dixonautomotivetx

Why It's Impossible To Get Your Car Repaired This Summer

Thu, 20 Jul 2023 18:06:39 GMT

The Wall Street Journal, 1 July, 2023

RONNIE CLENDENIN has been working in the auto-repair business for three decades. He’s never been so frazzled. The parking lot at Clendenin’s Tire and Auto Service in Guy, Ark., a town about an hour north of Little Rock, was recently packed with 62 vehicles, double the typical workload from a few years ago. Without the workers or car parts he needs to keep up, Clendenin says, he regularly turns away loyal customers. “It’s hard to do. People aren’t used to it,” he says. “They’re used to just dropping it off and getting it taken care of.” Across the U.S., a shortage of car parts in the past few years has collided with a continuing dearth of service technicians. The result: more frustrated customers, who are waiting longer to get their cars back, and paying more for service.

The backlog risks becoming a drag on the U.S. economy as higher repair costs prompt consumers to cut back spending elsewhere, or simply not having a working car curtails their mobility and productivity. A swath of service industries are facing labor shortages, from home construction to restaurants, appliance repair to trucking. For the big automakers, this is the latest sign that the industry is still struggling to adapt to the shifts from the last few years. Nearly everything about shopping for and owning a car is different since the Covid-19 pandemic: Americans wait to get the car they want instead of driving it off the lot, they have fewer choices, and discounts or cheap leases are a thing of a past, prepandemic life.

Health Care Program: Providing Simple, Transparent, and Affordable Coverage Nationwide

kaesar102@gmail.com (Kaesar Ocado) — Sun, 16 Jul 2023 11:21:36 GMT

In the face of rising healthcare costs and the need for accessible coverage, IGO Benefits has taken the initiative to establish a comprehensive health care program designed to cater to the health insurance demands of IGO's mechanics, their support staff, and their family members across the United States. The program aims to provide Americans with the best access to healthcare, virtual and in-person care options, and concierge care throughout their healthcare journey.

The Need for a Nationwide Health Program

Recognizing the challenges posed by increasing healthcare costs and disparities in coverage across the nation , IGO Benefits made it their mission to develop a nationwide health care program. By extending their services to all states, they aim to address the pressing need for accessible and affordable health insurance for a broader population.

In the United States, millions of individuals struggle to obtain adequate healthcare coverage due to financial constraints or lack of employer-sponsored plans. The nationwide health program is designed to fill this gap and provide quality healthcare solutions to IGO's, mechanics, support staff, and their families, regardless of their location or income level.

Navigating Cost Impacts and Media Attention

As with any ambitious nationwide health care program, there have been challenges in navigating cost impacts and addressing media attention. The healthcare landscape is complex, and ensuring the affordability of coverage for all participants requires careful consideration and collaboration.

IGO Benefits understands the importance of balancing the costs and benefits of the program, ensuring that individuals who don't qualify for certain subsidies can still access affordable health insurance options. By actively engaging with stakeholders, including health insurers and the federal government, IGO Benefits aims to find innovative solutions to mitigate potential price hikes and promote transparent communication with the public.

IGO Benefits' Health Care Program: Providing Solutions Nationwide

In response to the nationwide healthcare needs of IGO's, mechanics, support staff, and their families, IGO Benefits has developed a comprehensive health care program tailored to deliver simple, transparent, and affordable coverage across the United States.

1. The Best Access to Healthcare

IGO Benefits' health care program offers virtual and in-person care options, providing the flexibility and convenience to access healthcare when it is needed, on the individual's schedule. With an emphasis on continuity of care, the program aims to contribute to longer, healthier, and happier lives for its members nationwide.

In today's fast-paced world, access to quality healthcare has become increasingly important. With IGO Benefits' health care program, individuals and families throughout the country can benefit from both virtual and in-person care options, providing them with the flexibility to choose the most suitable mode of care for their specific health needs.

Virtual care, including telehealth services, allows members to connect with healthcare providers remotely, eliminating the need for physical visits in many cases. This not only saves time but also reduces transportation costs and the hassle of booking appointments. It enables individuals to receive medical consultations, prescription refills, and follow-ups conveniently, making healthcare more accessible than ever before.

