone else to have health insurance is always good.  If there are any premium savings along with it, well, that's a plus. 

Health insurance is not the only insurance program Civil Union partnerships can take advantage of.  Auto, homeowners, life insurance and annuities are just some to name a few.  Life insurance is a big one because insurance companies look at 'insurable interests' for beneficiaries.  Many life insurance carriers have been allowing some applications to pass with domestic partners as beneficiary. Now this law opens up the door. 

This may be the time to review your insurance with your trusted insurance advisor to make sure you have the most amount of coverage for the same price or less.  Make sure you are getting the most out of your insurance.

Butch Zemar
www.EliteBenefits.net

Summer is here and your days are filled with joy and fresh air. The kids finally have a chance to get out of the house and play. Some kids will still stay in the house to play video games or read a book. However, most kids cannot wait to get out and enjoy the weather. They will go to the park, build a tree house, play sports or tag in the backyard. Life just could not be any better.

Most parents have one major concern when it comes to kids and that is accidents. They are so playful and adventurous but what happens when they slip and fall? Their footing could have been wrong on the stairs to the slide or they may not have been paying attention when that bat came around too fast. Now your kid is hurt, what do you do?

The fact is, most kids that are injured recover just fine. The likelihood they will be off and running again is very high. As parents, we just hope they remember not to do whatever it was they did, again.

As the years pass with health insurance, more and more families are taking higher deductibles to keep premiums more in lined with their budget. At the time of this writing, we are in the longest recession in the history of this wonderful nation. This has put even more strain on the family's budget as well as savings in the bank. One accident can deplete the funds really fast. Then the family has nothing to fall back on.

The average deductibles for the family are $2,500 for each person or $5,000 family if they are on an HSA. After you have met the $2,500 deductible for each family member, usually with a max of 3 deductibles, you will still have co-insurance (cost sharing with the insurance carrier) until you reach your maximum out-of-pocket. This can easily be a total of $4,500 - $5,500, depending on your plan. Splitting the difference at $5,000 out-of-pocket max, for an individual would be fair to use as an example and comparative to a $5,000 family deductible on an HSA.

Taking an affordable monthly investment of about $50 per month it would take 8 years and 4 months to save $5,000. There is a good chance injury would happen in 8 years with kids running around, unless you are lucky. If you are that lucky you might also have good chances at playing the lotto.

The insurance industry has what they call 'supplemental insurance' specifically designed for accidents. It is a reimbursement for your out-of-pocket exposure for an injury up to the max you pick for the policy, i.e. 2,500, 5,000, 10,000... 25,000. It is for each injury that occurs. There is a small $100 or $250 deductible that you will have to meet for each injury, but that is peanuts compared to the full bill. You are then reimbursed up to the maximum benefit, and in the above mentioned example it would be $5,000.

Take a case study of a business owner in the south suburbs of Chicago who went with a high deductible plan and added the accident supplemental insurance to it. One day during a sports activity he blew out his knee and had to have surgery. The bill racked up to about $27,000. Typically, he would have had $5,000 out-of-pocket. However, by adding this supplemental insurance his total out-of-pocket expense was $100.00! That's it!

What does this cost? The cost of pizza and few beers (or sodas) per month. That's it. In the example above it would take almost 8 1/2 years to save $5,000. Financially, this is a much better way to leverage insurance without depleting the family's savings account.

Now the summer can go on with all the joys and laughter every family ever hopes for. As the sun sets on the summer days ahead, knowing you did the right thing with an accident supplemental insurance will give you peace of mind that everyone should enjoy.


Butch Zemar
www.EliteBenefits.net

In a recent article from the LA Times, it talks about people after bankruptcy that are still over extended.  Some of them have not even paid their mortgage in months but still somehow find other things more important.  A family can barely afford to live but they are spending $275 a month on beauty products and services.  The same family also spends $200 a month on the family’s pets.  How many people do you know spend their money the same way?

Six-two percent of bankruptcies are due to medical bankruptcies.  Most of them had health insurance at the time of the onset of the illness.  It does not take a rocket scientist to figure this out.  You can have the best health insurance in the world, it still will not prevent you from going bankrupt.

An article on CNNMoney.com, talks about Steve Jobs from Apple taking a leave of absence to take care of his health.  Granted he had to get approved by the board of directors, but he still gets the time off.  Some may say he is rich!  Rich is relative.  I bet Jobs would not say he would agree.

The point to get across is creating opportunity so that when a situation presents itself, such as a critical illness, more Americans are more prepared.  Creating financial opportunity to allow families to take care of their health is more than just money, it is a gift of opportunity.

Everyone likes cash.  It is a big portion of the pie. Not now, but when the moment strikes. When in life is anything free?  Anything that holds any value comes at a cost.  By taking half of $275 a month you may spend on beauty products and services, maybe even just the cost of pizza and a couple of beers you can protect your family. Now that should be a right of every American, isn't it? 

Butch Zemar
www.EliteBenefits.net

At one point over 60% of employers offered health insurance as a benefit for working for a company.  In 2008 that number dropped to 50%.  As of February 2011, that number fell below 48%.  Even though the healthcare costs are skyrocketing, Americans are shocked to see the percentage of employers pulling the plug.

Mathematically, it would only add up that the more employers are dropping their health insurance plans the number of uninsured would go through the roof.  For every health plan dropped it could be hundreds, if not thousands, of employees losing coverage.  However, over the last 2 years the uninsured rate stayed consistent at 16%. 

The big question is how is that possible?  Thousands of employees losing their health insurance but the uninsured rate is held at 16%.  Sure the numbers could be skewed, but not like the unemployment rate going down because those who are unemployed exhausted all unemployment benefits.  There is a very specific reason why this has happened.

There has been a growing demand of private policies for individuals and families.  Some people did not know you can buy a policy on your own outside of the work place.   The fortunate part, most of the time, is that it is less expensive than what the employer is paying through the group plans.

Private policies for individuals and families are more Portable, Permanent and provides more Control .  With employer sponsored plans employees have to take what is provided to them, they can’t take it with them.  COBRA is the only exception, however it is very expensive and it expires.  Why would you pay a lot and have it run out on you?  For those who are trying to retire early you are stuck in this new term called ‘Job Lock’ because of health insurance.  Purchasing private policies are more permanent than employer sponsored plans because the employer plan can simply go away one day without any word from or to the employees.  Today, in 2011, this is happening every day throughout the country. 

The last thing purchasing a private plan can do is give employees more control over their health care.  If one family wants to have a richer policy because they have four kids they can have it.  That family can look at the true cost of insurance and decide if they want a certain type of coverage.  It is just like buying a car or house.  You take responsibility, evaluate costs and take a needs analysis.   This will help individuals and families make better decisions for their current situation.

Let us know how your shopping for your own private insurance policy.

Butch Zemar

Depending on the life insurance policy, there are multiple 'living benefits' the policies will pay out for in cash to the policy holders.  Being chronically ill, depending on the policy, is when someone only has twelve to twenty-four months to live.  It is not a pleasant thought but some people have to deal with this question every day.  This will trigger a pay out on the life insurance.  Another trigger can be long term care benefits or a critical illness.  Some will even pay out for some type of disability benefit. 

The industry has the traditional term insurance that will run out after a certain term period but have a living benefits option.  This is a great fit for a lot of people.  Others would like to see a long term investment side of things.  Using a universal life can provide flexibility and make their money go further.  Today, the average interest rates at the bank are less than 1.5% even with a money market.  With some Universal Life products a policy holder can earn as high as 4% (some cases there are higher earnings with other life and annuity type products).  Ask a banker for 4% and see what they say.  Life insurance, at this point, can be a better investment than letting money sit in the bank.

One drawback to having a life insurance policy with living benefits is not having enough coverage.  It is expensive not to have a policy that pays out but can be nearly as expensive if there was not enough coverage.  Some living benefits will pay out 100% of the death benefit but some are at a fixed percentage of 2%-4% of the death benefit.  Like buying any insurance coverage, making sure there is enough coverage is important.  An evaluation with an expert can be a way to determine how much you need and make a goal to obtain that amount.

Butch Zemar
www.EliteBenefits.net

The first three to six months after the onset of the illness is the most critical.  Financially, the expenses can range from $10,000 to over $50,000.  Just your medical out-of-pocket expenses can reach about $10,000 alone.  Your health insurance should pick up most of the medical bills.  What about your non-medical expenses?  You can have the best health insurance in the world, but it doesn't mean anything if you cannot afford to make the insurance premiums.

Let's go beyond the health insurance premiums for a moment.  How about your life insurance premiums?  We are already in a critical state emotionally, and health wise, we are fighting for survival.  What if our time comes to an end but you couldn't pay the life insurance premiums? 

Now, let's move towards the positive and you are winning this fight.  What about your mortgage or rent, food and clothing for the rest of the family?  Your kids still need help from you, financially and emotionally, how will you cover that?  You still want them to have a good education, right?  How about your daughter to have the most beautiful wedding?  The everyday living doesn't stop because you have to put things on hold to get better.  Most people are facing this today in the economy with the job losses out there.

What's the alternative?  Go back to work after the diagnosis?  Work causes stress of some kind.  We all know stress is counterproductive to improving our health. So where is the balance?

