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Here’s what’s happening with WOW Insurance Marketing.

Webinar Monday, November 26th.

 

ALIERA GROUP PLANS: HOW TO GET B OF R’S BY PRESENTING ALTERNATIVE HEALTHCARE PLANS

 

 

 

Now, it’s easier to provide employees with the healthcare they desire at an affordable cost. Health insurance is bookended in volumes of mystery. You know you need it, you want to have it, but odds are, you don’t know enough about it to make the first two points happen. If you’re an employer thinking about offering group health insurance to your employees for the first time, it can be unclear why you should provide something that’s saddled with so much confusion. Why would you want it? Well, outfitting your team with health benefits makes it a lot easier for your employees to cover their regular and urgent doctor visits, hospital stays, and medical treatments like physical therapy. It also allows employees to buy additional insurance to cover their entire families in one fell swoop. A health plan from Aliera Healthcare provides group employers with the ability to choose from many options. Choose from the basics of minimum essential coverage as required to meet the minimum standards of the ACA to full comprehensive self-funded plans ranging in coverage levels from 70% to 90% of the employee’s needs. Either way, you will receive a unique and usable healthcare benefits package.

 

TOP ALIERA AGENTS WEEK OF 11/18/18 to 11/24/18

Blue Shield Blue Card Restrictions

The ACA (Obamacare) marketplace continues to have changes and uncertainty. In California  2019 Blue Shield is the only available PPO in most of the state, and this situation is similar in many counties across the nation.

Blue Shield of California was one of the last individual/family insurance carriers to offer a National PPO network through the BlueCard program, and this has been discontinued for 2019.

As you likely know, All plans cover emergency services at any hospital in the United States, regardless of what state the plan was purchased from, with the exception of Hawaii. As long an emergency is considered life-threatening, it will be covered as in-network, regardless if the hospital is in your plan’s network. Of course, there are some limitations. Every health plan has a “network” of healthcare providers. Whenever you visit a provider outside of your network, you will pay a larger share of the cost. 

Your client’s out-of-state coverage is going to really only cover emergencies, and not much else–there’s also loopholes to what’s considered an Emergency. In most cases, insurance companies are required to pay for reasonable emergency medical expenses regardless of the hospital you go to. This means that if you’re involved in a car accident and taken by ambulance to a hospital outside of your network, your insurance company should still be responsible for paying this expense.

Unfortunately, there is no concrete definition of “emergency,” and some insurance companies will deny claims that they judge as being not true emergencies. It’s always better to understand exactly what your insurance coverage will pay for before traveling than to run the risk of a denied claim after an emergency occurs.  

However, for 2019, we are not aware of any fully-insured conventional insurance plans that offer out-of-state routine care as both HMOs and PPOs have moved to local, more constricted networks to keep costs down. 

Aliera does offer out of state routine care through its association with the PHCS Multiplan network. With Aliera and supplemental accident coverage (strongly recommended), your clients are covered!

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