In-person care remains crucial for certain medical conditions and procedures, and IGO Benefits ensures that members have access to a wide network of healthcare providers nationwide. Whether it's a routine check-up or a specialized treatment, the program's network of healthcare professionals is ready to provide the highest quality care.

Moreover, the continuity of care offered by IGO Benefits ensures that individuals receive consistent, ongoing healthcare support, regardless of their location. This approach contributes to better health outcomes, as healthcare providers can monitor progress, adjust treatment plans, and address potential issues promptly. By prioritizing access to healthcare and the continuity of care, IGO Benefits' health care program empowers Americans across the country to live longer, healthier, and happier lives.

2. Guided Care Program: $0 Co-Pays, $0 Deductibles, $0 Out-of-Pocket

One of the key features of IGO Benefits' health care program is the guided care program, which ensures that members do not have to put off essential healthcare due to high costs. By holding the hand of the members throughout their healthcare journey, the program strives to achieve the best outcomes at the lowest possible cost, making healthcare accessible and affordable.

For many individuals and families, the high costs associated with healthcare can be a significant barrier to seeking medical attention. IGO Benefits recognizes this challenge and has developed a guided care program that aims to eliminate financial obstacles and ensure that members receive the care they need without the burden of excessive expenses.

The program boasts several elements that make it particularly attractive to those seeking affordable coverage nationwide. With $0 co-pays, members can visit healthcare providers without having to worry about upfront costs for appointments. This applies to various services, including primary care visits, specialty consultations, and behavioral health sessions.

In addition to $0 co-pays, the program offers $0 deductibles, which means that members do not have to reach a specific amount in out-of-pocket expenses before their insurance coverage kicks in. This feature is particularly advantageous for individuals who require regular medical care or who have chronic conditions, as it provides financial relief from the outset of their healthcare journey.

Furthermore, the program includes $0 out-of-pocket costs, reducing the financial burden on members even further. With no need to worry about unexpected expenses related to medical treatment, individuals and families can focus on their health and well-being without undue financial stress.

The guided care program is designed to ensure that members receive the best possible care at the lowest possible cost, no matter where they reside in the United States. By proactively assisting individuals in navigating the healthcare system, IGO Benefits strives to optimize health outcomes while minimizing financial strain.

3. Concierge Care and Direct Primary Care

The program offers concierge care that is seconds away, including direct primary care, specialty care, and behavioral health care. With (830) 741-2886 access to healthcare and no waiting times, members can rest assured that their health concerns will be addressed promptly and efficiently. Additionally, the program helps schedule appointments with specialists, ensuring that members receive the necessary care on their schedule.

Concierge care is a personalized approach to healthcare that prioritizes the individual needs and preferences of patients. At IGO Benefits, this form of care ensures that members can access healthcare services promptly and without unnecessary delays, no matter where they are located. Whether seeking primary care, specialized treatment, or mental health support, members can receive the care they need when they need it.

Direct primary care is a cornerstone of IGO Benefits' health care program, providing members with a direct and personalized relationship with their primary care provider. This model of care eliminates the need for traditional fee-for-service payments and copays, simplifying the healthcare experience and reducing administrative overhead.

In a direct primary care setting, the primary care provider (PCP) charges a monthly or annual fee that covers a wide range of services. Members can visit their PCP as often as needed without incurring additional costs, making preventive care more accessible and promoting early intervention for health issues.

Specialty care is another essential aspect of the program, ensuring that members have access to a network of healthcare specialists across various medical disciplines nationwide. Whether an individual requires the expertise of a cardiologist, an oncologist, or a pediatrician, the program aims to facilitate appointments and ensure timely access to specialized care.

Behavioral health care is a critical component of overall well-being, and IGO Benefits recognizes the importance of mental health support. Through the program, members can access behavioral health services, including counseling and therapy, to address emotional and psychological concerns. By integrating mental health care into the program, IGO Benefits aims to promote holistic health and well-being for all its members across the country.

Conclusion

IGO Benefits' health care program stands as a testament to the power of community-driven solutions in addressing healthcare challenges nationwide. By offering accessible, transparent, and affordable coverage to IGO's, mechanics, support staff, and their families across the United States, the program aims to transform lives and create a brighter, healthier future for all Americans.

