Thursday, 27 February 2014

Tips to reduce your health cover premium over a period of time

Avinash, a businessman, knows how to deal with all kinds of clients.

Avinash, a businessman, knows how to deal with all kinds of clients. However, his inexperience in finding good health insurance policies has landed him in trouble a couple of times.

In the recent past, he hasn’t been able to keep an eye on the rising premiums of his health coverage and ended up spending much more than he should have. It is essential for you to go through the policy premium rates from time to time. Several strategies can be adopted for reducing the premium over a period of time.

Rising health insurance policy premiums could be devastating because you would end up spending a big part of your income in paying them. We buy a health insurance policy to secure our future in case of a medical emergency. Even if you can’t control expenses with respect to sickness, you can definitely control the rising health cover premiums.

Avoid a policy with claim holding

Insurance firms are known to charge a huge amount of premium to cover the client, considering it is going to cover the entire cost if the policy benefits are claimed. Sometimes, when you claim the policy benefits, your insurance provider hikes the premiums for the next year. So, it becomes imperative to go for an insurance policy that entails lower burden.

For keeping a tab on premiums, it is recommended to opt for a family floater policy. These coverage policies can be taken for all your family members. They are much cheaper as the premiums are divided and you have to pay on an individual basis.

Family floater insurance policies come with a two-year waiting period and some of the diseases/disorders that are covered during that time are all kinds of duodenal or gastric ulcers, sinuses, hemorrhoids, fibromyoma, hysterectomy, cataracts, endometriosis, hernia, etc.

Opt for a policy with high top-up/deductible

People often make the mistake of going for policies with low deductibles. Overlooking the advantages of health coverage with a fairly high deductible/top-up can prove to be expensive. Here, you just have to pay a certain amount of medical cost before your insurance provider reimburses the remaining amount on your


Wednesday, 26 February 2014

IRS Offers Health Care Tax Tips to Help Individuals Understand Tax Provisions in the Affordable Care Act

February 25, 2014 - The Internal Revenue Service is offering educational Health Care Tax Tips to help individuals understand how the Affordable Care Act may affect their taxes.
The IRS has designed the Health Care Tax Tips to help people understand what they need to know for the federal individual income tax returns they are filing this year, as well as for future tax returns. This includes information on the Premium Tax Credit and making health care coverage choices.
Although many of the tax provisions included in the law went into effect on Jan. 1, 2014, most do not affect the 2013 tax returns.

The Health Care Tax Tips, which are now available at, include:

·         IRS Reminds Individuals of Health Care Choices for 2014? Find out what you need to know about how health care choices you make for 2014 may affect your taxes.

·         The Health Insurance Marketplace - Learn about Your Health Insurance Coverage Options – Find out about getting health care coverage through the Health Insurance Marketplace.

·         The Premium Tax Credit? Learn the basics of the Premium Tax Credit, including who might be eligible and how to get the credit.

·         The Individual Shared Responsibility Payment – An Overview? Provides information about types of qualifying coverage, exemptions from having coverage, and making a payment if you do not have qualifying coverage or an exemption.

·         Three Timely Tips about Taxes and the Health Care Law?  Provides tips that help with filing the 2013 tax return, including information about employment status, tax favored health plans and itemized deductions.

·         Four Tax Facts about the Health Care Law for Individuals? Offers basic tips to help people determine if the Affordable Care Act affects them and their families, and where to find more information.

·         Changes in Circumstances can Affect your Premium Tax Credit? Learn the importance of reporting any changes in circumstances that involve family size or income when advance payments of the Premium Tax Credit are involved.

In addition to Health Care Tax Tips, the website offers informative flyers and brochures, Frequently Asked Questions and in-depth legal guidance regarding the tax provisions of the Affordable Care Act.


Tuesday, 11 February 2014

Pay close attention to your health plan to pay less

First things first: Obtain a copy of your plan summary from human resources or directly from your insurer. Take the time to read the policy and if you don’t understand something be sure to ask questions. 

Know your plan
Doctor’s offices are not perfect and sometimes mistakes are made on your bill. Always ask for an itemized statement and review it to make sure all of the services were provided. The following notes may help you save on your out-of-pocket costs:
If you have a hospital stay planned, ask if you can bring your own regular medications. Hospitals charge by the pill and you could easily pay double what the medications cost you at the pharmacy.
Go to an in-network provider whenever possible. The insurance companies negotiate fees with doctors and decide on a reasonable price for services rendered. When you go to an in-network doctor, she may not bill you for anything other than your deductible, copayment or coinsurance. If she bills you for a higher amount than has been agreed, she must write off that amount. The doctor is not allowed to bill you for it.