You could draw from your 401K, annuity or other retirement funds. You worked so hard your whole life to save money to cover a catastrophic illness, right?  Isn't that why we go to work?  Obviously, that's being facetious.  If you look at things from a bigger picture you would think most American's work their whole life just so they can give it away to doctors, hospitals and creditors.  However, that wasn't the original intentions.

In conclusion:  A catastrophic illness does not discriminate on gender, origin, race, how healthy or unhealthy, etc.  Most of us go out of our way to insure what's important to us.  This is typically your car, house, jewelry, your life, etc.  We forget about our most important asset, our ability to earn a living.  We take it for granted.  Disability insurance and Long Term Care Insurance just may not be enough.  Ask your advisor about Life Insurance with Living Benefits.  It may be the best thing you ever did.

To your health,

Butch Zemar
www.EliteBenefits.net

A couple good points were made in the Article.  The truth is everyone knows that an insurance company won't pay for a car accident if you didn't have insurance at the time of the loss or accident.  The American public accepts this as fact, at least most of them.  In fact they make fun of it in TV shows and movies about someone trying to buy auto insurance for their car after an accident.  What would make you think health insurance could be any different?

In that perspective, you cannot insure a pre-existing.  Finacially, it's unaffordable.  The article references New Jersey, a guaranteed issue/community rated state like in the ObamaCare program.  They are sharing the cost of the pre-existing; premiums will go up.  The example given, if you take the average 35 year old, monthly premiums in Colorado they are $204 and in Illinois it's about $180.  In New Jersey its about $2,150 per month.  If you were making $50,000, in New Jersey, fifty percent of your income would go to health insurance. 

I like the term "job lock". Many American’s financially are in a position to retire, but they have several years, or more before Medicare kicks in.  The only reason they go to work is to hold on to that health insurance.  It's crazy we live in a nation of freedom but we are 'locked' into something.  It's almost like falling short of the finish line knowing you are so close.

If you were to buy private insurance, typically the cost savings can be thirty to sixty percent. The unfortunate part is there is a tax incentive to have an employer sponsor a group health insurance.  The only way, that I know - I'm not a tax advisor, you can get a tax incentive for buying private health insurance is if you are self-employed.  Now, there are reimbursement programs available as a tax incentive and still provide health insurance to employees.  This is called Health Reimbursement Arrangement, or known as HRA.  This is a different topic all together.

This method keeps employers tied to the cement block but they are still drowning.  Many businesses based in the United States pay more in health insurance for their employees than they earn in net profit at the end of the year.  It goes back to the saying "there is no free lunch". 

Butch Zemar
www.EliteBenefits.net

As devastating as it may seem to even think of it, you could be saving just so you can pay for a catastrophic illness. Most people ignore the fact that it could even happen to them.

I have something to tell you that you may not know. A critical illness does not discriminate. No matter how hard we try, it is something we just cannot avoid. You can do everything right and you could still fall into the percentages of developing a critical illness.

Let me run something past you, so listen up...

You work hard and save. No wait, you slave so you can save. You complete your due diligence with your financial advisor to invest in order to make your money go further. Life couldn't be any better, right? And then it happens...

Out of nowhere a catastrophic illness strikes! You do everything you can to stay alive, including taking off work for the treatments and rest. You start draining your investments to make ends meet. The health insurance you have pays for the medical bills. Then you take off more time just so you can keep fighting the fight. Now you are about a month behind on your bills because you used up all available paid time from your employer. You decide it's the right thing to cash out on more of your retirement to catch up. Your employer meets with you and tells you that they feel bad for you but they will have to fill your position because they have a business to run and need the man power to service their customers. Once you get better you can come back full time.

Was that music to your ears? I think not.

The company offers you COBRA for your health insurance... at a hefty price! You cannot give up your health insurance. What if you get worse or something else happens? You hang on by a thread to keep it. So now you withdraw all you can to pay your premiums and play catch up on your bills at home. It seems this nightmare will never end.

I think you see the pattern here. Eventually you run out of money, no health insurance because you couldn't afford it and up a creek without a paddle. What's next?

In conclusion: Most people insure what's important to them... Cars, homes, jewelry and your life! The general population forgets to insure their number one asset, their ability to work. The price is a fraction of what it will cost without proper protection. If you do not insure your ability to work, everything else in life just will not be the same.

To your health,


Butch Zemar
http://www.EliteBenefits.net/

According to the Washington Times, forty million Americans are paying higher taxes this week due to what is being called OBAMACARE.  Effective January 1, 2011, on your Flex Spending account (FSA) or Health Savings Account (HSA) , you can no longer use YOUR funds for over the counter medication.  Before now you could use your pre-tax dollars for aspirin, cough syrup, and many other over the counter medications.

Now on an HSA, I would not recommend using your funds for these services anyway.  On an FSA, you cannot carry your funds over to the next year, so a common practice was to buy aspirin or anything you knew you would need next year. The Times quotes “this will be an unsuccessful remedy for the nation’s health care woes.”

In this writers opinion, it will deter the use of preventative medicine, which I think was one of the things Obamacare was to encourage.

Thanks for reading.

Eric Willson
I Sell Health, Inc.
http://www.iSellHealth.com

This year has really passed by fast.  I know for me it has especially with my 11 month old son running around.  He is already walking! Just incredible!  I hope you finish off the year strong with work, family and passion.

There are lots of changes going on all around us with health care.  As most of us have heard, the first phase of the health care bill has started a couple of weeks ago and some people have already seen the impact, maybe including you.  Some are negative, some are positive.  Unfortunately, there is more to come and with that comes uncertainty. 

With this in mind, I was invited to be a guest speaker on a conference call with Beverly Financial Group in Chicago to talk about health insurance.  I personally invite you to join me on the call on October 20, 2010 at 12pm CST.  The call is titled “Would You Rather Have a Root Canal Than Deal With Health Insurance?”. 

The items that we will be discussing will be:
• Should you buy from an agent or a broker?
• Why does Health Insurance cost so much?
• How do you find the best value?
• What tax incentives are available?
• What is critical illness insurance and is it right for you?

To join the call please dial 218-548-1957, then put in passcode: 234462#

Until then, I’ll be negotiating rates for my root canal.  Feel free to contact my office with any questions or concerns you may have. 

To your health,
Butch Zemar
Elite Benefits of America
www.EliteBenefits.net

What to bring to the class:
1) A Sense of adventure and fun!
2) Swimsuit and towel - There are changing rooms there with a handful of lockers to lock your items.
3) Bring a Scuba buddy (friend, relative, co-worker, employee, etc)

Anyone 10 years old or older can participate. Children ages 8 and 9 are welcome if there is a supervising, participating parent or guardian in the water with them. The March 6th free experience is really a great family outing; a mini vacation right here in the neighborhood. If you end up enjoying it as much as we do and want to learn more you can talk to the staff about what the next step is. It’s a great experience. Once you get certified, you are certified for life! You can take the card anywhere in the world and go scuba diving. You don’t have to worry about taking a small class every time you want to go out and enjoy the underwater world while on vacation.

There are a limited number of spaces available, so reservations are recommended. A signed medical and liability form are required before class begins and may be completed on site. For more information, to reserve your spot and to request the forms, please call Scuba Emporium at 708-226-1614 or email to butch@scubabutch.com.

Click here for a map to Scuba Emporium.

Date: Saturday, March 6, 2010 Time: 1pm - 4pm Location: Scuba Emporium Street: 16336 104th Ave City/Town: Orland Park, IL

Before I begin with my opinion on what is happening, let me be clear on one thing:  I do not believe nor do I claim to have “the answer” to solving our country’s healthcare woes.  Instead, I want to provide you with an insurance agent’s perspective on what is currently happening with the healthcare debate.  Please remember that the following is merely my humble opinion.

Sunshine and lollipops are not coming our way: There has been a lot of talk about low-cost, benefit-rich health plans that will be available to everyone and how rising healthcare costs will be solved by using electronic medical records.  I’m skeptical about how true these predictions are.  Unfortunately, someone has to pay for healthcare.  Insurance companies and the Federal Government do not have money trees in the backyard (the government can only print so much money out of thin air before inflation and other economic problems arise).  Insurance companies and the Federal Government get money from you and me, so we either have to pay for healthcare through our own pocket, health insurance premiums, or taxes.  If you are financially stable, you’re going to be paying for those less fortunate’s healthcare one way or another.  This is part of the reason why an aspirin at the emergency room costs $25.00; you’re paying for your aspirin and all of the people who cannot afford to pay’s aspirin.

While electronic health records may reduce certain administrative costs, you’re still going to have to pay a doctor to remove your appendix.  Not too mention you have to pay for all those nurses and high-tech medical equipment.

A big, complicated piece of legislation is not the most efficient way to solve our problems:  I think many people have forgotten that snappy Schoolhouse Rock episode where the bill sings and dances about how a bill becomes a law.  Big bills allow individuals in Congress to tack on questionable amendments to bills that are not often in the public’s best interest.  These amendments are easier to hide in a big bill especially when the members of Congress haven’t even read the entire bill word for word.  I advocate for a series of smaller bills to be passed to address certain key issues that represent part of the whole problem.  Smaller bills passed over time would give Congress more flexibility should adjustments be needed as a result of unintended consequences caused by the new legislation.  Smaller bills would also make it easier for our representatives in Washington as well as the public at large to read the full bill text before its passed into law.