As discussions surrounding the Basic Health Program and healthcare costs continue, it is essential to foster a spirit of cooperation and innovation to forge a path forward towards improved healthcare access and outcomes for everyone. With dedication, collaboration, and a commitment to prioritizing the health and well-being of all citizens, IGO Benefits' nationwide health care program sets an example for other organizations and states to emulate.

As the healthcare landscape evolves, the need for nationwide health programs that prioritize affordability, access, and transparency becomes increasingly evident. By extending their health care program to all states and encouraging everyone to enroll in their health insurance, IGO Benefits is taking a significant step towards creating a more equitable and comprehensive healthcare system for all Americans. Through their dedication to simplifying healthcare and making it more affordable, IGO Benefits is contributing to a healthier, happier, and thriving nation for generations to come.

Rising ACA Insurance Costs: Comparing Private Health Insurance for Employee-Employer Benefits

kaesar102@gmail.com (Kaesar Ocado) — Sun, 02 Jul 2023 16:08:44 GMT

The Affordable Care Act (ACA) has significantly transformed the healthcare landscape in the United States. As ACA insurance costs continue to rise , employers are exploring alternative options, such as private health insurance, to provide employee benefits. In this analysis, we will assess the financial impact of ACA premiums on employee-employer benefits and compare them with the benefits offered by private health insurance. By examining various factors, including cost, coverage options, network accessibility, customization, provider choices, employee satisfaction, and long-term viability, we aim to provide insights into the advantages and considerations of private health insurance for employers and employees.

Cost Analysis: Assessing the Financial Impact of ACA Premiums on Employee-Employer Benefits

ACA premiums play a significant role in determining the financial burden on employers and employees. Proposed median premium increases of 10% in ACA Marketplaces can strain employers' budgets, especially small businesses. Employers may need to reallocate resources or increase employee contributions to offset rising healthcare costs. The cost analysis considers the potential implications of higher ACA premiums on employee-employer cost-sharing dynamics and overall affordability of employee health insurance.

Coverage Options: Contrasting the Benefits and Services Provided by Private Health Insurance for Employees

Private health insurance offers employers a range of coverage options beyond what is available through the ACA. These options often include more extensive benefits and services, such as access to a broader network of providers, specialized treatments, and additional wellness programs. Employers can tailor private health insurance plans to better meet the specific needs of their employees, providing a potentially higher level of coverage compared to ACA plans.

Network Accessibility: Evaluating the Provider Networks of Private Health Insurance Plans for Employees

One critical aspect of employee health insurance is the availability and accessibility of healthcare providers. Private health insurance plans often provide access to larger networks of doctors, specialists, and hospitals compared to ACA plans. This broader network can offer employees more choices and flexibility when seeking medical care. However, employers must consider the potential trade-off between network size and the associated costs when selecting private health insurance options.

Customization and Flexibility: Comparing the Degree of Plan Personalization in Private Health Insurance for Employees

Private health insurance plans generally offer greater customization and flexibility compared to ACA plans. Employers can work with insurers to design benefit packages tailored to the unique needs of their employees. This customization may include selecting specific coverage options, deductible levels, and wellness programs. The ability to customize plans provides employers with greater control over the cost and design of employee benefits, resulting in potentially higher employee satisfaction.

Provider Choices: Analyzing the Freedom to Choose Healthcare Providers for Employees under Private Health Insurance

Private health insurance often grants employees more freedom to choose healthcare providers. Unlike ACA plans, which may have narrower networks and require referrals for specialized care, private health insurance allows employees to select their preferred doctors and hospitals without referral restrictions. This freedom to choose healthcare providers can enhance employee satisfaction by providing a more personalized healthcare experience.

Employee Satisfaction: Exploring the Level of Contentment with Employee Benefits Provided by Private Health Insurance

Employee satisfaction is a crucial consideration for employers when selecting health insurance options. Private health insurance plans, with their greater coverage options, customization, network accessibility, and provider choices, can contribute to higher employee satisfaction. Employees may perceive private health insurance as providing better value, improved access to care, and more comprehensive coverage. Higher employee satisfaction can positively impact recruitment, retention, and overall workplace morale.

