Contact us if you have any questions or would like to know how O’Brien Benefits & Financial Services, Inc. can help you with your insurance needs.
UnitedHealthcare is available in these states: VA – WV– MD – PA
The IHC Group is available in these states: WV, TN, NC, MD, PA
With a dental savings plan you pay an annual fee and get access to significantly reduced rates. And dental savings plans offer many benefits over traditional dental insurance. Things like no annual caps or limits and absolutely no paperwork.
Our plans cover more than 100,000 dentists nationwide. These quality providers have agreed to charge reduced fees on the dental services you need. So you’ll get the quality care you deserve at a bigger savings than you ever imagined possible.
Use your account to pay for deductibles and other qualified medical expenses with pre-taxed dollars.
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Buy-Sell Agreements protect a business after the death of a key employee. Also, known as Continuation Agreements, they are tied to and funded by life insurance policies. The agreement sets out the details of the transfer of business interest by the key-person (or his/her estate) upon a certain triggering event–usually death, disability and retirement. The surviving or continuing business owner or partner can rest assured knowing that they will be able to purchase the key-person share without interference from other survivors of the key person and his/her estate
A Business Overhead Disability policy prevents businesses from going under from regular overhead expenses while the business owner is unable to work and run the business due to disability. These types of policies will typically pay for things like employee salaries, rent and utilities, among other expenses.
Key Person (Key Man) Life Insurance protects your business if one of the main partners passes away unexpectedly, and helps to minimize financial loss. Your business is typically responsible for the premiums, as it is also the beneficiary. The value of your business (as established through financial records) will help to determine the benefit level and premium amounts.
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Disability Insurance protects your ability to earn a living during your working years. In other words, it protects one of your most valuable assets. And, this is pretty important considering that statistics show our chances are greater of becoming disabled than dying between the ages of 25 & 45. During the time you are unable to work due to a qualifying disability (illness or injury), the replacement of your regular income through a monthly benefit provided by disability insurance helps to maintain your pre-disability lifestyle.
Employers often provide standard short-term disability (STD) and long-term disability (LTD) insurance to meet federal guidelines. Individual disability income insurance can be customized to meet your needs and considers your occupation, age, income and other factors in determining your cost and monthly benefit payment amount.
What type of coverage is available?
A standard Short Term Disability (STD) policy allows for income payments to begin after a two-week waiting period. Payments will continue to the insured until he/she recovers or maxes out the benefits. Thus, total benefits for a STD could last for anywhere from one month to two years, depending on the policy.
A Long Term Disability (LTD) policy allows for income payments to begin after a ninety-day waiting period, although it could be much longer depending on the policy. Once payments begin, they will continue far longer than STD. Thus, the total benefits for a LTD could last for a few years, up to age 65, or even for life.
A Long Term Care Plan augments your health insurance or Medicare and pays for services associated with performing tasks required for daily living such as dressing, bathing, eating, getting in/out of bed, toileting, walking or other basic activities. These services fall under skilled care or personal care and are the types of services that regular health insurance, Medicare or Disability generally does not cover.
As stated, long-term care is usually not medical care and most often does not require a doctor or a nurse. In addition, the need for LTC is not always age related. In fact, statistics tell us that more than half of all individuals age 65 & over will need LTC at some point. Even so, it is important to note that roughly 40% of those receiving LTC today are between the ages of 18 and 64.
Why LTC Insurance?
Regular health insurance, Medicare or Medicaid typically will not pay for Long-Term Care services. The cost of LTC can quickly add up and burden those closest to you, both financially and emotionally. Purchasing a LTC plan can help you avoid those difficult situations, as well as give you the power you need to maintain control of your care, choosing the facilities that best suit your needs. Thus, instead of allowing welfare or the government to make your LTC decisions for you, you are in charge. Additionally, you should be aware that Disability Income Insurance is not designed to cover LTC expenses, but simply replaces part or all of your income during your working years should you become disabled. You need specific coverage to pay for long-term care needs.