Key items that need to be addressed:  One item I believe Congress and I would agree on is the need to eliminate insurance company’s ability to decline health insurance coverage.  The current system allows some people to be locked out from getting coverage due to their past medical history.

Post-issuance underwriting needs to be banned.  Currently, many states allow health insurance companies to go back and re-underwrite a person who was previously approved for coverage when they file a claim.

Tort reform needs to be discussed.  Even if we don’t want to admit it, our lawsuit-happy culture is adding to the cost of healthcare for everyone.  This is an important issue that cannot be left on the side of the road because it makes some people politically uncomfortable.



Michael J. Lloyd
Brockhaus, Stuber, Fox & Lloyd, Inc. Insurance Agents
http://bsflinsurance.com/

Ever wonder what its like to breath underwater? Join us underwater on October 17th. The Discover Scuba Diving program lets you experience the thrill of diving in a pool. During your adventure, you’ll master some basic concepts and have a lot of fun doing it! It’s a great experience for the whole family.

We will introduce scuba diving to you in a heated pool in water shallow enough to stand up in. Once you get comfortable with this great experience we will allow you to swim in 9ft of water. This is your chance to finally try it. There will be a video camera there to video tape those who want to be video taped. We will then publish them on YouTube and Facebook. It will be a blast!

You should check out a couple videos from another class:
http://www.facebook.com/home.php#/video/video.php?v=1149275221569
http://www.facebook.com/home.php#/video/video.php?v=1149273741532
http://www.facebook.com/home.php#/video/video.php?v=1149272181493
http://www.facebook.com/home.php#/video/video.php?v=1149268821409

What to bring to the class:
1) A Sense of adventure and fun!
2) Swimsuit and towel – There are changing rooms there with a handful of lockers to lock your items.
3) Medical questionnaire – http://bit.ly/zcTRx
4) Bring a Scuba buddy (friend, relative, co-worker, employee, etc)
You can send them this link to preregister: http://www.eventbrite.com/event/440268856

If you end up enjoying it as much as we do and want to learn more you can talk to the staff about what the next step is. It’s a great experience. Once you get certified, you are certified for life! You can take the card anywhere in the world and go scuba diving. You don’t have to worry about taking a small class every time you want to go out and enjoy the underwater world while on vacation.

Click here for a map to Scuba Emporium:
http://maps.google.com/maps?hl=en&source=hp&rlz=1R2GGLL_en&um=1&ie=UTF-8&q=scuba+emporium+orland+park&fb=1&gl=us&hq=scuba+emporium&hnear=orland+park&cid=0,0,10343741038053843880&ei=AtO0SvX6NIjSMuWe3NoO&sa=X&oi=local_result&ct=image&resnum=1

The not so fun stuff:

- Have to be at least 10 years of age. (there are programs available for under the age of 10)
- If there are any yes’s on the medical questionnaire it has to be signed by your doctor (a fax is OK). The lawyers require you to consult with your doctor if there are any medical questions.

Date: Saturday, October 17, 2009
Time: 8:30am – 12:30pm
Location: Scuba Emporium
Street: 16336 104th Ave
City/Town: Orland Park, IL

To register click here: http://bit.ly/JFqbR

- Butch Zemar

Butch Zemar - Elite Benefits of America
 

You’re healthier. If you have quit smoking, lost a substantial amount of weight or made significant improvements to your health, let your insurance company know. You may be able to qualify for a lower rate on your coverage.

Rates are near historic lows. Life insurance rates remain near historic lows. In fact, the cost of basic term life insurance has fallen by nearly 50 percent over the past decade. So if your family’s budget is tight and your health status hasn’t changed much since the time you last purchased coverage, you may want to apply for a new policy. If you do, make sure not to drop your current coverage until the new policy is in force.

Circumstances have changed. It is smart to review your policy every year to make sure it’s adequate and up to date. If the kids are out of the house, your mortgage has been paid off, you’ve gotten divorced or family members no longer need your financial support, your need for life insurance coverage may have decreased. A smaller face amount policy will likely save you money. “If people depend on you financially, life insurance is an absolute must and needs to remain a priority,” says Zemar. “But no one should pay more than they have to, especially in these tough economic times.”

About Life Insurance Awareness Month

Held each September, Life Insurance Awareness Month is an industry-wide effort that is coordinated by the nonprofit Life and Health Insurance Foundation for Education (LIFE). The campaign was created in response to growing concern about the large number of Americans who lack adequate life insurance protection. Nearly 70 million adult Americans have no life insurance, and most of those who do have far less coverage than most financial experts recommend. For more information on life insurance, visit LIFE’s website at http://www.lifehappens.org

Butch Zemar
www.EliteBenefits.net


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"The doctors gave me back my life. They repaired the aneurysms in the artery leading to my brain that would have either killed or impaired me. And I know how valiantly they worked to restore my sons' health after they were involved in a serious automobile accident as children. No doubt about it, for this and many other reasons, the U.S. health care system is wonderful. Sure it costs a lot, and of course, we must help those who don't have enough health insurance. But I don't want to destroy this great system in the process." - JOE BIDEN

Market Driven Health Care (chapter 5)
Regina Herzlinger, Harvard Business School, 1997


Fast forward to 2009 and the most dangerous administration in U.S. history. Instead of allowing Americans to solve our health care "crisis" through free-market transactions, they're forcing "solutions" on us that are guaranteed to make things worse!

Latest and MOST DANGEROUS example: A House proposal (during an economic recession!) costing taxpayers TRILLIONS, because Americans have a "RIGHT" to universal (Canadian-style) health care. Joe?

Reality Check: The "right to health care" doesn't exist in a government-run system... ANYWHERE in the world! The right to health care is nothing more than an opportunity is to get (TAXPAYER PROVIDED) services for "free"... IF the government decides to make those services available.

But the government is under no obligation to provide anything... and when it decides to ration or deny treatment... people can't go to court and sue the government (like Americans can sue an insurance company for denying a covered benefit).

Government-run health care is inefficient and provides inferior medicine. Look no further than Medicare (our own "universal" government-run program for seniors) and all of its coverage gaps. Medicare has an unfunded liability in the TRILLIONS of dollars... which proves that government programs aren't affordable either.

If the lawmakers are intent on spending taxpayer money, they should give refundable tax credits to people who need help, so they can purchase their own private individual coverage on the open market!

But don't just take my word for it...

Check Out This ALARMING Video and email it to EVERYONE concerned (and, more importantly, unconcerned!) about socialized medicine in America!

- Mark Goldstein

www.TheProducersAlliance.net

The part that I think stood out the most to me was the government would be in control of making the rules.  What the government may not be sharing is that the new rules can, or should I say will, force competing companies out of business.  It won’t be the driving force to reduce the prices. 

Is anyone aware that we all pay for the for what Medicare doesn’t pay?  The cost shift goes to the private sector.  Not only will insurance companies shut their doors but hospitals will close them as well.  Have you thought of that?

Check it out:

http://www.cnsnews.com/public/content/article.aspx?RsrcID=50064

Butch Zemar

www.EliteBenefits.net

The authors put things into a different perspective by having the auto insurance industry add co-pays for service.  It starts out that most of the maintenance is free for the consumer while paying premiums.  Each year the insurance company has to raise the premiums to offset the usage.  Now that people were paying more for it they felt they were entitled to get services done even though they didn’t need the service.  No matter how much premiums go up people keep their co-pays in the plan so they can get services done that are paid for by the insurance company.  In turn, this creates waste.  The book elaborates on how networks are started and more negotiation occurs to stabilize premiums.   

The authors stated that in 1960 Americans paid for 48 percent of their healthcare, i.e. doctors and hospital bills, and the insurance company paid the rest of the bill.  However, in 2006, the number dropped to 12 percent of those Americans paying for the health care.  Those who had health insurance back then remember that health insurance premiums were not a problem.  No one complained about paying out of pocket for services they needed.  This led to asking what it cost, shopping around, and making sure the services were actually needed.  It was what people were used to.  

As time went on, insurance companies added in pre-paid maintenance programs, or co-pays.  You paid a little more in your premiums but in return you were able to go to the doctors and not have to pay out of pocket for the whole bill.  As time goes on the insurance companies have to keep raising the premiums more drastically just to cover the costs. 

Some people think that insurance companies are like the oil companies.  They believe that more the price goes up the more the profits are.  However, that it couldn’t be further from the truth.  There was a report done by Wellpoint that indicated that on the average insurance companies only make 3% in profits.  I’ll discuss that more in detail in another blog post. 

The book went on to explain in a little more detail.  Towards the end of the book they noted that in 2007 $725 billion for health care were paid for by private insurance companies.  There are a lot of zeros after that number.  If Americans choose to do away with private health insurance and move into a government-run health system, where would $725 billion come from?  That $725 billion will eventually exceed $1 Trillion.  Do you think raising all of our taxes will be a good solution?  If that’s the case eventually we will pay more in taxes for our healthcare than it would have cost just paying our own premiums.