Future Considerations: Predicting the Long-Term Viability and Sustainability of Private Health Insurance for Employee-Employer Benefits

When evaluating private health insurance options, employers must consider the long-term viability and sustainability of these plans. Factors such as cost stability, insurer reputation, market dynamics, and regulatory changes can influence the sustainability of private health insurance offerings. Employers need to assess the potential risks and benefits associated with private health insurance, ensuring the stability and continuity of employee benefits over time.

Conclusion:

As ACA insurance costs rise, employers are increasingly comparing private health insurance options for employee-employer benefits. A comprehensive analysis encompassing cost, coverage options, network accessibility, customization, provider choices, employee satisfaction, and long-term viability is essential. Private health insurance offers employers greater flexibility, customization, and potentially improved employee satisfaction. However, employers must carefully evaluate the financial implications and long-term sustainability of private health insurance options. By considering these factors, employers can make informed decisions about the most suitable health insurance options to provide comprehensive and cost-effective benefits to their employees.

Long-Term Care Insurance for Small Businesses: Ensuring Financial Protection

igobenefits@gmail.com (Robert Steele) — Sun, 11 Jun 2023 00:49:25 GMT

Being a small business owner entails juggling numerous responsibilities, from managing teams to maintaining financial stability. Amidst the hustle, one aspect that should not be overlooked is long-term care insurance.

By defination long-term care insurance serves as a safeguard , shielding both your business and employees from the potential financial strain associated with long-term care expenses. Such care encompasses services like nursing home care, assisted living, and in-home care, which come with substantial costs. For instance, the average annual expense of a nursing home stay exceeds $100,000.

Without long-term care insurance, if you or one of your employees requires long-term care, the burden of payment may fall squarely on your shoulders . This could adversely impact your business's financial well-being while also subjecting your employee to financial hardship.

Long-term care insurance is a means to avert such predicaments. By obtaining this coverage, you secure peace of mind, knowing that if the need for long-term care arises, you possess the financial means to address it.

When seeking long-term care insurance , there are several factors to consider. First, determine the coverage amount necessary, which hinges on factors such as age, health status, and budgetary constraints.

Next, decide which type of policy best suits your needs. Indemnity policies provide a fixed monthly payout that can be utilized towards long-term care expenses. Conversely, reimbursement policies cover the actual cost of care, up to the policy limits.

Lastly, it is prudent to conduct thorough research and compare prices among various insurance providers before making a decision.

Long-term care insurance serves as a vital investment for small businesses , offering protection against the financial burdens associated with long-term care. If you are uncertain where to commence, consult with an insurance agent who can guide you towards selecting the most suitable policy for your requirements.

Here are additional advantages of long-term care insurance for small businesses:

Enhanced employee satisfaction and loyalty:

Employees who receive long-term care insurance from their employer tend to exhibit higher job satisfaction and are less likely to seek alternative employment opportunities.

Improved employee productivity:

When employees are not preoccupied with concerns about covering long-term care expenses, they can focus more effectively on their work, leading to increased productivity.

Reduced financial risk for the business:

In the event that an employee necessitates long-term care, the business may bear responsibility for the associated costs. Long-term care insurance mitigates this financial risk, providing a safety net.

If you are a small business owner, it is highly recommended that you consider offering long-term care insurance to your employees. This prudent investment ensures protection for both your business and employees from the potential financial burdens associated with long-term care.

How to Remove the Wheels from Your Mechanics Toolboxes

info@vivabove.com (VIV Builder) — Wed, 01 Mar 2023 20:39:46 GMT

Independent Garage Owners, IGO's, are a unique group of individuals. Many became shop owners because of their previous working environment, a tyrant for a boss, the visions of grandeur of being their own boss or the ability to do all of the above and train up the next generation to continue their legacy. I have met with, talked with, "Zoomed" with and reached out to via e-mail, social media and direct marketing to IGO's across the country.

The things I love about IGO's are this. They are good people. They care about their community. They truly serve their clients trying to do a great job under many stresses and strains of managing a business. Customers can be brutal. A business colleague once shared with me this quip. "If it weren't for our customers, this would be a great business". to which I replied. Customers are what drive the business. Customers ring the cash registers and taking care of customers is what builds a legacy company.