Here are examples of what LTC policies may cover:
Take care of your eyes with an individual vision plan that can be purchased separately or combined with your major medical insurance. Individual vision plans are similar to individual dental policies, as they are inexpensive and save you money on routine eye care, such as exams, eyeglass frames and lenses, contacts, and even offer big discounts on procedures like LASIK. Additionally, monitoring your eye health with regular exams helps to prevent serious eye diseases like glaucoma and cataracts, and also helps to detect early stages of diabetes, high blood pressure, and high cholesterol.
A Gap plan provides benefits that supplement a major medical and comprehensive benefit package. It works by paying a significant amount of the deductible on a major medical plan. More specifically, the additional benefits help to cover out-of-pocket expenses related to coinsurance, co-pays and deductibles for inpatient and outpatient services. For example, if you have a $5,000 deductible on your major medical plan, gap coverage could pay up to $4,000 of that deductible.
Unlike a traditional major medical plan that reimburses you or pays directly to a provider for approved hospital stays and medical care, a Hospital Indemnity Plan pays a lump-sum payment directly to the insured. The cash payments can help with out-of-pocket expenses and covers your employees when they off work due to a hospital stay. The coverage is usually a set amount per day, per week, per month, or per visit depending on the benefit level selected.
This special type of coverage can reduce the personal financial impact of the cost of fighting critical illnesses, helping to keep up with everyday bills through that process. Some key features include cash benefits paid directly to the employee and plans to fit different levels of coverage/budgets.
Employees always appreciate dental & vision coverage as part of the benefits package. We offer both dental and vision as part of the employer sponsored package or on a voluntary basis.
Dental Plans
Studies have shown that regular dental exams help employees to stay healthier and more productive in the work place. Additionally, you can detect serious underlying conditions such as heart disease and diabetes, through regular dental exams. In fact, the National Association of Dental Plans and the Centers for Disease Control have performed studies that show that employees with dental insurance have better attitudes and are less likely to suffer from depression, a common condition in today’s fast-paced world.
Dental insurance offers a variety of diagnostic, preventative care and corrective services. This includes cleanings, exams, x-rays, fillings, root canals, orthodontia for children, and emergency care while traveling.
Vision Plans
Similar to dental policies, vision plans are inexpensive and save employees money on routine eye care. Examples of care include exams, eyeglass frames and lenses, contacts, and even discounts on procedures like LASIK. Additionally, monitoring your eye health with regular exams helps to prevent serious eye diseases like glaucoma and cataracts. In addition, regular eye exams help to detect early stages of diabetes, high blood pressure, and high cholesterol.
Long-Term Care plans are becoming an increasingly common voluntary benefit offered by employers today. The prospect of long-term care is one of the most important issues your employees may have to face. The cost of long-term care is expensive and generally not covered by other employee benefits, disability or even Medicare.
If someone requires long-term care, it is not just an emotional strain but a financial one as well, impacting retirement savings and overall financial position. Savvy employers know that access to additional resources can increase employee productivity when confronted with managing long-term care situations. Long-Term Care plans demonstrate to your current and prospective employees that your company cares about them–increasing the ability to attract and retain the very best talent.
Most LTC plans are designed to provide benefits for care through nursing homes, assisted living centers, home health care and adult day care.
Employers can provide a base benefit while giving the employees the opportunity to “buy up” and obtain the level of coverage that they need for their families.
Accidents can happen anytime. Accident insurance helps to protect employees from financial hardship due to a great deal of medical and out-of-pocket expenses that follow accidental injuries. For example, emergency treatment, hospital stays, medical exams, transportation and lodging needs are just a few of the expenses that accident insurance can help cover. In fact, some policies can even pay benefits in as little as one day, based on time of claim submission.
Employees are more productive when they feel secure that their loved ones will be taken care of, in the event of illness or an untimely death. Thus, you should consider life insurance a key part of the benefit package for your employees. And, also a valuable tool in attracting top talent.
Whether employer paid or voluntary, a good life insurance policy provides for an employee’s final expenses, taxes, and mortgage. Additionally, it may even pay for their children’s education.
Permanent Life Insurance
This type of life insurance builds cash value which is sometimes used as collateral for loans, if needed. However, most employers only offer basic term life insurance (see below), but also offer permanent life insurance on a voluntary basis. Even so, employees appreciate the opportunity to widen their safety net.
