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FAQ
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FAQ
The following are the most frequently-asked questions about the Elements Health
program. Simply select a question to view the answer. If you have other
questions or require further assistance, please contact us.
Individual/Family Health Insurance: Tax Advantages
What is the new tax deduction for the self-employed?
Beginning in 2003, self-employed individuals may deduct from their taxable income 100% of the amount they spend on health insurance. Prior to this legislation, it was often not advantageous to obtain your own health insurance since employer-provided health insurance provided up to a 2-to-1 income tax advantage over purchasing health insurance yourself with after-tax dollars.
What are Health Reimbursement Arrangements (HRAs)?
On June 26, 2002 the IRS authorized Health Reimbursement Arrangements (HRAs) where employees may purchase their own individual/family health insurance policy and be reimbursed by their employers with pre-tax dollars.
Individual/Family Wellness Insurance and Health Insurance
What is the difference between an Individual or Family Health Policy (HP) and an Individual or Family High-Deductible Health Insurance Policy (HDHP)?
The main difference between an Individual or Family Health Policy (HP) and an Individual or Family High-Deductible Health Insurance Policy (HDHP) is that an HDHP is simply a health insurance policy with a higher annual deductible-you are only reimbursed for medical expenses incurred above a cumulative annual amount, typically $2,000 (individual) to $4,500 (family) per year. However, with an HDHP, you may save this amount or more in your annual health insurance premium. In general, a higher deductible means a lower premium charged by the insurance carrier. After you research the difference in price between the $500, $1,000-$2,500 and $5,000 deductible plans, you should consider obtaining an HDHP with the highest annual deductible that you can comfortably afford. By choosing the right plan, you can save a significant amount of money each year to invest in your wellness, or to cover your deductible should you or a family member become ill.
How much can I save with an HDHP?
The annual premium saving with an HDHP, compared to a traditional low-deductible plan, is sometimes equal or greater than the annual deductible amount. For example, a typical low- or no-deductible health insurance family policy may cost $5,000 per year, while the same policy from the same insurance company with a $2,500 per person annual deductible may cost only $2,000 per year-a $3,000 reduction in the annual premium. In this example, even if one member of your family gets very sick and you have to pay for the first $2,500 of their medical expenses, you are still ahead $500 per year. If you all remain healthy, you have up to $3,000 per year more to invest in your continued wellness and save for future health expenses. However, you should consider the type of policy you could afford in a catastrophic situation-for example, if everyone in your family became very ill during the same year, you could incur a $2,500 per person expense before your met the deductible for your HDHP.
What are some other benefits of having a High Deductible Health Policy (HDHP)?
With an HDHP, you decide how to spend your healthcare dollars up to the amount of your deductible (potentially several thousand dollars) for your family's medical care without having to ask anyone's permission or argue later on for reimbursement. You can use the Preferred Provider Organization (PPO) that is included with most HDHPs or you can join a separate Health Maintenance Organization (HMO) or PPO with a fixed co-pay or that offers better discounts in your area.
You can also choose your own physicians and select your own discount pharmacy plan, eyeglass plan, vitamins and supplement plan, fitness club membership-or any other customized wellness or sickness services. But, best of all, if you are healthy, you can save thousands of dollars that you can invest today in your continued wellness.
Why is an HDHP up to $3,000 less expensive?
Two reasons:
(1) Lower Administration Costs-The first $2,500 per year of a family's medical care is typically spent in $100 increments in 25 transactions, potentially costing the insurance company $30 or more to process the paperwork for each transaction ($2,500 medical cost + $750 processing costs = $3,350);
and
(2) Health Applicant Pool-Only healthy people without preexisting medical conditions qualify for HDHP-insurance companies generally reject about 1/3 of Individual (or Family) HDHP applicants because they (or someone in their family) have a preexisting medical condition.
Why haven't I ever heard about Individual/Family health insurance policies?
Three reasons:
(1) Healthy members mean lower group rates-If you are healthy and a member of a group health insurance policy, it is not in your employer's best financial interest for you to leave the group since your typical $5,000 annual premium goes to support other less-healthy group members;
(2) Lower agent commissions-Some insurance agents cannot afford to sell HDHPs for individuals since the commission they earn on an HDHP is less than half of the commission on a non-HDHP policy; and
(3) Unhealthy applicants-When insurance companies sometimes advertise affordable Individual or Family health insurance policies, they get too many applications from unhealthy applicants-which are expensive to process and can cause regulatory problems when many of these applicants get rejected. Therefore, they are not as heavily advertised.
What if I receive free health insurance from my employer?
If you receive free health insurance from your employer, you may still want to consider getting an Individual or Family health insurance policy for your dependents (and possibly for yourself). Most private employers today charge employees for coverage of their dependents who participate in the company's group policy; however, if your family is healthy, it could be less expensive to buy them their own Individual or Family policy. This will also guarantee your family coverage if someone develops a medical condition, you change jobs, or your company group plan is terminated.
What is individual and family health insurance?