I have found these IGO's fall into three categories when it comes to managing their business and attracting and retaining the best talent for their shop. Some shop owners provide no benefits and believe they offer a competitive wage. Some also provide limited benefit plans that are not Affordable Care compliant but adequate for the price. Finally, there IGO's that provide a full benefits plan, wanting to do the right thing with High Deductible Health plan (HDHP) for them and their employees.

The first two choices will in many cases result in the employee moving to a new IGO or a dealership, school district or other option because they are providing a benefits package when the employee faces a healthcare concern with themselves or their family. There is another factor that many have not thought of. Employees will put off care, in many cases for themselves, but not their family. This results in delaying care because of the cost and only delaying the expense in many cases.

What is interesting is the exact same thing happens with the High Deductible Health Plan where a $5,000 deductible is not laying around in their checkbook waiting for a rainy day. The shop employee will put off care, primarily for themselves, when a large expense would need to be incurred for a healthcare procedure. That is when there will be some medical debt, just not as much as not having insurance at all.

The end result for many of the IGO shop employees, in all three of the above scenarios, will get the care they or their family need and incur medical debt. This may break the family piggybank, break their spirit or break up the family because the medical debt brought on other stresses or strains of life. Those options need to be dealt with upfront.

The solution is a new approach to healthcare and health insurance. Doing the same thing over and over expecting different results is the definition of insanity.

Our approach to doing things different is really simple. We do not sell an Affordable Care Act product. We sell products that are Affordable Care Act compliant. There is a significant difference. We are able to work with our shop owners and meet their budget needs, meet their employees needs and provide greater access to healthcare, lower cost healthcare, lower premiums and lower out of pocket maximums for your team. Together, our solutions allow you to remove the wheels from your mechanics toolboxes. We have learned that when your mechanic do not remove the wheels, they are not staying put. We need them to remove those wheels because of the programs we bring to the table.

The solution is a new approach to healthcare and health insurance. The following information will give you some basic knowledge.

Health insurance and Healthcare continue to skyrocket each and every year. There are many factors that lead to this but the basics are all the same. As I shared, IF we want to bend the healthcare cost curve we will need to purchase health insurance differently and healthcare differently as well. This is accomplished with our Good, Better Best approach.

The Four drivers of healthcare are:

Hospital Care (In-patient): 30%
Pharmacy (Prescription Drugs) 27%
Physician (Primary and Specialty Care) 20%
Out-Patient Surgery: 20%

Today, employees (and even some shop owners) find themselves confused, frustrated or mad about the insurance market and the overall healthcare experience today. Too many choices means no one knows what to do, health plans are not the easiest to navigate which causes frustration and when a health care concern does not work out the way it was supposed to in terms of outcome or out of pocket cost people get angry.

Medical Loss Ratio (MLR) is one of the key drivers, based on the four cost drivers above, for premiums going up each and every year. MLR, for a small shop owner means that 80% of all premiums must be paid out in claims. That leaves only 20% for the health plan to pay all salaries, operating expenses, commissions and other fees. When premiums were $100 a month for an individual and $250 for a family, yes that was a long time ago but this is a math exercise, there is not much money left at the end pf the month like our family budget. I am hearing premiums for full family coverage at $1,800, $2,200, $2800, and even higher for some regions of the country. This has happened since 2010 and the passing of the Affordable Care Act.

If pharmacy expenses, prescription drugs is 27% of the total cost of care, why does every health plan OWN the PBM’s that control prescription drugs. Aetna is owned by CVS. Express Scripts is owned by Humana. United Health owns OptumRX. Humana owns Humana Pharmacy Solutions. Who is guarding the hen house? An Affordable Care Act (ACA) plan is controlled by every state insurance commissioner which means you cannot sell the products across state lines like Amazon for the same price and the same benefits. An ERISA plan is an ACA compliant but able to be sold in every state for the same price and the same benefits because an ERISA plan has government oversight by the Department of Labor, the same government department that oversees 401k, 403b, Workers Comp and Self-Funded health plans. This is how you purchase health insurance differently.