Know your keywords
Copayment is a set fee that you pay for each doctor’s visit or for each medication.
Deductible is the amount you must pay before payment coverage starts. Check your plan to see if doctor’s visits and emergency room visits are paid before the deductible is met; you still have the copayment for the visit and any coinsurance will apply.
Coinsurance is the percentage of the bill you must pay. An example: For an in-network provider, you may have to pay 10 percent of the bill and for an out-of-network provider you may have to pay 20 percent. Each insurance policy is different. Once you have met your out-of-pocket maximum, the coinsurance and deductible are waived.
Contribute to a flexible spending account for medical fees. You can contribute up to $2500. If you are married you and your spouse may each contribute $2500. Depending on your plan, you may now be forced to meet a deductible before any medical fees will be covered, even doctors visits. (Note this is not how every plan works; each one is different). I have seen posts on Facebook where premiums have gone up so there will be less to bring home in a paycheck; to make matters worse they must also meet their deductible before their costs are covered. Many people will have health insurance and not be able to afford to actually use it. A flexible spending card can help. Contribute at least your deductible to the account. You will pay a set amount each pay period towards your FSA. It comes out of your check before taxes. The entire amount that you have designated is available to you at the beginning of the year. You must continue to make the contributions for the entire year unless you change employers. In that event, if what you used exceeded what you had contributed you won’t be required to pay it back. I have a friend whose child received braces and shortly after he lost his job. The braces were covered by the FSA and he didn’t pay a dime; this was before they lowered what you may contribute to the FSA. If you have funds left at the end of the year or leave the company any leftover funds will be forfeited.

Know your network
Compare the costs of procedures at different facilities. If you are having a CT scan, MRI, myelogram, ultrasound or other tests, check to see which facilities are in-network near you. This is important for the dentist as well. Make some calls to compare the prices at different facilities for that test to find the best rate. Usually you are required to pay a percentage of the testing; the lower the fee for the test, the lower your out-of-pocket costs will be. For example: If a test is $10,000 and you have to pay 10 percent, your fee would be $1,000. If the test is $6,000 your fee will be $600 dollars. Check to see if the facility requires your payment up front or if they will allow you to make payments.
Sometimes a facility will require you to pay an estimated amount before services are rendered, and then they bill the insurance company. This can result in an overpayment by you — especially if you have already met your deductible. Always check your explanation of benefits to see what your insurance company paid and what it has determined to be your out-of-pocket costs. If you paid more than you should have, call the doctors office and ask for a refund. Don’t count on them just sending it to you; most times that won’t happen.
Don’t assume that because you went to an in-network facility for testing or a hospital stay that all of the doctors who see you will be in-network. Most of the time they are not. In this case, if you went to an in-network facility most insurance companies will treat the claim as an in network one. This results in the insurance company paying a higher percentage of the bill and reduces your costs. You still will be required to pay whatever the insurance doesn’t pay, but your cost will be lower. If you are required to pay 10 percent of a $1,000 dollar bill, your fee will be $100. If you are required to pay 20 percent because it is not in the network, you would be required to pay $200. Review the explanation of benefits and if you were billed for out-of-network services at an in-network facility, call the insurance company and request it to reprocess the claim. This has resulted in refunds for me in the past.


WellPoint Offers Seniors Tips for Bouncing Back from Hospitalization

INDIANAPOLIS, Feb 10, 2014 (BUSINESS WIRE) -- Imagine you’ve been in the hospital. You’ve eagerly waited for the day you could go home. When that day finally arrives, you’re thrilled. It’s a safe bet the last thing you want to do is to have to return to the hospital.

Unfortunately, far too many people are returning to the hospital after receiving care there, particularly seniors. According to a study published in the New England Journal of Medicine, nearly one-fifth (19.6 percent) of traditional Medicare beneficiaries who had been discharged from a hospital were re-hospitalized within 30 days, and 34 percent were re-hospitalized within 90 days.1 The Medicare Payment Advisory Commission has estimated the cost of hospital readmissions at $15 billion.

“We know that many of these instances are unavoidable,” said Dr. Mary McCluskey, chief medical officer of WellPoint’s Government Business Division. “However, some are preventable, which is unfortunate since hospital stays can expose patients to a host of complications, including possible infections, as well as being costly, stressful and inconvenient.”