Individual and family health insurance is a type of health insurance
coverage that is made available to individuals and families, rather than to
employer groups or organizations. Given the option, most people would prefer to
have their employer provide group health insurance coverage. But, if this is not
an option for you, it is still important for you to seek coverage. You may be
pleasantly surprised with the variety and affordability of the individual and
family health insurance options available.
What is a co-payment?
A "co-payment" or "co-pay" is a specific charge that your health insurance
plan may require that you pay for a specific medical service or supply. For
example, your health insurance plan may require a $15 co-payment for an office
visit or brand-name prescription drug, after which the insurance company often
pays the remainder of the charges.
What is a deductible?
A "deductible" is a specific dollar amount that your health insurance
company may require that you pay out-of-pocket each year before your health
insurance plan begins to make payments for claims. Not all health insurance
plans require a deductible. As a general rule (though there are many
exceptions), HMO plans typically do not require a deductible, while most
Indemnity and PPO plans do.
What is coinsurance?
Coinsurance is the term used by health insurance companies to refer to the
amount that you are required to pay for a medical claim, apart from any
co-payments or deductible. For example, if your health insurance plan has a 20%
coinsurance requirement (and does not have any additional co-payment or
deductible requirements), then a $100 medical bill would cost you $20, and the
insurance company would pay the remaining $80.
What is the difference between in-network and out-of-network
providers?
An in-network provider is one contracted with the health
insurance company to provide services to plan members for specific
pre-negotiated rates. An out-of-network provider is one not contracted with the
health insurance plan. Typically, if you visit a physician or other provider
within the network, the amount you will be responsible for paying will be less
than if you go to an out-of-network provider. Though there are some exceptions,
in many cases, the insurance company will either pay less or not pay anything
for services you receive from out-of-network
providers.
When can my coverage start?
You can request that your Individual and Family health
insurance plan start anytime between 1 and 90 days in the future. However, the
insurance companies will typically need some time to process your application so
keep in mind that the actual date for the start of your coverage may vary
depending on the underwriting process and the availability of your medical
records.
How can I insure just my child?
When getting quotes for your child(ren) only, enter the
child's gender and birth date in the " Applicant" or first row. Additional
children should be entered below in the " Child" rows, but not the " Spouse"
row.
However, many health insurance companies require one policy
per child. So if you have more than one child, try entering just one child to
see a larger selection of plans and prices. You are free to apply for each child
separately.
Why should I shop with you rather than buying an insurance
plan elsewhere?
By combining high quality health insurance with personalized
lifestyle management support, we are able to offer our customers:
- Peace of Mind. Buy purchasing health insurance
through Elements Health you are insuring your financial protection against any
high cost health event.
- Lifestyle Management Support. Our lives are filled
with difficult and challenging choices. Elements Health will help you navigate
your life choices by providing you private and confidential personalized
assessment tools focusing on your Physical, Financial,
Relationship, Spiritual and Self health.
How do you protect my private information?
Shopping with Elements Health is safe. As your health
insurance agent, we're committed to protecting your privacy and the information
you provide to us. Elements Health will not sell, trade or give away your
personal information to anyone, except those specifically involved in the
referral or processing of your health insurance quote or application. We use
industry-leading technologies to ensure the security of all the information
under our control.
If you have any questions about our privacy policy or
how your personal information is protected at Elements Health, contact us by
email at support@insureyourhealth.com
When I buy an insurance plan, how do I make
payments?
In most cases, when you complete your application you'll
provide a credit card number or a check written to the health insurance company
for the first premium payment. Typically, your credit card will not be charged
nor will your check be cashed until you are approved for coverage. If you are
not approved for coverage, or if you cancel your application, your card will not
be charged and any check payment you made will be returned or refunded.
Once you've been approved for coverage, your ongoing premium
payments are paid to your health insurance company typically on a monthly or
quarterly basis. Insurance companies typically offer several payment options
including monthly billings to be paid by check or credit card, automatic bank
drafts or automated credit card charges. Please note that credit card billing of
premiums is optional and you can obtain coverage without using that method of
payment.
If I apply for an insurance plan, am I obligated to
buy?
No. You are under no obligation to buy a health insurance
plan when using our site. After submitting your application you may cancel it at
any time during the underwriting process. When you submit an application you
will typically include your credit card number, bank account information, or a
check for the initial premium payment. Most insurance companies will not charge
your card, debit your account, or deposit your check until you are approved. If
you are charged or your check is cashed and you are denied for coverage or
cancel your application prior to approval, the insurance company will issue a
refund to you.
A few insurance companies may charge an application fee,
typically $25 or less. You will be notified in the application if the plan you
chose requires an application fee. Please note that these fees are
non-refundable.
Can I contact someone if I need help?
Yes. We believe in providing you with top-quality customer
service
Click here
to send us an email. One of our knowledgeable customer care representatives will
reply to you soon. Please note that our licensed health insurance agents can
discuss insurance plan benefits and rates only by phone.
1.800.363.9488 for customer support
(available 9am-5pm PST).
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