Health insurance is built on two buckets of money, administrative expenses and healthcare costs. No matter the health plan type you have, it is handled all the same. All of this is combined into your health insurance premiums. Where it gets dicey is with the healthcare bucket of money and who navigates the healthcare decision of cost and quality. If you know what the cost drivers are, you can find the best care at the lowest cost. If you do not know those things, you will not always make the right choice for cost and quality. You, your employees and all dependents need an advocate to help you along your healthcare journey to find the best care at the appropriate cost and not pay $5,000 for an MRI when you could have gone across the street for $250. The cost and quality of care differs in every town and even inside a every hospital for every procedure.

Shopping for healthcare is NOT like shopping for a new engine, a new computer, a new house or anything else for that matter including a meal for you and your family. Would you go to a restaurant where you consume your meal, your adult beverage and your dessert and the servers says let me run your credit card and in a few weeks you will receive an itemized statement for the meal which will include the charge for the use of the restaurant, the table, the tablecloth, each napkin, each food item, each beverage, the server, the chef and even the dishwasher and the amount will be charged to your card at that time? Never in a million years, right? You do this every day with healthcare. It does not have to be that way.

The average deductible in the US is $5,800 for an individual per year.

A high deductible health plan could force your employees to put off care, even not talking with you about it, and causing them harm or a greater expense in the long run. We need health plans with no co-pays or very low co-pays and help your employees get the care they need for the price they can afford.

A health plan that becomes your employees advocate (830) 741-2886 that also is able to offer services for on the job or off the job healthcare means your company checkbook can also be helped by reducing your eMod score for your next years rate renewal for Workers Compensation. There are plenty of worker comp physician “factories” that want your employees coming back for care long past the time required. Reducing your eMod score and managing the $250 MRI will keep your premiums at the lowest possible cost AND give your employees the best healthcare experience.

The lowest cost MRI is the one that is not needed. Like the Liberty Insurance commercial, “Only pay for what you need” is also the best approach in healthcare. The lowest cost surgery is also the one not needed. Second opinions for a surgical procedure does not mean second guessing. It is like cutting a piece of wood. Measure twice, cut once.

When I had my double knee replacement in 2015, yes both knees on the same day, took me about 30 days to research the twelve physicians and twelve surgical centers to determine where to go for my “hopefully” once in a lifetime procedure. The cost estimates were $28,000 all the way up to $128,000 and everywhere in between. The quality measures were all over the board as well. I used a technology tool to help me navigate and negotiate the best price AND the best outcome. You too should have that ability for every surgical procedure. The results speak for themselves.

Health insurance and healthcare does not have to be that hard. Many in our industry try to make it so, kind of like my good friend the doublespeak professional where we do not understand a word they are saying.

The difference between an HMO, PPO, Narrow network plan, indemnity plan, limited benefits plan, medical cost sharing plan, health sharing plans, level self-funded plans, fully insured plans and ERISA plans all have advantages and disadvantages. It is best to work with an advisor that has experience with all types.

Our team does partner with local brokers where appropriate if there is a relationship you would like to keep. We also will work with a shop and become your advisor and maintain your current health plan if you are not getting the service you need or the answer to your questions in plain English.

Finally, don’t take my word for any of this, let me prove it to you.