WellPoint, which serves thousands of seniors through its affiliated Medicare plans, offers the following tips for making sure a hospital stay doesn’t end up turning into a round-trip.

Understand discharge directions. The transition home really starts before the patient leaves the hospital. It is critical to understand hospital discharge directions. This isn’t as easy as it sounds since patients may be medicated, stressed, groggy or confused. For that reason, it is recommended that patients repeat instructions to their physicians to make sure they understand them. It also may help to write down the instructions or enlist a family member or caregiver to help document them. Another way for a patient to smooth the transition home is to make sure someone at the hospital contacts their primary care physician (PCP) with information about their condition and treatment. People with chronic conditions see many different doctors. It is important for those doctors to communicate with each other.

Fill prescriptions and take them as prescribed. Upon being discharged from the hospital, it is important to fill prescriptions immediately and take them as prescribed. Patients should make sure to understand the timing, dosage and frequency of each drug. Also, patients should take care to understand how existing medicines, including over-the-counter drugs, interact with new drugs. Finally, if any drugs have been stopped, it’s important to ask why. It may be helpful to get a pill organizer to keep track of medicines.

Get follow-up care. According to America’s Health Insurance Plans (AHIP), half of patients who were re-hospitalized within 30 days did not have a physician visit between the time of discharge and re-hospitalization, suggesting one of the reasons people end up back in the hospital is lack of follow-up care. That is why it’s so critical for people to transition from the hospital to their PCP. Patients should schedule follow-up appointments with their regular doctor and keep them. The PCP can coordinate care, making sure patients aren’t exposed to dangerous drug interactions or unnecessary tests. Anyone with trouble getting a timely appointment can call their insurer for help.

Eat properly. People recently discharged from the hospital need to get proper nutrition, including following any dietary restrictions. Appetite is often suppressed after an illness; however, if someone is too sick to eat due to pain, nausea, inability to swallow, etc., then they should contact their doctor.

Take advantage of programs that are there to help. People with Medicare Advantage plans may have access to resources, including case managers, to help them return safely to their homes. Case managers may be able to help a recently discharged patient find transportation to doctor appointments, address potential safety issues in the home and help them locate community programs offering everything from meal delivery to free or discounted medicines. These people are experts at understanding the system and it is their job to help.

Know when things aren’t getting better. Patients should understand which symptoms require immediate intervention and return to the hospital, if necessary. People who aren’t getting better shouldn’t wait for their next appointment.

Be an engaged consumer. Many trips to the hospital occur without warning. However, people with advance notice have resources available to help them research quality and cost. Information about readmission rates for certain hospitals, for example, is available at , where visitors can enter a procedure and a zip code, select three hospitals, and click “Outcome of Care Measures” to compare results.

“Most of us will have to go to the hospital at some point in our lives,” said McCluskey. “The key is being an engaged patient to prevent hospitalization from becoming a downward spiral, both physically and financially.”

WellPoint affiliates are PPO plans, HMO plans and PDP plans with a Medicare contract. Enrollment in WellPoint affiliated plans depends on contract renewal.
1 Jencks SF, Williams MV and Coleman EA. “Rehospitalizations among Patients in the Medicare Fee-for-Service Program.” New England Journal of Medicine, 360(14): 1418-1428, April 2, 2009.
SOURCE: WellPoint

WellPointDoug Bennett Jr., (502) 889.2103


Thursday, 6 February 2014

Westhill Consulting Insurance - Saving for your ageing parents: an easy guide to where to start

Saving for your ageing parents: an easy guide to where to start

The needs of elderly parents can surprise even those who are prepared, but you don’t have to support your family alone

Adult children of older parents should prepare financially for the costs of care and travel. Photograph: Alamy
Adult children of older parents should prepare financially for the costs of care and travel. Photograph: Alamy
We all want to age like the late Pete Seeger, who celebrated his 90th birthday performing onstage in front of thousands of adoring fans of all ages at Madison Square Garden, and went on to entertain the Newport Jazz Festival audiences a few months later.

In our pragmatic moments, we know that the odds of living that long and in such good health aren’t in our favor. We know we need to plan not only to live longer but perhaps to spend more time in costly nursing homes or care facilities.