Term Policy
This type of life insurance does not build cash value. However, it will pay a set amount to the named beneficiary upon the death of insured within the stated term. Additionally, some policies may also make payments upon terminal or critical illness.
National surveys have shown that Short Term Disability and Long Term Disability remain of high importance for most employees. Thus, savvy employers attract and retain top talent by offering both STD and LTD insurance as part of the employer paid benefit package or as a voluntary (worksite) benefit.
Short Term Disability
During the time an employee is unable to work due to a qualifying disability (illness or injury), STD generally allows for income payments to the employee to begin after about a two-week waiting period and will continue to pay the employee until he/she recovers or maxes out the benefits–usually anywhere between one month to two years, depending on the policy.
Long Term Disability
During the time an employee is unable to work due to a qualifying disability (illness or injury), LTD generally allows for income payments to the employee to begin after about a 90-day waiting period. However, it could be much longer depending on the policy. The policy will pay the employee far longer than STD–for a few years, up to age 65, or even for life.
Health Maintenance Organization Or HMO
An HMO offers lower premiums and a significant savings on routine and preventative healthcare. However, this type of health plan requires you to appoint a primary care physician and to use doctors and facilities that are affiliated with the HMO. Thus, if you use healthcare service providers outside of the HMO, there is a good chance those charges won’t be covered by your policy. But, the great thing about an HMO is that the only charges you incur, outside of your premiums, are co-pays for doctor’s visits and other services such as procedures and prescriptions.
Preferred Provider Organization Or PPO
A PPO will save you money on services if you use the preferred providers within the network. Keep in mind that deductibles must be met on this plan before some services will be covered. The good thing about a PPO is they generally will allow a certain amount of services annually outside of the deductible with a small co-pay, and most often the PPO has a large network with quality care providers and excellent prescription drug coverage.
Health Savings Account (HSA)
An HSA is a tax-advantaged bank account tied to certain high-deductible health plans. It allows you to use tax free dollars to pay for allowable health expenses, such as copays, prescription drug costs and more.
The public health insurance Marketplace (also referred to as an “Exchange”) is where you can purchase health insurance (also known as Obama Care) for you and your family. A plan from the marketplace is considered a comprehensive major medical plan and also contains the essential health benefits as established under the ACA law. When you purchase your health insurance through the marketplace, you are guaranteed issue regardless of any pre-existing condition and you may be eligible for a subsidy (premium tax credit) to help off-set high premiums. When you visit our partner’s website, HealthSherpa, they will be able to help you determine if you are eligible for a subsidy.
The essential health benefits are as follows:
Are you required to buy health insurance?
Currently, most people are not required to purchase health insurance. The ACA “shared responsibility payment” and the individual mandate has been eliminated by the Trump Administration for 2019 and beyond. However, some states have established their own individual mandates, so you still may may be subject to your specific state tax penalty, if any.
When can you enroll?
It’s important to know that you can only purchase your health insurance during the annual open enrollment which is November 1 to December 15th of each year, or unless you qualify for the special enrollment period.
What if you miss the deadline?
You can still sign up for health insurance after the deadline if you meet any of the following qualifying events:
This Health and Wellness Option is very affordable and gives you access to a variety of discounted health services that include prescriptions, counseling, as well as telehealth solutions. Our telehealth solutions are provided by DialCare, which is a modern, easy-to-use telemedicine solution for non-emergency illnesses and general care. Members and their families have direct access to state-licensed and fully credentialed doctors, via phone or video consultations, to receive treatment (including prescriptions) and advice for common ailments, including colds, the flu, rashes and more. All for a $0 consult fee.
Our Fusion Plan can be purchased any time of the year and combines hospital, surgical and critical illness fixed insurance benefits together for one low price, and is designed to be paired with short-term health insurance, for those who for whatever reason do not have major medical coverage (maybe they missed the open enrollment period per the Affordable Care Act (ACA), and do not qualify for special enrollment, or are in between jobs, or maybe do not expect to need a great deal of medical services and need a more affordable alternative to the ACA).