Butch Zemar
www.EliteBenefits.net

 
Butch Zemar
www.EliteBenefits.net

Press Release For Immediate Publication

Part of the change being discussed in our country today is in health care and, overwhelmingly, we see misinformation and lack of information being detrimental to this national conversation. When it comes to conversations around our kitchen tables and small business conference tables, misinformation is an even greater problem. Do you understand thoroughly how and what your health insurance policy covers? Do you have a firm grip of what you need to do to receive proper health care? If you’re a small business owner, are you completely comfortable with the details of your policies – and does it really meet the needs of your industry, your staff and your budget?

Most people, including small business owners, really don’t understand their existing coverage and often find themselves at a huge disadvantage when making a claim. Without the proper knowledge, you can find yourself empty-handed, or in significant debt when a health care crisis occurs. “Finding out at claim time how your policy works – or doesn’t work - is the wrong time,” says Butch Zemar, President of Elite Benefits of America.

That’s why Zemar and Elite Benefits have devoted a significant portion of resources to educating families, individuals and small business owners about health insurance, all accessible via the web. At www.elitebenefits.net/articles, readers will find information about providing coverage for themselves and their families while unemployed, things that business owners can do to cut costs, when critical illness insurance is appropriate, what options are available for young people after graduation and making a decision between being part of an employer-based group or holding an individual policy. Zemar says, “With the right education, the cost of health care insurance and out-of-pocket expenses can dramatically decrease.”

Zemar is also cognizant of different learning styles and posts information as written articles, interactive blogs and videos. Because the health care situation is evolving so quickly now, a link also makes it easy for readers to register to receive new information regularly via an e-mailed newsletter.

Providing cutting edge information and updates on current events in the health care industry enables Elite Benefits of America, which specializes in health care insurance, to help consumers make better choices for their health insurance. Zemar’s seven years as a health and life insurance specialist helps individuals, families and small businesses find the right insurance product to fit both budget and needs as well as personally provide education and consultation.

Having the right information about health care can save your financial security – and your life. Visit www.elitebenefits.net, or call 888-535-3006 so that when a conversation begins about the state of health care in this country, you’ll be the one with all the intelligent answers.

Contact: Butch Zemar, Elite Benefits, 888-535-3006  

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Most Americans spend more money than they can make, leaving them with high personal debt. Families are taking out home equity loans and second mortgages to extend their spending limits. Most Americans are just a heart attack, cancer or stroke away from financial disaster.

Fortunately, with advances in medical technology, patients are no longer dying. People are outliving their illnesses and continuing on their lives. When a critical illness strikes it puts a financial toll on the family. Most people have health insurance through their jobs. However, they will either lose their benefits because they were too sick to go back to work or they couldn’t pay their premiums anymore. You can have the best health insurance policy and still have a financial problem. For most of us, we still have a financial obligation to our family. Health insurance will not pay for your living expenses such as your mortgage, utility bills or food for the family. Financial concerns impacted your health even though more people are surviving critical illnesses. This can increase stress for the illness that can prolong the recovery period.

Despite the fact disability income protection plans are widely available it isn’t enough to help people through this financial crisis. Since 1983, Critical Illness Insurance became very popular in many countries, such as the UK, Australia, Canada and the United States. It is an insurance policy that pays out one lump sum of money based on a specific qualified critical illness. The lump sum is based on the amount you need and how much you can afford. It is not tied to your income.

Is this kind of insurance expensive? No, it’s far more expensive not to own a critical illness policy. Just in case you are a little skeptical check it out for yourself by clicking here. Keep in mind not all critical illness policies are the same. Some will have certain restrictions such as waiting periods. Some will make you wait 90 days to get a check. You want to find one with the shortest elimination period. Some policies available only have the waiting period in the beginning of the policy i.e. you cannot make a claim within the first 60 to 90 days. The other thing to look out for is some health insurance companies offer their critical illness insurance as part of the health insurance. There are two downsides to this:

1) The premiums are subject to change based on the health insurance market, which could be yearly.

2) Most people are changing their health insurance every couple years. When you change your policy you will lose the critical illness policy.

Other critical illness insurance policies are on a term life insurance structure. This can have more advantages than on the health insurance ‘chassis’. There are three advantages:

1) The premiums could be locked in ten to twenty years, similar to a term life insurance policy
2) The policy is separate from your health insurance policy. This way you can have the freedom of choosing the health insurance policy that is best fitting for your family even if the policy does not offer critical illness. This also allows you to buy a policy if your employer is paying for, or the majority of, your health insurance at work.
3) The benefit will pay according to the policy in a result of a death as well. Some restrictions could apply. Refer to your agent or policy certificate.

The policy is not limited to homeowners, the wealthy or the poor. Critical Illness Insurance is for everyone. If you have to take time away from work because your spouse is now sick, critical illness coverage would eliminate the added burden of losing the income that is required to pay their bills.

The expense of health insurance could be astronomical, especially if coverage is denied or cancelled. Critical illness insurance is routinely confused with health insurance. People have become bankrupt trying to pay medical bills that were not covered by their health insurance provider. The majority of health insurance policies feature limited benefits, ceilings and caps on the yearly payouts and/or life time maximums. Purchasing a critical illness policy will guarantee your ability to meet life’s financial obligations.

So, how much coverage will you need? That depends on your situation. Your family can only determine the amount you want based on what you can afford. There are three questions to ask to determine the amount:

1) How much are your monthly expenses
2) How much is left on your mortgage
3) If you couldn’t go back to work for a while, how much would you need to continue your lifestyle.

In conclusion: Fifty percent of bankruptcies are due to medical bankruptcy. Most of them had health insurance at the time of the onset of the illness. All of us could be one paycheck away from losing everything we have worked so hard for. Unfortunately, our expenses don’t stop when our income stops. If you don’t have the ability to go back to work you won’t have a source of income. Fortunately, now you have the ability to choose the amount of the lump sum benefit, and is not tied to how much your income. Check it out today before it’s too late.

Butch Zemar
Elite Benefits of America
www.EliteBenefits.net

Many households are carrying more personal debt than ever. In fact, debt is at an all time high. With mortgages on depreciating homes, families are taking out home equity loans and second mortgages to get by. The financial obligation is that mounting higher and higher is just a crisis waiting to happen. Most Americans are just a heart attack, cancer or stroke away from financial disaster.

Unfortunately, illnesses don’t discriminate. Within the next four minutes, fourteen Americans will have a heart attack or a stroke. Ten more will be diagnosed with cancer. Five families will be forced to declare bankruptcy because of a medically related financial hardship. A family has an eighty-three percent chance of either the husband or the wife having a heart attack, stroke or being diagnosed with cancer. With those odds, what are your plans? Are you ready to take that kind of devastation?

In 1967, Dr. Christian Barnard was recognized for performing the first successful human heart transplant. On the same team of surgeons was his brother, Dr. Marius Barnard, whom came up with a concept in 1983 called Critical Illness Insurance. Due to the modern miracle of medical progress patients are no longer dying. He developed an insurance product that pays out one lump sum of money based on a specific qualified critical illness. Although more people were surviving critical illnesses, financial concerns impacted their health. In turn, recovery was delayed as a result from stress and other factors. Critical Illness Insurance started out in South Africa, where Dr. Barnard was from, and has grown drastically since then in countries such as Australia, New Zealand, Great Britain and the United States. Every country it has penetrated has become a huge success. Most countries Critical Illness Insurance outsell their Mortgage Protection Insurance.

Even if we look closer at the statistics:

1) Forty-eight percent of all mortgage foreclosures are due to some type of major illness, according to HUD.

2) Fifty percent of personal bankruptcy is due to some type of major illness, a Harvard University study revealed.

3) Only three percent of illnesses result in death of a major illness, according to HUD.

Even the statistics show that having mortgage protection would only help three percent of the people. Seventy-five percent of these people had health insurance, according to the Harvard University study. They either lost their benefits because they were too sick to go back to work or they couldn’t pay their premiums anymore. You can have the greatest health insurance policy and still get wiped out because health insurance is designed to cover medical expenses only. Health insurance will not pay for your living expenses such as your mortgage or rent payment, college tuition, car payments, utility bills or food for the family.

What Dr. Marius Barnard realized was despite the fact disability income protection plans were widely available, it wasn’t enough. From his personal research he discovered two things:

1) The people that lived would have been dead without the procedure

2) They were dying financially. Above all, being financially stressed took a toll on their health.

Not only is it financially devastating to not have the ability to produce an income but what about the treatment that your health insurance won’t pay for? The average household has less than $10,000 in retirement. They have no money set aside to pay for any type of critical illness. What if you had to pay out of pocket for experimental treatment that your health insurance wouldn’t cover even if it was the best thing to do for your situation? Where would you get the money?

Critical Illness insurance is for everyone. The policy is not limited to home owners or employed individuals. If your spouse becomes sick and you have to take time away from work, critical illness coverage would eliminate the added burden of not making the required income for your family to pay their bills.

In conclusion: Most of us are just one paycheck away from going bankrupt. In a moments notice we can lose everything we have worked hard for all of our lives. With the ability to choose the amount you need based on what you can afford not tied to how much your income is, your mind can be put at ease. The benefit will pay one lump sum, in most cases, for a qualified event. Some of the programs send the check within two weeks of diagnosis. There are things outside of our control that health insurance isn’t going to pay for alone. Such as experimental treatment, internal limitations or caps on your health insurance policies. Let’s not forget your mortgage, food and living expense or your child’s college education. How much would you need?

