Last week-end, my husband and I were invited to our first ever pig roast. This was the tenth year that the hosts were having this annual event. Friends, family, and neighbors came with their hands full of dishes to share and their stomachs empty to make room for all the food. You name it; it was there – Roasted turkey, baked spiral ham, haddock, hamburgers, hotdogs, salads, fruit, vegetables, every dessert you can imagine, and of course, the main event, the roasted pig. We asked if they needed anything special and their request was cornbread. I tried two recipes; one made with honey and the other without. Everything was amazing and so yummy!
It doesn’t matter if I am making dinner for my husband or trying a new recipe for a Pig Roast, I love cooking. While at the Pig Roast, recipes were shared of different dishes that the guests shared. The topic of work came up and when people asked what I did for work, health insurance was a big discussion. It made me realize that whether you are sharing recipes or sharing what you do for work, each of us has a recipe to share with the world. As far as my work goes, each client has a different recipe that they need. We may look at some of the same plans, however, we have to look at things such as where they want to get their health care, what medications they take and what pharmacy they use.
Let me share some examples of the recipes I “cooked up” for my clients in the last few weeks. Of course, names of people and/or businesses cannot be shared.
1) Small business owner that employees six people – They wanted a health care plan that allowed their employees to go out of state, but to keep the cost down, not go across the country. With their current plan, they were able to go to any of the New England hospitals. Since one of the employees went to the State of Maine for treatment of a health condition, this was important to both the employer and employee that this condition would still be treated where he/she was already being cared for. Another employee had a health condition that made him ineligible for a Life Insurance plan with medical underwriting. Under the group plan, he was able to get the Life Insurance he needed. This employer also had a short term disability plan in place, but it was put in place twenty years prior and never updated. With that said, we put them in another Short Term Disability plan with better protection for all the employees. Even though the premium was higher, the benefit was three times as much should a disability occur and each of the employees were better protected.
2) Small business owner that employees eight people – This employer has one employee that has to go out of state across country for treatment of a health condition twice a year. The recipe for this client includes a health care plan that had a PPO (Preferred Provider Organization) which simply means that the network is much larger and they can go out of state for their health care. Of course, to be sure, I made calls and found out if the hospital this employee needed to go to was in the network.
3) Small business owner that employees four people – This employer was up for renewal and they called me to let me know that a medication that one of the employees was taking was finally being covered. They wanted to not only stay with the same plan, but loved the insurance company. Every year, plans can change slightly so to be sure, I made some calls and was able to help them stay on their current plan and make sure the drug formulary (list of medications) had not changed. They were able to stay on their current plan and the medication that was so badly needed would still be covered.
4) Medicare client – Client was on a health care plan with is wife and they currently were eligible for a subsidy of $900.00 a month. This simply meant that their health care premium was $900.00 less than what it would have cost without the subsidy. This client will be eligible for Medicare this fall and isn’t sure of he should go on Medicare or stay on the plan with his wife. After sharing with him that he would not be eligible for a subsidy once he becomes eligible for Medicare, I provided him with information and education on Medicare Supplemental Plans and Medicare Part D Prescription Drug plans. His wife could stay on the current health plan, however, the subsidy would be less without him on the plan. They ended up taking Medicare for him, purchased both a Medicare and Medicare Part D Prescription Drug plan for him, his wife stayed on her current health plan with a smaller subsidy. The premium was higher for her health plan with a smaller subsidy, but the Medicare Supplemental would have no out of pocket costs and he would have a $0 co-pay with all of his medications. With that said, their medical costs went down.
5) Long Term Care and Medicare client – While sitting with a Medicare client helping him choose a Medicare Supplemental and Medicare Part D Prescription Drug Plan, the topic of Long Term Care Insurance came up. This client and his wife were very interested. Because Long Term Care isn’t one of my specialties, I call on both my mentor and friend, Fred Roberts to guide me through it. Long Term Care would help protect their assets should they need Long Term Care in the future.
6) Health Insurance client – A client called and had just lost her job. COBRA would have cost her over $1,000 a month. She had heard that because it wasn’t open enrollment for health care, she would have to purchase COBRA even though the cost was just about triple what she was paying while employed. After speaking with her and finding out her situation, I let her know that she didn’t have to wait until Open Enrollment because she qualified for a Special Enrollment Period (SEP) because of losing her job. Not only did she find another plan less than what she was paying, but she also qualified for a subsidy.
If I had to sum it up, the recipes I “cook up” for clients are Recipes for Success. They include planning, the right ingredients, the right insurance company, and most importantly, solutions to provide them the peace of mind they deserve.
Balanced Care can help you with a solution for your family, your employees, and your business. Give Balanced Care a call and let us help find the right recipe for you. The taste may be sweeter than you think.
Terri Trepanier is the owner of Balanced Care Health and Supplemental Insurance and a licensed broker in Maine and New Hampshire. Her specialty is working with small businesses, individuals, and families with their health and life insurance needs. She is certified to offer health plans both on and off the exchange and is contracted with every health insurance company that offers plans in both New Hampshire and Maine. Her other passion is assisting Medicare beneficiaries with their Medicare Supplemental, Medicare Part D Prescription Drug Plans, and Medicare Advantage plans. Terri has seen firsthand the importance of insurance products and how they help families. Her goal with Balanced Care is to “Insure Security and Peace of Mind One Family at a Time”.