> Indemnity Indemnity plans are also referred to as “fee-for-service.” Unlike managed-care plans, indemnity plans allow absolute freedom in selecting physicians or medical facilities and permit self-referral to a specialist.
> Flood Coverage for damage caused by floods is not included in ordinary homeowners and commercial policies, but must be added as an endorsement. Flood insurance, which also covers damage caused by mudslides, is available through a program run by the Federal Insurance Administration; contact your agent or call (800) 427-4661 for more information.
> Deregulation Under Washington state law known as “use-and-file,” commercial property/casualty contracts negotiated between insurers and businesses may go into effect immediately. The policy itself can be filed for state review later.
HIPAA offers protections for individuals who have preexisting conditions, helping them to keep coverage for those conditions or get coverage in no more than 12 or 18 months through limits on preexisting condition exclusions.
HIPAA includes protections to help ensure individuals are not excluded from coverage under their group health plan or charged a higher premium based on health status.
COBRA generally requires that group health plans of employers with at least 20 employees offer employees and their dependents the opportunity to continue their health plan coverage for limited periods of time when the employee loses his or her job due to retirement.
ERISA Claims Procedures help ensure fair and timely appeals process for covered individuals.
ERISA Disclosure Provisions require that group health plan disclosure material furnished to plan participants and beneficiaries must contain information about specialists in the plan network and the plan’s rules for accessing specialty care.
ERISA Disclosure Provisions also require that plan disclosure material must describe the ability of the employer to reduce plan benefits or terminate the plan.
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Did You Know?
Generally, you must report as income any amount you receive for your disability through an accident or health insurance plan paid for by your employer.
If both you and your employer have paid the premiums for the plan, only the amount you receive for your disability that is due to your employer's payments is reported as income. If you pay the entire cost of a health or accident insurance plan, do not include any amounts you receive for your disability as income on your tax return. If you pay the premiums of a health or accident insurance plan through a cafeteria plan, and the amount of the premium was not included as taxable income to you; the premiums are considered paid by your employer, and the disability benefits are fully taxable.
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general information related to insurance issues commonly encountered.
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