Butch Zemar
Elite Benefits of America
www.EliteBenefits.net

Do you really think you have $5,000,000 of coverage for the life of your health insurance policy? Take another look. Most plans, probably close to ninety-five percent, or more, have internal limitations. The limitations in these plans most health insurance agents are not aware of. Your local auto and home insurance agent? Forget it! Only the exceptional insurance agents will know. These are the ones that take the time to find this information.

There are so many internal limitations in plans I won’t be able to list all of them here. Refer to your health insurance expert. If you are on a group plan, limitations are still there – some will be higher than private insurance – some will be lower.

These limitations can range from a certain number of doctor visits or wellness coverage to $250,000 maximum coverage for organ transplant, in or out-of-network. Quite frankly, that isn’t nearly enough for organ transplants. One of the biggest limitations, and it’s one of the most expensive, is outpatient physical therapy. This one is huge. Some of the most well known carriers put these limits on their policies to control abuse of these services. It’s more like controlling costs. If you needed $20,000 in physical therapy, based on your situation, you could be vulnerable to at least $17,000 ($3,000 max benefit). Some could be as much as $19,640 ($360.00 max benefit)!

When would you ever need physical therapy? It could be for a little sprain in the ankle or wrist to as big as a heart attack or stroke. Physical therapy isn’t cheap these days. What if you broke your leg and needed to learn how to use it again, but you were well enough to be released from the hospital? You would go through rehabilitation therapy.

Some of the carriers that have such limitations are as follows, but not limited to:

-Blue Cross and Blue Shield
-Aetna
-Unicare
-Celtic

Check your state variations.

Each one of these carriers has their own limitation which varies from company to company. Where does this leave you? Vulnerable possibly? Medically bankrupt?

Since we don’t have a crystal ball we can’t predict the future. If you claim you are not worried about physical therapy I would say: Congratulations, you are officially the world’s smallest insurance company. Have you ever seen an ambulance fly by with their lights and sirens on? Do you really think they are just practicing?

By now I think you get the point. Some carriers have raised the bar on this limitation. Some have raised the outpatient physical therapy to twenty visits. If you had to go to therapy a couple times per week, that’s almost three months of therapy – that’s reasonable. Some others have raised it to sixty visits – depending on the plan you choose. To ensure that your insurance is covered, it might not be a bad idea to get a good amount of Critical Illness Insurance. Critical Illness Insurance is a policy that pays one lump sum if you are diagnosed with a critical illness. It could save your life, literally.

With the recession upon us, unemployment has become a reality and is at an all time high. The media and organizations are getting information out to the public on how expensive health insurance can be when combined with unemployment income, or the lack of income. It is so true that health care costs are on a rise, even more so when you elect to take on the expense of COBRA (Consolidated Omnibus Budget Reconciliation Act of 1986). Fortunately, there are other options families have to choose from. Health insurance is a necessity, like food and shelter. It is not worth the “cost” of not having health insurance. With COBRA being at the high expense that it is, most people move to alternative means of healthcare, such as a Short Term Medical (STM) or their own private health insurance plan.

There is the argument that if you have a pre-existing condition you will not be able to get any coverage or have to settle for lack of coverage. This is true; if you have one of over 150 conditions out there you can become uninsurable. You will not be able to buy coverage on your own outside of the high-risk pools. COBRA has its downsides when it comes to pre-existing conditions as well. However, the most common conditions are usually covered, as well as many other conditions that could be covered, only if you work with the right health insurance agent. A truly independent agent has the ability to develop relationships with multiple carriers along with the ability to converse with them to see what the probable outcomes are. Some of my best clients are still amazed that I was able to get them coverage, often times better than what they had before despite the pre-existing condition.

Another option for families who are on a tight budget is taking on a Short Term Medical (STM). Basically, you are renting a health insurance policy for catastrophic, only over a short period of time. The health insurance companies give you a break on the price because:

1) The policies expire at a maximum of 6 months with an option to renew.
2) They may only provide a discount for the minor things such as, but not limited to:

* Doctor Visits
* Lab Work
* Wellness
* Rx coverage

The downsides to having an STM are:

1) Like COBRA, the policy eventually runs out. If you develop a health condition while on the policy and you need to continue treatment, the insurance company may turn down the renewal.
2) If the condition is on their list of conditions that are uninsurable, even if the treatment is over, a policy would not be offered for that individual.

From my experience, I can tell you that it is much safer to provide your family with more permanent coverage such as a private health insurance policy. The policy can never cancel on you due to health and usage of the policy. It will also never expire on your family. This way if you move to a new employer that does not provide health insurance benefits for your family, or if you start your own business, you can still buy more catastrophic health insurance (such as a Health Savings Account (HSA) Plan) to keep premiums more affordable and have more coverage than an STM.

The lack of health insurance can cause major problems. Far too often the uninsured delay the needed medical attention. As a result, adults can wind up with conditions that otherwise could have been prevented. The flip side is if you end up seeking medical attention, many people end up in debt over it.

There are a couple of things you can do to have permanent insurance more affordable for your family. The first you have to do is ask yourself what is the most important thing for you to insure. This is a very good question to ask. Some people may claim going to the doctor is the most important thing for them, however you cannot buy health insurance to cover just doctor visit co-pays. There is a reason for that. We don’t buy health insurance to save $70+/- at the doctor. We would buy insurance for the big expensive claims. To make it more affordable you may have to go with a high deductible. The good news is you don’t need your deductible in cash at the time of claim. The facilities are usually reasonable with payment plan options to make it more affordable for your family. Having $5k-10K out of pocket if something happened to your family is much better than having $100,000.00 bill hanging over your head for not having insurance.

Your employer is in complete control of how they distribute your health insurance coverage. This is one of the contributing problems when you become unemployed. They can make changes to the policy (i.e. deferring more cost to the employees), do away with the health insurance all together or lay you off. Unfortunately, you do not have a say so unless you are the owner or on the board of directors. It seems the problem starts when unemployment hits. In the world of health insurance, many of these problems can be prevented if families just took advantage of buying their own private health insurance policy. This way if you are employed or not, it is not a reality check. In fact, it is already factored into the monthly budget, right? You have control of the benefits by choosing the plan that best fits your needs, your wants and your budget. Work with an independent agent to be sure you have all the options.

American Community has been around since 1938. They are an insurance company that uses its independent field force to do their advertising. They are one of the oldest health insurance providers in the country. So far, from what I have experienced they are an excellent carrier to work with.

One of the benefits I, as well as most of clients, am excited about is the accident benefit. It’s so unique that I haven’t seen it in any other policy. Most accident benefit programs are in a form of supplemental insurance. It is most common that the supplemental program will have $100.00 or $250.00 deductible and you receive a check up to $2,500, $5,000 or even up to $10,000 for each accident. Please note that the benefit is chosen when you sign up for the policy and is only paid up to your exposure at the time of claim. If your exposure is zero, you don’t get a check. On top of this, you are paying additional premiums for the benefit.

American Community has their accident plan built into all of their plans, at no additional cost! They waive the entire deductible at the time of claim. That’s better than receiving a check for your exposure. The covered charges are then paid at your selected co-insurance level, i.e. 80%/20%, 100%. The only catch to this is you have to seek treatment within the first 30 days of the injury.

Some may argue that you still have exposure due to the co-insurance. I would agree with that statement. However, if you add up all over exposure you are anywhere from $4,500-$9,000 out of pocket, typically. This is the reason I would advise my clients to go with a higher deductible, such as $5,000 or move to American Community’s HSA Plan. We would then choose the 100% co-insurance. This way you would have 100% for the accident benefit. As an added bonus, if you elect a $5,000 deductible or higher on their standard plan, American Community will lock the premium rate in for 24 months – at no additional cost!

In summary: You reduce your overall exposure by increasing your deductible. Add the 100% co-insurance, and have your deductible waived for an accident. From there my clients add in a decent amount of Critical Illness Insurance to eliminate their exposure from a critical illness, possibly enough to pay off their mortgage and take some time off of work to insure they will gain their health back, stress free. Refer to your local agent and plan details.

Butch Zemar
Elite Benefits of America
http://Blog.eliteBenefits.net

The healthcare industry is finally acknowledging that there is cost shifting to the patients in terms of their healthcare, such as prescriptions. This forces the patients to find alternatives. It is an interesting point because most people do not know they can shop healthcare. Some think that Walgreens® can get a better price on drugs because they are on every corner in America.

Every pharmacy buys drugs at different prices. On that statement alone we should shop around for our prescriptions. At times your regular pharmacy isn’t the best spot for certain medications.

To top this off, many of the brand name companies make their own generic with the same active ingredients. If that is the case, why wouldn’t people switch to a generic drug and save everyone money? Good question! I often wonder that even with a generic co-pay being $10.00 on many health insurance plans these days, if you can get it for less why wouldn’t you? Lots of places like Wal-Mart® and other chains are offering generics for under $10.00.

