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Published byNeal Martin Modified over 9 years ago
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Health, Disability and Life Insurance
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Costs of going to the hospital Cost of having a child? $4000 - $11,000 Ambulance Ride $500 - $1000 Average cost of someone staying in the hospital… $21,000 Average cost of paying medical insurance without help of job. $370 per month or about $4500 per year. Family of 4 almost $13,000 per year.
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Type of health insurance Group Health Many employees are grouped under the same plan so cost is fairly low. Individual Health Plans Self-employed people have these, not covered under a group plan. Can meet special needs. COBRA Consolidated Omnibus Budget Reconciliation Act If an employee looses their job they are covered for a set period of time. Usually private companies or state or local government are eligible for these benefits.
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Basic Health Coverage Hospital Expenses Pay for some or all of the costs of room and board during the hospital stay. Routine nursing care, minor medical supplies. Usually have a number of set days that the policy will cover. Usually also a deductable. Surgical Expenses Covers all or part of the surgical fees for an operations. Policies have a list of the total amount that the policy will cover and you have to pay the rest. For example a appendectomy may be $1000 and your policy only covers $500 so you have to pay $500
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Phy Physician Expenses Meets some or all of the costs of a physician care that do not involve surgery. Physician expense coverage is usually combined with surgical and hospital coverage in a basic health insurance package.
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Major medical expense insurance. Coinsurance – is the percentage of the medical expenses the policyholder must pay in addition to the deductible amounts. Usually 20% to 25% of expense after they have paid the deductible.
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Dental Expense Insurance Covers many different types of surgical, and examinations for the mouth. Does not usually cover alternative surgeries. Teeth whitening ex….
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Section 14.2
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Terms that you hear everyday…. HMO PPO Blue Cross/Blue Shield Medicaid Medicare
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A plan that directly employs or contracts with selected or preapproved, physician and other medical professionals to provide health care services in exchange for fixed, prepaid monthly premiums. Based on the idea for preventive care Pay a small co-payment Must attend your selected doctor – unless it is an emergency HMO – Health Maintenance organization
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P.P.O.
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Health Insurance Companies Hospital and Medical Service Plans BLUE CROSS/ BLUE SHIELD Blue Cross – is an insurance company that provides hospital care benefits. Blue Shield – is an insurance company that provides surgical and medical services performed by physicians.
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Government Health Care Programs Medicare Medicade
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Medicad State funded program Medical assistance offered to certain low-income individuals and families. For people over 65 Pregnant women Children under the age of 19 People who are blind People who are disabled People who need nursing home care Usually for low income families are for people who have trouble paying for health care. Medicare The other well known government health plan. People 65 and over People of any age who have kidney failure or long term kidney disease People who are permanently disabled and cannot work Paid and funded by the people who get pay checks
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Medicaid Things that are not covered. Long-term nursing care Out-of-hospital prescription drugs, routine checkups, dental care If a doctor doesn’t accept Medicaid full payment, patient has to pay the rest. Or can apply for medigap insurance Medicare With Medicare coverage there is usually not a need for supplemental insurance. Part A- Hospital Part B – Medicine
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Disability Insurance
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Disability Income Insurance Provides regular cash income when an employee is unable to work due to pregnancy, a non-work-related accident or an illness.
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Sources of Disability Income Worker’s Compensation If your disability is a result of an accident or illness on the job. Employer Provided through group health plans Social Security If you pay social security, then you are eligible for social security benefits. Very strict qualifications, but last as long as you need it. Personal plans Pay as much as 60-75%
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Purpose of life insurance Pay off a home mortgage or other debts at the time of death Provide lump-sum payments as a n endowment for children when they reach a certain age Provide an education or income for children Accumulate savings Establish a regular income for survivors Set up an estate plan Pay estate and death taxes
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AgeBoth Sexes MaleFemaleAgeBoth Sexes MaleFemale 076.974.179.54534.432.236.3 176.473.7795030.027.931.8 572.569.875.15525.723.827.4 1067.664.970.16021619.923.1 1562.659.965.26517.916.319.2 2057.855.260.37014.413.015.5 2553.150.655.47511.310.112.1 3048.345.950.6808.67.69.1 3543.641.345.8856.35.66.7 4038.936.741.0
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Types of Life Insurance policies Term Life insurance Also called temporary life insurance – is insurance that provides protection against loss of life for only a specified term or period of time. Could be for 1,5,10, or 20 years or even up to the age of 70. If you stop paying your coverage stops. Used mostly when raising children so that in case something happens to you, there is money to help raise the children.
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Provisions to life Provision – is what things can the company has to make sure that they do not pay the premiums that you pay. Beneficiary designation - if your beneficiary passes with you and you do not change it no one gets the money. Incontestability clause – if the company was to go under bankrupt then the policyholder is still covered. Suicide clause - only receives the amount that the policy holder pays in premiums.
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Last couple of slides Riders to Life insurance Waiver of premiums for disability – if you have a disability you can say that you will take care of the disability out of pocket to keep premiums lower. Accidental Death Benefit – Double indemnity – meaning the policy will pay double if the policyholder was killed in accident. Guaranteed insurability Pre-Existing Condition.
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