It's not just ourselves we have to worry about. Failing to develop a plan to help our parents in their final years could deliver a similar kind of blow to our emotional and financial wellbeing. In the last few months, I’ve watched three friends, ranging in age from their 40s to the early 60s, scramble to resolve non-medical problems for their parents. In all cases, that meant forking out on costly airfares to be there in person; in one case, it required money to hire a new accountant. “I’ve always been aware that at some point, there would be an emergency, but I had assumed it would be a stroke or something, not this,” one told me, ruefully.

A recent US Trust survey revealed that while about half of all Americans have planned for their own long-term care needs, only 18% of those with parents still living have factored in the possible need to help parents.

And yet, 26% of those under the age of 49 already were footing the bill for parents’ out-of-pocket medical expenses while 18% were contributing to long-term care costs.

I’m not suggesting that you double your savings rate to ensure that your nest egg is large enough to cover your needs as well as the needs of your parents and in-laws. That’s both illogical and – given that most of us are struggling to save for our own retirement – impractical. That doesn’t mean your hands are tied, however.

Start with the basics. Make a list of questions and fill out the answers. It's easiest to start with the most important documents you need to be prepared.

Do your parents have a health care proxy? A power of attorney prepared? Where are they located? In the midst of a crisis, you don’t want to go on a treasure hunt in quest of these crucial documents.

“Clients call me to say that hospitals won’t talk to them about treatment for their elderly father with dementia because no one has a healthcare proxy or knows where it is,” says Nan Giner, a partner at Boston-based Choate Investment Advisers.

Do your parents have long-term care insurance, or do they plan to “self-insure” and cover their costs from their savings?

“Knowing the answer to that question can help you understand how much risk there is that you’ll be called on to help” whether directly or by helping them to navigate the labyrinth of federal, state and local programs that exist to help fill gaps of this kind, says Dave Richmond, a financial adviser in Jackson, Michigan.

Beginning conversations on these topics might feel awkward – after all, it hasn’t been that long since your mom and dad were monitoring your behavior. But it’s important to be proactive. The more you’re able to communicate openly, the better the odds that you’ll spot something that otherwise might have developed into a crisis.

“Most of the parents I’ve worked with don’t want to be a burden to their children,” says Gideon Schein, founding partner of Eddy & Schein, a New York firm that manages personal finance and health insurance issues for senior citizens still living in their own homes. “The best way is to make parents aware that you’re asking for everyone’s benefit; that it’s a kindness to everyone in the family to be prepared – not for death, but for the rest of their lives.”

There are plenty of tips out there for ways to start tricky conversations like these. Bringing a third party into the discussion can also help, especially if your parents feel you’re overstepping your bounds, or you’re afraid of sounding greedy or self-interested. “Sometimes having a mediator takes the tension out of a situation,” says Schein.

A good place to start is an elder care attorney, who is intimately familiar with these issues, including specialized vehicles like pooled income trusts that can be invaluable to elderly individuals facing a financial shortfall in covering the cost of their care in their final years. They can refer their clients to other specialists, including people in Schein’s rapidly-growing industry, members of the American Association of Daily Money Managers.

None of this practical stuff will make it easier to deal with the emotional burden of octogenarian parents struggling with dementia or other major ailments. But part of everyone’s personal financial plan should include strategies for dealing with some of the most likely scenarios involving their parents. That leaves everyone in a less vulnerable position.


Wednesday, 5 February 2014

Study: More exercise, less sitting reduces heart failure risk for men – Westhill Consulting Insurance

More exercise, less sitting reduces heart failure risk for men

DALLAS — sitting for long period’s increases heart failure risk in men, even for those who exercise regularly, according to new research published in the American Heart Association journal Circulation: Heart Failure.

Preventing heart failure, researchers found, requires a two-part behavioral approach: high levels of physical activity plus low levels of sedentary time. The study is the first to examine the link between heart failure risk and sedentary time, said Deborah Rohm Young, Ph.D., lead researcher and a senior scientist at Kaiser Permanente in Pasadena, Calif.
"Be more active and sit less. That's the message here," Young said.
Researchers followed a racially diverse group of 84,170 men ages 45 to 69 without heart failure. Exercise levels were calculated in METs, or metabolic equivalent of task, a measure of the body's energy use. Sedentary levels were measured in hours.  After an average of nearly eight years of follow-up, researchers found:

Men with low levels of physical activity were 52 percent more likely to develop heart failure than men with high physical activity levels, even after adjusting for differences in sedentary time.