Originally, our health insurance plans gave us incentive to ask for the brand drug due to the lower co-pays. The brand drug wasn’t that much more for the patient compared to the generic. It’s like getting the name brand item in your local grocery versus the generic for only pennies on the dollar more. The pharmaceutical companies capitalized on this by giving incentives all the way down the line to the doctor prescribing the medication.

The other issue Americans face is that many of us are treated for symptoms of the problem without getting to the root of the problem. Sometimes just avoiding certain foods can change the outcome of your health. If action is taken on your part you could possibly eliminate the medication altogether. You could be on your way to a healthier lifestyle.

With more and more Americans being responsible for their own healthcare in one way or another, it forces us to do something different. This not only goes for our prescription drugs but our treatments as well. Sometimes just by asking for a discount the facilities will give it to you. If you shop around for that test you have been putting off you might find it for less due to competition.

Now we all can live a better, healthier life.

To your Health!

Butch Zemar
Elite Benefits of America ©

How would you like a way to save fifty-percent, or more, by giving your employees Tax-Free dollars to buy their own “private” health insurance policies? The most serious economic challenge facing businesses today is reducing the cost of healthcare. Far too often employers are drastically reducing healthcare benefits and deferring more of the monthly and yearly costs back to the employees and their families. If your company is providing group health insurance, you need to know about the changes in the law that have created the most dramatic and money saving opportunities since World War II, when employers were first allowed to provide tax-free health insurance benefits during the rate freeze.

In today’s business world, employees are quick to go elsewhere if they see a better career opportunity. Providing good benefits is essential to retaining the best employees, but group health insurance can be too expensive for some small business owners to sustain.

A Health Reimbursement Arrangement (HRA), sometimes called “Section 105 Plans”, allows you, the employer, to reimburse your employees for their individual health insurance premiums and/or expenses, taking you out of the middle. Employees will carry their own private coverage which is totally portable and not tied down to their employment. Your employees will also love the fact that they now have the benefit of guaranteed health insurance for life, even if they become too sick or hurt to work, or decide to retire early. Premiums cannot be raised, nor can policies be canceled because of a catastrophic illness, injury or job loss. The employees will each get to choose the insurance plan and plan options, such as deductibles, that best suits their family’s needs. It also allows your employees and their families to work with a health insurance expert to get the best value for their situation. Many are choosing Health Savings Accounts as a way to further reduce their health insurance costs. Once everyone is approved they will have permanent coverage that is not tied down to their employment. And you, the employer can get out of the health insurance business, for good.

Employers will no longer be required to administer the plan, and you no longer have to shop it every year with an HRA established. This gives the employers the ability to get rid of their overpriced and profit-draining group plans and give tax-free dollars directly to their employees through an HRA. The employees can purchase their own better, safer and permanent private health insurance polices. The savings can be huge with premiums averaging fifty-percent less than typical employer-sponsored plans. HRAs, along with HSAs, represent the newest and most cutting-edge development in the employer-sponsored health benefits. While usually a high-deductible plan is chosen for the insurance portion, there is no requirement to do so, and any approved plan can be used. When employees carry their own private health insurance coverage, there are also no COBRA issues to deal with when employment terminates.

HRAs represent the future of health insurance in America. They are the only employee benefit vehicle allowed to pay for premiums on individual health insurance! Best of all you, the employer, decide how much of an allowance you want to provide and your contributions are completely tax deductible for you and tax-free for your employees! Congress created the HRA as the newest consumer-directed plan designed to cover medical expenses and it is subject to IRS regulations and guidelines.

Employer funds are used to reimburse employees for qualified medical expenses in accordance with the pre-established employer arrangement. The arrangement specifies a dollar-limit for the amount of qualified expenses that will be reimbursed to an employee each year. The arrangement also usually specifies that any unused allocation of funds can be accumulated and carried over for use next year. IRS requirements for qualified medical expenses also apply. Employer payments are a tax-deductible business expense and reimbursements to employees are tax-free. Availability of plans is limited to the qualified plans offered by insurance companies conducting business in your State.

Since the employer owns the funds until presented with valid receipts, there are no actual funds accumulated that employees own to rollover to a new employer or take with them if they leave the company. An employer could continue to reimburse a former employee if he chooses to do so, such as retirement.

As for the forty-something percent of employers, and growing, who do not offer group health insurance because it is too expensive, now there is an affordable solution; give your employees tax-free money to buy their own, better coverage at a fraction of the cost of group insurance.

Why are so few employers taking advantage of them? That is a great question! It is surprising that very few attorneys, accountants, insurance agents, benefits administrators or benefits consultants are even aware of these new “defined-contribution” plans, but that does not mean that you need to continue wasting thousands of unnecessary dollars every year on health insurance and double-digit rate increases! (Have your tax advisor refer to section 213(d) of the Internal Revenue Code. Health insurance premiums were added to 213(d) in 2004 as allowable tax-free reimbursements from employers)

In conclusion: This is great news for Employers. They can finally get out of the health insurance “business”. If you want to finally escape your “health insurance nightmare,” yet still attract, retain and have outstanding and grateful employees. You create these savings through a Health Reimbursement Arrangement (HRA). Employers can save as much as fifty-percent or more on their healthcare costs. This gives the employer flexibility and cost savings for the health insurance and the employees can purchase their own better, safer and permanent private health insurance polices. Health insurance premiums cannot be raised, nor can policies be canceled because of a catastrophic illness, injury or job loss. The employees will each get to choose the insurance plan and plan options, such as deductibles, that best suits their family’s needs. On top of all of this, the employer gets a tax break for contributing and employees receive the benefit tax-free. This will increase profits and your employees will be much happier. What more can an employer ask for?

Butch Zemar

HRA/HSA Expert

www.EliteBenefits.net

Blog.EliteBenefits.net

I found this article on the Wall Street Journal’s website. I think it’s interesting despite the fact I don’t believe everything they say as fact. That’s reporters for you.

http://online.wsj.com/article/SB122887085038593345.html

-Butch Zemar

New Articles have been posted. Check them out:

http://ezinearticles.com/?expert=Butch_Zemar

As we mature and grow it can get harder to know who we can trust and depend upon. When we are young it is the foundation of our security that our family, teachers, and loved ones advise us impartially and with our well being at heart.
But, when dealing with the many complexities of life, advice is harder to come by and even harder to trust. Knowing when to ask for help and using good discretion in choosing who to trust is an invaluable life skill. One good rule of thumb when choosing an advisor is to look for independence and experience. This is vitally true when you enter the complex arena of health insurance for the first time.

Obtaining health coverage at any time in one’s life is a complicated and time consuming process. But it is much more involved when you are doing it as a young adult, just leaving the safety of your parent’s coverage, and seeking coverage for yourself for the first time. Graduating from college, getting a job, and signing up for your employer’s health care plan all used to come in logical progression. But, today, many employers are eliminating health care coverage from their benefits package and many young people will go to work in one of the millions of small businesses who can’t afford to offer health insurance. Thus, shopping for and acquiring coverage is a rude welcome to the adult world for many young people. Just who can you trust to give you the best advice and recommendations? In the health insurance industry there is a valuable resource with no hidden agendas that offers sound, impartial, and independent guidance—an Independent Insurance Broker.

An Independent Insurance Broker is an agent that owes no allegiance to any specific carrier, nor do they represent any one company. An Independent Broker can be the mentor every young person needs when first purchasing insurance coverage. Rather than opening up the Yellow Pages and calling an agent that offers only one company’s coverage, they can turn to a Broker who can research all the relevant companies and make the recommendation that can give them the insurance and financial security they need. It is all a matter of trust.

An Independent Insurance Broker is, by virtue of years of experience and impartial commitment, an expert at finding the right coverage for the best value. In addressing life skills with it’s young people, many college placement advisors and counselors are including information about how to find balanced and impartial legal, insurance, and financial advice for its graduates. Insurance brokers can be the difference between years of medical and financial strain and the beginning of a responsible and successful life.

A young person needs mentors to succeed in life and they can find such a mentor in an Independent Insurance Broker. At their jobs, recent graduates will find the guidance they need in their more experienced co-workers who have learned the ropes from their more experienced co-workers. The right of passage in learning from the adults who came before them is evident in every phase of life.

Health insurance is something that many young adults take for granted because Mom and Dad provided coverage and it is surprising how little many graduating seniors know about health insurance. It isn’t something they have ever had to deal with and the experience Mom and Dad have with insurance may be equally lacking because they have always had employer sponsored health care coverage. But the world our young people are entering is a lot different than Mom and Dad’s. The demands and decisions they have to make are in many ways more complicated. Independence and a lack of agenda are the hallmarks of Insurance Brokers and they answer a critical need—unbiased recommendations.

When the stakes are so high, parents and educators owe young people not only the benefit of their experience but up-to-date solutions to today’s problems. One of these solutions is going to an expert and independent Insurance Broker the guidance to start adult life off on the right foot with the best health insurance coverage.

-Butch Zemar

Concerned that some self-employed, small business owners and even employees may be scrimping on essential healthcare benefits during the current economic turmoil? Maybe it’s your own business and you do not offer insurance but you are concerned for your own family. With family budgets strained by higher fuel and food costs, people are filling fewer prescriptions and visiting the doctor less often. The cost of medications and physician doctor visits are on a rise when families are putting together all they have to eat and keep a roof over their heads. When people are worried about the costs of living and about whether they will have a job tomorrow, they are reducing their prescription drug intake, particularly those drugs that do not have a symptom-relieving effect.