Healthcare 101

info@vivabove.com (VIV Builder) — Tue, 17 Jan 2023 20:26:13 GMT

Health insurance and Healthcare continue to skyrocket each and every year. There are many factors that lead to this but the basics are all the same. As I shared, IF we want to bend the healthcare cost curve we will need to purchase health insurance differently and healthcare differently as well. This is accomplished with our Good, Better Best approach.
The four drivers of health care cost are:
Hospital: (In-patient stays and Emergency Care) 30%
Pharmacy: (Prescription Drugs) 27%
Physician: (Primary Care, Specialty Care) 20%
4.Outpatient Surgery: 20%
Today, employees (and even some shop owners) find themselves confused, frustrated or mad about the insurance market and the overall healthcare experience today. Too many choices means no one knows what to do, health plans are not the easiest to navigate which causes frustration and when a health care concern does not work out the way it was supposed to in terms of outcome or out of pocket cost people get angry.
Medical Loss Ratio (MLR) is one of the key drivers, based on the four cost drivers above, for premiums going up each and every year. MLR, for a small shop owner means that 80% of all premiums must be paid out in claims. That leaves only 20% for the health plan to pay all salaries, operating expenses, commissions and other fees. When premiums were $100 a month for an individual and $250 for a family, yes that was a long time ago but this is a math exercise, there is not much money left at the end pf the month like our family budget. I am hearing premiums for full family coverage at $1,800, $2,200, $2800, and even higher for some regions of the country. This has happened since 2010 and the passing of the Affordable Care Act.
If pharmacy expenses, prescription drugs is 27% of the total cost of care, why does every health plan OWN the PBM’s that control prescription drugs. Aetna is owned by CVS. Express Scripts is owned by Humana. United Health owns OptumRX. Humana owns Humana Pharmacy Solutions. Who is guarding the hen house?
An Affordable Care Act (ACA) plan is controlled by every state insurance commissioner which means you cannot sell the products across state lines like Amazon for the same price and the same benefits. An ERISA plan is an ACA compliant but able to be sold in every state for the same price and the same benefits because an ERISA plan has government oversight by the Department of Labor, the same government department that oversees 401k, 403b, Workers Comp and Self-Funded health plans. This is how you purchase health insurance differently.
Health insurance is built on two buckets of money, administrative expenses and healthcare costs. No matter the health plan type you have, it is handled all the same. All of this is combined into your health insurance premiums. Where it gets dicey is with the healthcare bucket of money and who navigates the healthcare decision of cost and quality. If you know what the cost drivers are, you can find the best care at the lowest cost. If you do not know those things, you will not always make the right choice for cost and quality. You, your employees and all dependents need an advocate to help you along your healthcare journey to find the best care at the appropriate cost and not pay $5,000 for an MRI when you could have gone across the street for $250. The cost and quality of care differs in every town and even inside a every hospital for every procedure.
Shopping for healthcare is NOT like shopping for a new engine, a new computer, a new house or anything else for that matter including a meal for you and your family. Would you go to a restaurant where you consume your meal, your adult beverage and your dessert and the servers says let me run your credit card and in a few weeks you will receive an itemized statement for the meal which will include the charge for the use of the restaurant, the table, the tablecloth, each napkin, each food item, each beverage, the server, the chef and even the dishwasher and the amount will be charged to your card at that time? Never in a million years, right? You do this every day with healthcare. It does not have to be that way.
The average deductible in the US is $5,800 for an individual per year.
A high deductible health plan could force your employees to put off care, even not talking with you about it, and causing them harm or a greater expense in the long run. We need health plans with no co-pays or very low co-pays and help your employees get the care they need for the price they can afford.
A health plan that becomes your employees advocate (830) 741-2886 that also is able to offer services for on the job or off the job healthcare means your company checkbook can also be helped by reducing your eMod score for your next years rate renewal. There are plenty of worker comp “factories” that want the employees coming back for care long past the time required. Reducing your eMod score and managing the $250 MRI will keep your premiums at the lowest AND give your employees the best healthcare experience.
The lowest cost MRI is the one that is not needed. Like the Liberty Insurance commercial, “Only pay for what you need” is also the best approach in healthcare. The lowest cost surgery is also the one not needed. Second opinions for a surgical procedure does not mean second guessing. It is like cutting a piece of wood. Measure twice, cut once.
When I had my double knee replacement in 2015, yes both knees on the same day, took me about 30 days to research the twelve physicians and twelve surgical centers to determine where to go for my “hopefully” once in a lifetime procedure. The cost estimates were $28,000 all the way up to $128,000 and everywhere in between. The quality measures were all over the board as well. I used a technology tool to help me navigate and negotiate the best price AND the best outcome. You too should have that ability for every surgical procedure. The results speak for themselves.
Health insurance and healthcare does not have to be that hard. Many in our industry try to make it so, kind of like my good friend the doublespeak professional where we do not understand a word they are saying.
The difference between an HMO, PPO, Narrow network plan, indemnity plan, limited benefits plan, medical cost sharing plan, health sharing plans, level self-funded plans, fully insured plans and ERISA plans all have advantages and disadvantages. It is best to work with an advisor that has experience with all types.
Our team does partner with local brokers where appropriate if there is a relationship you would like to keep. We also will work with a shop and become your advisor and maintain your current health plan if you are not getting the service you need or the answer to your questions in plain English.
Finally, don’t take my word for any of this, let me prove it to you.