Outside of work, men who spent five or more hours a day sitting were 34 percent more likely to develop heart failure than men who spent no more than two hours a day sitting, regardless of how much they exercised.

Heart failure risk more than doubled in men who sat for at least five hours a day and got little exercise compared to men who were very physically active and sat for two hours or less a day.

Study limitations included: Since no women were studied the results may not apply to them; results were self-reported, which could mean physical activity was over reported; results were based only on time outside of work and can't be applied to overall sedentary activity; and participants were members of comprehensive health plans, so results may not apply to men lacking health insurance.

The study supports the American Heart Association recommendation that people get at least 150 minutes a week of moderate-intensity aerobic activity to reduce their risk for heart failure and other cardiovascular diseases, Young said.

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Tuesday, 4 February 2014

Strong opinions voiced on single - payer health insurance system - Westhill Consulting Insurance

If our email inbox is any indication, Las Vegans feel strongly about starting up a single-payer health insurance system.
After we wrote on Jan. 19 about a Vermont lawmaker’s federal proposal to mandate that states set up one-payer systems that would operate like Medicaid and guarantee coverage for all, the feedback rolled in.
We’ve selected two letters with opposing takes on the issue to keep the discussion going.
Once you’ve finished reading up on the debate, check out how a local consumer got a pleasant surprise when he recently signed up for new coverage.
■ Al Popp reached out with a novel idea. He writes: Let’s just expand Medicaid to everyone. How do we pay for this system? We pay for it by taxing all food and beverages at 10 percent. Just add it to the price of the product before the sale, like we do with gasoline excise taxes. If a person spends $200 a week for food and beverages, whether it be in a grocery store, convenience store, restaurant or catering business, one would be paying $20 a week for their health care, which equates to $1,040 a year. That, to me, is affordable health care. The more you spend on food and beverages, the more you will contribute to health care. I’m curious what your thoughts are on this plan.
Well, Al, I’m a reporter, so I’m completely flexible and I have no opinions.
In the interest of public debate, though, your plan is definitely worth sharing.
One common criticism of this kind of funding source is that poor Americans spend an above-average share of their income on groceries, so it becomes a regressive tax that penalizes lower-income earners more than wealthier households. This is why Nevada’s sales tax exempts food bought inside grocery stores.
So although you’re correct that people would pay less if they spent less, a plan to tax food and drink would disproportionately hurt discretionary income among working-class households.
Plus, low-income households already face higher food costs because their neighborhoods might have fewer supermarkets and pricier food as a result.
As you note, Al, your idea does have upsides. No one would be mandated to use Medicaid; they could still buy a private plan for more coverage, the way some affluent households pay both local property taxes and private-school tuition. International tourists who buy pricey meals on vacation also would feed into the system. And undocumented residents would pay as well, anytime they visit the grocery store. So would “panhandlers, the underground market and cash-paid workers,” as you said.
So, readers: Add what you’d like to Al’s suggestion.
■ On the other side, Las Vegas insurance broker Patrick Casale chimed in on single-payer with this: There are five reasons single-payer can never work for the United States: immigration; taxation; capping doctors’ and hospitals’ earnings; capping Big Pharma; and medical access.
Part of Patrick’s concern is that our country already is strapped financially, and a plan that opens free health care access to all (Medicaid doesn’t charge copays or premiums) would be unsustainable given current immigration rates. What’s more, he said, countries with one payer “have a tax rate that exceeds 50 percent, and numerous other taxes,” including sales taxes. Accounting firm KPMG backed that up with a 2012 study that pegged top marginal income-tax rates at 56.6 percent in Sweden, 55.4 percent in Denmark and 48 percent in Canada. The marginal U.S. rate is 39.6 percent.
Making a single-payer system work also might require limiting hospital charges and incomes, and that would in turn hurt access as providers perform fewer procedures to control costs, Patrick said. And tangling with the major pharmaceutical companies on what they charge would be a Herculean task in what he called “the most overdrugged nation worldwide.”
Patrick said he also would like to see the federal government eliminate fraud in Medicare and Medicaid before the programs expand to all Americans. Curbing malpractice lawsuits might make a difference in costs, too.
Anything else you can think of, readers?
■ Steve Selbrede wrote in with praise for a little-known provision of Obamacare: There have been many recent stories and letters about the absurdly high deductibles of Obamacare insurance plans. When I first began to investigate the Nevada Health Link website to choose my own plan, I was distressed to see very high deductibles. After about 30 hours of studying my options, I found that these deductibles are not always so high.
Steve discovered Cost Sharing Reduction, a little-known discount in the Affordable Care Act that lowers what you owe out of pocket for deductibles, coinsurance and copayments. It’s above and beyond the tax credit that helps cut premiums for lower-income earners.
You do need to meet a few guidelines to benefit. For starters, you have to buy your plan through Nevada Health Link, the state exchange’s website. Plus, the discount is good only on silver plans, the federal law’s benchmark coverage. And you have to make less than 250 percent of the federal poverty level. That’s $59,625 for a family of four, or $29,175 for a single.
Steve qualified, and after he chose Nevada Health CO-OP’s Southern Star Silver Plan, here’s what he found: His calendar-year deductible dropped from $4,250 to $750, while his out-of-pocket maximum fell from $6,350 to $1,500. His office visits went from $15 or $45, depending on network level, to $5 or $30. Specialist copays were reduced from $50 or $150 to $10 or $50.
You do need to complete the sign-up process at to determine whether you’ll get the break. So Steve offered some tips on how to make it through, if you have issues with the site.
First, forget about browsing for a plan without creating an account, because you won’t get a full reckoning of the cost unless you put in your details. Start an account at the site with a user name and a password, or you won’t be able to get back into your account. Do not provide your e-mail address, or you might not be able to return to your account. Make sure you know exactly what your adjusted gross income is before you get started. And check your insurer’s website for a provider list because the state exchange’s site doesn’t always match, he said.
“Don’t wait for a bill. Send a check in right away,” he added.