If your income decreases because of a lack of business profit, layoff, disability, illness, etc., your family may find it extremely difficult to pay insurance premiums. If your monthly budget is tight or you are not able to make a payment, you need to determine your minimum needs for insurance. It is very important to review your insurance coverage. At times, families have been on a policy for a certain length of time and they do not realize that even reapplying for the same coverage can lower their premiums to more affordable levels. However, the coverage they have had may be inadequate for today’s unforeseen events. This is a reason to work with a true health insurance expert to bring you all the options that are available to you, in order to lower your premium without jeopardizing coverage. Someone who does not review these items on a daily basis may either get themselves into something they wish they had not; or they may have missed another opportunity for better coverage by not realizing there were other options available to them.

Although you cannot eliminate risk from your life, you can postpone, minimize or control some losses. By looking at the numbers closely you may end up coming out ahead just by making minor adjustments on your coverage. Using higher deductibles (the amount of money you agree to pay per year before the insurance company pays for a claim) is a great way to lower your premiums, however, try not to get out of hand with your exposure.

A comprehensive insurance review with your agent every year to two years will help you determine whether you have adequate, or perhaps too much, insurance coverage.
Insurance is the primary way you protect yourself against financial loss caused by illness, accidents and other unknown events. Premiums are paid to an insurance company that in return pays for the losses that may occur. You have to make sure you have enough in all the right areas while keeping the monthly premiums affordable.

Some of the things to review:

• Only insure for the things you cannot afford, i.e. Emergency Room, Hospital, etc. Pay for what you can afford, i.e. doctor visits and lab work - your auto insurance does not pay for your oil changes or diagnostic testing, now does it? Does your homeowners insurance cover the cost of changing your furnace filter? Why is health insurance any different?

• Ask your doctors if they are willing to work with you and Ask for the discount. I have found people do not even know you can get additional discounting from your doctors and hospitals. Sometimes you have to play hardball to get the bills more affordable for you. Remember, they do not know what your pocket book looks like. Also, you do not know what they are willing to do unless you ask. Most places are willing to work with you.

• Talk with your doctor about alternative medications. Is there a possibility of eliminating the medication altogether or possibly switching to a generic form? Most brand companies make a generic form with the same active ingredients.

Employees have a natural tendency to transfer the burden of medical costs on to the employers. They either do not realize or do not care about the cost that is involved to have those kinds of benefits. Many also do not realize what causes their employer sponsored health insurance premiums to raise. Some employees abuse and overuse the insurance offered to them, and this is what drives the premiums up for all of the employees on the plan. There is no free lunch. If you no longer have a job or your new job does not provide benefits, what are you going to do then?

Employers have been so preoccupied about the economy in general from a business perspective that they may not realize some of the changes that have gone on in the health insurance industry. There are many ways to cut cost for employers as well as the employees. It might be a good time to have the Human Resource department take a review on the way the company does things. Just like most things we have to do today, they may have to step outside of what they are used to, in order to meet the ultimate goal.

In conclusion: It is always a good idea to review your insurance with an insurance expert. Make sure the agent is an expert in the type of insurance you are reviewing. It is very common that you will find that your local auto and home insurance agency usually do not work with health insurance on a daily basis (most of them try to avoid health insurance). Also, make sure they represent the majority of the carriers in the market place. There are agents that are independent but are fixed only to a few carriers. This greatly reduces your options. Reviewing your policy with an expert will most likely ease the financial pain of the monthly cost and possibly reduce your overall healthcare cost. There might be things in your policy that you may never be using even though you are paying for it.

-Butch Zemar, President
Elite Benefits of America

FOR IMMEDIATE RELEASE / PRURGENT

Elite Benefits of America, a national agency for providing leading-edge health insurance options, is now offering a customized insurance program that waives deductibles in the event of an accident or injury and reduces the insured out-of-pocket expenses to $0 at the time of service.

By taking advantage of competitive rates and savvy solutions that some insurance companies are offering to individual and small groups and combining these with the out-of-pocket savings realized by establishing a Health Savings Account, it is more than realistic that at the time of illness, the stress usually accompanying a family crisis will not be compounded by worries about the financial consequences of rising out-of-pocket costs demanded by insurance companies in the United States.
“Most self-employed professionals do not realize that the current IRS code allows full deduction of premiums, as well as funds in your personal Health Savings Account,” says Arthur “Butch” Zemar, President of Elite Benefits of America. “It takes the proper set up and execution of these plans to get the greatest tax and out-of-pocket expense benefits,” Zemar continues, “and if you are dealing with insurance generalists, it is probable you will not be given all the options for long-term financial asset protection.”

With more financial options than those professionals who depend on employer-provided health care insurance plans, the entrepreneurial self-employed professional, working with a health insurance specialist, can realize the benefits of “full funding” of HSA (Health Savings Account) and choosing the “Embedded Deductible” when a family member is currently dealing with a chronic or long-term health concern.

While most independent insurance brokerage firms offer a full-range of insurance, the growing trend is for Health Insurance Specialty Brokerage firms, like Elite Benefits of America, who dedicate their resources in marketing, training, and product offerings to Health Care Insurance. “With currently over 47 million Americans not currently insured, and the rising numbers of the uninsured due to the current economic condition, small business owners and the self-employed make up a sizable amount of these uninsured,” reports Zemar. “They are unaware of the financial benefits we can provide, along with the security and peace of mind that having health care insurance can offer.”

Currently, Butch Zemar is presenting this valuable information at Chicago-area Chambers of Commerce and Community and Professional Organizations. With tenure and specialization in the Health Care Insurance industry, Butch Zemar and his team at Elite Benefits of America is expanding its client base throughout the Midwest. For more information or to request a health care insurance presentation at your community event, please visit www.elitebenefits.net or contact Elite Benefits headquarters at 888-535-3006.

About Elite Benefits of America – Elite Benefits is a nationally recognized marketing and sales organization that recommends and provides intelligent solutions to the rising costs of health care insurance. By publishing articles, e-reports, e-books and CDs that offer comprehensive information on the continually changing health insurance industry. Butch Zemar, President of Elite Benefits has been presenting this valuable information to Chamber of Commerce and Chicago Area Community events.

Website Link: http://www.elitebenefits.net

Health care costs are escalating to an all time high for many reasons, including new medical technologies that increase life expectancy, medications that increase quality of life, increasing number of patients with chronic illness, over-utilization of health care and administrative waste. Everyone is challenged by health coverage rates increases, and is searching for reasonable ways to control costs. Changes in the practice of medicine, as well as consumer preferences, also affect the way health care dollars are assigned and spent.

The implementation of a Health Savings Account eliminates any type of Co-pays, Service Deductibles and has only one family deductible vs. multiple family deductibles like your current policy. This has an advantage due to the entire family accumulating to one deductible (and possibly co-insurance). Once the deductible and co-insurance maximums are met it’s 100% for the remainder of the year (Calendar or policy year, read your policy or check with your Health Insurance Specialist) for the entire family.

2008 IRS HSA requirements for an HSA:
Annual HDHP Deductibles
Minimum’s: Single $1,100 and Family $2,200.
Maximum OOP (Out-of-Pocket) Single $5,600 and Family $11,200.
Maximum HSA Yearly Contributions:
Single $2,900 and Family $5,800

NOTE: Not all plans are HSA qualified. This is typically a High Deductible Health Plan (HDHP) that is filled with the department of insurance meeting all the mandated requirements set in place to be HSA qualified. Check with your health advisor to make sure you find one that is qualified in addition to the things listed previously in this report.

That’s not even the best part. Everyone needs Health Insurance to cover medical expenses, future as well as current. The best part is you get a tax break of the amount you put into your account equivalent to your tax bracket. Another words, the more you make, the more you can deduct from you over all taxes. This concept is very similar to an IRA. Now if you are self-employed, you know you have the ability to deduct your health insurance premiums. Thus, bringing your over all Health Insurance costs down to a more manageable level or in some cases get it for FREE, or pretty close to it.

Here is an example: Family of 4, 40 year old male non-smoker, 38 year old female non-smoker and 2 kids, paying $3,600 per year. For a family the max you can contribute to your HSA account is $5,800 for the year. If you were in a 30% tax bracket (most who read this will be in a higher one) this is giving you a tax benefit of $1,740.00 for the year for your contributions. If you are self-employed and deducting the premiums as well this will give you an additional $1,080.00 per year. This brings your total yearly savings to $2,820. Your net cost on paying $3,600 on your premium is $780.00 per year for the entire family. If you break it down it would be $65.00 per month, or $2.17 per day. That’s the cost of a can of pop and chips per day. Wouldn’t you say that’s affordable? There is no excuse why your family shouldn’t be without insurance.

Now take a single male, Johnny, striking it on his own on his Million dollar idea. Let’s say he is 31 years old non-smoker. His yearly premium is $1,020. The max an individual can contribute to your account is $2,900. This will give him a deduction of $870.00 on his contribution and $306.00 from his health insurance, for a total savings of $1,176 per year. Johnny’s net expenses is $-156.00. In other words, the government is allowing him to deduct a qualified tax expense and get his Health Insurance for FREE! Now he can run his business without the fear of losing it if something happened to him and he was stuck with the medical bills.