This fixed-benefit indemnity plan pays specified amounts for covered medical expenses related to hospitalization, surgery, chemotherapy and radiation services, and keeps you from paying 100% out-of-pocket for an unexpected illness or accident.
A Gap plan provides benefits that supplement a comprehensive medical plan that you purchase from the marketplace. It works by paying a significant amount of the deductible on your major medical plan. More specifically, the additional benefits help to cover out-of-pocket expenses related to coinsurance, co-pays and deductibles for inpatient and outpatient services, and provide a lump sum payment that is sent directly to you and can be used for anything you choose. For example, if you have a $2,500 to $10,000 deductible on your major medical plan, gap coverage could pay some or all of that deductible, depending on the level of benefits you select. Plans include critical illness and accident (disability) benefits, with the option to purchase additional hospital confinement coverage.
This non-ACA option is special hospital and surgical indemnity insurance containing benefits designed to supplement short-term medical insurance or a comprehensive medical major plan purchased from the Marketplace. Considering many of the lower-priced options on the Marketplace have extremely high deductibles, pairing an ACA plan with our hospital indemnity plan would be a smart way to ensure you have affordable, adequate coverage, should you suffer from a medical condition requiring a hospital stay.
The policy pays fixed benefits for a covered inpatient hospital stay. It pays benefits regardless of other coverage you may have, and benefits may be paid directly to you, unless you assign them to a physician, hospital or other health care provider. Diagnostic and surgical services are may also be covered, not to exceed the selected plan maximum amount. Pre-existing clause and exclusions apply.
Unlike a traditional major medical plan that reimburses you or pays directly to a provider for approved hospital stays and medical care, a Hospital Indemnity Plan is a limited benefit plans that pays a lump-sum payment directly to the insured. Also, unlike a comprehensive plan on the Marketplace, you can enroll in this non-ACA option any time of the year.
When paid directly to the insured, cash payments help with out-of-pocket expenses and covers you when you are off work due to a hospital stay. There are no plan maximums, however the coverage is usually a set amount per day, per week, per month, or per visit depending on the benefit level selected. Some plans include optional benefits, such as preventive wellness, diagnostic testing and physician office visits.
If you have missed the open enrollment period per the Affordable Care Act (ACA), and do not qualify for special enrollment, or are in between jobs, or maybe you need a more affordable alternative to the ACA, you can purchase Short Term Health Insurance any time of the year. Per the new health insurance regulations as set by the Trump Administration, there is no longer a tax penalty or individual mandate, so you do not have to worry about non compliance of the essential health benefits.
A short term health plan is a non-ACA option that is much less expensive than a comprehensive health plan, because it does not cover pre-existing conditions nor does it contain all of the essential benefits required by the ACA. The great thing about a short term policy is that it will help you avoid financial disaster in case of unexpected illnesses and accidents. And, per new federal guidelines, carriers allow for plans up to one year, and are renewable for up to three years in some states.
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FINAL EXPENSE
Final expense insurance is designed to help protect your loved ones from the financial burden of funeral costs related to your passing. Unlike life insurance, final expense policies have a much lower face value because they are intended to only cover costs related to a person’s final expenses. Therefore, these policies can often be purchased at low or reasonable premiums.
Features include:
GAP INSURANCE
A Gap plan provides benefits that supplement a major medical and comprehensive benefit package. It works by paying a significant amount of the deductible on a major medical plan. More specifically, the additional benefits help to cover out-of-pocket expenses related to coinsurance, co-pays and deductibles for inpatient and outpatient services. For example, if you have a $5,000 deductible on your major medical plan, gap coverage could pay up to $4,000 of that deductible.
HOSPITAL INDEMNITY PLANS
Unlike a traditional major medical plan that reimburses you or pays directly to a provider for approved hospital stays and medical care, a Hospital Indemnity Plan pays a lump-sum payment directly to the insured. The cash payment helps with out-of-pocket expenses and covers you when you are off work due to a hospital stay. The coverage is usually a set amount per day, per week, per month, or per visit depending on the benefit level selected.
