FAQs

Frequently Ask Questions:

1) What is the advantage of using your services versus going to the carrier directly?

You have the convenience of a direct contact person for all your needs. We spend our time to research for you. This saves you tine from calling each and every carrier to get a quote. It saves you the hassle of having multiple agents contacting you. It saves you from the frustration of being on hold or having to press multiple extensions to get to the right department. Our services are FREE and we know how to navigate through the carrier to get the right answers quickly and accurately.

2) How much are your plans?

Plan prices vary with coverage choices, the more comprehensive and inclusive the protection, the higher the premium. There are over 200 carriers and each company has an average of 15 plans. Which one is right for you? A broker can help you sort out your options with the different carriers. You can’t get a lower price anywhere because insurance is regulated. What are our budget ranges and features that are important to you? This is how a plan is recommended. If you don’t have a budget, we may quote you a plan that is out of your price range. Or, we may quote a plan that does not have enough protection. You have to be realistic.

3) What is co-insurance?

Coinsurance is a specific dollar amount (or percentage) that an individual (or family) is required to pay for services after a deductible has been paid. Coinsurance can range from $2,500 to $15,000. The percentage allocation can range from as low as 20% to as high as 50% for your share of any bill after you have satisfied the deductible, up to a maximum of $15,000.

4) What is an out of pocket (OOP) maximum?

An out of pocket (OOP) maximum can sometimes be referred to as a stop loss. It is a pre-determined limit amount of money that an individual (or family) must pay before an insurance company will pay 100% for the medical expenses. It is the sum total of your deductible and co-insurance amounts.

5) What is the difference between a “per incident” plan and an “annual” deductible?

Per incident mean EVERY time you go to the hospital or have outpatient services, you pay a deductible for that incident. For example, your son broke his arm playing football and had to go to urgent care, you have a deductible to satisfy. A few months later, your daughter sprains her ankle from ballet class, you have another deductible. Each and every different incident, you have a separate deductible to satisfy. Whereas, an annual deductible allows you to accumulate your entire out of pocket expenses towards your family’s deductible.

6) What is the difference between a discount plan and a major medical plan?

A discount plan affords you a reduced price on doctors and/or services that are rendered. It is not health insurance. A major medical plan provides out of pocket protection in the event a major illness.

7) How do I choose whether I want a low or high deductible?

The higher the deductible, the lower your monthly premium. A low deductible is good, if you go to the doctor frequently. However, your monthly premium is higher. Conversely, a higher deductible is good for healthy people who do not need to see their doctor frequently. They have a lower monthly premium.

8) What is a Deductible?

It is the amount of covered expenses that you must pay for each period of confinement before benefits are provided.