But what about my co-pay?

Believe it or not, I just saved you approx. $2,800 for the year on your family’s health insurance and someone is worried about the Co-pay. “But, what if my doctor visit is $1,000 or my lab work was $2,000.” If your doctor visit or lab work is that much, either you have something serious going on or you have to find a doctor that isn’t over charging for services. Believe it or not people have said this. Most people have no idea what doctors charge. The average adult goes to the doctor less than 2 times per year (unless their employer is paying for it giving you incentive to use it by not seeing what it truly cost for those benefits. Children may go a few more times than the adults. The average doctor visit in America is approximately $100-120 per visit, depending on where you live. If we used $100.00 for example, if the parents go 2 times each and the kids go 4 each, that’s only $1,200 for the year. Keep in mind, this is being deducted from your calendar deductible. Also, if you really needed to you can use a portion of the $5,800 that you contributed to your HSA account.

MY BEST ADVICE: Fully fund your account every year. DO NOT wait until April 15th, tax day, to contribute for the previous year’s tax return (the government allows you contribute up to tax day for the previous year). The reason for this is you are missing out on your TAX-FREE growth of your account due to it being interest bearing.

And you say health insurance isn’t affordable?

Now, let’s not get a head of ourselves here with the savings we have here. You may have saved over all monthly premium compared to your previous plan by switching to an HSA. I wouldn’t recommend going out and buy a new car, new fishing boat or spend it on a luxury vacation. I would recommend investing it in your family.

First, take a portion of the savings and buy yourself and your spouse what’s called a Critical Illness insurance policy. This a policy that writes you a check for the amount you choose based on what you can afford, not tied to your income when diagnosed with a critical illness such as cancer, stroke or heart attack. Wouldn’t it be better to pay off your house at a time like this instead of losing your house? Granted, even on the HSA plan you cannot deduct Critical Illness Insurance or Life Insurance premiums for tax purposes or use your Account to pay for the premiums. More important than tax savings you are protecting your income and your assets. Your income and assets are what supports your family’s lifestyle. The remaining premium savings should go towards other long term investments such as Long Term Care, college funding, IRA or other Retirement Portfolio and whatever else you need to help your family to live more comfortable and secure.

When it comes to Health Insurance, some families are confused about their deductibles. Without the right guidance this could cost you a fortune at claim time. If your family doesn’t have anything going on outside of doctor visits you could be over spending on your insurance policy. At that point, the insurance company gets to keep the over spent premiums.

The deductible is the amount you pay in a single year before the insurance company kicks in. Be careful of plans out there that claim they are based on a 365 day period. If you read the next line it says for EACH Injury or Sickness period of treatment. This means if you have 2 completely different ‘periods of treatment’ in one year you will be exposed to two separate deductibles!! If you have what they call ‘Calendar Year Deductible’ once your deductible is satisfied for the year there are no more deductibles. This is outside of ‘out-of-network deductibles’ or ’service deductibles’.

The out-of-network deductible is the insurance company’s way of penalizing you for going out side of a preferred provider network. Usually this deductible can be anywhere from $2,000, or more commonly, twice your original deductible. Of course, this is in addition to your in-network deductible. The problem is that even if you’re admitted into an in-network facility for a scheduled surgery… the surgeon, pathologist, radiologist or anesthesiologist may not be a participating provider in your network… and you could easily be stuck with an additional $5000 or more out-of-pocket. There are only a few insurance carriers out there that do not have out-of-network deductibles. Once it is satisfied for the year, in-network or not, it’s satisfied, period. Check with your Health Insurance Specialist on these carriers.

Unfortunately, too many insurance agents like to steer their clients toward low deductibles like $500 or $1000. These are the absolute worst values! The lower the deductible, more the premium you have to pay each month.

Since agents get paid a percentage of your premium, in turn, the lower your deductible, the bigger their commission! Obviously, the agent has a financial disincentive to save you money. Be suspicious of insurance agents that recommend health insurance deductibles under $1500!
Affordable plans have deductibles of $2500 and up. The higher your deductible, the lower your cost. In fact the money you save will almost always far exceed any potential additional out-of-pocket expenses!

Conclusion: Work with a Health Insurance Expert. They will walk you through affordable options to lower your premiums to keep them affordable. Usually, your premiums savings will offset any potential out of pocket expenses. There is no point of over paying your policy ‘just in case’ something does occur. When that ‘just in case’ occurs you would have saved enough hard earned premium dollars to offset the out of pocket expenses.

By: Butch Zemar, President

Years ago, acquiring your first health coverage was almost a right of passage. You began your career and you were automatically enrolled in your employer’s health plan. That still takes place today but the health care industry has moved into a gigantic monster gobbling up resources everywhere. Rates keep going up at an astounding pace and more employers are cutting back on their plans or doing away with their health benefits entirely. Where does this leave you?

The most important tool you can have when looking for good health insurance is knowledge. Unfortunately, there aren’t too many places where you can obtain that knowledge without having to spend months (or even years) going through the small print. This is why you should consult with a specialist, a true expert. Your local Auto Insurance guy or gal may not be the answer.

A word of caution: Do not rely on employer-based group insurance. This could be a threat to your financial future. How long do you think an employer will keep you on the pay-roll and provide benefits if you are too sick or hurt to work? Eventually the company will replace you and you will lose the benefits along with it. Sure, they may offer you COBRA (Consolidated Omnibus Budge Reconciliation Act) to continue your coverage at your own expense. Usually, these premiums are quite high and will eventually run out. Then what? You may qualify for the High Risk Pool of your state but this could be just as expensive and in some cases more. This whole problem can be prevented with the right knowledge.

Our Health care system does not make a direct connection between receiving a service and paying for it. Instead, a third party actually processes and pays the bill. This could be the insurance company or plan administrator. The consumer never sees the actual price of these services. The consumer is usually only aware of the amount of his or her co-payment or their deductible, rather than the full price for Doctor Office visits, lab tests, etc. The co-payment seems to be the price most know. As services become more expensive, the consumer does pay for the increase indirectly, through higher deductions from wages for health care or their benefits reducing by going with higher co-payments or deductibles. The result is that premium costs are pricing health care out of reach for employers and individuals. Dissatisfaction with the lack of choice in care and financing adds to the precarious state of health care coverage.

Conclusion: Since our Economy has changed there is no guarantee that you will have a job with the same employer until you retire. The employers that are dropping their health plans all together to stay in business is increasing each year. Our chances of having the employer-sponsored health plans are slowly going away. Just like with any change, you have to prepare. In order to be prepared you have to obtain more knowledge specifically to the area of change. Most of us are so busy in our everyday lives that it’s hard to take time away from our family and work to learn more. This is why you should consult with a health insurance expert when it comes to your health insurance.

By: Butch Zemar, President

Do you know someone who has suffered a heart attack, a stroke or has had cancer? If there was a program which would have written them a check for $10,000, $20,000, $25,000 or more, do you think it would have had a better impact on them - at least financially? What if in six months you or your spouse suffered a critical illness - how would that impact your family?

Ninety-five percent of men and seventy percent of women will suffer from cancer, stroke or heart attack during their lifetime. A married couple has an 83% chance of one of them getting cancer. The first 3-6 months are critical. Your expenses can range anywhere from $13,460 to as much as $50,000. What about the things that aren’t medically related. You still have a house to take care of, a family to feed, maybe a wedding to pay for or college tuitions. What if this happened to you or your spouse? How prepared are you?

Bill Clinton said it best back during his presidency “Millions of Americans are just a pink slip away from losing their health insurance, and one serious illness away from losing all of their savings. Millions more are locked into the jobs they have now just because they or someone in their family has once been sick and they have what is called the preexisting condition. “

A fairly recent Harvard study states that 54.5% of all bankruptcy filings are due to medical bankruptcy. Most of them were middle class and nearly three-quarters of them had insurance. Often illness led to job loss, and with it the lost of health insurance. Out-of-pocket medical cost (such as co-payments, deductibles and uncovered medical services) averaged $13,460 for those with insurance at the onset of their illness, vs. $10,893 for the uninsured. In many cases, high medical bills combined with a loss of income as illness forced breadwinners to lose time from work.

Most of the medically bankrupt were average Americans who happened to get sick. Health insurance offered little protection at the time of the onset of the illness. Families with coverage had unaffordable co-payments, deductibles and bills for uncovered items like physical therapy. Even the best job-based health insurance often vanished when illness caused job loss precisely when families needed it most. “Too often, health insurance is an umbrella that melts in the rain.”

The study mentioned uncovered items like physical therapy. In just about every major medical, employer or private insurance has a separate limitation on physical therapy. How much do you think physical therapy cost now a days? Some of these limitations are lower than the average deductible or even worse insurance companies only pay up to a small number of visits or only $25-$30 for each visit. Now, you pay the difference.

The biggest question here is how prepared are you? How protected is your income as well as your assets? What if you did lose your job due to a critical illness? There are programs that will write you a check for an amount you choose, based on what you can afford, not tied to your income. The investment is small compared to the benefit of receiving that check when your family needs it the most.

Butch Zemar - President

Elite Benefits of America