It depends. A group health insurer that offers group health insurance may not, under any circumstances, impose a pre-existing condition that relates to or includes pregnancy as a pre-existing condition. It is common practice however, for an individual health insurer, due to possible complications of a pregnancy, to consider pregnancy a pre-existing condition and therefore deny a person access to an individual health insurance plan.
Which personal lines of medical insurance are marketed by the Gregorys Insurance Agency?
We specialize in health, life, disability (income-protection) and long-term care insurance for individuals and families, third party administrators, small and mid-sized groups (5-1000 employees), consultants and the self-employed.
My doctor recently told me that my blood pressure and cholesterol levels are high and suggested that I lose weight. I am currently awaiting several quotes. How could this potentially affect my insurance rates?
Healthy blood pressure and cholesterol levels are largely dependent on gender and age, and there are levels most insurance companies consider acceptable and other levels they consider preferred (which may qualify you for discounted rates). Your build is your height to weight ratio; if you weigh too much for your height, you may find your rates will be higher. (Being 10-15 pounds overweight is unlikely to affect your costs.) The same idea applies to cholesterol and blood pressure; normal adult blood pressure is generally identified as 130 over 85 or below, and most doctors recommend that you keep your cholesterol below 200 (with your LDL, or low density lipoprotein level, below 100). You are considered hypertensive if your blood pressure is above 140 over 90. Take note: If you have successfully lowered your levels with diet and exercise, your former higher levels are not likely to affect your healthcare costs.
What is a pre-existing conditions clause and what is the effect of its inclusion in a major medical plan?
A pre-existing condition is often defined as a medical condition (i.e., an injury or illness) that required treatment during a prescribed period of time, e.g., 6 months, prior to the insured's effective date of coverage under a major medical expense plan. A pre-existing conditions clause denies coverage to individuals on account of specific pre-existing conditions; such conditions may be excluded for periods of as long as 12 months to 2 years after the effective date of coverage. From time to time, the definition and provisions of the clause may differ considerably from one plan to another; we therefore suggest that all newly and prospective insureds thoroughly familiarize themselves with the provisions of a policy before and after they apply for coverage.
What is the difference between working with an Insurance broker and an Insurance Agent? From which professional would you recommend I purchase insurance?
Insurers deliver their insurance products to policy owners primarily via independent or exclusive agents. Historically, almost all insurance agents were independent business professionals who were paid sales commissions. In recent times however, several insurance companies have adopted a classification system which considers certain types of agents independent employees of an insurance company; these agents are now referred to as ‘exclusive’ or ‘captive’ agents. Recent studies suggest captive agency is a less efficient method of providing clients with viable insurance options, as they are affiliated with a single company. Independent brokers on the other hand, are affiliated with several companies, and are thus able to offer advice, access to higher quality plans, education, personalized service and claims assistance, once the claim is filed with the insurance company. The services of an independent broker might be considered a viable option for those who consider support, guidance and variety in the health insurance selection process a necessity.
I am currently self-employed with a thriving business. In the event I became disabled and couldn’t work, I’d like to make sure I can maintain my standard of living and keep my business. I recently heard about short-term and long-term disability. Which of these would you recommend?
Assuming that only one of these types of disability insurance products will be purchased, sound risk management principles would suggest the purchase of a long-term disability (LTD) insurance policy. LTD insurance protects an insured against disabilities that may last many years, even a lifetime, and thus provides protection against losses of a potentially catastrophic magnitude. Although long-term disabilities occur less often than disabilities of a relatively short duration (e.g., several weeks or even a few months), the loss of income of a shorter duration is more easily absorbed by a family unit than income loss that lasts for several years or longer.
How much disability insurance should I own?
The recommended amount of disability income insurance generally ranges from 60-70 percent of pretax income. The applicable percentage for higher-income persons is usually somewhat lower than the percentage recommended for lower-income individuals, due primarily to differences in income taxes. Amounts considerably less than full replacement of earnings are recommended due to a reduction in income taxes and decreases in commuting and other work-related costs that are likely to occur in the event of a disability. On the other hand, medical, rehabilitation and other expenses are often higher for disabled individuals, creating a need for larger amounts of replacement income. While determining how much disability income insurance one should purchase, a person should consider disability benefits which are subject to income taxation, any benefits payable under Workers' Compensation and Social Security benefits. For more information, contact one of our licensed disability consultants.
My new employer typically offers health coverage to employees in their third month of service to the company. Unfortunately, my combined tenure thus far is only a week, and my COBRA policy expires in one month. Are there any temporary or short-term health plans available?
Yes. Several health insurance companies offer temporary or short-term health insurance plans to people who are in-between jobs, students and self-employed. You have a choice of several deductibles and optional benefits that are similar to individual or family health plan benefits. These plans are flexible and payable on a month-to-month basis, should you need to retain coverage for a longer period of time than originally anticipated.
I hear a lot about HSAs and CDHPs. What are they, and why are they so popular?
Consumer-driven health plans are high deductible health plans that are designed to encourage consumers to make wiser, cost-effective healthcare decisions. They are usually attached to health reimbursement arrangements and health savings accounts, (HSAs and HRAs.) These tax-advantaged, pre-taxed-dollar savings accounts may be used to pay for the out-of-pocket healthcare expenses that are not covered by a high deductible plan. The surge in popularity in CDHPs is due to recent studies that show that individuals who are responsible for a significant amount of their healthcare expenses are more likely to adopt healthier lifestyle patterns and behaviors, such as such as quitting smoking, losing weight, and exercising regularly.