Tips for those waiting to receive proof of insurance coverage

Information submitted

COLUMBUS — Complications with the federal health insurance exchanges have created challenges for some consumers who have not yet received proof of their insurance coverage. As a result, many consumers are unsure if their medical treatments are covered and are unable to provide their proof of coverage.
“Since open enrollment began on Oct. 1 the federal exchange has struggled to process applications and enroll consumers in coverage,” Ohio Lieutenant Governor and Department of Insurance Director Mary Taylor said. “These delays are making it more difficult and confusing for consumers to use the health insurance plans they have purchased through the federal exchange.”
If you recently purchased a plan, but still haven’t received proof of insurance from your insurance company, Taylor offers these tips.

Contact the Company
The first thing you should do is contact your insurance company to verify that you do have insurance coverage. Ask your insurance company for proof of coverage, such as an insurance card or identification numbers. Take detailed notes of conversations and include the representatives names, and date and time they took place. Keep copies of written communication you received from your insurance company such as emails or letters. You may need these materials later.
You should also verify that you have paid your first premium on time. Some insurers have permitted late payments for coverage that is retroactively effective to Jan. 1. Ask your insurer for their deadline and keep any records that can serve as proof of payment.
If you are about to buy coverage from the federal exchange, print any paperwork or confirmations that you receive during the enrollment process.

Payment Options
You may need to get a prescription filled or see your doctor before you receive your insurance card. Your provider (hospital, doctor, pharmacy) may be able to verify your coverage by contacting your insurer directly. If verification of coverage cannot be obtained, you still have options. One option is to pay for expenses out of pocket.

Once your insurance coverage is effective, your insurance company should reimburse you to the extent that the service or medication is covered under your policy. You may also be able to work with your doctor’s office, hospital or pharmacy to delay payment or set up a payment plan until they can verify that you’re insured.
Keep your receipts and any bank statements that show that you’ve paid for the services.

Contact the Ohio Department of Insurance
If you are still having difficulty obtaining proof of coverage from your insurance company, call the Ohio Department of Insurance consumer hotline at 1-800-686-1526 for assistance. Insurance information is available at You can follow the Department on twitter @OHInsurance and on Facebook.


Sunday, 2 February 2014

N.J. Commissioner Offers Insurance Purchasing Tips for Small Businesses

Making the right insurance choices can have significant impact on the small business owner’s operation costs. With that in mind, New Jersey Department of Banking and Insurance Commissioner Ken Kobylowski offered some basic tips for small businesses for purchasing or updating their insurance coverage.
There are different types of policies available to small business owners that range from life insurance options to mandatory workers’ compensation.
Commissioner Kobylowski said small business and home-based business owners potentially have several different policies that can provide necessary protections.
“Small businesses should annually review their insurance policies to verify that their coverage meets their needs,” Commissioner Kobylowski said. “This could include workers’ compensation, commercial auto, business property and liability, group health and disability as well as group life and key-person life insurance.”

Commissioner Kobylowski offered the following tips:

What steps should a small business owner take?
• Shop around – Examine rates from several companies, being sure to compare plans providing identical coverage.
• Protect yourself – Stop. Call. Confirm. Verify with the Department that the companies quoting coverage are licensed by the State of New Jersey by calling 1-800-446-7467 or by checking online at Then use the National Association of Insurance Commissioners’ Consumer Information Resource (CIS) at to compare a company offering coverage to other firms in the industry using their consumer complaint ratios.
• Review Annually – Small business insurance needs change as a company grows. Additional machinery purchased for a manufacturing plant or expansion to a larger facility could require an increase in property limits. Additions to an auto fleet could mean changes in a commercial auto policy or sales growth could result in the need for more business continuation coverage.
Commissioner Kobylowski reviewed the following policy options a small business owner might want to consider:
1. Workers’ Compensation. State law requires that all New Jersey employers, not covered by federal programs, have workers’ compensation coverage or be approved for self-insurance.
Typically, workers’ compensation covers the employee’s medical expenses, rehabilitation costs and lost wages if he or she is injured on the job. If an employer does not have workers’ compensation and an employee is injured on the job, the business may be liable for any medical expenses that individual incurs. The company might also face fines and penalties for noncompliance.
2. Property. Property insurance protects small business owners from losses due to damage to physical space or equipment and as a result of theft. For insurance purposes, a business’ property includes the physical building in which it resides, as well as its other assets.
All of the following, owned or leased, can be considered business property: the actual building; inventory; furniture, equipment and supplies; machinery; computers and other data processing equipment; valuable papers, books and documents; artwork and antiques; television sets, VCRs, DVD players, and satellite dishes; signs, fences and outdoor property not attached to a building; and non-tangible items, such as trademarks and copyrights.
3. Flood Insurance. Flood is not a covered peril in a standard business property insurance policy. Business owners can purchase flood coverage from the National Flood Insurance Program (NFIP), administered by FEMA. Flood insurance policies have a 30 day waiting period before going into effect. To find out more about the NFIP consumers can go to If the flood insurance property limits from the NFIP are inadequate to cover a business, owners can check with an insurance agent or carrier representative about additional coverage options.
4. Ordinance or Law Coverage. This pays for rebuilding a destroyed property so that it will meet the current building codes. Older structures damaged may need upgraded electrical, heating, air conditioning and plumbing units based on current municipal codes. This covers the additional cost to upgrade due to new codes.
5. Business Interruption/Continuation. This type of insurance covers lost earnings due to a loss covered by one of the property insurance plans purchased, such as a fire or theft that shuts down a business for an extended period of time. Business interruption/continuation insurance covers expenses associated with running a business, such as payroll and utility bills, based on the company’s financial records.

Business interruption/continuation coverage can be added to a property insurance policy or purchased as part of a package insurance product.
6. Liability. This insurance product covers workplace risk, for example, if an individual falls while visiting a business premises, or a customer is hurt by a product a business sells, the business owner can be held responsible. Standard policies do not provide protection against sexual harassment, professional liability or commercial auto or truck claims.
7. Commercial auto. All motorized vehicles, whether used for personal or business purposes, need auto insurance. Automobile liability insurance – required by most states – covers medical expenses for injured persons and damages to the property of other individuals as a result of a motor vehicle accident caused by the insured’s negligence.
While the types of coverage provided by personal and commercial auto insurance policies are essentially the same, there are important distinctions. Typically, commercial auto insurance policies have higher liability limits, for example $1 million. They also may have provisions that cover rented and other non-owned vehicles, including employees’ cars driven for company business.
Several factors related to ownership and use of vehicles determine whether a personal or commercial policy is appropriate. These include: who owns or leases the vehicle –individually or the business as an entity; who drives the vehicle – owner or employees; and how the vehicle is principally used – for example, transporting people, delivering packages or carrying hazardous materials.
8. Umbrella Insurance. This coverage provides protection for an individual or business above the limits for a primary policy. It is recommended for a business with a value above its primary limits for various policies selected. It is also a smart purchase for high net worth individuals. A policy can cost relatively little for the protection it provides.
“Small business owners should discuss these insurance matters with a licensed insurance professional at an agency or carrier,” said Commissioner Kobylowski. “A life and health insurance professional should also be consulted to make sure every aspect of a small business is protected.”